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Cerebral palsy surgery

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https://www.readbyqxmd.com/read/29165794/leptomeningeal-metastasis-from-systemic-cancer-review-and-update-on-management
#1
REVIEW
Nancy Wang, Mia S Bertalan, Priscilla K Brastianos
Leptomeningeal metastasis is an uncommon and typically late complication of cancer with a poor prognosis and limited treatment options. Diagnosis is often challenging, with nonspecific presenting symptoms ranging from headache and confusion to focal neurologic deficits, such as cranial nerve palsies. Standard diagnostic evaluation involves a neurologic examination, magnetic resonance imaging of the brain and spine with gadolinium, and cytologic evaluation of the cerebral spinal fluid. Therapy entails a multimodal approach focused on palliation with surgery, radiation, and/or chemotherapy, which may be administered systemically or directly into the cerebral spinal fluid...
November 22, 2017: Cancer
https://www.readbyqxmd.com/read/29149666/relationship-between-radiographic-patella-alta-pathology-and-walking-dysfunction-in-children-with-bilateral-spastic-cerebral-palsy
#2
Matthias Hösl, Harald Böhm, Michaela Seltmann, Chakravarthy Ugandhar Dussa, Leonhard Döderlein
BACKGROUND: Patella-alta is very common in patients with Cerebral Palsy (CP). While several diagnostic x-ray indices have been developed for patella-alta in general, the specific relationship with walking dysfunction in CP is only partly understood. METHODS: 33 participants with bilateral spastic CP between 4 and 20 years (GMFCS I-II without previous surgery) that underwent 3D gait analysis as well as a radiographic exam within 0.8 (SD 1.2) months were retrospectively included...
November 10, 2017: Gait & Posture
https://www.readbyqxmd.com/read/29145580/effect-of-botulinum-toxin-a-on-muscle-healing-and-its-implications-in-aesthetic-and-reconstructive-surgery
#3
Eldad Silberstein, Ehud Maor, Oleg Sukmanov, Alexander Bogdanov Berezovsky, Yaron Shoham, Yuval Krieger
Background: Muscle activity contributes to the enhancement of facial aging deformity, blepharospasm, cerebral palsy spasticity, trismus, torticollis, and other conditions. Myotomy of the involved muscles in order to reduce the deformity has variable success rates due to muscle healing and regeneration of activity. Objectives: The goal of this study was to investigate whether blocking striated muscle activity with Botulinum toxin (BtxA) during the healing time after myotomy alters the healing process and reduces long-term muscle activity...
November 14, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/29135566/management-of-hypertonia-in-cerebral-palsy
#4
Nickolas J Nahm, H Kerr Graham, Mark E Gormley, Andrew G Georgiadis
PURPOSE OF REVIEW: The review provides an update on the treatment of hypertonia in cerebral palsy, including physical management, pharmacotherapy, neurosurgical, and orthopedic procedures. RECENT FINDINGS: Serial casting potentiates the effect of Botulinum neurotoxin A injections for spasticity. Deep brain stimulation, intraventricular baclofen, and ventral and dorsal rhizotomy are emerging tools for the treatment of dystonia and/or mixed tone. The long-term results of selective dorsal rhizotomy and the timing of orthopedic surgery represent recent advances in the surgical management of hypertonia...
November 11, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29102966/effects-of-scalp-electroacupuncture-on-the-pi3k-akt-signalling-pathway-and-apoptosis-of-hippocampal-neurons-in-a-rat-model-of-cerebral-palsy
#5
Hanhong Zhang, Jing Gao, Mengmeng Wang, Xuefeng Yu, Xiuhua Lv, Huan Deng, Xiangwei Fan, Kaiyun Chen
Background Substantial evidence from clinical reports has established that most cerebral palsy (CP) patients benefit from a comprehensive rehabilitation exercise training programme. Such advances are enhanced when scalp electroacupuncture (EA), applied at a location corresponding to the projection of the motor area, is combined with rehabilitation exercise training. However, little information exists regarding the mechanistic basis for these effects.Objective To examine whether EA stimulation within the scalp projection location of the motor area can inhibit apoptosis of hippocampal neurons by regulating the PI3k/Akt signalling pathway in a rat model of CP...
November 4, 2017: Acupuncture in Medicine: Journal of the British Medical Acupuncture Society
https://www.readbyqxmd.com/read/29101470/pancreatic-fracture-a-rare-complication-following-scoliosis-surgery
#6
Mélodie Juricic, Kalitha Pinnagoda, Walid Lakhal, Jérome Sales De Gauzy, Olivier Abbo
STUDY DESIGN: Grand Round case report. OBJECTIVE: We report a pancreatic fracture associated with Wirsung duct disruption, following a scoliosis surgery in a cerebral palsy adolescent. Spinal fusion surgery is the standard treatment for severe neuromuscular scoliosis. Many complications such as digestive ones account for its complexity. Postoperative acute pancreatitis is well described, although its pathophysiology remains unclear. To our knowledge, pancreatic fracture following scoliosis correction has never been described to date...
November 3, 2017: European Spine Journal
https://www.readbyqxmd.com/read/29090251/prognosis-following-dental-implant-treatment-under-general-anesthesia-in-patients-with-special-needs
#7
Il-Hyung Kim, Tae Seong Kuk, Sang Yoon Park, Yong-Suk Choi, Hyun Jeong Kim, Kwang-Suk Seo
BACKGROUND: This study retrospectively investigated outcomes following dental implantation in patients with special needs who required general anesthesia to enable treatment. METHODS: Patients underwent implant treatment under general anesthesia at the Clinic for the Disabled in Seoul National University Dental Hospital between January 2004 and June 2017. The study analyzed medical records and radiographs. Implant survival rates were calculated by applying criteria for success or failure...
September 2017: J Dent Anesth Pain Med
https://www.readbyqxmd.com/read/29081846/avascular-necrosis-in-children-with-cerebral-palsy-after-reconstructive-hip-surgery
#8
L Phillips, K Hesketh, E K Schaeffer, J Andrade, J Farr, K Mulpuri
PURPOSE: Progressive hip displacement is one of the most common orthopaedic pathologies in children with cerebral palsy (CP). Reconstructive hip surgery has become the standard treatment of care. Reported avascular necrosis (AVN) rates for hip reconstructive surgery in these patients vary widely in the literature. The purpose of this study is to identify the frequency and associated risk factors of AVN for reconstructive hip procedures. METHODS: A retrospective analysis was performed of 70 cases of reconstructive hip surgery in 47 children with CP, between 2009 and 2013...
October 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/29079317/severe-neurodevelopmental-disability-and-healthcare-needs-among-survivors-of-medical-and-surgical-necrotizing-enterocolitis-a-prospective-cohort-study
#9
Brenna S Fullerton, Charles R Hong, Cristine S Velazco, Charles E Mercier, Kate A Morrow, Erika M Edwards, Karla R Ferrelli, Roger F Soll, Biren P Modi, Jeffrey D Horbar, Tom Jaksic
PURPOSE: This study characterizes neurodevelopmental outcomes and healthcare needs of extremely low birth weight (ELBW) survivors of necrotizing enterocolitis (NEC) compared to ELBW infants without NEC. METHODS: Data were collected prospectively on neonates born 22-27weeks' gestation or 401-1000g at 47 Vermont Oxford Network member centers from 1999 to 2012. Detailed neurodevelopmental evaluations were conducted at 18-24months corrected age. Information regarding rehospitalizations, postdischarge surgeries, and feeding was also collected...
October 12, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29050720/does-intrathecal-baclofen-therapy-increase-prevalence-and-or-progression-of-neuromuscular-scoliosis
#10
Kevin R Walker, Susan A Novotny, Linda E Krach
STUDY DESIGN: Retrospective, case-matched review. OBJECTIVES: Compare a group of individuals with cerebral palsy (CP) who had intrathecal baclofen (ITB) pumps to a group of individuals with CP who did not have ITB pumps in order to determine if there was a difference in the prevalence of new-onset neuromuscular scoliosis, an increased rate of progression of preexisting neuromuscular scoliosis, or an increased rate of posterior spine fusion surgery in skeletally immature individuals with CP who had ITB pumps...
November 2017: Spine Deformity
https://www.readbyqxmd.com/read/29018652/anastomotic-aneurysm-formation-after-high-flow-bypass-surgery-a-case-report-with-histopathological-study
#11
Tatsuya Uchida, Masanori Yoshino, Shinji Ito, Takayuki Hara
Bypass surgery is often used in the treatment of large and giant aneurysms. Major complications that often arise during the perioperative period include cranial nerve palsy, ischemic complications, and hyperperfusion. However, there have been a few reports about late onset complications such as anastomotic aneurysms. In particular, anastomotic aneurysm after high flow bypasses has never been reported. A 57-year-old woman who had been suffering from left eye pain was diagnosed with a large aneurysm of the left internal carotid artery (ICA) in the cavernous portion...
October 2017: NMC Case Rep J
https://www.readbyqxmd.com/read/28987316/bypass-for-symptomatic-in-stent-carotid-restenosis
#12
Francesco Stilo, Pasqualino Sirignano, Nunzio Montelione, Wassim Mansour, Laura Capoccia, Vincenzo Catanese, Francesco Spinelli, Francesco Speziale
BACKGROUND: To evaluate early and long-term outcomes of symptomatic patients treated for in-stent carotid restenosis (ISR) with carotid bypass (CB). METHODS: Data were retrospectively collected from a prospectively compiled database on patients treated with CB in two high-volume Italian centers between 2008 and 2016, for symptomatic high-grade ISR after CAS. After carotid endarterectomy and stent removal, a greater saphenous vein (GSV) was preferentially employed as the graft; when the GSV was not accessible, a 6mm polytetrafluoroethylene (PTFE) graft was implanted...
December 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28979174/delayed-onset-of-isolated-unilateral-oculomotor-nerve-palsy-caused-by-post-traumatic-pituitary-apoplexy-a-case-report
#13
Tomoki Ishigaki, Yotaro Kitano, Hirofumi Nishikawa, Genshin Mouri, Shigetoshi Shimizu, Fumitaka Miya, Hidenori Suzuki
Post-traumatic pituitary apoplexy is uncommon, most of which present with a sudden onset of severe headache and visual impairments associated with a dumbbell-shaped pituitary tumor. We experienced an unusual case of post-traumatic pituitary apoplexy with atypical clinical features. A 66-year-old man presented with mild cerebral contusion and an incidentally diagnosed intrasellar tumor after a fall accident with no loss of consciousness. The patients denied any symptoms before the accident. After 4 days, the left oculomotor nerve palsy developed and deteriorated associated with no severe headache...
2017: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/28961550/evidence-of-knee-extensor-dysfunction-during-sit-to-stand-following-distal-femoral-extension-osteotomy-and-patellar-tendon-advancement-in-young-adults-with-cerebral-palsy-a-pilot-study
#14
Elizabeth R Boyer, Jean L Stout, Jennifer C Laine, Sarah M Gutknecht, Lucas Henrique Oliveira, Meghan E Munger, Michael H Schwartz, Tom F Novacheck
A distal femoral extension osteotomy with patellar tendon advancement (DFEO+PTA) is a common treatment for individuals with cerebral palsy (CP) who walk in crouch. Musculoskeletal modeling suggests that the typical patella baja position post-DFEO+PTA may limit one's abilities to perform sit-to-stand (STS) tasks; however, STS function has not been assessed. Our purpose was to compare how well individuals who received a DFEO+PTA can perform a 5-times STS test (FTSST) eight or more years after surgery compared to their peers who did not receive a DFEO+PTA (non-DFEO+PTA group)...
September 19, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28953163/the-effect-of-plantar-flexor-lengthening-on-foot-pressure-in-ambulatory-children-with-cerebral-palsy
#15
Oussama Abousamra, Joshua Schwartz, Chris Church, Nancy Lennon, John Henley, Tim Niiler, Freeman Miller
This study aimed to assess the effects of plantar flexor lengthening (PFL) on dynamic foot pressures of children with cerebral palsy using pedobarographs. Of 97 enrolled, 13 children with 18 legs had PFL. Age at surgery was 4.7 (2.8-8.8) years. A significant increase in ankle dorsiflexion and heel impulse was achieved postoperatively and was maintained at 5 years. The coronal plane pressure index increased postoperatively, but reverted to preoperative levels at the 5-year follow-up. Children tend to have more valgus after PFL...
September 25, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28945691/should-proximal-femoral-implants-be-removed-prophylactically-or-reactively-in-children-with-cerebral-palsy
#16
Walter H Truong, Susan A Novotny, Tom F Novacheck, Eyun-Jung Shin, Andrew Howard, Unni G Narayanan
BACKGROUND: Implants are commonly used to stabilize proximal femoral osteotomies in children with cerebral palsy (CP). Removal of implants is common practice and believed to avoid infection, fracture, or pain that might be associated with retained hardware. There is little evidence to support a prophylactic strategy over a reactive approach based on symptoms. The aim of this study was to compare the outcomes of prophylactic and reactive approaches to removal of proximal femoral implants in children with CP...
September 22, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28935338/soft-tissue-surgery-for-adults-with-nonfunctional-spastic-hands-following-central-nervous-system-lesions-a-retrospective-study
#17
Laure Gatin, Alexis Schnitzler, Fabien Calé, Guillaume Genêt, Philippe Denormandie, François Genêt
PURPOSE: Soft tissue surgery for upper extremity contractures can improve hygiene, pain, and appearance in adults with central nervous system lesions. The goal of such interventions is highly individual; thus, goal attainment scaling (GAS; a method of scoring the extent to which patient's individual goals are achieved [5 levels] in the course of intervention and using T score values) is pertinent to evaluate outcome. The objective of this study was to assess the effect of soft tissue surgery for upper extremity muscle contractures in patients with central nervous system lesions using GAS...
September 19, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28928544/role-of-anesthesiologist-in-the-management-of-a-child-with-cerebral-palsy
#18
REVIEW
Safiya Imtiaz Shaikh, Ganapati Hegade
Cerebral palsy (CP) refers to a spectrum of nonprogressive neurological disorders with disturbances in posture and movement, resulting from perinatal intrauterine insult to developing infant brain. Many conditions associated with CP require surgery. Such cases pose important gastrointestinal, respiratory, and other perioperative considerations. Anesthetic management in these cases is delicate. Intraoperative complications including hypovolemia, hypothermia, muscle spasms, seizures, and delayed recovery might complicate the anesthetic management...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28918357/long-term-follow-up-after-tibialis-anterior-tendon-shortening-in-combination-with-achilles-tendon-lengthening-in-spastic-equinus-in-cerebral-palsy
#19
Michèle Kläusler, Bernhard Maria Speth, Reinald Brunner, Oren Tirosh, Carlo Camathias, Erich Rutz
Using Tibialis Anterior Shortening (TATS) in combination with Achilles Tendon Lengthening (TAL) to treat spastic equinus in children with cerebral palsy (CP) was described in 2011. Short-term results have indicated a good outcome, especially an improvement of the drop foot in swing phase and the correction of equinus in stance phase. The aim of this study was to analyse the results of the long-term follow-up and to determine the relapse rate of TATS and TAL. The kinematics of the sagittal, frontal and transversal planes were measured by using instrumented 3D gait analysis at three defined time points and then described using the Gait Profile Score (GPS) and Movement Analysis Profile (MAP)...
October 2017: Gait & Posture
https://www.readbyqxmd.com/read/28918222/vision-assessments-and-interventions-for-infants-0-2-years-at-high-risk-for-cerebral-palsy-a-systematic-review
#20
REVIEW
Olena D Chorna, Andrea Guzzetta, Nathalie L Maitre
We performed a systematic review and evaluated the level of evidence of vision interventions and assessments for infants at high risk for or with a diagnosis of cerebral palsy from zero to two years of age. Articles were evaluated based on the level of methodologic quality, evidence, and clinical utilization. Thirty publications with vision assessments and five with vision interventions met criteria for inclusion. Assessments included standard care neuroimaging, electrophysiology, and neuro-ophthalmologic examination techniques that are utilized clinically with any preverbal or nonverbal pediatric patient...
November 2017: Pediatric Neurology
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