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Pediatric Neurosurgery

Serdar Ercan, Ebru Guzel, Aslan Guzel
Tethered cord syndrome (TCS), a neurological disorder characterized by the lower settlement of the conus medullaris, is a congenital spinal disease which is caused by split cord syndrome, meningomyelocele, and spinal tumors. Cranial dermoid tumor (CDT) is a congenital benign tumor which is generally located on the midline of the cranium. Even though TCS is highly associated with spinal dermoid tumor, the relationship of CDT and TCS is unusual. We pre-sent a case with an unusual symptom of CDT, motion-dependent pain, and an uncommon togetherness with TCS...
November 8, 2018: Pediatric Neurosurgery
Binod Balakrishnan, Liyun Zhang, Pippa M Simpson, Sheila J Hanson
BACKGROUND: Severe traumatic brain injury (sTBI) is the leading cause of morbidity and mortality from trauma. Brain Trauma Foundation guidelines recommend intracranial pressure (ICP) monitoring in sTBI. We hypothesized that early ICP monitor placement was associated with better outcomes in children. METHODS: This was a retrospective study of children with sTBI admitted to the participating pediatric intensive care units (PICUs) and entered into the Virtual Pediatric Systems (VPS), LLC, database between 1 January 2010 and 31 December 2015...
November 7, 2018: Pediatric Neurosurgery
Li-Rong Cao, Jing Chen, Rui-Ping Zhang, Xiao-Li Hu, Yu-Lian Fang, Chun-Quan Cai
Choroid plexus papilloma (CPP) is a rare benign tumor of the central nervous system. Bilateral lateral ventricle CPP is extremely uncommon. In this case report, we described a case of bilateral lateral ventricle CPP in a 4-month-old female patient conceived by in vitro fertilization (IVF). Neurological examination and imaging were performed. In neurological examination, meningeal irritation signs and sunset phenomenon were positive. Brain computed tomography (CT) and magnetic resonance imaging (MRI) displayed masses located in the trigone of the bilateral lateral ventricle with hydrocephalus...
November 2, 2018: Pediatric Neurosurgery
Nobuya Murakami, Takato Morioka, Takafumi Shimogawa, Nobutaka Mukae, Satoshi Inoha, Takakazu Sasaguri, Satoshi O Suzuki, Koji Iihara
BACKGROUND: An ependyma-lined canal with surrounding neuroglial tissues can be present in lumbosacral lipomatous malformations; however, the precise embryological significance is still unclear. METHOD: Six out of 50 patients with lipomatous malformations had ependymal structures. We retrospectively analyzed the clinical, neuroradiological, and histological findings of these patients to demonstrate the relationship with the embryological background of the retained medullary cord (RMC), which normally regresses, but was retained here because of late arrest of secondary neurulation...
November 2, 2018: Pediatric Neurosurgery
Zeferino Demartini, Luana A M Gatto, Roberto Oliver Lages, Alexandre Novicki Francisco, Adriano Keijiro Maeda, Gelson Luis Koppe
PHACE(S) syndrome is a neurocutaneous syndrome with a wide array of presentations. The most known and present trait is facial hemangioma > 5 cm. The name is an acronym for Posterior fossa malformations, infantile Hemangiomas, Arterial anomalies, aortic Coarctation, Eye abnormalities, and middle-line malformations of the Sternum. The exact etiopathogenic mechanism of this syndrome is not fully understood, and its treatment depends on detailed and individualized assessment. The aim of this paper is to describe a child with a throat hemangioma, vascular malformations, cognitive delay, and other anomalies to illustrate the neuroimaging found in this syndrome...
October 18, 2018: Pediatric Neurosurgery
Mehmet Can Ezgu, Mehmet Ilker Ozer, Adem Dogan, Guzin Deveci, Cahit Kural, Yusuf Izci
Lhermitte-Duclos disease (LDD) is a rare, slow-growing, benign lesion of the cerebellum. It is often seen in the second and fourth decades. This disease is extremely rare in childhood. A 6-year-old girl presented with loss of balance. A mass lesion in the right cerebellum was detected by magnetic resonance imaging. The patient underwent surgical removal of the lesion, and the histological diagnosis was dysplastic gangliocytoma (LDD). The patient was discharged without complication, and her balance improved in the follow-up period...
October 10, 2018: Pediatric Neurosurgery
Pinar Aydin Ozturk, Omer Sanri, Adil Yilmaz, Abdurrahman Arpa, Unal Ozturk, Adnan Ceviz
Factor XIII deficiency is a rare hemorrhagic disorder that can cause spontaneous intracranial hemorrhage and bleeding after surgery. The diagnosis of factor XIII deficiency is difficult before surgical interventions, because coagulation parameters are normal in these patients. Important clinical findings are postsurgical bleeding and recurrent spontaneous intracranial hematomas. These findings should raise the clinical suspicion of factor XIII deficiency. Therefore, diagnosis of factor XIII deficiency is very important for neurologists and neurosurgeons in terms of reducing mortality and morbidity...
September 3, 2018: Pediatric Neurosurgery
Yusuke S Hori, Keina Nagakita, Yuki Ebisudani, Mizuho Aoi, Yoko Shinno, Toru Fukuhara
Choroid plexus hyperplasia/papilloma and resulting hyperproduction of cerebrospinal fluid is a rare cause of hydrocephalus. In these patients, intractable ascites can occur after a ventriculoperitoneal (VP) shunting operation. However, shunt-related hydrocele is a rare complication of VP shunting. Previous reports have indicated catheter-tip migration to the scrotum as a cause of hydrocele. Here, we present the first documented case of choroid plexus hyperplasia that led to intractable ascites after shunting and a resulting hydrocele without catheter-tip migration into the scrotum...
August 29, 2018: Pediatric Neurosurgery
Maureen Lacy, Samantha DeDios-Stern, Sarah Fredrickson, Shravan Parikh, Todd Nader, David M Frim
This cross-sectional study investigates the prevalence and risks for psychiatric diagnoses in a large cohort of children with Chiari malformation type 1 (CM1) presenting for neurosurgical evaluation. Children between the ages of 6 and 17 years who were evaluated and diagnosed with CM1 at a neurosurgery clinic were identified. Eighty-six participants were recruited for this study with an average age of 11 years. Parents of participants completed a pediatric medical history questionnaire and a semistructured interview regarding the child's psychiatric, developmental, medical, and family history...
August 27, 2018: Pediatric Neurosurgery
Zhiqiang Feng, Qiuping Li, JianJun Gu, Wenjun Shen
Endoscopic third ventriculostomy (ETV) provides a physiological restoration of cerebrospinal fluid and a shunt-free option for hydrocephalus children. Continuous developments in techniques and instruments have improved ETV as the first-line treatment. This paper focuses on the recent advances in surgical techniques, instruments, predictive models, imaging tools, and new cohort studies. The efficacy, safety, indications, and remaining challenges of ETV are discussed. More patients undergo ETV with a better outcome, identifying a new era of hydrocephalus treatment...
August 15, 2018: Pediatric Neurosurgery
Zeferino Demartini, Luana Antunes Maranha Gatto, Tatiane Coghetto da Rocha, Adriano Keijiro Maeda, Adriana Valerio, Gelson Luis Koppe, Alexandre Novicki Francisco
Intracranial aneurysm surgery is commonly performed using pinned head holders, which pose a higher risk for the pediatric population. Several authors recommend avoiding the use of this device when it is not strictly necessary, and this is currently possible considering advances in anesthesiology and monitoring. As the literature on microsurgery without skull clamp use is scant, we report the case of a 15-year-old boy presenting with a subarachnoid hemorrhage after rupture of a middle cerebral artery aneurysm...
2018: Pediatric Neurosurgery
Thao N Do, Amy M Linabery, Richard J Patterson, Albert Tu
BACKGROUND: Rhabdomyosarcoma originating in the mastoid is rare and may be misdiagnosed as an infectious mastoiditis due to overlapping clinical and imaging features. We aimed to identify distinguishing characteristics to facilitate earlier diagnosis and treatment. METHOD: Here we describe a case report and a systematic review of 23 reports describing previous cases of mastoid rhabdomyosarcoma. We compare these patients to a systematic review of patients with infectious mastoiditis and identify distinguishing clinical features...
2018: Pediatric Neurosurgery
Valentina Baro, Luca Denaro, Domenico d'Avella
PURPOSE: We report our preliminary experience concerning the use of thrombin-gelatin hemostatic matrix to strengthen the final hemostasis after posterior fossa low-grade tumor surgery in children. To our knowledge, this is the first report regarding the use of hemostatic matrix in pediatric neurosurgery. MATERIALS AND METHODS: Between 2012 and 2016, twenty-three patients underwent posterior fossa surgery for low-grade gliomas in our department. The mean age was 6...
2018: Pediatric Neurosurgery
Mosab Abbas, Mohamad Bakhaidar, Saleh S Baeesa
Ventriculoperitoneal (VP) shunting is one of the most common simple neurosurgical procedures. VP shunt catheters are made of silicone-coated Silastic tubes, which are made to be inert and hardly induce any reaction in normal tissue. We report a rare case of an extensive intracranial calcification of a VP shunt. This is a very rare case of a documented extensive calcification around the ventricular catheter of a VP shunt. We review the previously reported cases in the literature and present our management of the case...
2018: Pediatric Neurosurgery
Islam Fayed, Matthew F Sacino, Willilam D Gaillard, Robert F Keating, Chima O Oluigbo
INTRODUCTION: MR-guided laser interstitial thermal therapy (MRgLITT) has emerged as a safe and effective treatment option for the ablation of epileptic foci. Its minimally invasive nature makes it attractive due to decreased morbidity and hospital stay. OBJECTIVE: To report the efficacy and safety of MRgLITT as a minimally invasive procedure for the ablation of epileptic foci in the pediatric population of medically refractory lesional epilepsy. METHODS: A retrospective review of patients who underwent MRgLITT via Visualase laser ablation at a single pediatric center was performed...
2018: Pediatric Neurosurgery
Michael G Z Ghali, Ayman Samkari, J Steve Hou, Manjula Balasubramanian, Sherri Besmer, Matthew Keisling, Prithvi Narayan
Primary central nervous system lymphoma (PCNSL) is rare in children with immunocompromise as an important risk factor. A 7-year-old girl with unspecified T-cell immunodeficiency presented with left-sided weakness and was found to have a right-sided frontal lobe mass on imaging. The mass was resected; histopathology and molecular studies evidenced diffuse large B-cell lymphoma. Prior chest imaging had revealed left upper lobe mass, and repeat chest imaging revealed multiple pulmonary nodules, initially concerning for metastasis...
2018: Pediatric Neurosurgery
Shrikant Rege, Jitendra Tadghare, Akhilesh Patel, Amit Varma
Spinal hamartoma is an extremely rare, benign spinal lesion occurring in children. It may cause spinal cord compression and subsequent neurological deficits. On reviewing the literature, of a total of 20 cases, only 2 cases are reported in an adolescent age group. It may be a pure spinal hamartoma, or sometimes it may be associated with either neurofibromatosis type I or spinal dysraphism. MRI is the investigation of choice. Surgical excision of the lesion and the decompression of the cord are the definitive treatment...
2018: Pediatric Neurosurgery
Zeferino Junior Demartini, Tatiana von Hertwig de Oliveira, Ricardo Munhoz da Rocha Guimarães, Alfredo Löhr, Gelson Luis Koppe, Luana A Maranha Gatto
No abstract text is available yet for this article.
2018: Pediatric Neurosurgery
Alexandrina Nikova, Dimitar Ganchev, Theodossios Birbilis
OBJECTIVE: Spinal arteriovenous malformations (AVM) manifest in the pediatric population very differently from the ones in adulthood. Despite that fact, the treatment strategy is quite the same, which provokes a question - whether some of the therapies have an advantage and if so, in which age group. METHODS: For this reason, the authors searched the world literature between 1989 and 2018 for spinal AVM in children and further categorized the studies into two age groups: < 12 and ≥12...
2018: 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...
2018: Pediatric Neurosurgery
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