Management of Sleep Apnea in Children with Chiari I Malformation: A Retrospective Study
Conclusions: Based our results, sleep apnea in CM-1 patients may be obstructive, central, or mixed and is likely multifactorial. A multi-disciplinary approach to management of these patients is important including ne urosurgery, otolaryngology, and sleep medicine. Future prospective studies will lend further insight into this condition and its management. (Source: Pediatric Neurosurgery)
Source: Pediatric Neurosurgery - February 24, 2022 Category: Neurosurgery Source Type: research
Detethering of MRI-demonstrated Tethered Cord Syndrome
The objective of this study was to describe the symptomatic presentation of TCS in our institution, detect demographic and diagnostic predictors of signs and symptoms, assess changes in symptoms over time, and examine whether demographic and diagnostic variables affect changes in symptoms over time.
Methods: Using a retrospective chart review from patients who underwent detethering at our institution between 4/1/2015 and 3/31/2019, we report on the signs and symptoms of patients undergoing detethering surgery at presentation and examine possible demographic and diagnostic predictors of those symptoms and changes in sympto...
Source: Pediatric Neurosurgery - January 21, 2022 Category: Neurosurgery Source Type: research
The absence of the neuronal component in Limited Dorsal Myeloschisis: A case report
Discussion:
The current paradigm explains the absence of neuroglial tissue in resected stalks of LDM by indicating that it should be present in the unresected part, more proximal to the dorsal spinal cord. We hypothesize a different mechanism in which following reopening of the neural tube, mesodermal invasion causes a tight and persistent strand between the cutaneous- and neuro-ectoderm. Elongation of this mesodermal strand during embryological development allows for the formation of a mesenchymal stalk without the presence of neuroglial tissue. Hydrodynamic forces can cause fistulation of the poorly differentiated mesode...
Source: Pediatric Neurosurgery - January 17, 2022 Category: Neurosurgery Source Type: research
Torcular dural sinus malformation
We present a case of a 28-year-old woman with an ultrasound at 32 weeks ’ gestation showing a fetal intracranial thrombosed lesion, measuring 6x4 cm. An elective c-section was performed at 38 weeks’ gestation, and a male neonate was born. He remained asymptomatic, and a brain MRI performed 9 days later showed a thrombosed midline mass due to a torcular DSM. The outc ome with conservative treatment was favorable, and further development was unremarkable. The 2-year follow-up imaging demonstrated spontaneous involution of the clot.
The torcular DSM is frequently diagnosed prenatally as an intraluminar lake thrombosis, a...
Source: Pediatric Neurosurgery - January 13, 2022 Category: Neurosurgery Source Type: research
The Cost of Serial Cerebrospinal Fluid Aspirations between Ventricular Access Device and Ventriculosubgaleal Shunt for Treatment of Posthemorrhagic Ventricular Dilatation in Premature Infants
Conclusion: Lower number of CSF aspirations using VSGS can be associated with considerably lower cost compared to VAD.Pediatr Neurosurg (Source: Pediatric Neurosurgery)
Source: Pediatric Neurosurgery - January 12, 2022 Category: Neurosurgery Source Type: research
The cost of serial cerebrospinal fluid aspirations between ventricular access device (VAD) and ventriculosubgaleal shunt (VSGS) for treatment of post-hemorrhagic ventricular dilatation (PHVD) in premature infants
Conclusion: Lower number of CSF aspirations using VSGS can be associated with considerably lower cost compared to VAD. (Source: Pediatric Neurosurgery)
Source: Pediatric Neurosurgery - January 12, 2022 Category: Neurosurgery Source Type: research
Gamma Knife Radiosurgery in the Management of Hypothalamic Glioma: A Case Report with Long-term Follow-up
Conclusion The outcome obtained after extended follow-up in our patient highlights the safety and efficacy of GKRS in the management of hypothalamic gliomas in pediatrics, which in turn can avoid potentially serious complications of surgery in this vulnerable patient population in this sensitive location. (Source: Pediatric Neurosurgery)
Source: Pediatric Neurosurgery - December 30, 2021 Category: Neurosurgery Source Type: research
Orbitofrontal Extradural Hematoma: Unusual Cause of Proptosis
Traumatic orbital subperiosteal hematoma are a distinct entity and should not be confused with orbital extradural hematoma. Most of the orbital subperiosteal hematoma are small in volume and resolve spontaneously. Management should be based on the clinico-radiological condition. A delayed proptosis may be simply due to orbital venous congestion due to a substantial hematoma or due to a carotid-cavernous fistula. Differentiation between the two is paramount to decide management strategy. (Source: Pediatric Neurosurgery)
Source: Pediatric Neurosurgery - December 28, 2021 Category: Neurosurgery Source Type: research
The Case for Early Antibiotic Commencement and Source Control in Paediatric Subdural Empyema: A Single-Centre Retrospective Case Series
Conclusions: We observed an evolution of practice from limited surgical approaches towards more extensive index surgery over the study period. Given that a microorganism was isolated in all cases using a comprehensive approach, initiation of antibiotic therapy should not be delayed on presentation. Concurrent ENT surgery may be an important factor in providing aggressive source control thereby reducing the need for repeat surgery.Pediatr Neurosurg (Source: Pediatric Neurosurgery)
Source: Pediatric Neurosurgery - December 27, 2021 Category: Neurosurgery Source Type: research
Validation of Sonographic Fronto-Occipital Ratio Based on Anatomical Landmarks compared to MR/CT-Derived Indexes in Children with Chiari II and Ventriculomegaly
Introduction: Ultrasound (US) based indexes such as fronto-occipital ratio (FOR) can be used to obtain an acceptable estimation of ventricular volume. Patients with colpocephaly present a unique challenge due to the shape of their ventricles. In the present study, we aim to evaluate the validity and reproducibility of modified US-FOR index in children with Chiari II-related ventriculomegaly.
Methods: In this retrospective study, we evaluated Chiari II patients younger than one year who underwent head US and MR or CT scans for ventriculomegaly evaluation. MR/CT based FOR was measured in the axial plane by identifying the w...
Source: Pediatric Neurosurgery - December 22, 2021 Category: Neurosurgery Source Type: research
Factors that Influence Intraoperative Decision-Making Among Pediatric Neurosurgeons: A Grounded Theory Study
Conclusions: The findings from this research can be used for training and educating surgeons about intraoperative decision-making processes. Pedagogical modules can be developed that includes training sessions on factors that may implicitly and explicitly influence thinking processes during an operation. Surgeons may also benefit from having open discussions with surgical colleagues about the rich, emotional, intellectual scope of the work that they do with all the challenges that these relationships can bring into decision-making in the operating room. (Source: Pediatric Neurosurgery)
Source: Pediatric Neurosurgery - December 13, 2021 Category: Neurosurgery Source Type: research
The burden of pediatric subarachnoid hemorrhage healthcare disparities in Senegal: A retrospective cohort study
Conclusion
Eight percent of deaths among pediatric aSAH patients who do not receive surgical treatment are attributable to lack of access to surgical treatment. Health systems strengthening policies should be implemented to address this health inequity. (Source: Pediatric Neurosurgery)
Source: Pediatric Neurosurgery - December 13, 2021 Category: Neurosurgery Source Type: research
Paediatric Spinal Tumours: Profile and Treatment Outcome in A Nigerian Tertiary Institution
Conclusion
Paedi atric spinal tumours mostly affected older children in our study group and were predominantly astrocytic in nature. The most common tumour location was extradural, involving mostly the thoracic spinal level. The preoperative neurological status correlates with the postoperative functional outcome. T herefore, the need for early diagnosis and treatment of these tumours cannot overemphasized. (Source: Pediatric Neurosurgery)
Source: Pediatric Neurosurgery - December 13, 2021 Category: Neurosurgery Source Type: research
Management of Lambdoid Craniosynostosis: A Comprehensive and Systematic Review
Background: Craniosynostosis is a condition characterized by the premature fusion of 2 or more skull bones. Craniosynostosis of the lambdoid suture is one of the rarest forms, accounting for 1 –4% of all craniosynostoses. Documented cases are separated into simple (single suture), complex (bilateral), and associated with adjacent synostoses (“Mercedes Benz” Pattern) or syndromes (i.e., Crouzon, Sathre-Chotzen, Antley-Bixler). This condition can manifest phenotypic deformities and ne urological sequelae that can lead to impaired cognitive function if improperly treated or left undiagnosed. Preferred surgical technique...
Source: Pediatric Neurosurgery - December 3, 2021 Category: Neurosurgery Source Type: research
Pediatric Cranioplasty Using Hydroxyapatite Cement: A Retrospective Review and Preliminary Computational Model
Conclusion
Pediatric cranioplasty is a necessary procedure for cranial defects with a relatively higher rate of failure than adults. Here, we use hydroxyapatite cement to perform the procedure while creating a preliminary computational model to understand osteointegration. Based on the findings, cranioplasty shape may alter rate of integration and lead to higher success rates. (Source: Pediatric Neurosurgery)
Source: Pediatric Neurosurgery - November 30, 2021 Category: Neurosurgery Source Type: research
