Journal of neurosurgery. Pediatrics最新文献

{"title":"Postconcussion physical activity frequency and plasma biomarker associations among adolescents.","authors":"Ross R Moseley, Mathew J Wingerson, Kelsie L Richardson, Katelyn D Hurlburt, Kaitlyn Warren, Julie C Wilson, William P Meehan, Rebekah Mannix, David R Howell","doi":"10.3171/2026.2.PEDS25624","DOIUrl":"10.3171/2026.2.PEDS25624","url":null,"abstract":"<p><strong>Objective: </strong>Existing studies have reported the utility of plasma biomarkers for concussion diagnosis and outcome prognostication. In parallel, physical activity (PA) after concussion is associated with better outcomes. Therefore, this study sought to investigate the association between PA frequency and plasma biomarker concentration levels following concussion.</p><p><strong>Methods: </strong>The authors performed a cross-sectional analysis of adolescents diagnosed and evaluated within 21 days of a concussion. Participants self-reported engagement in PA as well as PA frequency since injury and underwent venipuncture. To account for variability in evaluation time, PA frequency was calculated as the percentage of days between concussion and initial evaluation in which PA was reported. Plasma analysis assays included glial fibrillary acidic protein (GFAP), ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), total tau, and neurofilament light chain (NF-L).</p><p><strong>Results: </strong>A total of 57 adolescents participated, including 32 who reported participating in PA (mean age 15.9 [SD 1.7] years, 44% female, mean 13.0 [SD 3.8] days postinjury) and 25 who did not (mean age 15.5 [SD 1.4] years, 68% female, mean 10.6 [SD 3.6] days postinjury). Postconcussion PA frequency across the cohort was 29.3% (SD 23%, mean 3.6 [SD 3.0] days of PA since injury). A higher percentage of PA days postconcussion was associated with significantly lower levels of plasma GFAP (β = -0.52, 95% confidence interval [CI] -0.96 to -0.07; p = 0.02) and NF-L (β = -0.81, 95% CI -1.59 to -0.03; p = 0.04) after adjusting for age, sex, and symptom severity. Log-transformed coefficients indicated that for every 10% increase in the percentage of PA days since concussion, GFAP levels decreased by approximately 5.1% and NF-L levels decreased by approximately 7.9%.</p><p><strong>Conclusions: </strong>These results indicate that more frequent PA in the days after concussion was associated with decreased levels of two biomarkers, GFAP and NF-L. Given the relevance of plasma biomarkers as indicators of neurobiological cell damage and ongoing repair processes after concussion, these findings suggest that postconcussion PA is associated with improved biological as well as clinical recovery outcomes.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"370-377"},"PeriodicalIF":2.2,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148239537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heterogeneity of catheter insertion rates: an initial benchtop assessment of shunt catheter insertion for hydrocephalus.","authors":"Adam Menkara, Jeffrey Horbatiuk, James M Johnston, Anastasia Arynchyna-Smith, Taylor Brinkley, Andrew T Hale, Michael Joseph Feldman, Ricardo A Najera, Martina Gonzalez Gomez, Jeffrey P Blount, Carolyn A Harris","doi":"10.3171/2026.2.PEDS25395","DOIUrl":"10.3171/2026.2.PEDS25395","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to investigate hydrocephalus shunt insertion dynamics and variability across a group of clinicians using a polyvinyl alcohol (PVA)-Phytagel-based brain-mimicking model for ventricular catheter placement.</p><p><strong>Methods: </strong>The rate of catheter insertion through a simplified PVA-Phytagel-based brain mimic was assessed in a group of clinicians at an academic pediatric neurosurgery division. Lateral and longitudinal catheter position and motion throughout insertion depth were assessed and analyzed. Additionally, survey data were collected to better understand the intentionality and thought process underlying each surgeon's insertion approach.</p><p><strong>Results: </strong>A total of 57 insertions were collected across 19 participants, of whom 16 were neurosurgeons and included in the final analysis. Based on survey results, the authors found that there was a positive correlation between the surgeons' attempt to speed up at earlier anatomical landmarks (ependyma) and slow down at deeper anatomical landmarks (deeper ventricular levels) throughout the depth of insertion. However, in practice, there was no correlation between the intended insertion rate and the actual insertion rate of the surgeons. Additionally, the authors found a high degree of variability in both the longitudinal and lateral directions for both position and velocity, independent of trial number, individual surgeon, or insertion depth.</p><p><strong>Conclusions: </strong>In the brain mimic of compliant uniform hydrogel, the surgeon's insertion rate throughout insertion and across samples was found to not be uniform, with catheter insertion rates being highly heterogeneous and nonrepeatable. Analogous fields within the neural implant space have regulated output for both insertion rates and dynamics in order to optimize implant outcome and minimize neuroinflammatory response. The authors believe this study sets a precedent to begin exploration of hydrocephalic tissue response in vivo to differential longitudinal and lateral catheter velocities.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"341-351"},"PeriodicalIF":2.2,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13418182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148239511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seizure outcomes after laser interstitial thermal therapy for pediatric extratemporal lobe epilepsy.","authors":"Bryce S Owen, Amber L Gaulden, Torin Karsonovich, Hansel M Greiner, Ravindra Arya, James L Leach, Paul S Horn, Jesse Skoch, Francesco T Mangano","doi":"10.3171/2025.12.PEDS2553","DOIUrl":"10.3171/2025.12.PEDS2553","url":null,"abstract":"<p><strong>Objective: </strong>Approximately one-third of patients with epilepsy develop drug-resistant epilepsy (DRE). Extratemporal lobe epilepsy (ETLE) represents 30%-40% of focal epilepsy cases. ETLE poses significant challenges in localization and treatment because these patients often have diffuse and complex epileptogenic networks. Laser interstitial thermal therapy (LITT) has emerged as a minimally invasive alternative for localizable DRE, yet data for its use in the pediatric ETLE population remain limited. This study aimed to evaluate the safety and efficacy of LITT in pediatric ETLE and identify predictive factors for favorable seizure outcomes.</p><p><strong>Methods: </strong>This retrospective study reviewed pediatric patients who underwent LITT for ETLE at a single National Association of Epilepsy Centers level 4 epilepsy center from 2015 to 2023. Patients with prior LITT for temporal lobe epilepsy, hypothalamic hamartomas, or corpus callosotomies were excluded. Preoperative evaluations included noninvasive testing (e.g., video-EEG, MRI, PET, magnetoencephalography) and invasive monitoring with stereo-EEG. The primary study endpoints were 1) International League Against Epilepsy (ILAE) classification at 12 months after the index LITT or additional surgical intervention for the treatment of seizures, and 2) procedure-related complications. Secondary analyses examined imaging concordance with the final ablation location, total ablation volume, and perioperative metrics.</p><p><strong>Results: </strong>Twenty-nine patients underwent an index LITT procedure for ETLE. At 12 months, 14 patients (48.3%) achieved a good outcome (ILAE class 1-3), and 12 (41.4%) were seizure free (ILAE class 1). There were 6 patients (20.7%) who required additional surgery within 12 months. Concordant PET with the final LITT ablation volume independently predicted seizure outcome (p = 0.04). The total ablation volume ranged from 0.66 to 8.45 cm3, and was not statistically different between groups. In the perioperative period, 3 patients developed transient steroid-responsive LITT-related edema, while no permanent neurological deficits, hematomas, surgical site infections, or deaths occurred.</p><p><strong>Conclusions: </strong>This study demonstrated that LITT is a safe and effective treatment option for pediatric ETLE and may achieve acceptable rates of seizure freedom with a minimally invasive approach. Concordance between noninvasive imaging (particularly PET) with LITT targets was associated with favorable outcomes, underscoring the importance of thorough preoperative evaluations to determine appropriate ablation candidates. Future multicenter prospective studies are warranted to further refine patient selection criteria and optimize treatment paradigms.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"414-423"},"PeriodicalIF":2.2,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148239505","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":"Comparative sensitivity and specificity of change in third ventricular diameter or global ventricular change for detecting pediatric ventriculoperitoneal shunt malfunction: a 10-year retrospective cohort study.","authors":"Charlie Cho, Liam G Coulthard, Annabelle M Harbison, Norman Ma, Robert A J Campbell, Amelia J Jardim, Elena How, Michael J Stuart","doi":"10.3171/2026.2.PEDS25625","DOIUrl":"10.3171/2026.2.PEDS25625","url":null,"abstract":"<p><strong>Objective: </strong>Clinical features of shunt malfunction are often nonspecific and neuroimaging is a well-established aid in diagnosis. In practice, qualitative assessment of overall ventricular change guides management; however, change in third ventricular diameter (TVD) alone has been proposed as a low-complexity quantitative index of overall ventricular change. This study aimed to evaluate the diagnostic utility of change in TVD compared with global assessment of ventricular caliber change by a neurosurgeon in detecting shunt malfunction.</p><p><strong>Methods: </strong>A retrospective review of all pediatric ventricular shunt revisions performed at a single center (November 2014-September 2024) was conducted. TVDs were measured when the patient was last known well and on preoperative imaging. Quantitative change was compared to the overall impression of change in ventricular caliber by neurosurgeons for detecting shunt malfunction. Shunt malfunction was defined as the need to replace one or more shunt components at the time of surgery (diagnostic gold standard). Diagnostic performance was assessed using comparison of areas under the receiver operating characteristic (ROC) curve.</p><p><strong>Results: </strong>A total of 422 shunt revisions were performed during the study period, of which 315 (75%) were found to have shunt malfunction. ROC analysis utilizing a cutoff of ≥ 2-mm TVD increase detected shunt malfunction with 63% sensitivity and 58% specificity (area under the curve [AUC] 0.62, 95% CI 0.55-0.69; p < 0.001). Pragmatic refinement by restricting the cohort to the subset of 136 patients known to have a change in ventricular caliber at the time of previous shunt failure and selecting a ≥ 1-mm cutoff increased the discriminative power of change in TVD to 92% sensitivity and 21% specificity. In this restricted cohort, the overall assessment of ventricular change by neurosurgeons yielded 81% sensitivity and 62% specificity (AUC 0.72, 95% CI 0.59-0.84) and the AUC difference between the two techniques was not statistically significant (AUC difference 0.08, 95% CI -0.03 to 0.20; p = 0.16).</p><p><strong>Conclusions: </strong>In a pragmatically selected cohort, an increase ≥ 1 mm from baseline TVD alone provides sensitivity comparable to that of overall assessment of ventricular change by a neurosurgeon identifying shunt malfunction in a cohort undergoing shunt revision. This simple linear measurement could be integrated as a screening test in clinical, imaging, and/or AI algorithms to facilitate rapid recognition of pediatric shunt failure.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"326-334"},"PeriodicalIF":2.2,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148239524","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":"Editorial. Defining the role of LITT in pediatric extratemporal lobe epilepsy.","authors":"Gerald Grant, Bamidele Adebayo","doi":"10.3171/2026.2.PEDS25652","DOIUrl":"10.3171/2026.2.PEDS25652","url":null,"abstract":"","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"411-413"},"PeriodicalIF":2.2,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148239527","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":"Efficacy and safety profile of volume-staged stereotactic radiosurgery for ruptured, large pediatric arteriovenous malformations: a multicenter cohort analysis.","authors":"Yuki Shinya, Salem M Tos, Bardia Hajikarimloo, Georgios Mantziaris, Jason W Chan, Penny K Sneed, Michael W McDermott, Zachary A Seymour, Inga Grills, Ahmed M Nabeel, Wael A Reda, Sameh R Tawadros, Khaled Abdel Karim, Amr M N El-Shehaby, Reem Emad Eldin, Othman Bin-Alamer, L Dade Lunsford, Ajay Niranjan, Selcuk Peker, Yavuz Samanci, Cheng-Chia Lee, Huai-Che Yang, Darrah Sheehan, Kimball Sheehan, Roman Liscak, Tomas Chytka, Juan Alzate, Douglas Kondziolka, Ying Meng, Nuria Martinez Moreno, Roberto Martinez-Álvarez, David R Hallan, Chanju Fritch, Francis Jareczek, Bao Y Sciscent, David Mathieu, Louis Carrier, Ahmed Abdelsalam, Robert M Starke, Carolina Benjamin, Timoteo Almeida, Shakti Pratap Singh, Manjul Tripathi, Herwin Speckter, Erwin Lazo, Ching-Jen Chen, Yoshua Esquenazi, Andrea Becerril-Gaitan, Mark J Amsbaugh, Angel I Blanco, Rituraj Upadhyay, Joshua D Palmer, Andrea Franzini, Piero Picozzi, Luigi Alberto Andrea Lanterna, Greg N Bowden, Jennifer L Peterson, Veronica L Chiang, Stylianos Pikis, Zhiyuan Xu, Jason P Sheehan","doi":"10.3171/2026.1.PEDS25593","DOIUrl":"10.3171/2026.1.PEDS25593","url":null,"abstract":"<p><strong>Objective: </strong>Ruptured, large pediatric arteriovenous malformations (AVMs) pose a significant management challenge due to high rerupture risk and the morbidity of conventional treatments. Volume-staged stereotactic radiosurgery (VS-SRS) has emerged as an alternative; however, evidence for its use in this specific population is limited. This study aimed to evaluate the long-term efficacy and safety of VS-SRS for ruptured, large AVMs in a dedicated pediatric cohort.</p><p><strong>Methods: </strong>This international, multicenter, retrospective cohort study from 21 centers analyzed outcomes for 42 pediatric patients (age < 18 years) with previously ruptured, large AVMs treated with VS-SRS. The primary outcome was complete AVM obliteration, and secondary outcomes included post-SRS hemorrhage, radiation-induced changes (RICs), and favorable outcome. Favorable outcome in this study was defined as obliteration without post-SRS hemorrhage or permanent RIC.</p><p><strong>Results: </strong>At the initial SRS, the median patient age was 14.5 years, and the median AVM volume was 15.0 cm3; most AVMs were high grade (Spetzler-Martin grades IV and V). With a median follow-up of 41.5 months, complete AVM obliteration was achieved in 21 patients (50.0%). The cumulative obliteration rate was 37% at 5 years and 56% at 10 years. Patients with a nidus volume of ≤ 10 cm3 had significantly higher cumulative obliteration rates than those with a nidus volume > 10 cm3 (log-rank test, p = 0.021). Similarly, patients treated with a prescription dose > 17 Gy showed significantly higher cumulative obliteration rates compared to those treated with a dose ≤ 17 Gy (log-rank test, p = 0.012). The cumulative 5-year incidences of hemorrhage and RICs following VS-SRS were 19% and 7%, respectively. In multivariable analysis, only larger total AVM volume was an independent predictor of a lower likelihood of favorable outcome (hazard ratio 0.89, 95% CI 0.80-0.99; p = 0.036).</p><p><strong>Conclusions: </strong>In this multicenter pediatric cohort, VS-SRS for ruptured, large AVMs provides a reasonable chance of long-term obliteration, but generally acceptable risks of post-SRS hemorrhage and RICs exist. VS-SRS should be considered as an option for pediatric patients with large, ruptured AVMs.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"385-394"},"PeriodicalIF":2.2,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148239469","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":"Risk of mood, anxiety, and substance use disorders following adolescent traumatic brain injury: a retrospective cohort study.","authors":"Austin A Kennemer, Aritra Nag, Varun S Shah, Xiaofei Zhou","doi":"10.3171/2026.2.PEDS25597","DOIUrl":"10.3171/2026.2.PEDS25597","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to determine whether adolescent traumatic brain injury (TBI) is associated with long-term risk of depression, anxiety, suicide ideation, suicide attempt, and substance use disorders, and whether these risks differ by sex and injury severity.</p><p><strong>Methods: </strong>This retrospective cohort study used electronic health record data from January 1, 2000, to January 1, 2019, with a 5-year follow-up period. Data were obtained from the TriNetX platform, which aggregates deidentified information from 60 US healthcare organizations across all 50 states. A total of 262,262 adolescents aged 10-18 years diagnosed with mild or moderate to severe TBI were included. Cohorts were stratified by sex and TBI severity and matched to controls without TBI by race, socioeconomic factors, and prior psychiatric or head injury diagnoses. Exposures were defined by ICD-10 codes for TBI severity, and outcomes included incidence of depression, anxiety, alcohol dependence, nicotine dependence, suicide ideation, and suicide attempt within 5 years of TBI diagnosis.</p><p><strong>Results: </strong>Among 262,262 adolescents with TBI (154,149 male and 108,113 female), mild TBI was associated with increased risk of depression, anxiety, suicide ideation, suicide attempt, alcohol dependence, and nicotine dependence in both males and females compared with matched controls. Females with mild TBI had a higher risk of mood disorders and suicidality, whereas males had higher risk of substance use. Moderate to severe TBI was not associated with higher risk for these disorders compared with mild TBI.</p><p><strong>Conclusions: </strong>Adolescent TBI, regardless of severity, was associated with increased risk of psychiatric disorders and substance use, with females showing greater vulnerability to mood disorders and suicidality.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"378-384"},"PeriodicalIF":2.2,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148239489","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":"Systematic review of diffusion tensor imaging in spina bifida myelomeningocele: clinical implications in the era of prenatal repair.","authors":"Kellen Gandy, Heidi Castillo, Romain Corroenne, William E Whitehead, Arnett Klugh, Michael Belfort, Magdalena Sanz Cortes, Thierry A G M Huisman, Jonathan Castillo","doi":"10.3171/2025.12.PEDS25516","DOIUrl":"10.3171/2025.12.PEDS25516","url":null,"abstract":"<p><strong>Objective: </strong>Spina bifida myelomeningocele (SBM) is a neural tube defect associated with altered brain development and impaired cognitive function. Structural brain abnormalities in SBM are well documented but less is known about potential white matter abnormalities. Diffusion tensor imaging (DTI) is a unique MRI technique able to evaluate the integrity of brain microstructure. The primary objectives of this systematic review were to describe the utility of MRI/DTI and discuss the neuroanatomical and neuropsychological effects of affected tracts, as well as the potential clinical implications in SBM care.</p><p><strong>Methods: </strong>A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The inclusion criteria required that the studies 1) included patients with SBM who had undergone pre- or postnatal repair, and 2) reported DTI metrics for the brain in postnatal imaging studies.</p><p><strong>Results: </strong>Nineteen articles met the designated eligibility criteria. Abnormal microstructural anomalies were detected in the corpus callosum (n = 8), limbic fiber tracts (n = 4), tectocortical pathways (n = 4), and caudate putamen tract (n = 3). Disruptions were also noted in the middle cerebellar peduncle (n = 2), interhemispheric temporal tracts (n = 2), internal capsule (n = 2), inferior longitudinal fasciculus (n = 2), arcuate fasciculus (n = 1), inferior fronto-occipital fasciculus (n = 1), uncinate fasciculus (n = 1), and thalamotemporal tract (n = 1).</p><p><strong>Conclusions: </strong>SBM is associated with white matter brain abnormalities that have the potential to impact cognitive functioning (e.g., self-management skills) and related clinician recommendations. The detection of white matter microstructural injury in SBM may be useful to improve point-of-care recommendations and family education. Systematic review registration no.: CRD420251252084 (PROSPERO).</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"279-289"},"PeriodicalIF":2.2,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148175720","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":"Editorial. Advances in diffusion tensor imaging and its clinical implications for patients with spina bifida.","authors":"Mari L Groves, Jennifer M Strahle","doi":"10.3171/2026.1.PEDS25670","DOIUrl":"10.3171/2026.1.PEDS25670","url":null,"abstract":"","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"277-278"},"PeriodicalIF":2.2,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148175750","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":"Evaluating rapid spine MRI in pediatric imaging: utility, outcomes, and patient selection.","authors":"Megan D Malueg, Mathias Tevendale, Isabelle G Stockman, Shashwat Shah, Sanjida Riea, Luke J Hobika, Gaitree R Boojraj, Spencer D Maranto, Mohamed A R Soliman, Asham Khan, Veetai Li, Renée M Reynolds","doi":"10.3171/2026.1.PEDS25429","DOIUrl":"10.3171/2026.1.PEDS25429","url":null,"abstract":"<p><strong>Objective: </strong>Rapid spine MRI offers a sedation-free alternative for pediatric imaging, minimizing the risks associated with sedation for diagnostic imaging of suspected spinal anomalies. This study was designed to evaluate the clinical utility of this modality through analysis of imaging outcomes and patient selection to inform its integration into pediatric imaging protocols.</p><p><strong>Methods: </strong>In this retrospective study, the authors reviewed chart data from pediatric patients diagnosed with congenital malformations of the spine, spinal cord, or both between January 1, 2014, and October 25, 2024, who were under 18 years of age and had undergone at least one rapid or one regular MRI evaluation. Variables included were demographic characteristics, conversion from rapid MRI to regular MRI, need for further imaging, and clinical outcomes. Analyses included the t-test, chi-square test, and logistic regression with variance inflation factor adjustment to identify predictors of outcomes.</p><p><strong>Results: </strong>Among 788 patients, 151 underwent initial rapid MRI and 637 underwent initial regular MRI. Patients who received rapid MRI were younger (43.7 ± 67.9 months vs 56.5 ± 97.7 months, p = 0.001) and had longer hospital stays after surgery (9.02 ± 23.73 days vs 3.56 ± 8.62 days, p = 0.002). On multivariate regression analysis, significant positive predictors of conversion to regular MRI or need for further imaging included lower body mass index (BMI) (β = -0.255, p = 0.002), developmental delays (β = 1.772, p < 0.001), and leg weakness (β = 1.789, p = 0.036). Rapid MRI patients required more further imaging (β = 1.680, p < 0.001) but fewer surgical interventions (β = -1.393, p < 0.001). There was no significant difference between rates of conversion to rapid MRI or return to regular MRI.</p><p><strong>Conclusions: </strong>Rapid MRI is a valuable alternative to conventional MRI in pediatric neurosurgery, particularly for patients in whom sedation poses an elevated risk. In this cohort, lower BMI, leg weakness, and developmental delays were predictors of the need for further imaging. These findings support the targeted use of rapid MRI in select pediatric populations for whom further imaging would not be necessary in order to reduce sedation exposure during first-line imaging.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"232-241"},"PeriodicalIF":2.2,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148175746","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}