Journal of neurosurgery. Pediatrics最新文献

{"title":"Primary spinal cord astroblastoma: a case report and systematic review of the literature detailing management and understanding histopathological, epigenetic, and molecular analysis.","authors":"Adam Y Li, Tharan Mungara, Aman Singh, Anna C Kolstad, Catherine Jay, Rajnish Bharadwaj, David A Paul, Melissa A LoPresti, David N Korones, Howard J Silberstein","doi":"10.3171/2025.2.PEDS24426","DOIUrl":"https://doi.org/10.3171/2025.2.PEDS24426","url":null,"abstract":"<p><strong>Objective: </strong>Astroblastomas (ABs) are rare glial tumors categorized by MN1 gene alterations in the WHO 2021 CNS tumor guidelines. While previously reported primarily in cerebral hemispheres, there have been few reports regarding primary spinal ABs, and no established guidelines have been published on the management of these lesions. Here, the authors present an illustrative case with a systematic review exploring presenting characteristics, diagnosis, management, and outcomes of spinal AB.</p><p><strong>Methods: </strong>The patient's electronic medical record was retrospectively reviewed. Additionally, a systematic literature review was performed by searching the PubMed, Cochrane Library, Embase, and Web of Science databases for articles published through June 20, 2024, and all English-language articles describing patients with primary spinal AB were analyzed. Conference abstracts and articles describing secondary spinal AB or cerebral AB were excluded. Eleven previous cases of primary spinal AB were identified. Articles were screened by multiple reviewers to limit bias. For each case, clinical presentation, surgical pathology, molecular testing, treatment strategies, clinical course, and outcome were tabulated and compared.</p><p><strong>Results: </strong>A 6-year-old male presented with thoracic back pain and limp and was found to have a high-grade thoracic AB with EWSR1::BEND2 fusion, treated with resection and radiation therapy; he is clinically stable at 12 months of follow-up. A systematic review yielded 11 prior cases; patient ages ranged from 3 months to 36 years, with most cases being pediatric. Clinical presentations commonly featured back pain, motor weakness, and gait disturbances. All cases except one underwent resection. Common pathological findings included perivascular hyalinization, pseudorosettes, pseudopapillae, high cellularity, and positive staining for glial fibrillary acidic protein/epithelial membrane antigen/S100. Molecular testing showed direct MN1 alteration in 6 cases, while the remaining cases showed MN1 methylation, EWSR1::BEND2 fusion, and MAMLD1::BEND2 fusion. Eight patients underwent chemotherapy, and 7 underwent radiation therapy. Except for 2 reported deaths, most patients were alive at the last follow-up (range 1 month-15 years). Progression of spinal AB occurred in one-third (4/12) of cases.</p><p><strong>Conclusions: </strong>With the present report of a patient whose tumor exhibited EWSR1::BEND2 fusion, there are now 12 total reports in the literature of primary spinal AB. These cases span various pathological and molecular testing results, treatment strategies, and clinical courses. Given the diversity of current molecular signatures of spinal AB, this summative assessment of the current literature offers insights to inform guidelines for classifying AB and developing evidence-based treatment strategies going forward.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-9"},"PeriodicalIF":2.1,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated ventricular segmentation in pediatric hydrocephalus: how close are we?","authors":"Birra R Taha, Gaoxiang Luo, Anant Naik, Luke Sabal, Ju Sun, Robert A McGovern, Carolina Sandoval-Garcia, Daniel J Guillaume","doi":"10.3171/2025.2.PEDS24590","DOIUrl":"https://doi.org/10.3171/2025.2.PEDS24590","url":null,"abstract":"<p><strong>Objective: </strong>The explosive growth of available high-quality imaging data coupled with new progress in hardware capabilities has enabled a new era of unprecedented performance in brain segmentation tasks. Despite the explosion of new data released by consortiums and groups around the world, most published, closed, or openly available segmentation models have either a limited or an unknown role in pediatric brains. This study explores the utility of state-of-the-art automated ventricular segmentation tools applied to pediatric hydrocephalus. Two popular, fast, whole-brain segmentation tools were used (FastSurfer and QuickNAT) to automatically segment the lateral ventricles and evaluate their accuracy in children with hydrocephalus.</p><p><strong>Methods: </strong>Forty scans from 32 patients were included in this study. The patients underwent imaging at the University of Minnesota Medical Center or satellite clinics, were between 0 and 18 years old, had an ICD-10 diagnosis that included the word hydrocephalus, and had at least one T1-weighted pre- or postcontrast MPRAGE sequence. Patients with poor quality scans were excluded. Dice similarity coefficient (DSC) scores were used to compare segmentation outputs against manually segmented lateral ventricles.</p><p><strong>Results: </strong>Overall, both models performed poorly with DSCs of 0.61 for each segmentation tool. No statistically significant difference was noted between model performance (p = 0.86). Using a multivariate linear regression to examine factors associated with higher DSC performance, male gender (p = 0.66), presence of ventricular catheter (p = 0.72), and MRI magnet strength (p = 0.23) were not statistically significant factors. However, younger age (p = 0.03) and larger ventricular volumes (p = 0.01) were significantly associated with lower DSC values. A large-scale visualization of 196 scans in both models showed characteristic patterns of segmentation failure in larger ventricles.</p><p><strong>Conclusions: </strong>Significant gaps exist in current cutting-edge segmentation models when applied to pediatric hydrocephalus. Researchers will need to address these types of gaps in performance through thoughtful consideration of their training data before reaching the ultimate goal of clinical deployment.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-8"},"PeriodicalIF":2.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The incidence of subsequent high intracranial pressure in patients undergoing early, open, and wide strip craniectomy for sagittal synostosis.","authors":"Sapir Sadon, May Brami, Jonathan Roth, Anat Bachar Zipori, Margaret Ekstein, David Leshem, Shlomi Constantini","doi":"10.3171/2025.3.PEDS24651","DOIUrl":"https://doi.org/10.3171/2025.3.PEDS24651","url":null,"abstract":"<p><strong>Objective: </strong>Secondary bone closure following single-suture craniosynostosis (SSCS) correction has been previously reported. However, the incidence of such secondary closure, which leads to increased intracranial pressure (ICP), following strip craniectomy for sagittal synostosis (SS) has not been systematically described. The possibility of secondary closure must be taken into account when determining the optimal long-term follow-up regimen after the procedure. Secondary closure leading to high ICP can cause silent papilledema, optic atrophy, and even blindness. In this study, the authors investigated the long-term follow-up of children who underwent early, open, and wide strip craniectomy for SS. They analyzed the incidence of secondary closure that led to increased ICP and the subsequent need for surgical or medical intervention.</p><p><strong>Methods: </strong>This was a single-center, retrospective, observational study with a follow-up of 2 to 25 years (9.1 ± 6.2 years). The study cohort included 286 children who underwent strip craniectomy for SS at the age of 2-4 months.</p><p><strong>Results: </strong>Three of 286 patients developed papilledema with documented increased ICP (formal ICP monitoring for 3 days). Two of them required cranial vault expansion at the ages of 1.8 and 1.9 years. The third patient was diagnosed with papilledema and borderline high values of ICP at the age of 2.8 years. He was treated with acetazolamide, resulting in persistent normalization of his fundoscopic examination findings, even after the acetazolamide treatment was stopped (8 months).</p><p><strong>Conclusions: </strong>This study verifies that the incidence of secondary closure is very low following early, open, and wide strip craniectomy for SS. However, careful clinical and ophthalmological follow-up is advised during the first few years following surgery.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-5"},"PeriodicalIF":2.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical management of recurrent medulloblastoma: a scoping review.","authors":"Nathan Fredricks, Anthony Price, Soren Jonzzon, Preston D'Souza, John C Wellons, Vijay Ramaswamy, Michael C Dewan","doi":"10.3171/2025.2.PEDS2534","DOIUrl":"https://doi.org/10.3171/2025.2.PEDS2534","url":null,"abstract":"<p><strong>Objective: </strong>This scoping review aims to provide a comprehensive analysis of our current understanding of the role of neurosurgery in treating recurrent medulloblastoma in children. Focusing specifically on repeat resection and biopsy, this review offers insights into the existing strengths and weaknesses of the literature and explores future directions for the treatment of recurrent medulloblastoma cases.</p><p><strong>Methods: </strong>This review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews guidelines. The Ovid MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, and Cochrane databases were searched for terms regarding medulloblastoma, pediatric patients, and tumor subtypes.</p><p><strong>Results: </strong>A total of 2381 articles were retrieved from the database search along with an additional 7 studies from manual reference searching. After deduplication, 1347 articles were screened by title and abstract for inclusion and exclusion criteria. Full-text review was completed for 45 articles, and 21 were included in the final review. This review found limited evidence suggesting potential survival benefits of repeat resection in select cases, while the role of biopsy remains largely investigational.</p><p><strong>Conclusions: </strong>Despite significant scholarship on primary medulloblastoma, new approaches are urgently needed concerning surgical options for recurrence. More common interventions such as repeat resection are limited due to the metastatic propensity of medulloblastoma at relapse and the lack of information about the specific applications to tumor subtypes. Robust protocols and studies involving the utility of repeat biopsy at relapse for targeted therapy are lacking and further studies are required. The absence of studies evaluating the role of surgery revealed by this review highlights that to truly understand the biology of personalized approaches to recurrent medulloblastoma, it will be critical that neurosurgeons are intimately involved in these efforts.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-7"},"PeriodicalIF":2.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of left ventricular systolic dysfunction with outcome following pediatric traumatic brain injury.","authors":"Vanessa M Mazandi, Kaitlyn Boggs, Kumaran Senthil, Ellie D Gabriel, Nankee Kumar, Christie Glau, Adam S Himebauch, Chong-Tae Kim, Todd J Kilbaugh, Shih-Shan Lang, Thomas Conlon, Jimmy W Huh","doi":"10.3171/2025.3.PEDS24655","DOIUrl":"https://doi.org/10.3171/2025.3.PEDS24655","url":null,"abstract":"<p><strong>Objective: </strong>Traumatic brain injury (TBI) is one of the leading causes of morbidity and mortality in children. While left ventricular systolic dysfunction (LVSD) has been observed following TBI in adults, very little is known regarding it in the pediatric TBI population. The aim of this study was to evaluate the frequency and admission risk factors for systolic dysfunction following pediatric TBI. The authors hypothesized that systolic cardiac dysfunction would be associated with morbidity and mortality.</p><p><strong>Methods: </strong>This was a single-center retrospective observational study from a quaternary children's hospital. Pediatric patients with TBI who were younger than 18 years and had a transthoracic echocardiogram obtained by the pediatric cardiology team from January 2011 to December 2021 were evaluated. The primary outcome was in-hospital mortality. The secondary outcome was the Glasgow Outcome Scale-Extended (GOS-E) score at 6 months in survivors.</p><p><strong>Results: </strong>Of 1059 pediatric patients who presented with TBI, 70 had an echocardiogram, all of which were obtained within 72 hours of admission. LVSD on the echocardiogram was observed in 24 of 70 patients (34%). The mortality rate was 47% (33 of 70). Low admission Glasgow Coma Scale (GCS) score, abusive head trauma, and cardiac arrest were independent risk factors associated with a higher odds of LVSD on univariate analysis, while a low admission GCS score was also a risk factor on multivariate analysis (p < 0.05). Systolic cardiac dysfunction increased the odds for in-hospital mortality or worse outcome (low GOS-E score) in survivors at 6 months on univariate analysis (p < 0.05). When accounting for admission GCS scores, abusive head trauma, and cardiac arrest on multivariate analysis, LVSD did not have a significant association with mortality and morbidity.</p><p><strong>Conclusions: </strong>Nearly 35% of pediatric TBI patients who underwent transthoracic echocardiography were found to have LVSD within 72 hours of admission. Low admission GCS score, abusive head trauma, or cardiac arrest significantly increased the risk of LVSD on univariate analysis, while the GCS score was a risk factor on multivariate analysis. The presence of LVSD was associated with an increased risk of mortality and morbidity in survivors on univariate analysis. Future prospective studies are warranted to further characterize myocardial dysfunction in pediatric patients with TBI and determine whether earlier recognition and treatment might improve outcomes.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-7"},"PeriodicalIF":2.1,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrathecal baclofen pump versus combined dorsal/ventral rhizotomy for spastic quadriplegia: healthcare cost and complication analysis.","authors":"Emma Hartman, Marcella Ruppert-Gomez, Amanda Mosher, Kristin Buxton, Ann Morgan, Scellig Stone, Weston T Northam","doi":"10.3171/2025.2.PEDS24576","DOIUrl":"https://doi.org/10.3171/2025.2.PEDS24576","url":null,"abstract":"<p><strong>Objective: </strong>Combined dorsal/ventral rhizotomy (CDVR) has emerged as a tone management option for pediatric patients with cerebral palsy and medically refractory spasticity. However, its costs to the patient and the healthcare system compared with those of an intrathecal baclofen (ITB) pump are understudied. The authors aimed to evaluate ITB and CDVR with respect to healthcare cost, resource utilization, and clinical safety.</p><p><strong>Methods: </strong>The records for all pediatric patients who underwent ITB pump placement or CDVR at a single institution between 2003 and 2024 were retrospectively reviewed. Hospital and professional charge data, both inpatient and outpatient, as well as clinical data were collected and analyzed.</p><p><strong>Results: </strong>Seventeen patients underwent CDVR and 392 underwent ITB therapy. There were no clinically significant differences between the two treatment groups in terms of baseline demographics or Gross Motor Function Classification System level, preoperative risk factors, and comorbidities. None of the patients who had undergone CDVR experienced surgical site infection or CSF leakage, whereas 4.1% of patients in the ITB group had surgical site infection and 1.8% had CSF leakage. There were no differences (p ≥ 0.05) between the treatment groups in terms of mean hospital length of stay (6.5 days) and return to the emergency department or readmission within 30 days, although readmissions were longer in the ITB group (3 vs 0 median days). Accounting for professional and hospital charges for surgery, hospitalization, and follow-up care during the 1st postoperative year, patients in the CDVR group saved a median $7907 relative to those in the ITB group. Over a 10-year period, the projected differential would grow and ITB would ultimately be expected to be 4.6 times more expensive than CDVR, yielding a median cost differential of $182,432 per patient (p < 0.005). Additionally, CDVR, as compared to ITB, required less postoperative follow-up, averaging a projected decrease of 15 clinic visits per patient over 10 years, reducing hospital resource utilization, the burden on caregivers, and indirect costs to families associated with lost wages and transport to and from appointments.</p><p><strong>Conclusions: </strong>CDVR offers significantly decreased healthcare costs and resource utilization relative to ITB. CDVR has a comparable clinical safety and complication profile and deserves further study as an alternative to ITB.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-8"},"PeriodicalIF":2.1,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Poor surgical outcomes following Paenibacillus infant infectious hydrocephalus.","authors":"Jessica E Ericson, Davis Natukwatsa, Peter Ssenyonga, Justin Onen, John Mugamba, Ronald Mulondo, Sarah U Morton, Mercedeh Movassagh, Kelsey Templeton, Christine Hehnly, Edith Mbabazi-Kabachelor, Abhaya V Kulkarni, Benjamin C Warf, James R Broach, Joseph N Paulson, Steven J Schiff","doi":"10.3171/2025.1.PEDS24254","DOIUrl":"10.3171/2025.1.PEDS24254","url":null,"abstract":"<p><strong>Objective: </strong>The authors previously identified Paenibacillus species in the CSF of 44% of infants presenting for neurosurgical evaluation with findings consistent with postinfectious hydrocephalus (PIH) in Eastern Uganda. Here, they sought to compare outcomes among hydrocephalic infants with and without Paenibacillus detection at the time of hydrocephalus surgery.</p><p><strong>Methods: </strong>In a prospective observational study of 189 infants with PIH who underwent a CSF diversion prior to 90 days of age, 78 had a positive CSF polymerase chain reaction result for Paenibacillus species (PP), and 111 had a negative result (PN). The primary outcome was diversion failure-free survival, defined as being alive without diversion failure at last patient contact. Secondary outcomes included overall survival and diversion success.</p><p><strong>Results: </strong>After a median follow-up period of 35.7 months, the primary outcome was observed in 42 PP patients (54%) and in 76 PN patients (68%) (adjusted hazard ratio [aHR] 2.45, 95% CI 1.42-4.22; p = 0.001). PP patients who underwent endoscopic diversion had a worse primary event rate (aHR 6.47, 95% CI 2.40-17.42; p < 0.001). Death from any cause occurred in 16 PP patients (21%) and 9 PN patients (8%) (aHR 3.47, 95% CI 1.44-8.37; p = 0.006). Diversion failure occurred in 28 PP patients (36%) and 29 PN patients (26%) (aHR 2.24, 95% CI 1.31-3.85; p = 0.003).</p><p><strong>Conclusions: </strong>In this study, Paenibacillus detection in the CSF at the time of hydrocephalus surgery was associated with a significantly increased rate of the composite of diversion failure or death, death, and diversion failure, and was particularly increased for patients who had an endoscopic diversion.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-12"},"PeriodicalIF":2.1,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stereotactic laser ablation for pediatric central nervous system tumors: a systematic review and meta-analysis of the literature.","authors":"Sean O'Leary, Muhammad Ammar Haider, Nina Truong, Dhillon Advano, Sruja Arya, Sruthi Ranganathan, Abigail Jenkins, Preston D'Souza, Anant Naik, Peace Odiase, Umaru Barrie, Bruno P Braga, Angela V Price","doi":"10.3171/2025.1.PEDS24387","DOIUrl":"https://doi.org/10.3171/2025.1.PEDS24387","url":null,"abstract":"<p><strong>Objective: </strong>Stereotactic laser ablation (SLA) or laser interstitial thermal therapy (LITT) is an emerging alternative to conventional surgery for CNS tumors. Further characterization of its effectiveness and safety in the pediatric population is needed.</p><p><strong>Methods: </strong>A review was conducted according to PRISMA guidelines using the PubMed/MEDLINE, Scopus, Embase, Google Scholar, and Science Direct databases to investigate the effectiveness and safety in the use of LITT to treat pediatric CNS tumors in children.</p><p><strong>Results: </strong>A total of 24 articles met the inclusion criteria. From the 4 retrospective studies comprising 97 patients (mean age 11.4 years, 55.0% males in the pooled prevalence), the most common tumor types were pilocytic astrocytoma (31.5%) and subependymal giant cell astrocytoma (SEGA; 68.5%). Tumors were primarily located in the frontal lobe (29.7%) and thalamus (24.4%). Postoperative complications included transient neurological deficits in 12.1% and permanent deficits in 6.0% of patients. At a mean follow-up of 43.9 months, mass reduction was observed in 68.8% of patients and overall disease improvement in 91.9% of patients, and the mortality rate was 2.6%. From the 20 case reports/series involving 67 patients (mean age 10.8 ± 4.7 years, 52.2% males), the mean tumor size was 15.7 ± 8.7 cm3. Predominant tumor subtypes were pilocytic astrocytoma (29.9%) and SEGA (16.4%). Tumors were located in eloquent areas in 61.3% of cases, notably the thalamus (24.2%) and ventricular system (24.2%). Prior treatments included surgery (78.8%), chemotherapy (51.5%), and immunotherapy (27.3%). Key LITT parameters were duration (7.2 ± 8.8 minutes), dose (10.2 ± 2.4 W), and extent of tumor volume decrease (68.3% ± 30.4%). The most commonly used LITT system was Visualase (95.7%). Postoperative complications were reported in 26.9% of patients, including transient neurological deficits (55.6%), perilesional edema (22.2%), and hydrocephalus (22.2%). Hospital stays were ≤ 3 days in 92.7% of patients. Tumor size reduction was achieved in 86.7% of patients, and 78.9% experienced disease improvement. Comparative analysis showed that a greater extent of ablation was associated with a reduced need for secondary surgery (p = 0.038, OR 0.94) and improved disease outcomes (p = 0.023, OR 1.05). Longer LITT duration was significantly associated with postoperative complications (p = 0.050).</p><p><strong>Conclusions: </strong>LITT appears effective in reducing tumor size and improving disease outcomes in pediatric CNS tumors. The long-term effectiveness of LITT in pediatric brain tumors requires further randomized prospective investigation.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-14"},"PeriodicalIF":2.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal clinical and imaging analysis of hydrocephalus in a single-center study in 57 patients with mucopolysaccharidosis type IH (Hurler syndrome).","authors":"Shiwei Huang, David R Nascene, Ryan Shanley, Minsoo Choi, Troy C Lund, Ashish O Gupta, Paul J Orchard, Julie Eisengart, Daniel Guillaume, Carolina Sandoval-Garcia","doi":"10.3171/2025.2.PEDS24476","DOIUrl":"https://doi.org/10.3171/2025.2.PEDS24476","url":null,"abstract":"<p><strong>Objective: </strong>Hurler syndrome (mucopolysaccharidosis type IH [MPS IH]) is the most severe form of MPS type I. Hydrocephalus can be an early manifestation, but currently there are no established guidelines to monitor for its development or progression in these patients, either before or after treatment.</p><p><strong>Methods: </strong>In this retrospective study, the records of 57 patients with MPS IH who received a hematopoietic stem cell transplant at the University of Minnesota were reviewed, and 291 brain MRI studies were analyzed. Ventricular size over the years was measured using the fronto-occipital horn width ratio.</p><p><strong>Results: </strong>Fifty-seven patients were included in the analysis. Fifty-one patients without a shunt showed a decrease in ventricular size and eventual stability of ventricular size about 2 years after transplant. No new cases of hydrocephalus as part of the natural disease process requiring shunt placement were observed after transplant (0%, 95% CI 0%-5.8%).</p><p><strong>Conclusions: </strong>In patients without preexisting hydrocephalus, no new cases of hydrocephalus developed, and ventricular size stabilized within 2 years after transplant. The authors call into question the overall utility of serial brain MRI after transplant in patients with MPS IH.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-8"},"PeriodicalIF":2.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time-STAMP MRI of CSF motion for evaluation of Chiari malformation and endoscopic third ventriculostomy.","authors":"Madison E Gutierrez, Isabel Torres, Joseph Ha, Eamon K Doyle, Meghan Drastal, Jacob K Al-Husseini, Matthew Borzage, Tai-Wei Wu, Benita Tamrazi, Marvin Nelson, Shinya Yamada, J Gordon McComb, Stefan Blüml, Peter A Chiarelli","doi":"10.3171/2025.1.PEDS24526","DOIUrl":"https://doi.org/10.3171/2025.1.PEDS24526","url":null,"abstract":"<p><strong>Objective: </strong>Assessing abnormal CSF motion at the craniocervical junction (CCJ) and aqueduct of Sylvius (AS) can be clinically useful in the pediatric neurosurgical evaluation. Noninvasive monitoring of CSF flow at these locations can assist in determining the need for surgery or conservative management and in monitoring the outcomes of such interventions. In this retrospective study, the authors investigated the use of noninvasive time static tagging and monocontrast preservation (Time-STAMP) MRI as a diagnostic adjunct for neurosurgical evaluation at a high-volume pediatric institution.</p><p><strong>Methods: </strong>Radiology records were queried to identify Time-STAMP studies conducted from April 2014 to March 2023. Search parameters included patients who had undergone or were undergoing clinical assessment for Chiari decompression or endoscopic third ventriculostomy (ETV). An independent panel performed a quality review of the Time-STAMP studies to determine their interpretability. Patient records were then reviewed to determine the extent to which Time-STAMP scans contributed to clinical decision-making.</p><p><strong>Results: </strong>Screening of the radiology records yielded 175 patients with Time-STAMP studies, of whom 102 had been assessed for Chiari decompression and 73 for ETV. Among this group, 147 patients (84%) had interpretable Time-STAMP studies, which aided in the decision to clinically observe versus perform surgery in 130 of these patients (88%). The Time-STAMP interpretation was not contradicted by later follow-up studies in any of these patients.</p><p><strong>Conclusions: </strong>The authors found that the noninvasive Time-STAMP technique to visualize CSF motion at the CCJ or AS is helpful to the clinician in managing these conditions.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-9"},"PeriodicalIF":2.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}