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Pediatric Neurosurgery

Takafumi Shimogawa, Takato Morioka, Nobuya Murakami, Nobutaka Mukae, Kimiaki Hashiguchi, Satoshi O Suzuki, Koji Iihara
PURPOSE: It is well known that bony and cartilaginous tissues can be present in lumbosacral lipomas; however, the relationship between their presence and clinical features has not been demonstrated. METHODS: Five (10.4%) out of 48 patients had osteochondral tissues in lipomas. We retrospectively analyzed the clinical, neuroradiological, and histological findings of these patients. RESULTS: Five (45.5%) of 11 patients with dorsal and transitional type lipomas had osteochondral tissues, while none with caudal and filar type lipomas had these tissues...
July 4, 2018: Pediatric Neurosurgery
Jeyaseelan Nadarajah, Leve Joseph Devarajan Sebastian, Nishchint Jain, S B Gaikwad, Prashant Jauhari, Ashish Saini
Pediatric posterior-circulation aneurysms are uncommon, difficult-to-treat lesions associated with significant morbidity and mortality. Infections and trauma are important risk factors in children. Here, we present a 10-year-old boy with a lower respiratory tract infection, rapidly progressive right-neck swelling, and weakness of the right upper limb. Imaging revealed a partially thrombosed right vertebral-artery pseudoaneurysm with multiple cavitory lung lesions. Subsequent laboratory work-up showed underlying primary immunodeficiency disorder (chronic granulomatous disease)...
July 4, 2018: Pediatric Neurosurgery
Matthew Pease, Sheri Dewan, Stephanie Greene
Shunt infections are common pediatric neurosurgical cases with high morbidity that almost always requires surgical removal of the shunt, external ventricular drain placement, and delayed shunt replacement. Tunnel infections are well-described clinical entities occurring with indwelling catheters, whereby the indwelling tunnel portion of a line becomes externally infected with a sterile central lumen. These infections are typically treated with line replacement or antibiotics depending on clinical circumstances...
June 26, 2018: Pediatric Neurosurgery
Humam Tanki, Harshita Singh, Uday S Raswan, Abdul R Bhat, Altaf R Kirmani, Altaf U Ramzan
Hydatid disease is an endemic zoonotic disease in many areas of the world. An intracranial hydatid cyst is a relatively rare entity, accounting for only 1-2% of all intracranial space-occupying lesions. Most commonly they are seen in children and young adults. Here, we present 9 cases of pediatric intracranial hydatid cyst operated at Sher-I-Kashmir Institute of Medical Sciences, Srinagar, India, between 2009 and 2015. The mean age of presentation was 11.5 years. The male to female ratio was 5: 4. In 7 cases, a history of contact with pet dogs was present...
June 19, 2018: Pediatric Neurosurgery
Can Sarica, Cem Yucetas, Ali Ozen, Necati Ucler, Capan Konca, Selahattin Akar
Holoprosencephaly is a rare congenital malformation resulting from an impaired midline division of the prosencephalon into distinct cerebral hemispheres. Hydrocephalus is a frequent problem among the few survivors with alobar holoprosencephaly (aHPE), its most severe form. The literature about neurosurgical management of hydrocephalus in this condition is limited and dispersed, and there are still some points that need to be resolved. We report the case of a newborn with aHPE, hydrocephalus, and central diabetes insipidus...
June 14, 2018: Pediatric Neurosurgery
Ashley Gibson, Sheldon L Kaplan, Jesus G Vallejo
Coagulase-negative staphylococci (CoNS) are a common cause of pediatric ventricular shunt infections. The Infectious Diseases Society of America recommends vancomycin serum troughs of 15-20 µg/mL when treating CoNS shunt infections in adult patients. We report a series of pediatric cases of CoNS shunt infections in which clinical cure was obtained with troughs < 15 µg/mL. These findings question the relevance of this recommendation in pediatric patients.
April 26, 2018: Pediatric Neurosurgery
Felipe José Santaella, Pedro Tadao Hamamoto Filho, Gianfelipe Belini Poliseli, Victor Azevedo de Oliveira, Luis Gustavo Ducati, Marcelo Padovani de Toledo Moraes, Marco Antônio Zanini
No abstract text is available yet for this article.
April 26, 2018: Pediatric Neurosurgery
Maurizio Domanin, Silvia Lanfranconi, Silvia Romagnoli, Letterio Runza, Francesca Cortini, Giacomo Piero Comi, Livio Gabrielli
Extracranial carotid artery aneurysms (ECAA) are a rare cause of embolic stroke. The underlying etiology is variable, with atherosclerosis being the most common entity in older subjects. Several treatments have been developed over the last 20 years, but the preferred method remains unknown. Notwithstanding the widespread use of endovascular techniques, surgical reconstruction by means of a bifurcated venous bypass graft should be applied in younger patients. In this way, it is possible to avoid major concerns about the development of long-term intrastent restenosis, and also to spare the external carotid artery which represents the main branch for the ipsilateral cerebral and facial perfusion...
April 25, 2018: Pediatric Neurosurgery
Amir H Faraji, Pawel G Ochalski, Alp Ozpinar, Jason E Blatt, Ian F Pollack
Traumatic clival fractures in the pediatric population are associated with high mortality rates. In our previously reported series, a subset of clival fractures were associated with traumatic diastasis of the surrounding clival synchondroses. Herein, we describe a pediatric case of an isolated traumatic diastasis of the clival synchondroses without clival fracture with significant injury to neurovascular structures. To our knowledge this is the first report to describe this entity. Careful radiological attention should be made towards the clival synchondroses in crushing head injuries to best tailor screening for cerebrovascular injury even in the absence of clival fractures...
April 19, 2018: Pediatric Neurosurgery
Necati Ucler, Seyho Cem Yucetas
Although rarely reported in the literature, serious occipital and condylar fractures have been diagnosed more often with the widespread use of computed cranial tomography in traumas. In this paper, a 16-year-old female with a left occipital fracture extending from the left occipital condyle anterior of the hypoglossal canal to the inferior part of the clivus is presented. The fracture which had caused a neurological deficit was cured with conservative treatment. For delayed hypoglossal nerve paralysis due to swelling within the canal, methylprednisolone was started, and a complete cure was attained in about 10 days...
March 22, 2018: Pediatric Neurosurgery
In-Kyung Song, Soolyoen Choi, Seohee Lee, Eun-Hee Kim, Ji-Hyun Lee, Hee-Soo Kim, Jin-Tae Kim
BACKGROUND: Hypocapnia has been associated with an increased risk and adverse outcomes in the injured brain. This study aimed to identify risk factors of intraoperative hypocapnia in pediatric neurosurgical patients when tidal volumes and respiratory rates were determined based on their weight and age, respectively. METHODS: Electronic medical records of pediatric patients (≤18 years) who underwent neurosurgery from December 2014 to January 2016 were retrospectively reviewed...
January 18, 2018: Pediatric Neurosurgery
Daniel Thomas Ginat, Daniel Lam, Andrew Scott Kuhn, Russell Reid
Several surgical options are available for treating the different types of craniosynostosis, including fronto-orbital advancement and remodeling, total or subtotal cranial vault remodeling, barrel stave osteotomy with cranial remodeling, endoscopic suturectomy, monobloc advancement and cranioplasty, and revision cranioplasty. High-resolution, low-dose CT with 3D reconstructed images and volumetric analysis can be useful for evaluating the craniofacial skeleton following surgery. The various types of craniosynostosis surgery and corresponding imaging findings are reviewed in this article...
2018: Pediatric Neurosurgery
Valentina Baro, Ignazio D'Errico, Domenico d'Avella, Luca Denaro
No abstract text is available yet for this article.
2018: Pediatric Neurosurgery
Abhinith Shashidhar, Rose Dawn Bharath, Malla Bhaskar Rao, Arimappamagan Arivazhagan
No abstract text is available yet for this article.
2018: Pediatric Neurosurgery
Vitor Nagai Yamaki, Barbara Albuquerque Morais, Roger Schmidt Brock, Wellingson Silva Paiva, Almir Ferreira de Andrade, Manoel Jacobsen Teixeira
A 4-year-old girl was admitted to the emergency department after having been buried beneath a wall. A computed tomography scan revealed anterior grade V L5-S1 spondylolisthesis, and magnetic resonance imaging showed a traumatic rupture of the fibrous annulus of the L5-S1 intervertebral disc and lesion of the anterior longitudinal and yellow ligaments. The patient underwent anterior and posterior fixation. Four months later she was able to walk independently, despite a persistent left foot drop. Additionally, we conducted a literature review on lumbosacral spondyloptosis in the pediatric population published between 1990 and 2017...
2018: Pediatric Neurosurgery
Joshua T Scantland, Mercia J Gondim, Andrew S Koivuniemi, Daniel H Fulkerson, Chie-Schin Shih
Ewing sarcoma (ES) is an aggressive, primary bone malignancy with occasional soft tissue extension. Purely extra-osseous ES is rare. A primary intraspinal, intradural ES without bone involvement is exceedingly rare. ES may be differentiated from other primitive neuroectodermal tumors by molecular analysis. The authors report the case of a 14-year-old female who suffered an acute neurologic decline from a hemorrhagic, intraspinal, intradural ES. The patient has been tumor free for 2 years after the initial emergency surgery...
2018: Pediatric Neurosurgery
Mehmet Turgut, Meral Baka, Yiğit Uyanıkgil
OBJECTIVE/AIM: Hydrocephalus is defined as an incapacitating neurological disorder characterized by ventricular enlargement in children, but the effects of melatonin on this hydrocephalus have not yet been fully elucidated. In the present experiment, we attempted to investigate the effects of exogenous melatonin administration on hydrocephalus-induced hippocampal changes in infantile rats. METHODS: In this study, we randomly divided 45 Swiss albino rats aged 2 weeks into 3 groups: group I, the control group received a sham injection with needle insertion only; groups II and III were given kaolin injections before treatment - group II, the hydrocephalus group, was treated with an isotonic NaCl solution, and group III, the hydrocephalus plus melatonin group, was treated with 0...
2018: Pediatric Neurosurgery
Mohammed Babgi, Alaa Samkari, Abeer Al-Mehdar, Shaker Abdullah
INTRODUCTION: Atypical teratoid/rhabdoid tumor (AT/RT) of the central nervous system is characterized by SMARCB1/INI deletion or mutation in the long arm of chromosome 22 11(22q11.2), also resulting in loss of nuclear expression of INI1 protein immunohistochemically. AT/RT tumors usually occur in children below 3 years. The tumor is usually seen in the cerebellum or the cerebrum, with an extremely rare incidence in the spinal cord. MATERIALS AND METHODS: We report a rare case of AT/RT in a 6-year-old boy who had a primary spinal cord lesion in the thoracolumbar junction...
2018: Pediatric Neurosurgery
R Ramnarayan, C V Shankar Ganesh, Ramesh Kumar
BACKGROUND: Traditional teaching is that Chiari 1 malformations with syrinx should be operated as soon as possible. We present 2 cases of a radiologically proven Chiari 1 malformation with syrinx which were treated nonoperatively and improved radiologically. METHODS: Two children with an MRI-proven Chiari 1 malformations were followed up nonoperatively for 7 years (2010-2017). One was a boy aged 8 years and the other a girl aged 9 years at first presentation. Their parents were not interested in a surgical option and so it was decided to adopt a wait-and-watch policy...
2018: Pediatric Neurosurgery
Can Sarica, Bahattin Tanrikulu, Yener Sahin, Adnan Dağçınar, Feyyaz Baltacioglu, Yasar Bayri
INTRODUCTION: Intracranial aneurysms are very rare in children. Although subarachnoidal hemorrhage (SAH) is by far the most common presentation of aneurysms in the majority of the pediatric case series, it is not rare for an unruptured aneurysm to present with a mass effect. Acute hydrocephalus is a common finding following aneurysmal SAH. However, this malady may develop even in the absence of SAH but secondary to direct obstruction by a giant aneurysm. This situation is extremely rare in children, with only a few known case reports in the literature...
2018: Pediatric Neurosurgery
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