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Journal of Neurosurgery. Pediatrics

Yanbin Zhang, Qifeng Peng, Shengru Wang, Yang Yang, Guanfeng Lin, Jianguo Zhang
OBJECTIVEConcerns remain over the influence of pedicle screw instrumentation on the growth potential of an immature spine. Previous studies have reported discrepancies between animal experiments and clinical studies. The authors' objective was to explore the influence of pedicle screw instrumentation on the growth of an immature spine at a very young age.METHODSIndividuals who met the authors' criteria were included. Anteroposterior diameter of the vertebral body; pedicle length on both sides; and anteroposterior diameter, transverse diameter, and area of the spinal canal were measured on CT images before surgery and at the final follow-up...
March 15, 2019: Journal of Neurosurgery. Pediatrics
You Gyoung Yi, Keewon Kim, Hyung-Ik Shin, Moon Suk Bang, Hee-Soo Kim, Jinwoo Choi, Kyu-Chang Wang, Seung-Ki Kim, Ji Yeoun Lee, Ji Hoon Phi, Han Gil Seo
OBJECTIVEThis study aimed to investigate the feasibility and safety of intraoperative motor evoked potential (MEP) monitoring in infants less than 3 months of age.METHODSThe authors investigated 25 cases in which infants younger than 3 months (mean age 72.8 days, range 39-87) underwent neurosurgery between 2014 and 2017. Myogenic MEPs were obtained through transcranial electrical stimulation. In all cases, surgery was performed under total intravenous anesthesia, maintained with remifentanil and propofol.RESULTSMEPs were documented in 24 infants, the sole exception being 1 infant who was lethargic and had 4-limb weakness before surgery...
March 15, 2019: Journal of Neurosurgery. Pediatrics
Jeremy Steinberger, Dominic A Nistal, Saadi Ghatan
Infantile hemangiomas (IHs) are the most common benign neoplasm of the neonatal and newborn period, affecting approximately 5% of infants. However, true IHs presenting in the neuraxis are quite rare with only 15 documented cases in the literature. Management of IH consists of utilizing steroids and immunomodulatory therapies to reduce the size of the tumor and surgery to remove the tumor to decrease symptoms and the risk of bleeding. Operative management of epidural and intradural extramedullary spinal hemangiomas has been described; however, management of intradural intramedullary IH has not been detailed in the literature...
March 8, 2019: Journal of Neurosurgery. Pediatrics
Kiril Mladenov, Lena Braunschweig, Jennifer Behrend, Heiko M Lorenz, Urs von Deimling, Anna K Hell
OBJECTIVEDuring childhood, early-onset scoliosis (EOS) may show severe progressive deformity, which consequently leads to aggressive treatment strategies, such as serial casting, long-term bracing, or surgical interventions. The latter usually includes repeated surgeries for implant lengthening every 6 months in order to allow sufficient growth of the thorax and spine. In 2011, the 24-item Early-Onset Scoliosis Questionnaire (EOSQ-24) was introduced to measure health-related quality of life for this patient group and their families...
March 8, 2019: Journal of Neurosurgery. Pediatrics
Angela G Viers, Khoi D Nguyen, Perounsack X Moon, Scott E Forseen, Ian M Heger
OBJECTIVEOccipitocervical fusions in the pediatric population are rare but can be challenging because of the smaller anatomy. The procedure is even more exacting in patients with prior suboccipital craniectomy. A proposed method for occipitocervical fusion in such patients is the use of occipital condyle screws. There is very limited literature evaluating the pediatric occipital condyle for screw placement. The authors examined the occipital condyle in pediatric patients to determine if there was an age cutoff at which condylar screw placement is contraindicated...
March 1, 2019: Journal of Neurosurgery. Pediatrics
Coleman P Riordan, Armide Storey, David J Cote, Edward R Smith, R Michael Scott
OBJECTIVEThere are limited data on the long-term outcomes for children undergoing surgical revascularization for moyamoya disease (MMD) in North America. The authors present a series of pediatric MMD patients who underwent a standard revascularization procedure, pial synangiosis, more than 20 years previously at a single institution by a single surgical team.METHODSThis study is a retrospective review of all patients aged 21 years or younger treated for MMD at Boston Children's Hospital who were operated on more than 20 years previously by the senior author (R...
March 1, 2019: Journal of Neurosurgery. Pediatrics
Michael Ragheb, Ashish H Shah, Sarah Jernigan, Tulay Koru-Sengul, John Ragheb
OBJECTIVEHydrocephalus is recognized as a common disabling pediatric disease afflicting infants and children disproportionately in the developing world, where access to neurosurgical care is limited and risk of perinatal infection is high. This surgical case series describes the Project Medishare Hydrocephalus Specialty Surgery (PMHSS) program experience treating hydrocephalus in Haiti between 2008 and 2015.METHODSThe authors conducted a retrospective review of all cases involving children treated for hydrocephalus within the PMHSS program in Port-au-Prince, Haiti, from 2008 through 2015...
February 22, 2019: Journal of Neurosurgery. Pediatrics
Kimberly Hamilton, Susan Rebsamen, Shahriar Salamat, Raheel Ahmed
An extraosseous intradural presentation for a sacral chordoma in the pediatric age group has not been reported to date. This is a report on an 11-year-old boy who presented with an extraosseous, intradural sacral chordoma. He underwent gross-total resection and received adjuvant proton beam therapy. Neoplastic transformation of the notochord is reviewed to illustrate the developmental basis for the surgical anatomy and pathogenesis of the classic chordoma variant. Clinical and pathological features are reviewed to differentiate this chordoma presentation from classic osseous chordomas and ecchordosis physaliphora, a related benign developmental notochordal lesion...
February 22, 2019: Journal of Neurosurgery. Pediatrics
Nobuhito Morota
OBJECTIVEDespite the surge in the intraoperative use of the bulbocavernosus reflex (BCR) during lumbosacral surgeries, there are as yet no widely accepted BCR warning criteria for use with intraoperative neurophysiological monitoring (IONM). The author's aim was to find clinically acceptable warning criteria for use in IONM of the BCR.METHODSRecords of IONM of the BCR in 164 operations in 163 patients (median age 5 months) with a conus spinal lipoma who underwent surgery between August 2002 and May 2016 were retrospectively analyzed...
February 22, 2019: Journal of Neurosurgery. Pediatrics
Kalina A Misiolek, Zachary G Osborn, Natalie Hauser, Diana Thomas, Jessica F Goodman, Daniel H Fulkerson
Choroid plexus papillomas (CPPs) are rare, benign tumors that can arise in young children. Most pediatric patients present with signs of hydrocephalus and require immediate treatment. The natural history of choroid plexus tumors in children without hydrocephalus is poorly defined. In this report, the authors present the very rare case of a child without hydrocephalus but with two intraventricular choroid plexus tumors discovered shortly after birth. Initial imaging had been performed for seizures and showed agenesis of the corpus callosum and enhancing tumors in the third and left lateral ventricles...
February 22, 2019: Journal of Neurosurgery. Pediatrics
Francesco Puccinelli, Minh Ngoc Thien Kim Tran Dong, Marta Iacobucci, Jean-Xavier Mazoit, Philippe Durand, Pierre Tissieres, Guillaume Saliou
OBJECTIVEEndovascular treatment in children, especially neonates, can be more challenging than analogous procedures in adults. This study aimed to describe the clinical and radiological findings, type and timing of endovascular treatment, and early outcomes in children who present with neurovascular malformations, who are treated with embolization, and who weigh less than 5 kg.METHODSThe authors carried out a retrospective review of all consecutively treated children weighing less than 5 kg with neurovascular arteriovenous malformations (AVMs) at a single institution over a 10-year period...
February 22, 2019: Journal of Neurosurgery. Pediatrics
John R W Kestle
No abstract text is available yet for this article.
February 22, 2019: Journal of Neurosurgery. Pediatrics
Min-Hee Lee, Nolan B O'Hara, Yasuo Nakai, Aimee F Luat, Csaba Juhasz, Sandeep Sood, Eishi Asano, Jeong-Won Jeong
OBJECTIVEThis study is aimed at improving the clinical utility of diffusion-weighted imaging maximum a posteriori probability (DWI-MAP) analysis, which has been reported to be useful for predicting postoperative motor, language, and visual field deficits in pediatric epilepsy surgery. The authors determined the additive value of a new clustering mapping method in which average direct-flip distance (ADFD) reclassifies the outliers of original DWI-MAP streamlines by referring to their minimum distances to the exemplar streamlines (i...
February 22, 2019: Journal of Neurosurgery. Pediatrics
Michael M H Yang, Walter Hader, Kelly Bullivant, Mary Brindle, Jay Riva-Cambrin
OBJECTIVEThe shunt protocol developed by the Hydrocephalus Clinical Research Network (HCRN) was shown to significantly reduce shunt infections in children. However, its effectiveness had not been validated in a non-HCRN, small- to medium-volume pediatric neurosurgery center. The present study evaluated whether the 9-step Calgary Shunt Protocol, closely adapted from the HCRN shunt protocol, reduced shunt infections in children.METHODSThe Calgary Shunt Protocol was prospectively applied at Alberta Children's Hospital from May 23, 2013, to all children undergoing any shunt procedure...
February 22, 2019: Journal of Neurosurgery. Pediatrics
Daniel W Fults, Michael D Taylor, Livia Garzia
Leptomeningeal dissemination (LMD) is the defining pattern of metastasis for medulloblastoma. Although LMD is responsible for virtually 100% of medulloblastoma deaths, it remains the least well-understood part of medulloblastoma pathogenesis. The fact that medulloblastomas rarely metastasize outside the CNS but rather spread almost exclusively to the spinal and intracranial leptomeninges has fostered the long-held belief that medulloblastoma cells spread directly through the CSF, not the bloodstream. In this paper the authors discuss selected molecules for which experimental evidence explains how the effects of each molecule on cell physiology contribute mechanistically to LMD...
February 15, 2019: Journal of Neurosurgery. Pediatrics
Dan Laukka, Melissa Rahi, Riitta Parkkola, Tero Vahlberg, Arttu Rintala, Eeva Salo, Jaakko Rinne
OBJECTIVEKawasaki disease (KD) is a vasculitis that can cause aneurysm formation in coronary arteries and, more rarely, in peripheral arteries. A possible connection between KD and intracranial aneurysms is unclear. The purpose of this study was to determine if KD is associated with intracranial aneurysms.METHODSIn this prospective cohort study, all patients hospitalized and diagnosed with KD in the authors' hospital district area in the period from 1978 to 1995 were identified. Patients with a current age ≥ 25 years and a history of KD in childhood were included in the study, which was conducted between 2016 and 2017...
February 15, 2019: Journal of Neurosurgery. Pediatrics
Constanze Buus-Gehrig, Thomas Lehrnbecher, Luciana Porto, Martina Becker, Thomas Freiman, Michel Mittelbronn, Konrad Bochennek
Tumors of the central nervous system represent the largest group of solid tumors found in pediatric patients. Pilocytic astrocytoma is the most common pediatric glioma, mostly located in the posterior fossa. The majority of brainstem tumors, however, are classified as highly aggressive diffuse intrinsic pontine gliomas (DIPGs) and their prognosis is dismal.The authors report on the case of a neonate in whom MRI and neuropathological assessment were used to diagnose DIPG. Before initiation of the planned chemotherapy, the tumor regressed spontaneously, and the newborn exhibited a normal neurological development...
February 15, 2019: Journal of Neurosurgery. Pediatrics
Tamara D Simon, Matthew P Kronman, Kathryn B Whitlock, Samuel R Browd, Richard Holubkov, John R W Kestle, Abhaya V Kulkarni, Marcie Langley, David D Limbrick, Thomas G Luerssen, W Jerry Oakes, Jay Riva-Cambrin, Curtis Rozzelle, Chevis N Shannon, Mandeep Tamber, John C Wellons, William E Whitehead, Nicole Mayer-Hamblett
OBJECTIVECSF shunt infection treatment requires both surgical and antibiotic decisions. Using the Hydrocephalus Clinical Research Network (HCRN) Registry and 2004 Infectious Diseases Society of America (IDSA) guidelines that were not proactively distributed to HCRN providers, the authors previously found high adherence to surgical recommendations but poor adherence to intravenous (IV) antibiotic duration recommendations. In general, IV antibiotic duration was longer than recommended. In March 2017, new IDSA guidelines expanded upon the 2004 guidelines by including recommendations for selection of specific antibiotics...
February 15, 2019: Journal of Neurosurgery. Pediatrics
R Michael Scott, Edward R Smith
No abstract text is available yet for this article.
February 8, 2019: Journal of Neurosurgery. Pediatrics
Giulia Cossu, Mahmoud Messerer, Roy Thomas Daniel
No abstract text is available yet for this article.
February 8, 2019: Journal of Neurosurgery. Pediatrics
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