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Journal of Neurosurgery. Pediatrics

Tarek Y El Ahmadieh, Cody B Wolfe, Joyce Koueik, Bradley E Weprin, Bermans J Iskandar, Angela V Price
Neuroendoscopy has demonstrated safety and efficacy in the treatment of a host of pediatric neurosurgical pathologies. With the increase in its applicability, several associated complications have been described in the literature. A common practice in pediatric neurosurgery is the use of Gelfoam sponge pledget in the burr hole, followed by bone fragments and dust (obtained from the created burr hole), to cover the dural defect. This technique is used to enhance burr hole sealing and potentially prevent CSF leakage from the surgical site...
August 10, 2018: Journal of Neurosurgery. Pediatrics
Cecilia L Dalle Ore, Robert C Rennert, Alexander J Schupper, Brandon C Gabel, David Gonda, Bradley Peterson, Lawrence F Marshall, Michael Levy, Hal S Meltzer
OBJECTIVE Pediatric traumatic subarachnoid hemorrhage (tSAH) often results in intensive care unit (ICU) admission, the performance of additional diagnostic studies, and ICU-level therapeutic interventions to identify and prevent episodes of neuroworsening. METHODS Data prospectively collected in an institutionally specific trauma registry between 2006 and 2015 were supplemented with a retrospective chart review of children admitted with isolated traumatic subarachnoid hemorrhage (tSAH) and an admission Glasgow Coma Scale (GCS) score of 13-15...
August 10, 2018: Journal of Neurosurgery. Pediatrics
Michael D Cearns, Samantha Hettige, Paolo De Coppi, Dominic N P Thompson
OBJECTIVE It is well established that Currarino syndrome (CS) may be associated with spinal dysraphism. Here, the authors report on 10 CS patients with dysraphic anomalies who had undergone a combined neurosurgical and general surgical approach to repair the dysraphic anomalies and resect the presacral mass in a single operation. They discuss the spectrum of spinal dysraphism that may coexist in CS in the context of its developmental etiology. METHODS Children with a confirmed CS diagnosis who had undergone the combined operative approach were identified from a departmental database...
August 10, 2018: Journal of Neurosurgery. Pediatrics
Allison Strickland, Cordell M Baker, R Michael Siatkowski, Timothy B Mapstone
The authors present a case of Chiari type 1.5 malformation with the uncommon presenting symptoms of esotropia and diplopia due to divergence insufficiency in a 12-year-old girl. Imaging at initial diagnosis revealed cerebellar herniation with extension of the tonsils to the C2 vertebral body, a retroflexed odontoid, and a small cervical syrinx. The patient was initially treated with an uncomplicated Chiari malformation decompression without dural opening. Repeat imaging revealed an adequate decompression. Three months postoperatively the patient's diplopia recurred and she underwent repeat posterior fossa decompression with dural opening and duraplasty...
August 10, 2018: Journal of Neurosurgery. Pediatrics
Jun T Park, Guadalupe Fernandez Baca Vaca, Rachel Tangen, Jonathan Miller
Resection of the hippocampus ipsilateral to the verbal memory-dominant hemisphere frequently results in severe memory deficits. In adults with epilepsy, multiple hippocampal transections (MHTs) have resulted in excellent seizure outcome with preservation of verbal memory. The authors report the first detailed case of a child undergoing MHTs for mesial temporal lobe epilepsy. A 13-year-old right-handed boy had intractable seizures characterized by epigastric discomfort evolving to unresponsiveness and chewing automatisms, lasting 1 minute and occurring 2-3 times weekly, sometimes ending in a generalized tonic-clonic seizure...
August 10, 2018: Journal of Neurosurgery. Pediatrics
Shoko Yoshimoto, Keisuke Takai, Koichi Takahashi, Toshio Yasui, Makoto Taniguchi
Gorham-Stout disease (GSD) is an intractable disease characterized by massive osteolysis caused by abnormal lymphangiogenesis in bone. In rare cases of GSD, CSF abnormalities develop. The authors present the case of a 19-year-old woman with GSD presenting with orthostatic headache due to intracranial hypotension (5 cm H2 O). The clinical course of this case was very unusual. Orthostatic headache was associated with a CSF leak from the thigh after pathological fractures of the femur and pelvis. The chronic CSF leak led to acquired Chiari malformation (CM) with syringomyelia...
August 3, 2018: Journal of Neurosurgery. Pediatrics
Brendan F Judy, Jordan W Swanson, Wuyang Yang, Phillip B Storm, Scott P Bartlett, Jesse A Taylor, Gregory G Heuer, Shih-Shan Lang
OBJECTIVE Evaluation of increased intracranial pressure (ICP) in the pediatric craniosynostosis population based solely on ophthalmological, clinical, and radiographic data is subjective, insensitive, and inconsistent. The aim of this study was to examine the intraoperative ICP before and after craniectomy in this patient population. METHODS The authors measured the ICP before and after craniectomy using a subdural ICP monitor in 45 children. They regulated end-tidal carbon dioxide and the monitoring site under general anesthesia to record consistent ICP readings...
August 3, 2018: Journal of Neurosurgery. Pediatrics
Kathryn V Isaac, John G Meara, Mark R Proctor
OBJECTIVE Comparative effectiveness studies are needed for analyzing the clinical outcomes of treatment of sagittal craniosynostosis (SC) with endoscopic suturectomy (ES) or cranial vault remodeling (CVR). METHODS From 2004-2015, patients were consecutively reviewed and data recorded for operative details and complications. Cranial growth was measured by head circumference percentile (HCP) and cranial index (CI) Z-score. Aesthetic outcomes were compared using the Whitaker classification. RESULTS A total of 207 patients with nonsyndromic SC were treated with ES (n = 187) or CVR (n = 20)...
August 3, 2018: Journal of Neurosurgery. Pediatrics
Takuro Sakai, Masanori Sasaki, Yuko Kataoka-Sasaki, Shinichi Oka, Masahito Nakazaki, Shinobu Fukumura, Masaki Kobayashi, Hiroyuki Tsutsumi, Jeffery D Kocsis, Osamu Honmou
OBJECTIVE Children who have experienced neonatal hypoxic-ischemic encephalopathy often develop cerebral palsy. Although many treatments have been performed, few effective therapies are available. In this study, the authors tested in rats with hypoxia-ischemia (HI) injuries the hypothesis that the systemic infusion of mesenchymal stem cells (MSCs) would result in functional improvement by facilitating neural compensation in the contralesional cortex. METHODS Postnatal day (P) 7 (P7) rats that had undergone unilateral hemisphere hypoxia-ischemia (modified Rice-Vannucci model) were randomly assigned to MSC-infused or vehicle-infused groups...
August 3, 2018: Journal of Neurosurgery. Pediatrics
Ahmad Marashly, Michelle M Loman, Sean M Lew
Stereotactic laser ablation (SLA) is being increasingly used to treat refractory focal epilepsy, especially mesial temporal lobe epilepsy. However, emerging evidence suggests it can be used for extratemporal lobe epilepsy as well. The authors report the case of a 17-year-old male who presented with refractory nocturnal seizures characterized by bilateral arms stiffening or rhythmic jerking lasting several seconds. Semiology suggested an epileptogenic zone close to one of the supplementary sensory motor areas...
August 3, 2018: Journal of Neurosurgery. Pediatrics
James L West, Madison Arnel, Atilio E Palma, John Frino, Alexander K Powers, Daniel E Couture
OBJECTIVE Spine surgery is less common in children than adults. These surgeries, like all others, are subject to complications such as bleeding, infection, and CSF leak. The rate of incidental durotomy in the pediatric population, and its associated complications, has scarcely been reported in the literature. METHODS This is a retrospective chart review of all pediatric patients operated on at Wake Forest Baptist Health from 2012 to 2017 who underwent spine surgeries. The authors excluded any procedures with intended durotomy, such as tethered cord release or spinal cord tumor resection...
August 3, 2018: Journal of Neurosurgery. Pediatrics
Aiko Terada, Masaki Komiyama, Tomoya Ishiguro, Yasunari Niimi, Hidenori Oishi
OBJECTIVE This nationwide study was organized to evaluate the clinical characteristics, especially the annual detected rate, of pediatric intracranial arteriovenous (AV) shunts such as brain AV malformations (BAVMs), pial AV fistulas (PAVFs), vein of Galen aneurysmal malformations (VGAMs), and dural AV fistulas (DAVFs) in Japan. METHODS Participation invitation emails for the study were sent to all members of the Japanese Society for Neuroendovascular Therapy and the Japanese Society for Pediatric Neurosurgery, totaling 4123 physicians...
July 27, 2018: Journal of Neurosurgery. Pediatrics
Andrew F Alalade, Giovanni Briganti, Jo-Lyn Mckenzie, Mitesh Gandhi, Damian Amato, Benedict J Panizza, James Bowman
The fossa navicularis is an anatomical variant of the skull base thought to be a rare finding. It represents a bony depression in the skull base. The authors here report the case of a fossa navicularis magna in a 9-year-old female who had been treated for recurrent episodes of meningitis. A literature review was also done to highlight the unique features and clinical importance of this distinctive radiological skull base finding. The literature search covered papers from the 19th century up to 2018. Earlier authors described "fossa navicularis" as a very rare skull base finding...
July 27, 2018: Journal of Neurosurgery. Pediatrics
Tej D Azad, Arjun V Pendharkar, James Pan, Yuhao Huang, Amy Li, Rogelio Esparza, Swapnil Mehta, Ian D Connolly, Anand Veeravagu, Cynthia J Campen, Samuel H Cheshier, Michael S B Edwards, Paul G Fisher, Gerald A Grant
OBJECTIVE Pediatric spinal astrocytomas are rare spinal lesions that pose unique management challenges. Therapeutic options include gross-total resection (GTR), subtotal resection (STR), and adjuvant chemotherapy or radiation therapy. With no randomized controlled trials, the optimal management approach for children with spinal astrocytomas remains unclear. The aim of this study was to conduct a systematic review and meta-analysis on pediatric spinal astrocytomas. METHODS The authors performed a systematic review of the PubMed/MEDLINE electronic database to investigate the impact of histological grade and extent of resection on overall survival among patients with spinal cord astrocytomas...
July 20, 2018: Journal of Neurosurgery. Pediatrics
Santiago Candela, María Isabel Vanegas, Alejandra Darling, Juan Darío Ortigoza-Escobar, Mariana Alamar, Jordi Muchart, Alejandra Climent, Enrique Ferrer, Jordi Rumià, Belén Pérez-Dueñas
OBJECTIVE The purpose of this study was to verify the safety and accuracy of the Neuromate stereotactic robot for use in deep brain stimulation (DBS) electrode implantation for the treatment of hyperkinetic movement disorders in childhood and describe the authors' initial clinical results. METHODS A prospective evaluation of pediatric patients with dystonia and other hyperkinetic movement disorders was carried out during the 1st year after the start-up of a pediatric DBS unit in Barcelona. Electrodes were implanted bilaterally in the globus pallidus internus (GPi) using the Neuromate robot without the stereotactic frame...
July 20, 2018: Journal of Neurosurgery. Pediatrics
Jonathan E Martin, Thomas Manning, Markus Bookland, Charles Castiglione
OBJECTIVE Minimally invasive (MI) synostectomy with postoperative helmet orthosis is increasingly used in the management of sagittal craniosynostosis. Although the MI technique reduces or eliminates the need for access to the lateral skull surface, the modified prone/sphinx position remains popular. The authors present their initial experience with supine positioning for MI sagittal synostectomy. METHODS The authors used supine positioning with the head turned laterally on a horseshoe head holder in 5 consecutive patients undergoing MI sagittal synostectomy...
July 20, 2018: Journal of Neurosurgery. Pediatrics
Surya Sri Krishna Gour, Mohit Agrawal, Dattaraj Sawarkar
No abstract text is available yet for this article.
July 20, 2018: Journal of Neurosurgery. Pediatrics
Andrew C Vivas, Nir Shimony, Eric M Jackson, Risheng Xu, George I Jallo, Luis Rodriguez, Gerald F Tuite, Carolyn M Carey
OBJECTIVE Hydrocephalus associated with subdural hygromas is a rare complication after decompression of Chiari malformation type I (CM-I). There is no consensus for management of this complication. The authors present a series of 5 pediatric patients who underwent CM-I decompression with placement of a dural graft complicated by posterior fossa hygromas and hydrocephalus that were successfully managed nonoperatively. METHODS A retrospective review over the last 5 years of patients who presented with hydrocephalus and subdural hygromas following foramen magnum decompression with placement of a dural graft for CM-I was conducted at 2 pediatric institutions...
July 20, 2018: Journal of Neurosurgery. Pediatrics
Hannah E Goldstein, Brett E Youngerman, Belinda Shao, Cigdem I Akman, Arthur M Mandel, Danielle K McBrian, James J Riviello, Sameer A Sheth, Guy M McKhann, Neil A Feldstein
OBJECTIVE Patients with medically refractory localization-related epilepsy (LRE) may be candidates for surgical intervention if the seizure onset zone (SOZ) can be well localized. Stereoelectroencephalography (SEEG) offers an attractive alternative to subdural grid and strip electrode implantation for seizure lateralization and localization; yet there are few series reporting the safety and efficacy of SEEG in pediatric patients. METHODS The authors review their initial 3-year consecutive experience with SEEG in pediatric patients with LRE...
July 20, 2018: Journal of Neurosurgery. Pediatrics
Nitish Agarwal, Mohit Agrawal, Dattaraj P Sawarkar
No abstract text is available yet for this article.
July 13, 2018: Journal of Neurosurgery. Pediatrics
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