Pediatric Neurosurgery最新文献

{"title":"Team building in Pediatric Neurosurgery.","authors":"Chima O Oluigbo, Albert Tu","doi":"10.1159/000552384","DOIUrl":"https://doi.org/10.1159/000552384","url":null,"abstract":"<p><p>: Background: Pediatric neurosurgery is practiced in a complex, demanding and high-stakes environment. Consequential and high-impact decisions are made while undertaking delicate operations on very young and vulnerable patients. Summary: The team dynamics in pediatric neurosurgery - how the team communicates, functions under stress, adapts and supports each member - is the prime determinant for success in this high-stakes milieu. Key messages: Building an effective team in pediatric neurosurgery requires focused vision and mission alignment, effective communication infrastructure, inspirational and transformative leadership as well as efficient mechanisms for conflict management, and burnout prevention.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":" ","pages":"1-8"},"PeriodicalIF":1.3,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum.","authors":"","doi":"10.1159/000551586","DOIUrl":"https://doi.org/10.1159/000551586","url":null,"abstract":"<p><p>The article \"Technical Neurosurgical Aspects of Pediatric Epilepsy Surgery Including Resections and Disconnections\" [Pediatr Neurosurg. 2025; https://doi.org/10.1159/000549430] by Botros et al. was published with the wrong open access license. The correct license of the article is CC-BY.The original article has been updated.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":" ","pages":"1"},"PeriodicalIF":1.3,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Striving for Meaning and Purpose in Mentoring.","authors":"Kimberly Hamilton, Renee Reynolds, Susan Durham","doi":"10.1159/000552004","DOIUrl":"https://doi.org/10.1159/000552004","url":null,"abstract":"<p><strong>Background: </strong>Mentorship is essential to neurosurgical training and career development, shaping technical ability, professional identity, and leadership capacity. Three pediatric neurosurgeons at different stages in their careers share their reflections on how mentoring gives them meaning and purpose.</p><p><strong>Summary: </strong>In early career, effective mentorship involves proactively seeking guidance, identifying multiple mentors for varied goals, and engaging actively in the relationship. Mid-career marks a shift toward providing mentorship, with emphasis on aligning roles with personal strengths, helping mentees define achievable goals, prioritizing quality interactions, and modeling resilience by sharing both successes and failures. Late career perspectives highlight mentorship as reciprocal and sustaining, offering enduring meaning and contributing to legacy through the growth of future neurosurgeons.</p><p><strong>Key messages: </strong>Mentorship is a dynamic, lifelong process that evolves with each career stage. It benefits both mentors and mentees, strengthens the neurosurgical community, and represents one of the most lasting contributions to the profession.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":" ","pages":"1-7"},"PeriodicalIF":1.3,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Meningiomas: Clinicopathological Spectrum, Long-Term Outcomes, and Recurrence Predictors.","authors":"Jeena Joseph, Swaminathan Ganesh, Krishnaprabhu Raju","doi":"10.1159/000551876","DOIUrl":"https://doi.org/10.1159/000551876","url":null,"abstract":"<p><p>Objective Pediatric meningiomas are rare tumors with clinical and biological features distinct from adult meningiomas. This study reviews a 20-year experience in managing pediatric meningiomas at a tertiary referral center, focusing on their clinical characteristics, pathological features, treatment outcomes, and prognostic factors. Methods A retrospective analysis of 47 pediatric patients (<18 years) diagnosed with meningiomas between January 2005 and December 2024 was performed. Data on demographics, clinical presentation, radiological features, tumor location, histopathology, extent of resection, adjuvant therapy, and outcomes were collected. Recurrence rate and event-free survival (EFS) were analyzed using Kaplan-Meier estimates, and predictors of recurrence were assessed with univariate and multivariate analyses. Results Pediatric cases accounted for 3.9% of all meningiomas treated during the study period (47/1194). The median age was 13 years (IQR, 10-15), with a slight female predominance (55.3%). Neurofibromatosis was present in 21% of patients. Most tumors were supratentorial (76.6%), and 19% were intraventricular. The mean tumor volume in the series was 61.4 ± 75.2 cm³. High-grade meningiomas (WHO grade II and III) comprised 61.7% of cases. Gross total resection was achieved in 82.9%, and 53.2% received adjuvant radiotherapy. At a median follow-up of 41 months (IQR, 20-74 months), recurrence occurred in 21.3% of patients. On multivariate analysis, higher MIB-1 labelling index and longer follow-up duration were independent predictors of recurrence. Conclusion Pediatric meningiomas, though rare, often display aggressive histopathology and a high risk of recurrence despite gross total resection. Multivariate analysis identified the MIB-1 labelling index and longer follow-up duration as independent predictors of recurrence, highlighting the importance of proliferative activity and extended surveillance in long-term disease control. These findings underscore the importance of biomarker-driven risk stratification and ongoing post-treatment monitoring in pediatric meningioma management.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":" ","pages":"1-19"},"PeriodicalIF":1.3,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selective Dorsal Rhizotomy in Children with Hereditary Spastic Paraplegia.","authors":"Amanda N Stanton, Nathan S Fredricks, Anthony M Price, George Koutsouras, Macey Martin, Heidi Chen, Alice P Lawrence, Elizabeth N Martin, Robert P Naftel","doi":"10.1159/000551915","DOIUrl":"https://doi.org/10.1159/000551915","url":null,"abstract":"<p><strong>Introduction: </strong>While Selective Dorsal Rhizotomy (SDR) improves spasticity, the benefit in hereditary spastic paraplegia (HSP) remains unclear. This study describes a single institution's outcomes and experience with SDR in children with HSP.</p><p><strong>Methods: </strong>We conducted a retrospective chart review of pediatric patients (≤18 years) with HSP who underwent SDR at Monroe Carell Jr. Children's Hospital between July 2013 and January 2024. Patients were evaluated with standardized assessments, including the Modified Ashworth Scale (MAS), Gross Motor Function Classification System (GMFCS), Gross Motor Function Measure-66 (GMFM-66), Manual Ability Classification System (MACS), Functional Mobility Scale (FMS), 10-Meter Walk Test (10MWT), Pediatric Balance Scale (PBS), and Pediatric Quality of Life (PedsQL) Cerebral Palsy Module.</p><p><strong>Results: </strong>Six patients (2 males, 4 females) aged 4-14 years underwent SDR, with median follow-up of 17.65 months (range 11.8-38.9). Our cohort had four ATL1 and two SPAST mutations. Five patients had uncomplicated HSP, while 1 had complicated HSP. A median of 60% of rootlets were cut bilaterally (range 56-63). No major surgical complications occurred. Median MAS decreased from 16 preoperatively to 0 postoperatively. GMFM-66 improved from 74.8 to 79.1. In FMS testing, three patients achieved independent ambulation across all surfaces. 10MWT times improved from a median of 5.6 to 4.7 seconds. MACS scores improved in one patient and were otherwise stable. Balance scores remained stable or improved. Absolute PedsQL scores improved in five patients, with pain and fatigue showing greatest reduction. At follow-up, only one patient required orthotic support, compared to four preoperatively Conclusion: SDR may offer marked reductions in spasticity, with associated improvements in ambulation, functional mobility, quality of life, and orthotic dependence. SDR was safe and well-tolerated. Larger studies are needed to confirm statistical significance, define long-term efficacy, and optimize patient selection.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":" ","pages":"1-16"},"PeriodicalIF":1.3,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147655270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gamma Knife Stereotactic Radiosurgery for Pediatric Meningiomas.","authors":"Regan M Shanahan, Chris Z Wei, Tracy Miller, Hansen Deng, Constantinos G Hadjipanayis, Ajay Niranjan, L Dade Lunsford","doi":"10.1159/000551777","DOIUrl":"https://doi.org/10.1159/000551777","url":null,"abstract":"<p><p>Objective Despite the generally benign and slow-growing nature of many adult meningiomas, meningiomas in pediatric patients often exhibit more aggressive behavior. Gamma Knife stereotactic radiosurgery (SRS) is a non-invasive modality that is widely used as either an initial upfront or adjuvant management for meningiomas. We reviewed our 35-year meningioma experience to assess its role in pediatric patients. Methods The authors reviewed the clinical and imaging data of 2,030 meningioma patients who underwent SRS between 1987 and 2022 at the University of Pittsburgh Medical Center (UPMC). We identified 9 patients <18 years (2 female; median age, 14.5 years). None of the patients had neurofibromatosis type 2. The neurological outcomes, overall survival, local tumor control, and development of adverse radiation effects were evaluated. Three patients received prior therapeutic radiation: one underwent prophylactic cranial irradiation for lymphoblastic leukemia, one received focal cranial irradiation for craniopharyngioma, and one underwent craniospinal irradiation for medulloblastoma. Seven patients had prior tumor resection, while two asymptomatic patients were diagnosed incidentally (one during craniopharyngioma surveillance imaging and the other after head trauma). The median cumulative tumor volume at SRS was 6.0 cc (range, 0.5 - 11.8 cc). The median margin dose prescribed was 14 Gy (range, 11 - 25 Gy). Results At last follow-up, 5 patients were alive. Four patients had died, two from progressive intracranial disease and two from unrelated medical causes. The median overall survival was 8.9 years (range 2.0 - 16.2 years). The median progression free survival was 8.2 years (range 1.1 - 13.4 years). Five patients experienced tumor progression at a median of 2.1 years (range, 1.1 - 13.4 years) after SRS. After local tumor progression, 2 patients received repeat SRS, and the remaining patients required additional surgery, fractionated external beam radiotherapy (EBRT), or chemotherapy. No patient developed adverse radiation effects, had malignant tumor transformation or developed other types of CNS malignancies. Conclusions Meningiomas are rare tumors in the pediatric age group and can exhibit aggressive behavior. Tumor control was achieved in 6 of 9 patients after one or more SRS procedures. SRS presents as a reasonable primary option or should be considered for early intervention after surgery. Patients and families should be counseled that multiple SRS sessions might be needed to achieve eventual tumor control.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":" ","pages":"1-18"},"PeriodicalIF":1.3,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147655338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age filtering bias in a retrospective study of pediatric hydrocephalus.","authors":"Joshua Wang","doi":"10.1159/000551837","DOIUrl":"https://doi.org/10.1159/000551837","url":null,"abstract":"","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":" ","pages":"1-6"},"PeriodicalIF":1.3,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Boundaries, Balance, and the Courage to Say No.","authors":"Zulma Tovar-Spinoza","doi":"10.1159/000550282","DOIUrl":"10.1159/000550282","url":null,"abstract":"<p><strong>Background: </strong>Burnout and overcommitment are increasingly recognized challenges in neurosurgery, particularly among women and underrepresented groups.</p><p><strong>Summary: </strong>This article reflects on professional lessons regarding the importance of boundaries, balance, and the courage to say no as essential components of wellness and sustainable careers in neurosurgery. The discussion highlights systemic pressures, gender disparities, and strategies for resilience.</p><p><strong>Key messages: </strong>Boundaries are safeguards, not barriers; saying no is an act of leadership; redefining success beyond volume metrics is critical for long-term wellness.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":" ","pages":"1-3"},"PeriodicalIF":1.3,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13008383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147504644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complex Type Split Cord Malformation: A Two-Center Study.","authors":"Pinar Aydin Ozturk, Harun Emre Sen, Abdurrahman Arpa, Muharrem Karatas, Baris Aslanoglu, Kamuran Aydin, Sezer Onur Gunara, Volkan Etus","doi":"10.1159/000551495","DOIUrl":"https://doi.org/10.1159/000551495","url":null,"abstract":"<p><strong>Introduction: </strong>Complex spinal dysraphism is the condition where multiple dysraphic pathologies are observed in the same patient. Complex type SCM is a compound dysraphic phenotype involving disruptions at multiple developmental stages, characterized by the co-occurrence of SCM and spina bifida aperta. This study aimed to understand the differences between complex SCMs from classical SCM cases in terms of embryological aspects, perioperative management, and follow-up.</p><p><strong>Results: </strong>The study included 44 patients who underwent surgery for complex SCM. Of the patients, 81.8% were operated on during the neonatal period in the same session with spina bifida aperta surgery. Surgery was planned for 11.4% of patients for follow-up purposes, and for 6.8% following detection of SCM on MRI performed due to gait disturbances. It was observed that 68.2% of patients were plegic/severely paretic, 22.7% had moderate paresis, and 9.1% had mild paresis/normally. Regarding the type of spina bifida aperta, 72.7% of patients had myelomeningocele, and 27.3% had myeloschisis. Type 1 SCM was detected in 79.5% of patients, Type 2 SCM in 13.6%, and Type 1.5 SCM in 6.8%. Additionally, 93.2% had tethered cord/thickened-fatty filum terminale, 90.9% had posterior fusion defects, 77.3% had hydrocephalus, 68.2% had kyphoscoliosis, 65.9% had Chiari malformation, 54.5% had syringomyelia, 45.5% had intracranial pathologies other than hydrocephalus, and 4.6% had lipoma.</p><p><strong>Conclusion: </strong>Complex SCMs should not be viewed solely as a spinal pathology; they should be evaluated multidisciplinarily in the perioperative period in terms of anomalies accompanying spina bifida aperta. In these cases are diagnosed at a younger age, the incidence of Type 1 SCM increases, while the frequency of occurrence in the lumbar region decreases and increases in the thoracic region. Furthermore, it has been determined that additional anomalies accompanying spina bifida aperta occur more frequently with complex SCMs.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":" ","pages":"1-12"},"PeriodicalIF":1.3,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147476375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Congenital Occipital Exostosis in the Pediatric Patient: Illustrative Case Report.","authors":"Olivia Patch, Evan Bowen, Tyler Giles, Kristin Weaver","doi":"10.1159/000551494","DOIUrl":"https://doi.org/10.1159/000551494","url":null,"abstract":"<p><p>Background The authors present a case of a 2-week-old male referred for neurosurgical evaluation after occipital bony prominences were detected on a postnatal exam. The patient was born full term via uncomplicated vaginal delivery and underwent a head ultrasound, which disclosed an occipital heterotopic ossification. Physical exam revealed dimpling bilaterally over bony prominences at the occiput. CT and MRI confirmed symmetric exostoses without clear intracranial involvement. However, fibrous adhesions were noted extending through the dermis, suggesting dermal involvement likely secondary to the bony changes, although no definitive sinus tracts were identified. The patient was monitored for the first year of life with no symptoms or developmental concerns. At follow up at 15 months of age, the bony prominences and overlying fat pad were noticeably enlarged, which prompted corrective surgery. The exostosis was excised to restore normal occipital contour, and excess fat and skin were removed. Pathology revealed cartilage, cortical and trabecular bone, hematopoiesis, and mild intramedullary fibrosis. The surgery was successful with no complications, and the patient had an uneventful recovery. Observations Postoperatively, the patient continues to meet developmental milestones without neurological deficits or complications. Lessons This case highlights the surgical management of an unusual occipital exostosis in an asymptomatic pediatric patient. It underscores the importance of individualized preoperative planning, comprehensive imaging, and ongoing clinical monitoring to assess changes over time.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":" ","pages":"1-12"},"PeriodicalIF":1.3,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147476359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}