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Pediatric Neurosurgery

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https://www.readbyqxmd.com/read/28910815/the-outcome-and-patterns-of-traumatic-brain-injury-in-the-paediatric-population-of-a-developing-country-secondary-to-tv-trolley-tip-over
#1
Muhammad Waqas, Gohar Javed, Karim Rizwan Nathani, Badar Ujjan, Syed A Quadri, Muhammad Zubair Tahir
BACKGROUND: Television (TV) trolley tip-over incidences are common and can cause significant morbidity and mortality in children. This study was aimed at analyzing the pattern and outcomes of head injuries resulting from TV trolley tip-over. METHOD: We conducted a medical chart review of children with TV trolley tip-over head injuries from January 2009 to April 2016. We collected data on demographics, the mechanism of injury, clinical and radiological features of the injury, and outcomes...
September 15, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28866663/infections-of-intrathecal-baclofen-delivery-systems-and-ventriculoperitoneal-shunting-systems-clinical-series-discussion
#2
Oussama Abousamra, Maria Del Pilar Duque Orozco, Kenneth J Rogers, Freeman Miller, Julieanne P Sees
BACKGROUND/AIMS: The physiological interaction between the intrathecal baclofen (ITB) delivery system and the ventriculoperitoneal (VP) shunting system in a patient who had both systems implanted has not been reported previously. The aim of our report is to evaluate the effect that one system's infection might have on the other. METHODS: Records of children who were followed at our institution between 2004 and 2015 for management of their ITB systems were reviewed...
September 2, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28850946/the-role-of-age-and-initial-deformation-on-final-cranial-asymmetry-in-infants-with-plagiocephaly-treated-with-helmet-therapy
#3
Charles E Mackel, Michael Bonnar, Heather Keeny, Bethany M Lipa, Steven W Hwang
BACKGROUND/AIMS: To characterize the impact of cranial asymmetry and age at initiation of therapy on final cranial asymmetry in infants with deformational plagiocephaly treated with helmet orthotics. METHODS: We conducted a single-center retrospective review of 45 pediatric patients <12 months of age with deformational plagiocephaly who underwent STARband cranial orthotic helmet treatment. Cranial asymmetry was measured using a 3-dimensional laser surface scanner and defined as a cranial vault asymmetry index (CVAI) >3...
August 30, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28848171/resolution-of-middle-fossa-arachnoid-cyst-after-minor-head-trauma-stages-of-resolution-on-mri-case-report-and-literature-review
#4
Mustafa Nadi, Ana Nikolic, Dalal Sabban, Tahani Ahmad
Arachnoid cysts (ACs) are frequently encountered in pediatric neurosurgical practice. Their natural history and optimum treatment are not well determined. The authors describe a resolution of asymptomatic middle fossa AC after trivial head trauma in a 7-year-old child. Intracystic bleeding was noticed on interval MRI. Serial MRI follow-up demonstrates stages of resolution of the AC that did not require surgical intervention. Few cases of nonsurgical AC disappearance have been reported, much fewer with trauma as a triggering factor...
August 29, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28848125/surgically-managed-pediatric-intracranial-aneurysms-how-different-are-they-from-adult-intracranial-aneurysms
#5
Harsh Deora, Kannepalli V L Narasinga Rao, Sampath Somanna, Dwarakanath Srinivas, Dhaval P Shukla, Dhananjaya Ishwar Bhat
PURPOSE: Intracranial aneurysms in children are rare compared to those in adults, and their causes, presentations, and outcomes also vary. Thus, they need to be studied intricately and as an independent entity. METHODS: We retrospectively reviewed intracranial saccular aneurysms in 44 children of <19 years of age who had been surgically treated during the last 30 years at our institute. We analyzed presentation, characteristics, size, multiplicity, cause, and eventual outcome, and compared these to the adult cases of aneurysms operated on during the same period...
August 29, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28848162/intramedullary-thoracic-spine-astrocytoma-presenting-as-hydrocephalus-in-an-infant-a-case-report
#6
Shivani D Rangwala, Gerald Oh, Ashley L Barks, Demetrios C Nikas
We present the case of an intramedullary spinal cord tumor from C7 to T4, classified as a WHO grade I pilocytic astrocytoma, manifesting solely with isolated, acute hydrocephalus and a normal neurological exam in a 5-month-old infant. We discuss the common presenting symptoms of spinal cord tumors in the pediatric population and possible anatomical explanations for this unique presentation and offer recommendations for the management of isolated hydrocephalus in an infant.
August 26, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28848212/comparison-of-three-different-cranio-cervical-decompression-procedures-in-children-with-chiari-malformation-type-i-does-the-surgical-technique-matter
#7
Pasquale Gallo, Drahoslav Sokol, Chandrasekaran Kaliaperumal, Jothy Kandasamy
BACKGROUND/AIMS: A broad spectrum of cranio-cervical decompression techniques (CCD) is employed for the treatment of Chiari malformation type I (CM1). The aim of this study was to compare the clinical and radiological outcome of 3 different CCD performed in a single paediatric centre. METHODS: A retrospective analysis of children treated between 2008 and 2014 was performed. Three different surgical techniques were offered to the patients: an extradural osseo-ligamentous bony decompression (BD), or a BD plus opening of the dura either without duroplasty (DOWD) or with watertight expansile duroplasty (DOPD)...
August 25, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28848203/role-of-dynamic-contrast-enhanced-perfusion-magnetic-resonance-imaging-in-grading-of-pediatric-brain-tumors-on-3t
#8
Pradeep Kumar Gupta, Jitender Saini, Prativa Sahoo, Rana Patir, Sunita Ahlawat, Manish Beniwal, Kandavel Thennarasu, Vani Santosh, Rakesh Kumar Gupta
BACKGROUND/AIMS: Perfusion magnetic resonance imaging (MRI) is useful for preoperative assessment of brain tumors. Dynamic susceptibility contrast perfusion MRI is commonly used for evaluation of brain tumors. Dynamic contrast-enhanced (DCE) MRI is an alternative method that has mainly been used in adult brain tumors. In this preliminary study, we report our initial experience with the DCE perfusion MRI in pediatric brain tumors. METHODS: Sixty-four newly diagnosed pediatric brain tumor patients underwent DCE perfusion MRI on a 3-T scanner...
August 25, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28848151/traumatic-posterior-fossa-subdural-hygroma-and-secondary-occlusive-hydrocephalus
#9
Anqi Luo, Sebastian Eibach, John Zovickian, Dachling Pang
BACKGROUND: Infratentorial subdural hygromas causing secondary occlusive hydrocephalus are extremely rare in children. Only a handful of cases have been reported in the literature. METHODS: We present a case of a 6-month-old infant with an occipital fracture and slow enlargement of a posterior fossa subdural hygroma that culminated in obstructive hydrocephalus. We give a review of the literature on post-traumatic posterior fossa hygroma with secondary occlusive hydrocephalus and discuss its pathogenesis and the mechanism of its later resolution, as well as the available treatment options...
August 25, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28848117/unintentional-head-injury-in-children-less-than-3-years-of-age-an-insight-into-safety-practices-in-a-developing-country
#10
Muhammad Waqas, Rashid Jooma
Being dependent on caretakers for their safety, children under the age of 3 years are particularly vulnerable to unintentional injury. To identify the circumstances and consequences of head injury in this age group and to assess preventability in a setting of low parental educational levels, we conducted a retrospective cohort study of children less than 3 years of age admitted to hospital with a head injury and in addition categorized the degree of preventability of injury. This study included 109 children, representing a third of head-injured children under the age of 16 years, and 23...
August 25, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28848108/intrathecal-baclofen-pump-implantation-for-type-2-gaucher-disease
#11
Yusuke S Hori, Toru Fukuhara, Mizuho Aoi, Motoharu Ochi, Mahoko Furujo
Gaucher disease (GD) is the most common type of lysosomal storage disease, with type 2 being the most severe subtype. Type 2 GD patients suffer significant progressive neurological impairment, including spasticity, opisthotonus, seizure, and apnea. The recently developed enzyme replacement therapy (ERT) has shown therapeutic benefit for GD. However, as the enzymes do not cross the blood-brain barrier, ERT does not ameliorate neurological impairment in GD. Intrathecal baclofen therapy (IBT) is indicated for spastic neurological diseases, such as cerebral palsy, and studies have shown its therapeutic benefit in improving several manifestations of GD, such as scoliosis caused by muscle spasticity and respiratory function...
August 24, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28848198/spontaneous-resolution-of-a-sylvian-arachnoid-cyst-in-a-child-a-case-report
#12
Utku Adilay, Bulent Guclu, Mehmet Tiryaki, Tufan Hicdonmez
We report the case of a 7-year-old boy with an incidentally diagnosed left sylvian arachnoid cyst. At a clinical follow-up of 2 years, cranial computed tomography scans found the cyst to be totally resolved. The mechanism of this rare spontaneous resolution of an arachnoid cyst is discussed.
August 19, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28848112/use-of-a-3d-skull-model-to-improve-accuracy-in-cranioplasty-for-autologous-flap-resorption-in-a-3-year-old-child
#13
Rodolfo Maduri, Edoardo Viaroli, Marc Levivier, Roy T Daniel, Mahmoud Messerer
Cranioplasty is considered a simple reconstructive procedure, usually performed in a single stage. In some clinical conditions, such as in children with multifocal flap osteolysis, it could represent a surgical challenge. In these patients, the partially resorbed autologous flap should be removed and replaced with a precustomed prosthesis which should perfectly match the expected bone defect. We describe the technique used for a navigated cranioplasty in a 3-year-old child with multifocal autologous flap osteolysis...
August 19, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28817819/progressive-kyphosis-associated-with-tethered-cord-syndrome-treated-by-posterior-vertebral-column-resection-in-a-pediatric-patient
#14
Kadir Oktay, Kerem Mazhar Ozsoy, Yurdal Gezercan, Nuri Eralp Cetinalp, Tahsin Erman
Posterior vertebral column resection is a novel surgical approach for the treatment of progressive kyphosis associated with tethered cord syndrome that was first treated with untethering surgery. A patient with tethered cord syndrome associated with kyphosis first underwent untethering surgery, resulting in progressive kyphosis. Posterior vertebral column resection was performed to correct the kyphosis while shortening the spinal column to prevent the spinal cord from stretch injury. Good correction of kyphosis and reduction of tension on the neural elements were achieved without any neurological deficits...
August 18, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28797007/cerebrospinal-fluid-biomarkers-of-pediatric-hydrocephalus
#15
David D Limbrick, Leandro Castaneyra-Ruiz, Roland H Han, Daniel Berger, James P McAllister, Diego M Morales
Hydrocephalus (HC) is a common, debilitating neurological condition that requires urgent clinical decision-making. At present, neurosurgeons rely heavily on a patient's history, physical examination findings, neuroimaging, and clinical judgment to make the diagnosis of HC or treatment failure (e.g., shunt malfunction). Unfortunately, these tools, even in combination, do not eliminate subjectivity in clinical decisions. In order to improve the management of infants and children with HC, there is an urgent need for new biomarkers to complement currently available tools and enable clinicians to confidently establish the diagnosis of HC, assess therapeutic efficacy/treatment failure, and evaluate current and future developmental challenges, so that every child has access to the resources they need to optimize their outcome and quality of life...
August 11, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28704811/the-evolution-of-cerebrospinal-fluid-shunts-advances-in-technology-and-technique
#16
Krystal L Tomei
Over the past few centuries, there have been many advances in shunt technology, from the evolution of shunt tubing materials, to advances in valves for regulating the flow of cerebrospinal fluid (CSF). Additional medical advances have enabled the antibiotic impregnation of catheters. Finally, advances in technology have expanded the options for minimally invasive techniques and improved the management of complicated cases of hydrocephalus. The evolution of technology and technique in the management of hydrocephalus with CSF shunts will be discussed here...
July 14, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28249297/cerebrospinal-fluid-shunting-complications-in-children
#17
Brian W Hanak, Robert H Bonow, Carolyn A Harris, Samuel R Browd
Although cerebrospinal fluid (CSF) shunt placement is the most common procedure performed by pediatric neurosurgeons, shunts remain among the most failure-prone life-sustaining medical devices implanted in modern medical practice. This article provides an overview of the mechanisms of CSF shunt failure for the 3 most commonly employed definitive CSF shunts in the practice of pediatric neurosurgery: ventriculoperitoneal, ventriculopleural, and ventriculoatrial. The text has been partitioned into the broad modes of shunt failure: obstruction, infection, mechanical shunt failure, overdrainage, and distal catheter site-specific failures...
March 2, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28125818/neural-stem-cells-and-fetal-onset-hydrocephalus
#18
Esteban M Rodríguez, María M Guerra
Fetal-onset hydrocephalus is not only a disorder of cerebrospinal fluid (CSF) dynamics, but also a brain disorder. How can we explain the inborn and, so far, irreparable neurological impairment in children born with hydrocephalus? We hypothesize that a cell junction pathology of neural stem cells (NSC) leads to two inseparable phenomena: hydrocephalus and abnormal neurogenesis. All neurons, glial cells, and ependymal cells of the mammalian central nervous system originate from the NSC forming the ventricular zone (VZ) and the neural progenitor cells (NPC) forming the subventricular zone...
January 27, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28095378/advanced-neuroimaging-techniques-in-pediatric-hydrocephalus
#19
Smruti K Patel, Weihong Yuan, Francesco T Mangano
From the early days of pneumoencephalography and ventriculography to the emerging technology of magnetic resonance diffusion tensor imaging (DTI) of the present day, neuroimaging has always been a critical tool in the diagnosis and treatment of pediatric hydrocephalus. There is accumulating evidence from both human and animal research suggesting that one of the major pathophysiological mechanisms underlying poor outcomes in these children is damage to vulnerable white matter (WM) structures in the brain as a result of ventricular enlargement and increased intracranial pressure...
January 18, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28704833/pica-in-a-child-with-anterior-cingulate-gyrus-oligodendroglioma-case-report
#20
Shivani D Rangwala, Matthew K Tobin, Daniel M Birk, Jonathan T Butts, Dimitrios C Nikas, Yoon S Hahn
The anterior cingulate gyrus (ACG) is a continued focus of research as its exact role in brain function and vast connections with other anatomical locations is not fully understood. A review of the literature illustrates the role the ACG likely plays in cognitive and emotional processing, as well as a modulating role in motor function and goal-oriented behaviors. While lesions of the cingulate gyrus are rare, each new case broadens our understanding of its role in cognitive neuroscience and higher order processing...
2017: Pediatric Neurosurgery
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