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Pediatric Neurosurgery

Syed I Khalid, Ryan Kelly, Owoicho Adogwa, Adam Carlton, Edric Tam, Salik Naqvi, Jacob Kushkuley, Shahjehan Ahmad, Josha Woodward, Ryan Khanna, Mark Davison, Lorenzo Munoz, Richard Byrne
BACKGROUND/AIMS: Large population-based studies are needed to assess the epidemiology and survival risk factors associated with pediatric brainstem gliomas. This retrospective study explores factors that may influence survival in this population. METHODS: Utilizing the SEER database, the authors retrospectively assessed survival in histologically confirmed brainstem gliomas in patients aged 17 and younger. Survival was described with Kaplan-Meyer curves and multivariate regression analysis...
April 4, 2019: Pediatric Neurosurgery
Harrison J Westwick, Sami Obaid, Frederique Bordeleau-Roy, Eric Truffer, Alexander G Weil
OBJECTIVE: Surgical treatment options are limited for medically and endovascular refractory cerebral venous sinus thrombosis (CVT). We describe the technical feasibility of open, direct sinus thrombectomy in a pediatric patient with medically and endovascular refractory CVT. METHODS: A 15-year-old patient with superior sagittal sinus (SSS) thrombosis refractory to medical and endovascular treatment experienced clinical deterioration with the progression of bifrontal hematomas and cerebral edema...
March 20, 2019: Pediatric Neurosurgery
Kathryn N Kearns, Kaan Yagmurlu, Ching-Jen Chen, John Jane, Min S Park, M Yashar S Kalani
Developmental dolichoectasia of the intracranial vessels is a rare occurrence. The authors report 2 sibling pediatric patients who were born with 6p25.3 deletion, associated with carotid and vertebrobasilar dolichoectasia. MRI imaging of both children showed asymptomatic elongation and dilation of the vertebrobasilar system and "kissing" carotid arteries. A microarray analysis was also performed for both patients, which identified a 1.5-Mb deletion of 6p25.3 covering 15 genes including FOXC1, which has been implicated in defects in vascular morphogenesis...
March 19, 2019: Pediatric Neurosurgery
Giuseppe Talamonti, Francesco Crisà, Gabriele Canzi
Large cranial defects in very young patients are challenging. The ideal material for cranioplasty in this age group has not yet been identified. Cryopreserved autologous bone presents very high rates of failures, acrylic resins pose a number of compatibility problems, bioceramics may be contraindicated, and autografts may be not adequate for repair of large defects. We present an 18-month-old baby with a large post-traumatic cranial defect which was repaired by assembling a new bone flap on a sterile stereolithographic 3-D model...
March 15, 2019: Pediatric Neurosurgery
Michael C Chiang, Michael M McDowell, Kristen Weaver, Alberto Broniscer, Stephanie Greene
Schimmelpenning syndrome is a rare, well-defined constellation of clinical phenotypes associated with the presence of nevus sebaceous and multisystem abnormalities most commonly manifested as cerebral, ocular, and skeletal defects [<xref ref-type="bibr" rid="ref1">1</xref>]. A single nucleotide mutation in the HRAS or KRAS genes resulting in genetic mosaicism is responsible for the clinical manifestations of this syndrome in the majority of cases. We report a case of an adolescent boy with Schimmelpenning syndrome with a multifocal pilocytic astrocytoma...
March 15, 2019: Pediatric Neurosurgery
Jonathan Roth, Shlomi Constantini, Liat Ben-Sira, Shelly I Shiran
BACKGROUND: Magnetic resonance imaging (MRI) is the "gold standard" method for the evaluation of hydrocephalus. However, diagnosing an obstruction in the ventricular or subarachnoid spaces may pose a challenge for standard diagnostic sequences. In this study, we describe our experience with MRI cisternography (MRIC) or ventriculography (MRIV) for diagnosing or excluding intra- and extraventricular obstructions. Such a differentiation may have a significant impact on choosing the optimal surgical solution...
March 14, 2019: Pediatric Neurosurgery
Joseph Juliano, Edward Melamed, Eisha Christian, Benita Tamrazi, Mark D Krieger
BACKGROUND/AIMS: Intracranial germ-cell tumors (GCTs) are a heterogeneous group of tumors that vary in their response to treatment. Standard treatment consists of chemotherapy and radiation therapy, with the consideration of second-look surgery in resistant disease. The present study aims to inform therapy by characterizing features on pretreatment imaging associated with recurrence. METHODS: Children with intracranial GCTs treated at a single institution between January 2000 and October 2016 were retrospectively reviewed under an Institutional Review Board-approved protocol...
March 13, 2019: Pediatric Neurosurgery
Andrew T Hale, Irene Say, Smit Shah, Michael C Dewan, Richard C E Anderson, Luke D Tomycz
BACKGROUND: Occipitocervical distraction injuries (OCDI) in children occur on a wide spectrum of severity, and decisions about treatment suffer from a lack of rigorous guidelines and significant inter-institutional variability. While clear cases of frank atlanto-occipital dislocation (AOD) are treated with surgical stabilization, the approach for less severe cases of OCDI is not standardized. These patients require a careful assessment of both radiographic and clinical criteria, as part of a complex risk-benefit analysis, to establish whether occipitocervical fusion (OCF) is indicated...
March 7, 2019: Pediatric Neurosurgery
(no author information available yet)
No abstract text is available yet for this article.
February 27, 2019: Pediatric Neurosurgery
Chesney S Oravec, Mustafa Motiwala, Kevin Reed, Tamekia L Jones, Paul Klimo
BACKGROUND/AIMS: We sought to describe pediatric "big data" publications since 2000, their statistical output, and clinical implications. METHODS: We searched 4 major North American neurosurgical journals for articles utilizing non-neurosurgery-specific databases for clinical pediatric neurosurgery research. Articles were analyzed for descriptive and statistical information. We analyzed effect sizes (ESs), confidence intervals (CIs), and p values for clinical relevance...
February 20, 2019: Pediatric Neurosurgery
Viral Vasani, Subhas Konar, Bevinahalli Nanjegowda Nandeesh, Shanti Sankar Praharaj
A spinal neurenteric cyst is a rare entity. It commonly presents already at 5 weeks of age up to the 6th decade of life. The most common location is the cervical region followed by thoracic and lumbosacral regions. We report a 9-month-old male infant with sudden onset of weakness in both lower limbs. MRI revealed 2 cystic lesions at cervical and thoracic level with spinal cord compression. He underwent laminectomy and excision of the cervical lesion. The child improved significantly. The postoperative MRI shows complete excision of a dorsal lesion and presence of a cervical lesion...
February 15, 2019: Pediatric Neurosurgery
M Burhan Janjua, Brandon Toll, Shashank Ghandi, Michael E Sebert, Dale M Swift, Joshua M Pahys, Amer F Samdani, Steven W Hwang
OBJECTIVE: This study aims to elucidate surgical risk factors in neuromuscular scoliosis (NMS) with respect to wound site infection after spinal fusion. METHODS: A retrospective review was performed of all patients treated surgically for NMS between January 2008 and December 2016 (minimum 6 months' follow-up). A sub-cohort of 60 patients with minimum 2 years of follow-up data was also analyzed. RESULTS: In 102 patients (53 boys and 49 girls), the mean age at surgery was 14...
February 15, 2019: Pediatric Neurosurgery
Pouya Entezami, Matthew A Adamo
No abstract text is available yet for this article.
February 7, 2019: Pediatric Neurosurgery
Emre Bilgin, Ali İhsan Ökten, Gökhan Çavuş, Vedat Açık, Ali Arslan, Semih Kıvanç Olguner, Yurdal Gezercan, İsmail İştemen
The existence of air in the spinal canal is referred to as pneumorrhachis. It is classified as extradural (epidural) or intradural (subdural or subarachnoid) according to the location where it is found. Nontraumatic, traumatic, and iatrogenic causes have been attributed to its occurrence. Traumatic pneumorrhachis is very rare and rarely seen in children. In our article, a 16-year-old male child in which air formation within the spinal canal was detected after an injury by a penetrating and cutting (knife) tool is discussed...
February 7, 2019: Pediatric Neurosurgery
Shun-Chang Ma, Chun-De Li, Siviero Agazzi, Wang Jia
OBJECTIVE: The purpose of this study was to explore the clinical features and risk factors of outcomes in pediatric posterior cranial fossa ependymoma. We aim to provide evidence-based recommendations for the improvement of prognoses. PATIENTS AND METHODS: The clinical data, treatment modalities, approaches performed, recurrence rates and times, as well as the outcomes of 94 cases were analyzed retrospectively. The characters of neuroimaging were further studied...
January 30, 2019: Pediatric Neurosurgery
Subhas K Konar, Dhaval Shukla, Bevinahalli Nanjegowda Nandeesh, Andiperumal Raj Prabhuraj, B Indira Devi
The incidence of bilateral thalamic glioma in children is not reported in the literature. The majority of cases comprise either diffuse astrocytoma, anaplastic astrocytoma, or glioblastoma. Partial surgical resection or biopsy followed by adjuvant therapy is the usual treatment for bilateral thalamic gliomas. Prognosis is dependent on tumor grade and extent of tumor spread to surrounding critical structures. We present a rare case of bilateral thalamic pilocytic astrocytoma. Endoscopic biopsy, septostomy, and placement of a ventriculoperitoneal shunt was done followed by radiotherapy...
January 24, 2019: Pediatric Neurosurgery
Kavya Kommaraju, Jeffrey H Haynes, Ann M Ritter
BACKGROUND: The purpose of this study was to determine if a pediatric neurosurgical consultation for isolated linear skull fractures (ILSF) in pediatric patients with Glasgow Coma Scale (GCS) scores of ≥14 changed their management. METHODS: A 10-year retrospective chart review at a Level 1 Pediatric Trauma Center was performed. Exclusion criteria were age > 18 years, open, depressed, or skull base fractures, pneumocephalus, poly-trauma, any hemorrhage (intraparenchymal, epidural, subdural, subarachnoid), cervical spine fractures, penetrating head trauma, and initial GCS scores ≤13...
January 23, 2019: Pediatric Neurosurgery
Ajit Mishra, Nupur Pruthi, B N Nandeesh, Dhaval Shukla
Osteoblastomas and aneurysmal bone cysts are uncommon benign tumors of the spine. Their presentation can vary between diffuse pain, restriction of neck movements, torticollis, radiculopathy, and myelopathy. Complete excision is the best treatment to achieve a cure, but recurrence is not uncommon. A combination of the two conditions in the pediatric population is extremely rare. To the best of the authors' knowledge, only 2 cases of such a combination in the cervical spine have been reported in the literature...
January 23, 2019: Pediatric Neurosurgery
Yoshitaka Tomita, Takato Morioka, Nobuya Murakami, Yushi Noguchi, Yuka Sato, Satoshi O Suzuki
Limited dorsal myeloschisis (LDM) and congenital dermal sinus (CDS) originate from incomplete disjunction between the cutaneous and neural ectoderms. Some LDM stalks have been found to have elements of a CDS or dermoid cyst. We surgically treated a saccular lesion in the lumbosacral region of a 7-day-old male neonate. Although fetal magnetic resonance imaging (MRI) failed to reveal a stalk, postnatal MRI including three-dimensional heavily T2-weighted imaging demonstrated a stalk originating from the lumbar cord and extending caudally to enter the lumbosacral meningocele sac...
January 17, 2019: Pediatric Neurosurgery
Belinda Shao, Matei A Banu, Jason J Carroll, Philip M Meyers, Sean D Lavine, Neil A Feldstein, Richard C E Anderson
Cerebral vasospasm is associated with significant morbidity, and most commonly occurs following subarachnoid hemorrhage. Rarely, vasospasm can follow tumor resection and traumatic brain injury. We present the first reported case of a young child who developed diffuse vasospasm following open fenestration of an arachnoid cyst and was promptly treated, with full recovery of neurologic function. Although vasopasm after arachnoid cyst fenestration is rare, it can be included in the differential for a new focal neurologic deficit...
January 16, 2019: Pediatric Neurosurgery
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