Archives of Pediatric Neurosurgery最新文献

{"title":"Posterior Fossa Tumors Special Edition. Celebrating 4 years!","authors":"Ricardo Santos De Oliveira, Matheus Ballestero","doi":"10.46900/apn.v5i3.223","DOIUrl":"https://doi.org/10.46900/apn.v5i3.223","url":null,"abstract":"Posterior fossa tumors account for approximately half of the central nervous system tumors in children. Major technological advances, mainly in the fields of molecular biology and neuroimaging, have modified their classification, leading to a more detailed description of these entities. Certain modifications in the general nomenclature introduced by the 2021 WHO classification of tumors of the CNS have an impact on how we approach the posterior fossa tumors described in this study. The focus of this annual special issue is posterior fossa tumors in children. There were several emerging technologies and approaches in the diagnosis and treatment of posterior fossa tumors in children. It's important to note that medical technology and research are continually evolving, so there may have been further advancements in this field since then. Here are some promising technologies and strategies that were being explored: Advanced Imaging Techniques: Functional MRI (fMRI): This technology helps in mapping the brain's functional areas, allowing surgeons to plan their approach more accurately and minimize damage to critical brain regions. Diffusion Tensor Imaging (DTI): DTI provides information on the brain's white matter tracts, aiding surgeons in preserving essential neural pathways during surgery. Spectroscopy: It helps in identifying tumor types and differentiating between tumor tissue and healthy brain tissue. Surgical Navigation Systems: The use of advanced navigation systems during surgery allows for precise tumor localization and safer tumor removal, minimizing damage to surrounding healthy tissue. Brain Ultrasound and iMRI: Some hospitals are equipped with iMRI suites that allow real-time imaging during surgery. Most common brain ultrasound helps a lot during the posterior fossa surgery and can use simultaneously with neuronavigation system. Minimally Invasive Techniques: Minimally invasive procedures, such as endoscopic surgery, are being explored for certain types of posterior fossa tumors. These techniques can reduce recovery times and complications. Intraoperative monitoring (IOM), also known as intraoperative neurophysiological monitoring (IONM), is a critical technique used during certain surgeries to monitor the nervous system's function in real-time. It helps surgeons and medical teams assess the integrity of neural structures, particularly the brain and spinal cord, during surgical procedures. Genomic and Molecular Analysis: Advances in genomic and molecular analysis of tumors can provide insights into the specific genetic mutations driving the tumor's growth. This information can help guide treatment decisions, including targeted therapies. Radiation Therapy Advancements: Techniques like proton therapy and stereotactic radiosurgery are being used to precisely target tumors while minimizing damage to surrounding healthy tissue, which is especially important in pediatric cases. Immunotherapy: Immunotherapy approaches, such as checkpoint inhib","PeriodicalId":491452,"journal":{"name":"Archives of Pediatric Neurosurgery","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135733606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on “Arachnoid cysts of the quadrigeminal cistern: Proposal of a therapeutic algorithm based on a systematic review of literature”","authors":"Luca Massimi","doi":"10.46900/apn.v5i3.198","DOIUrl":"https://doi.org/10.46900/apn.v5i3.198","url":null,"abstract":"Quadrigeminal plate arachnoid cysts (QACs) usually raise a great interest among neurosurgeons, especially those dealing with children, because of the peculiar location (midpoint of the intracranial space), the surrounding anatomy and the possible clinical implications (rich number of possible signs and symptoms, hydrocephalus).
 As for most of the other types of arachnoid cysts, QACs are treated by an endoscopic fenestration in many Centers since it is felt as the best approach to manage them and the associated hydrocephalus. However, according to the literature, there is not enough evidence to recommend this approach because of the rarity of QACs and, subsequently, the low number of dedicated studies. Actually, microsurgery and even shunt are still advocated as effective though burdened by a higher rate of complications [1].
 On these grounds, the review performed by Ferreira Furtado and coworkers provides a relevant update to increase the knowledge about QACs. First of all, a careful analysis of the anatomy of the quadrigeminal plate region, namely its anatomical limits and the differentiation of its arachnoid complex, allows to understand why ovoidal-shaped QACs mainly grow following an antero-posterior path without causing aqueduct compression while the globular-shaped ones mainly grow along a rostro-caudal axis resulting in aqueduct stenosis and hydrocephalus. These findings, which can be commonly found in the daily clinical practice, have important implications on the prognosis other than on the indications for surgery.
 Secondly, this review study further supports neuroendoscopy as the gold standard way to manage QACs. In the personal experience, a ventriculociststomy plus cisternostomy or ETV is realized whenever possible to increase the success of the endoscopic procedure, independently from the age of the patients [2-4]. Good results are reported even in infants old less than 6 month [5,6]. Actually, the risk of reoperation after neuroendoscopy for QACs is related only partially to the young age of children since it can result also from a misdiagnosed/not properly treated hydrocephalus [7].
 The proposed algorithm of treatment is shareable for several reasons: 1) It shows no need of surgical indications in asymptomatic cases with radiologically stable QACs. Indeed, the ovoidal-shaped cysts, in spite of an initial growth that can occur in the first months of life, tend to remain stable in size and asymptomatic; 2) It demonstrates the predominant role of neuroendoscopy in the management of QACs, especially when hydrocephalus is associated, by confirming its safety and effectiveness. Indeed, microsurgery maintains a role in selected case, that is when a reliable fenestration cannot be obtained through the endoscopic approach. Actually, due to the invasiveness of the supracerebellar infratentorial or the suboccipital transtentorial route, the routine use of microsurgery is discouraged [8]. Similarly, shunting procedures ","PeriodicalId":491452,"journal":{"name":"Archives of Pediatric Neurosurgery","volume":"64 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135204187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to “Commentary on “Arachnoid cysts of the quadrigeminal cistern: Proposal of a therapeutic algorithm based on a systematic review of literature””","authors":"Leopoldo Mandic Furtado","doi":"10.46900/apn.v5i3.222","DOIUrl":"https://doi.org/10.46900/apn.v5i3.222","url":null,"abstract":"Response to the letter Dear Dr. Luca Massimi Title: Response to the commentary regarding “Arachnoid cysts of the quadrigeminal cistern: Proposal of a therapeutic algorithm based on a systematic review of literature” by Ferreira Furtado et al. We appreciate your consideration of our manuscript and for sharing reviewer’s comments, which would add relevant information for the readers and enhance the discussion of this enthusiastic theme. Indeed, the quadrigeminal arachnoid cysts (QACs) are positioned on the core of encephalon and its management is challenging. Owing to this rarity, there is a paucity of evidence in the literature as well you postulated. We thank you for the comment regarding the shape of QACs and its relationship with the occurrence of aqueduct compression and an increased risk of developing hydrocephalus. In fact, a description of the anatomy of the quadrigeminal cistern allows the reader to understand the physiopathology of hydrocephalus and better surgical approaches. To our knowledge, further studies are required to investigate the variations in the shapes of QACs in order to quantify such risks. Moreover, we found that your experience of effectiveness is valid even in younger patients. Nevertheless, because of the incipient maturation aspects of cerebrospinal fluid pathway before sixth month, certain evidences of recurrence of QACs as per previous studies, and sufficient evidence to corroborate otherwise, the decision to consider age and the option of coagulation of choroid plexus is consistent with the large series of hydrocephalus treatment. [1] Choroid plexus coagulation in the context of QACs intends to increase the chance to control the hydrocephalus and reduce recurrence in this group of patients. Furthermore, to our knowledge, this proposed algorithm plays a role in compiling some findings and is limited due to the rarity of this disease. Therefore, we are aware that it will be required to contribute to this field of knowledge and further studies will help in achieving better evidences. Best regards Leopoldo M Furtado et al","PeriodicalId":491452,"journal":{"name":"Archives of Pediatric Neurosurgery","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135204185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Papilledema and Chiari I in childhood: case report","authors":"Jose Roberto Tude Melo, Leonardo Conrado Silva Lima, Igor Sandes Pessoa Da Silva","doi":"10.46900/apn.v5i3.199","DOIUrl":"https://doi.org/10.46900/apn.v5i3.199","url":null,"abstract":"Introduction: Chiari malformation type I (CM-I) is a condition characterized by an abnormal craniocervical transition whose main finding is cerebellar tonsillar ectopia of > 5 mm below the foramen magnum. The main clinical manifestations are occipital headache, truncal ataxia, corticospinal tract dysfunctions, and scoliosis.
 Objective: The scope of this article is to report a rare case of papilledema and visual impairment in a child diagnosed with CM-I.
 Methods/case presentation: Presentation of the case of an 8-year-old child with difficulty in performing school activities due to visual blurring in the 3 days prior to hospitalization. She was taken by her parents to the ophthalmologist who identified bilateral papilledema and was urgently referred to the pediatric emergency unit. She underwent magnetic resonance imaging of the brain and CM-I was identified. She underwent urgent surgical posterior cranial fossa decompression and progressed to complete visual improvement, confirmed by ophthalmological examination.
 Conclusion: Papilledema may be the initial clinical manifestation of CM-I in children and urgent surgical decompression of the posterior cranial fossa may prevent or even reverse the visual impairment.","PeriodicalId":491452,"journal":{"name":"Archives of Pediatric Neurosurgery","volume":"115 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136337182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Twenty Year review for Craniofacial Distraction in syndromic craniosynostosis","authors":"Ricardo Santos De Oliveira, Matheus Ballestero, Paulo Barrero Marques-Netto, André Andó","doi":"10.46900/apn.v5i2.179","DOIUrl":"https://doi.org/10.46900/apn.v5i2.179","url":null,"abstract":"Introduction: Craniosynostosis are cranial deformities resulting from the early closure of one or more sutures. Concomitant facial changes usually result from the involvement of multiple sutures, which may lead to restriction of cranial growth and brain expansion, ocular compression, and breathing difficulties. The distraction osteogenesis (DO)for frontofacial or posterior advancement have increased the safety of the procedure. The aim of this study was a critical evaluation of the use of DO in the surgical treatment of syndromic craniosynostoses, based on the experience of a single craniofacial team.
 Methods: Retrospective review of third six patients operated from 2003 to 2022 by the same craniofacial team.
 Results: 19 boys and 17 girls were operated, all with rigid distractors. Twenty-nine of them underwent monobloc frontofacial advancement. In seven patient a Le-Fort III/subcranial advancement was performed. A posterior craniofacial advancement was performed in 5. In 11 a fronto-orbital advancement was done in the first year of life. The mean age was 6.0 years (range, 6 months to 13 years). All patients presented with some degree of exorbitism, upper airway obstruction and signs of intracranial hypertension. Cerebrospinal fluid leakage was the most frequent complication (9 cases), pterygomaxillary disjunction was revised in 8, lateral rim orbital fracture in 3 cases, and 3 complication related to the device.
 Conclusions: The evolution of surgical techniques allowed DO with rigid distractors to be an important tool for treating the craniofacial issues related to syndromic craniosynostoses. The multidisciplinary team's learning curve is critical to reducing complications associated with osteogenic distraction.","PeriodicalId":491452,"journal":{"name":"Archives of Pediatric Neurosurgery","volume":"62 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136021900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acknowledgement to Editors and Scientific Referees 2022","authors":"Matheus Fernando Manzolli Ballestero, Alexandre Canheu, Aline Saré de Melo, Amanda Lopez, Artur Henrique Galvão Bruno Da Cunha, Bruno Fernandes, Carlos Eduardo Barros Jucá, Carlos Umberto Pereira, Cassio Raposo-Amaral, Clarissa Turrer, Daniel Giansante Abud, Emmanuel de Oliveira Sampaio Vasconcelos e Sá, Guilherme Podolsky-Gondim, Gustavo Sampaio, José Aloysio Da Costa Val Filho, José Roberto Tude, Leopoldo Mandic Furtado, Leyzeane Marques Do Nascimento, Linoel Valsechi, Luciano Furlanetti, Marcelo Volpon Santos, Marco Tulio Rezende, Marcius Benigno Marques Dos Santos, Marcos Devanir Silva Da Costa, Nelci Zanon, Patricia Dastoli, Paulo Ronaldo Jubé Ribeiro, Ricardo Santos De Oliveira, Ricardo de Amoreira Gepp, Sergio Cavalheiro, Simone Mendes Rogerio, Tatiana Protzenko Protzenko, Tiago Paiva Cavalcante, Vinícius Marques Carneiro","doi":"10.46900/apn.v5i1.183","DOIUrl":"https://doi.org/10.46900/apn.v5i1.183","url":null,"abstract":"A scientific journal’s greatest responsibility is to ensure that all contributions accepted for publications are rigorously but fairly reviewed. The Editor-in-Chief and Archives of Pediatric Neurosurgery gratefully acknowledge the qualified and regular collaboration of renowned medical doctors and scientists who kindly devoted their time to constructively review the submitted articles. Their expertise and invaluable assistance contributed to maintain a high scientific standard for APN. We are thus indebted to the Editorial Board members and the following experts who reviewed papers and completed the peer-reviewing process within 2022.","PeriodicalId":491452,"journal":{"name":"Archives of Pediatric Neurosurgery","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135062948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}