Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery最新文献

{"title":"Placento-cerebral adhesion: a morphology-based classification derived from a case report and literature review.","authors":"Kacper Kroczek, Krzysztof Dymek, Monika Lewandowska, Michał Tuchalski, Katarzyna Lipa, Iwona Sadowska-Krawczenko, Przemysław Gałązka","doi":"10.1007/s00381-026-07478-4","DOIUrl":"10.1007/s00381-026-07478-4","url":null,"abstract":"<p><strong>Background: </strong>Placento-cerebral adhesion is an exceptionally rare congenital cranial anomaly with heterogeneous anatomy and inconsistent terminology. We report a neonate with vascularized placento-cerebral adhesion, review the published morphology, and propose a descriptive anatomical framework.</p><p><strong>Methods: </strong>Published human cases were reviewed for the configuration of the placental attachment, tissue continuity, vascular communication, associated anomalies, operative findings, and pathological features. Recurring observable patterns informed the proposed classification.</p><p><strong>Results: </strong>Three recognizable patterns were identified: Type I, a thin avascular fibrous ABS-like adhesion; Type II, direct placento-neural continuity without demonstrable vascular communication; and Type III, direct continuity with organized vessels. The present Type III lesion required neonatal microsurgical separation, vascular control, preservation of viable pia and venous drainage, and staged soft tissue reconstruction.</p><p><strong>Conclusions: </strong>The framework standardizes anatomical description and multidisciplinary communication. It is an expert-informed descriptive model, not a validated grading scale, and it should not be used to predict survival, cranial re-ossification, or long-term neurocognitive outcome. Additional cases and prolonged follow-up are required for validation.</p>","PeriodicalId":520587,"journal":{"name":"Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery","volume":"42 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13601088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149032935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative outcomes and risk stratification following pediatric arteriovenous malformation resection: an ACS NSQIP-P database analysis.","authors":"Omar I Sbaih, Shubhang Bhalla, Stefan T Prvulovic, Arun Patel, Christian Bowers","doi":"10.1007/s00381-026-07472-w","DOIUrl":"10.1007/s00381-026-07472-w","url":null,"abstract":"<p><strong>Purpose: </strong>To characterize the 30-day postoperative outcomes following craniotomy for AVM resection in pediatric patients and to elucidate independent predictors of adverse events using a large, multi-institutional database.</p><p><strong>Methods: </strong>We performed a retrospective analysis utilizing the National Surgical Quality Improvement Program-Pediatric (NSQIP-P) database (2015-2023). Pediatric patients undergoing AVM resection were identified using a combination of CPT codes and ICD codes. The primary outcomes comprised a composite of 30-day mortality, complications, unplanned reoperation, readmission, non-home discharge, and extended length of stay. Multivariable logistic regression (Wald test; p < 0.05) was employed to identify independent predictors.</p><p><strong>Results: </strong>Analysis of 930 pediatric patients (median age 12.1 years, IQR 9.0-14.0) revealed that 34.3% experienced adverse outcomes within 30 days postoperatively. The observed mortality rate was 0.6%. Emergent surgical intervention demonstrated the strongest association with adverse outcomes (OR 8.58; 95% CI 5.12-14.37; p < 0.001), followed by preoperative ventilator dependence (OR 30.92; 95% CI 11.09-86.26; p < 0.001) and oxygen support requirements (OR 18.88; 95% CI 7.40-48.19; p < 0.001). Each additional minute of operative time conferred increased risk (OR 1.002/min; 95% CI 1.001-1.003; p < 0.001). Notably, we identified significant racial disparities, with African American/Black patients demonstrating an increased risk (OR, 1.65; 95% CI, 1.07-2.53; p = 0.023), while Hispanic ethnicity was associated with reduced adverse outcomes (OR, 0.73; 95% CI 0.53-1.00; p = 0.047).</p><p><strong>Conclusion: </strong>These findings demonstrate that adverse outcomes following pediatric AVM resection are significantly influenced by surgical urgency, preoperative cardiopulmonary status, and operative complexity. The identification of potentially modifiable risk factors, particularly nutritional status and cardiopulmonary optimization, provides tangible targets for preoperative intervention. The observed racial disparities underscore the critical need for equitable, risk-stratified care paradigms in this vulnerable population.</p>","PeriodicalId":520587,"journal":{"name":"Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery","volume":"42 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149032878","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":"Nit2/ω-amidase as a potential non-invasive diagnostic marker for moyamoya disease.","authors":"Tyra Martinez, Julie Sesen, David Zurakowski, Shih-Shan Lang, Gregory Heuer, Alexander Tucker, Edward Smith, Aram Ghalali","doi":"10.1007/s00381-026-07471-x","DOIUrl":"10.1007/s00381-026-07471-x","url":null,"abstract":"<p><strong>Introduction: </strong>Moyamoya (MM) is a progressive arteriopathy of the internal carotid artery and its branches that can lead to stroke and can be treated with surgical revascularization. The enzyme Nit2/ω-amidase (NIT2) is involved in glutaminase II and methionine salvage pathways. Recent studies have shown correlations between these metabolic pathways and MM arteriopathy, specifically increases in L-methionine, NO metabolites, and homocysteine. Here, we present data demonstrating that elevated levels of NIT2 correlate with the presence of MM, suggesting that it may have potential utility as a non-invasive biomarker for this condition.</p><p><strong>Methods: </strong>Urine (n = 58) and blood plasma (n = 29) samples were collected from MM patients (aged 0-19) who were undergoing surgical revascularization and compared to samples collected from age- and sex-matched healthy controls (n = 23). The samples were then analyzed using Olink Explore 3072 proteomic proximity extension assays (PEA) to determine expression levels across ~ 3000 validated protein assays, revealing NIT2 as significantly elevated in MM patients compared to controls. We then conducted a secondary analysis of NIT2 using enzyme-linked immunosorbent assay (ELISA) for independent validation. Results were further analyzed for salient radiographic and clinical features, including Suzuki grade, bilateral vs. unilateral disease, radiographic stroke, and transient ischemic attack (TIA).</p><p><strong>Results: </strong>ANOVA analysis of the MM urine and plasma samples showed a statistically significant increase in Nit2/ω-amidase (NIT2) compared to the control samples, with MM patients exhibiting 1.6-2.3-fold increases in plasma expression (p = 0.04) and 4-11-fold increases in urinary expression (p ≤ 0.001). Higher levels of NIT2 in the urine were associated with moyamoya, bilateral disease, higher grade, stroke, and TIA.</p><p><strong>Conclusions: </strong>NIT2 levels are significantly elevated in MM patients compared to matched controls, and higher levels correlate with measures of more severe disease. These novel data, coupled with the association of this molecule with metabolic pathways impacted by MM, support further investigation into NIT2 as a putative biomarker for MM.</p>","PeriodicalId":520587,"journal":{"name":"Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery","volume":"42 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027412","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":"Global burden of moyamoya syndrome in pediatric sickle cell disease and implications for the neurosurgical workforce: a systematic review.","authors":"Joseline Haizel-Cobbina, Anne Heukwa-Tefoung, Soumya Pahari, Ikeoluwa Lagunju, Lori C Jordan, Philip Aldana, Michael C Dewan","doi":"10.1007/s00381-026-07475-7","DOIUrl":"10.1007/s00381-026-07475-7","url":null,"abstract":"<p><strong>Objective: </strong>The aims of the study were twofold: 1) quantify the global burden of pSCD|MMS, and 2) estimate the number of children who warrant specialist evaluation for possible surgical revascularization.</p><p><strong>Methods: </strong>A systematic review was conducted following PRISMA guidelines. Clinical data extracted included number of patients with pSCD, pSCD-MMS, and those who underwent surgical revascularization. Using weighted proportions and 2021 Institute for Health Metrics and Evaluation (IHME) global estimates for pSCD, for each WHO region we estimated the burden of pSCD|MMS, and the volume of pSCD|MMS patients who underwent surgical revascularization.</p><p><strong>Results: </strong>Of the 6,845 studies identified, 14 were included. Nine (64%) studies were from AMR, 2 (14%) studies from EMR, 1 study (7%) from EUR, 1 study (7%) from AFR, and 1 (7%) multicenter study from AMR and EUR. Of the 2045 pSCD patients between the ages of 1-21 years identified, 1.5% were diagnosed with pSCD|MMS. Of 279 pSCD|MMS patients, 49.8% underwent surgical revascularization. The projected number of pSCD|MMS cases worldwide was 36,587, equating to 18,219 potentially benefiting from surgical revascularization. Across WHO regions, the African region harbors the largest number of projected pSCD|MMS cases (32,189) including 16,030 candidates for surgical consideration. Projections should be interpreted cautiously given the limited number and geographic distribution of the available studies.</p><p><strong>Conclusion: </strong>The vast majority of pSCD and pSCD|MMS burden resides in Africa, wherein SCD-related infrastructure is often limited. Sufficient capacity building for diagnostic accuracy and screening coupled with maximal medical therapy for pSCD, and robust neurosurgical infrastructure is required to improve longitudinal SCD care, mitigate neurologic complications and enhance functional outcomes. Derived from a limited body of published literature, these estimates should be considered exploratory.</p>","PeriodicalId":520587,"journal":{"name":"Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery","volume":"42 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13597574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parental distress - a predictor of treatment adherence in pediatric neuroblastoma: a cross-sectional study of chinese families.","authors":"Panyi Yang, Zhiyin Li, Juanli Zhao, Li Ma, Seidu A Richard, Zhigang Lan","doi":"10.1007/s00381-026-07468-6","DOIUrl":"10.1007/s00381-026-07468-6","url":null,"abstract":"<p><strong>Objective: </strong>This cross-sectional study examined whether parental distress is associated with treatment adherence in children with neuroblastoma and identified specific parental psychological factors as independent risk markers for non-adherence.</p><p><strong>Methods: </strong>Three hundred fifty families from four tertiary medical centers in China were enrolled. Parents completed the Parenting Stress Index-Short Form (PSI-SF), Medication Adherence Rating Scale (MARS-5), Beck Depression Inventory-II (BDI-II), and Family Assessment Device-General Functioning (FAD-GF). Path analysis examined associations between parental distress, family functioning, disease risk, and treatment adherence. Common method bias was assessed using Harman's single-factor test. Sensitivity analyses examined MARS-5 cutoff robustness using median split and MARS-5 < 18 thresholds.</p><p><strong>Results: </strong>Parental distress was significantly associated with lower treatment adherence (beta = -0.35, p = 0.002). Family functioning was statistically consistent with partial mediation (indirect beta = -0.12, p = 0.003), though causal interpretation is precluded by the cross-sectional design. Paternal depressive symptoms emerged as the strongest independent risk marker for non-adherence (OR = 2.2, 95% CI 1.18-4.09, p = 0.013). Mothers reported significantly higher parenting stress than fathers (Bonferroni-corrected p < 0.008; Cohen's d = 0.37-0.62). Families with poor functioning were 2.8 times more likely to exhibit suboptimal adherence. Harman's single-factor test yielded 8 factors with eigenvalues > 1.0, with the first factor explaining 28.4% of total variance-below the 40% threshold indicative of substantial common method bias. Sensitivity analyses using alternative MARS-5 cutoffs confirmed the robustness of paternal depression and family functioning as predictors.</p><p><strong>Conclusions: </strong>Parental distress, particularly paternal depressive symptoms, represents a modifiable risk marker associated with treatment non-adherence. Screening for paternal psychological distress and family dysfunction may support treatment adherence in pediatric neuroblastoma. Given the cross-sectional design, these associations should be interpreted as concurrent rather than causal.</p>","PeriodicalId":520587,"journal":{"name":"Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery","volume":"42 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009678","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":"Conversion of a ventricular rickham reservoir to a subcutaneous chest port for repeated intraventricular enzyme replacement therapy: technical note and surgical considerations.","authors":"Mahie Gopalka, Samiya Manocha, Kathleen Romanski, Erin Hoeman, Scott Boop, Sandi K Lam","doi":"10.1007/s00381-026-07463-x","DOIUrl":"10.1007/s00381-026-07463-x","url":null,"abstract":"<p><p>Cerliponase alfa enzyme replacement therapy has transformed the management of neuronal ceroid lipofuscinosis type 2 (CLN2) disease but requires lifelong cerebrospinal fluid (CSF) access for repeated intraventricular infusions. Conventional scalp-based ventricular reservoirs are associated with complications including infection, mechanical deterioration, and device revision related to repeated puncture. Chest port-mediated ventricular access has emerged as a potential alternative; however, detailed operative descriptions remain limited. We describe operative considerations and stepwise technique for establishing ventricular access using a Rickham reservoir connected via shunt tubing to a subcutaneous chest port system for repeated intraventricular cerliponase alfa infusion. Illustrative clinical experience demonstrates durable long-term use of this configuration. Key technical elements include neuronavigation-guided ventricular catheter placement, creation of a subcutaneous or subfascial chest pocket depending on patient body habitus, incorporation of strain-relief loops to reduce catheter tension, and systematic testing of the completed construct. The resulting system allows reliable ventricular access via a chest port while preserving ventricular catheter integrity. Chest port-mediated ventricular access represents a feasible and durable strategy for long-term intraventricular therapy in CLN2 disease. Dissemination of operative technique may facilitate broader adoption and support reliable delivery of enzyme replacement therapy for patients requiring lifelong treatment.</p>","PeriodicalId":520587,"journal":{"name":"Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery","volume":"42 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative MRI in pediatric brain tumor surgery: Optimizing surgical decision-making and extent of resection.","authors":"Jennifer To, Timothy Müller, Oliver Bozinov, Luca Regli, Niklaus Krayenbühl, Julia Velz","doi":"10.1007/s00381-026-07456-w","DOIUrl":"10.1007/s00381-026-07456-w","url":null,"abstract":"<p><strong>Objective: </strong>To assess the impact of intraoperative MRI (ioMRI) on the extent of resection (EoR) in pediatric brain tumor surgery and evaluate the benefits and limitations of its routine implementation.</p><p><strong>Methods: </strong>Observational single-center study, including prospectively collected data of 118 ioMRI-guided intracranial tumor resections in 108 children that were performed at the University Hospital Zurich between May 2013 and October 2022. EoR was graded as gross total (GTR; no residual tumor), sub-total (STR; > 90% tumor resection), and partial resection (PR; < 90% tumor resection).</p><p><strong>Results: </strong>A total of 118 ioMRI-guided interventions were performed in 108 individual children aged ≤ 18 years. The intended EoR determined pre-operatively was GTR in 81 cases (68.6%), STR in 24 (20.3%), and PR in 13 (11.0%). IoMRI confirmed the intended EoR achieved in 78/118 procedures (66.1%), demonstrating GTR in 48 cases (40.7%), STR in 50 (42.4%), and PR in 20 (16.9%). In 48 cases (40.7%), ioMRI findings prompted further intraoperative evaluation; additional tumor resection was performed in 45 cases (93.8%), resulting in improved EoR. The final EoR distribution after ioMRI-guidance was 80 GTR (67.8%), 25 STR (21.2%), and 13 PR (11.0%), resulting in a rate of achieving the intended EoR in 99.2% of cases (117/118). Surgical site infections (SSI) occurred in 4 cases (3.4%).</p><p><strong>Conclusions: </strong>This study highlights the substantial impact of ioMRI in pediatric brain tumor surgery, demonstrating a high rate of surgical site reopening for residual tumor resection, which substantially improved the EoR and minimized the need for a second operation - without increasing SSI incidence.</p>","PeriodicalId":520587,"journal":{"name":"Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery","volume":"42 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13582089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disentangling income and geography in perceived barriers to pediatric hydrocephalus care.","authors":"Zain Ul Abideen, Syed Mehmood","doi":"10.1007/s00381-026-07465-9","DOIUrl":"10.1007/s00381-026-07465-9","url":null,"abstract":"","PeriodicalId":520587,"journal":{"name":"Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery","volume":"42 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148979331","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":"The role of tonsillar manipulation in posterior fossa decompression for Chiari I malformation: a 26-year institutional experience.","authors":"Kelsi M Chesney, Saige Teti, Jean-Paul Bryant, Kashayer Mozaffarai, Daniel D Donoho, Hasan R Syed, Chima Oluigbo, John S Myseros, Robert F Keating","doi":"10.1007/s00381-026-07451-1","DOIUrl":"10.1007/s00381-026-07451-1","url":null,"abstract":"<p><strong>Introduction: </strong>Despite many years of research and advanced technology aiding in the diagnosis and treatment of Chiari 1 malformation (CM1), ideal surgical techniques remain controversial. When duraplasty is necessary, tonsillar coagulation is often performed to restore cerebrospinal fluid (CSF) pathways, though its benefits are unclear. Extensive intradural manipulation may increase surgical risk and reoperation rates secondary to arachnoid adhesions. The objective of our study is to delineate whether tonsillar manipulation is safe and ultimately necessary for adequate posterior fossa decompression in CM1 surgery.</p><p><strong>Methods: </strong>A retrospective review of all patients who underwent initial posterior fossa decompression and duraplasty for CM1 at a single institution from 1997 to 2024 was performed with IRB approval. Fourth ventricular stents were excluded. Indications for surgery included intractable occipital headache, neurological deficits, and/or syringomyelia. Demographics, radiographic details, and surgical outcomes were compared between patients with (PFDD + TM) and without (PFDD) tonsillar manipulation.</p><p><strong>Results: </strong>A total of 151 patients met inclusion criteria, with 73% undergoing PFDD + TM and 27% undergoing PFDD alone. The only significant difference in baseline characteristics was extent of tonsillar herniation, with all patients with > 20 mm herniation undergoing PFDD + TM (p = 0.01). Attending surgeon preference was also significantly associated with surgical approach (p < 0.0001). Thirty-day complication rates were similar between groups (PFDD 29.3% vs. PFDD + TM 14.5%, p = 0.06). Over a mean follow-up of 49.8 months, reoperation rates were 7.3% in PFDD and 4.5% in PFDD + TM (p = 0.68). Symptomatic improvement occurred in > 70% of patients across all symptom categories without significant differences between surgical approaches, with syrinx improvement in 85.2% of PFDD and 75.8% of PFDD + TM patients (p = 0.51).</p><p><strong>Conclusion: </strong>There were no significant differences between CM1 patients that underwent duraplasty with or without tonsillar manipulation regarding complications, reoperations, or symptomatic outcomes. Thus, there is no significant advantage to performing tonsillar manipulation nor any meaningful disadvantage. Multi-institutional studies are needed to uncover potential statistical differences in outcomes that may identify a superior surgical technique, especially over longer periods of follow-up.</p>","PeriodicalId":520587,"journal":{"name":"Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery","volume":"42 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972972","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":"Anterior interosseous to extensor carpi radialis brevis nerve transfer for wrist extension in brachial plexus birth injury.","authors":"Alejandro J Friedman, Brian Pettitt, Megan Gotlieb-Horowitz, Lynn Ann Forrester, Steven M Koehler","doi":"10.1007/s00381-026-07460-0","DOIUrl":"10.1007/s00381-026-07460-0","url":null,"abstract":"<p><p>Brachial plexus birth injuries (BPBI) affecting the C5 to C8 nerve roots commonly impair wrist extension, making its restoration a key goal of reconstruction. However, children with persistent wrist extension paralysis have limited surgical options, particularly in the setting of extensive plexus injury. Notably, infants with C5-C8 injuries often lose wrist extension while preserving median nerve function due to intact T1 contributions. We report two infants in whom wrist extension was successfully restored using an anterior interosseous nerve-to-extensor carpi radialis brevis (AIN-ECRB) nerve transfer.</p>","PeriodicalId":520587,"journal":{"name":"Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery","volume":"42 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}