Pediatric Neurosurgery最新文献

{"title":"Predicting Pathology by Location: Mapping of 180 Pediatric Cranial Inclusion Cysts.","authors":"Olga Sergeenko, David Leshem, Shlomi Constantini, Jonathan Roth","doi":"10.1159/pne/aeiag008","DOIUrl":"https://doi.org/10.1159/pne/aeiag008","url":null,"abstract":"<p><strong>Introduction: </strong>This study investigates the hypothesis that anatomical localization on the cranium dictates the internal composition of pediatric inclusion cysts, statistically mapping how specific scalp positions predispose lesions to distinct contents such as fluid or hair.</p><p><strong>Methods: </strong>A retrospective study of 180 pediatric patients who underwent surgical treatment for cranial inclusion cysts was performed. Demographic data, lesion localization, imaging findings, intraoperative characteristics, and histopathological results were analyzed.</p><p><strong>Results: </strong>Median age at surgery was 13 months (range 2-217 months), with equal sex distribution. Most lesions were laterally located (69%) near fusion zones, with frontal localization predominating (77%). Periorbital lesions represented the most common subtype. Bony involvement was identified in 75% of cases; however, no lesions demonstrated intradural extension. Anterior fontanelle midline lesions demonstrated strong positive associations with fluid content (OR 24.2, p < 0.001) and occipital with hair elements (OR 18.1, p < 0.001).</p><p><strong>Conclusions: </strong>Pediatric cranial inclusion cysts demonstrate distinct anatomical and radiological patterns associated with cyst content and histopathological subtype. Midline lesions, particularly anterior fontanelle cysts, are more likely to contain fluid. Occipital cysts are more likely to contain hair elements. Despite frequent bony involvement, intradural extension was not identified in this cohort.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":" ","pages":"1"},"PeriodicalIF":1.3,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148899","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":"A Bump in the Night: A Case Report of Pediatric Epidural Hematoma Secondary to Sinus Pericranii.","authors":"Pallavi Sai Kapilavaih, Naina Gross, Joanna Gernsback","doi":"10.1159/pne/aeiag006","DOIUrl":"https://doi.org/10.1159/pne/aeiag006","url":null,"abstract":"<p><p>A sinus pericranii (SP) is a rare transcranial vascular malformation caused by diploic emissary veins forming an irregular connection between a dural sinus and extracranial veins. It is generally considered a benign condition with few complications1. We report the case of a 5-year-old male patient who sustained a skull fracture from head trauma with development of an epidural hematoma that was traced to an underlying ruptured SP as the source. Non-contrast computer tomography (CT) confirmed epidural hematoma. Craniotomy for evacuation revealed an emissary venous connection along the skull fracture line consistent with an SP that had ruptured. The anomalous venous channel was ligated, and the hematoma was evacuated, with good recovery. To the authors' knowledge this case represents the only instance of a SP associated with intracranial hematoma In pediatric patients presenting with post traumatic epidural hematoma, especially where the bleeding source is uncertain or non arterial, undiagnosed venous malformations such as SP should be considered. Preoperative vascular imaging and intraoperative awareness of this possibility may be important.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":" ","pages":"1"},"PeriodicalIF":1.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129168","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":"Integration of S100B and GFAP with the PECARN Rule for CT Decision-Making in Pediatric Mild Traumatic Brain Injury: A Preliminary Study.","authors":"Ömer Yilmaz Ulutas, Ahmed Yasin Yavuz, Adem Karbuz","doi":"10.1159/pne/aeiag007","DOIUrl":"https://doi.org/10.1159/pne/aeiag007","url":null,"abstract":"<p><strong>Objective: </strong>Many mild traumatic brain injury (TBI) cases may not exhibit overt clinical symptoms; however, they still carry a risk of significant intracranial injury and even mortality. While brain computed tomography (CT) is the gold standard for diagnosis, minimizing radiation exposure in children is critical. This study aimed to evaluate whether integrating the PECARN rule with serum biomarkers S100B and glial fibrillary acidic protein (GFAP) could reduce unnecessary CT scans and improve the prediction of TBI in pediatric patients.</p><p><strong>Methods: </strong>This prospective study included 88 patients with isolated mild head trauma (presenting within three hours) and 88 healthy controls. Patients were evaluated using the PECARN rule, and serum S100B and GFAP levels were measured via ELISA. Receiver operating characteristic (ROC) curve analysis was used to determine diagnostic performance, reporting sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>The PECARN algorithm demonstrated 100.0% sensitivity but only 17.9% specificity for predicting abnormal CT findings. The median serum S100B protein level in the patient group was 407.6 ng/L (range: 109.5-12668.3), while the median GFAP level was 18.5 pg/mL (range: 5.2-112.0). Notably, patients with positive CT findings had significantly elevated median S100B (7261.6 ng/L vs. 383.4 ng/L; p<0.001) and GFAP levels (86.0 pg/mL vs. 17.5 pg/mL; p<0.001) compared to those with negative scans. Median S100B and GFAP levels were significantly higher in the patient group [407.6 ng/L (109.5-12668.3) and 18.5 pg/mL (5.2-112.0), respectively] compared to healthy controls [324.7 ng/L (148.5-1733.7) and 13.0 pg/mL (4.4-32.8)] (p=0.006 and p<0.001, respectively). Using optimized cutoff values (2667.14 ng/L for S100B and 61.1 pg/mL for GFAP), both biomarkers achieved high diagnostic accuracy.</p><p><strong>Conclusions: </strong>Our preliminary findings suggest that the addition of S100B and GFAP to the PECARN algorithm could refine CT decision-making in pediatric mild TBI. Within the PECARN intermediate-to-high risk subgroup, serum S100B levels below 2667.14 ng/L and GFAP levels below 61.1 pg/mL may identify patients in whom CT could potentially be deferred. However, larger cohort studies are required to validate these high cutoff thresholds and mitigate potential overfitting.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":" ","pages":"1"},"PeriodicalIF":1.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149771","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":"Impact of Surgical Resection on Tumor Growth Dynamics in Pediatric Pilocytic Astrocytomas.","authors":"Daute De Brucker, Nele Herregods, Simon Hautekeete, Louise Clabau, Leen Willems, Edward Baert, Jelle Vandersteene","doi":"10.1159/pne/aeiag005","DOIUrl":"https://doi.org/10.1159/pne/aeiag005","url":null,"abstract":"<p><p>INTRODUCTION Pilocytic astrocytoma (PA) is the most common pediatric brain tumor and generally exhibits slow growth and favorable outcomes. However, postoperative growth behavior of residual or recurrent tumors remains variable and not well quantified. This retrospective study aims to quantify the tumor growth velocity (TGV) of PAs in a pediatric population and estimate the influence of surgery on these values. We also aimed to determine the impact of absolute and relative measurements on these conclusions. METHODS Only pediatric patients with a histopathologically confirmed diagnosis of PA and with at least two consecutive MRI scans performed at an interval of at least 3 months were included in this study. Patients were excluded if the quality of their imaging data was poor or if additional treatments (e.g. chemotherapy or radiotherapy) were administered. Absence of residual tumor was an exclusion criterion, as visual tumor is necessary for the calculation of growth velocity. Thus, patients who underwent gross total resection (GTR) could be included in the preoperative cohort, but were excluded for the postoperative timepoints. Tumor sizes were measured on T1+Gd MRI images, using 3D Slicer software. Absolute (ATGV) and relative (RTGV) growth velocity were calculated between scans. ATGV was expressed as ml/day, RTGV as percentage of total tumor volume per day. Kruskal-Wallis and Wilcoxon signed-rank tests were used to compare TGV across three timepoints: before surgery, after the first surgery, and after the second surgery. RESULTS MRI scans of 37 patients were analyzed. Not every patient had data available for every timepoint (some had only 1 pre-operative scan, others had no postoperative follow-up scans). In the subgroup of 14 patients with data available for at least two timepoints , ATGV significantly decreased between the post-first-surgery and post-second-surgery periods (p = 0.047). RTGV demonstrated a near-significant decline (p = 0.084). In the total cohort, a decreasing trend in relative TGV was noted between the post-first-surgery and post-second-surgery periods, but without statistical significance (p = 0.095). Intra-patient analyses showed a consistent decrease in TGV after surgery. Spearman correlation showed volume dependency of ATGV, but not of RTGV. CONCLUSION Reduced TGV was observed after surgical resection, with the most pronounced decreases observed after a second resection in patients with longitudinal follow-up. The parallel findings for absolute and relative growth velocity suggest that this effect may not be explained solely by tumor volume reduction. These findings should be considered hypothesis-generating and require confirmation in larger prospective studies.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":" ","pages":"1"},"PeriodicalIF":1.3,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149066118","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":"Minimally Invasive Strip Craniectomy-Extended (MIS-E): A Technical Modification for Treatment of Sagittal Craniosynostosis.","authors":"Evan Welliver, Aylin Padir, Joshua Stone, Izabela Tarasiewicz","doi":"10.1159/pne/aeiag004","DOIUrl":"https://doi.org/10.1159/pne/aeiag004","url":null,"abstract":"<p><strong>Introduction: </strong>Treatment of sagittal craniosynostosis is achieved with a combination of surgery with or without helmet therapy, and a variety of surgical techniques have been described. Our institution utilizes early surgical correction, when possible, with a modified technique, the Minimally Invasive Strip Craniectomy-Extended (MIS-E) followed by strict post-operative orthotic treatment to achieve maximum correction.</p><p><strong>Methods: </strong>The modified approach emphasizes creation of enlarged anterior and posterior fontanelles to correct bossing, and a goal of 5 cm wide strip craniectomy with 2 cm wide at the base wedge ostectomies aiming towards the squamosal suture. Patients are then prescribed a cranial orthosis to be worn 23 hours per day for 12 months to achieve and maintain a normocephalic shape with a goal of a Cephalic Index of 0.8. Retrospective analysis was performed on 18 non-syndromic sagittal craniosynostosis patients treated from 2021-2025, assessing surgical metrics and morphologic outcomes using the cephalic index (CI).</p><p><strong>Results: </strong>The mean cephalic index increased from .726 to .807 by 3 months, .815 at 6 months, and .820 at 12 months (N=17). 13/18 patients (72%) received a transfusion during their hospital stay. Average width of strip craniectomy was 5 cm.</p><p><strong>Conclusion: </strong>MIS-E appears to be an effective procedure to rapidly correct sagittal craniosynostosis. At our institution, improved standardization of intraoperative transfusion protocols is needed to better determine the need for transfusions in patients treated with this technique. Assessment of sustained correction following helmet therapy is needed to further assess its long-term efficacy.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":" ","pages":"1"},"PeriodicalIF":1.3,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026646","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":"H3K27M-Mutant Diffuse Leptomeningeal Glioneuronal Tumor Presenting as Communicating Hydrocephalus: Case Report and Literature Review.","authors":"Ashok Narendrakumar, Sandeep Mishra, Amandeep Kumar, Kanwaljeet Garg, Ajay Garg, Mehar Chand Sharma","doi":"10.1159/pne/aeiag003","DOIUrl":"10.1159/pne/aeiag003","url":null,"abstract":"<p><strong>Introduction: </strong>Diffuse leptomeningeal glioneuronal tumor (DLGNT) with H3K27M mutation is a rare and potentially fatal condition, with only a few cases reported in the literature. We present an unusual case of DLGNT presenting with communicating hydrocephalus secondary to leptomeningeal spread, initially misdiagnosed as idiopathic intracranial hypertension (IIH), with coexisting BRAF-KIAA1549 fusion and H3K27M mutation.</p><p><strong>Case presentation: </strong>An 11-year-old boy presented with progressive, painless bilateral vision loss. Initial neuroimaging findings were misinterpreted as IIH, and a programmable ventriculoperitoneal shunt was placed. However, the underlying communicating hydrocephalus was secondary to leptomeningeal spread of DLGNT. Three months later, the patient developed lower limb weakness, and repeat imaging revealed diffuse leptomeningeal disease with spinal involvement. Histopathology and molecular testing confirmed DLGNT harboring both H3K27M mutation and BRAF-KIAA1549 fusion. Despite planned multimodal therapy, the patient experienced rapid neurological deterioration and died 4 months after diagnosis.</p><p><strong>Conclusion: </strong>This case demonstrates that DLGNT can present with communicating hydrocephalus secondary to leptomeningeal spread, which may be misdiagnosed as IIH. Early comprehensive neuroaxis imaging, prompt molecular characterization, and close surveillance are essential in pediatric patients with communicating hydrocephalus of unclear etiology.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":" ","pages":"1"},"PeriodicalIF":1.3,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765661","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":"Impact of a Multidisciplinary Spina Bifida Clinic on Healthcare Resource Utilization.","authors":"Christopher L Taylor, Anne G Dudley, Corey Baker, Timothy M Crombleholme, Jonathan E Martin, Markus J Bookland, David S Hersh","doi":"10.1159/pne/aeiag002","DOIUrl":"10.1159/pne/aeiag002","url":null,"abstract":"<p><strong>Introduction: </strong>Multidisciplinary spina bifida clinics using an integrated care model are designed to address the complex healthcare needs associated with open neural tube defects by delivering coordinated, streamlined, and comprehensive care. However, the impact of this care model on healthcare utilization patterns remains unclear, particularly among resource-limited populations. We therefore assessed the relationship between integrated care, social determinants of health, and healthcare utilization among patients with open neural tube defects, with a specific focus on unanticipated healthcare encounters.</p><p><strong>Methods: </strong>All patients with open neural tube defects who were seen by a pediatric neurosurgeon at Connecticut Children's between January 1, 2021, and May 1, 2023, were retrospectively reviewed. Patients seen in an integrated, multidisciplinary spina bifida clinic were compared to those who were evaluated exclusively in the pediatric neurosurgery clinic without concurrent multidisciplinary evaluations. Recurrent-event risk of an unexpected healthcare encounter following the index routine visit was modelled with Andersen-Gill Cox proportional hazards, adjusting for demographic, social determinants of health, and select clinical factors.</p><p><strong>Results: </strong>Forty-nine patients met the inclusion criteria. During the study period, they had a total of 326 appointments, including 196 unexpected visits. There was 1 median unexpected visit per patient (IQR 0-2.50) in the integrated cohort, compared to 3 (IQR 1-5.75) in the nonintegrated cohort (p = 0.02). The emergency department (ED) was the most common setting for unexpected encounters, with 82 total visits and 65.3% of patients having at least one visit. Integrated care was associated with a 79% lower hazard of having an unexpected clinic visit (adjusted HR 0.21, 95% CI 0.09-0.51; p < 0.001), but ED visits were similar between the two cohorts.</p><p><strong>Conclusion: </strong>In this preliminary analysis, engagement with a multidisciplinary spina bifida clinic was associated with a significant reduction in the risk of having an unplanned clinical encounter, highlighting integrated care as a promising strategy to curb high-cost utilization in this population. Prospective multicenter studies are needed to determine the extent of this effect, determine which clinic components drive this benefit, and to evaluate cost-effectiveness across diverse settings.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":" ","pages":"1"},"PeriodicalIF":1.3,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762416","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":"Burden of Racial Disparities in Pediatric Traumatic Brain Injury Among American Indian/Alaska Native Children: A Scoping Review of the Literature.","authors":"Mohammed A Fouda, Laurel A Seltzer, Aharnish Dev, Shazain Khan, Caitlin Hoffman","doi":"10.1159/pne/aeiag001","DOIUrl":"https://doi.org/10.1159/pne/aeiag001","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Traumatic brain injury (TBI) is a leading cause of morbidity and mortality in children worldwide. In the United States, and in the state of Alaska in particular, American Indian/Alaska Native (AI/AN) children experience a disproportionate burden of healthcare disparities. Understanding the epidemiology, mechanisms of injury, access to care, and long-term clinical outcomes in this vulnerable population is crucial for guiding management strategies and prevention initiatives.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;This scoping review aimed to characterize the epidemiology of pediatric TBI among AI/AN children in the United States; examine mechanisms of injury, hospitalization, and mortality patterns; assess disparities in diagnostic evaluation, insurance status, inpatient and post-discharge care; evaluate current prevention and intervention strategies; and and propose future directions to reduce healthcare inequities among AI/AN children.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;we systematically searched PubMed/MEDLINE, Embase, Scopus, Web of Science, and Google Scholar for English-language, peer-reviewed studies examining TBI in AI/AN children (&lt;18 years). Eligible studies reported epidemiology, clinical outcomes, healthcare disparities, or interventions. Data extraction and quality assessment were conducted independently by multiple reviewers, with methodological rigor assessed using the NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;AI/AN children demonstrated the highest TBI-related hospitalization and mortality rates nationally, with the burden most pronounced in children &lt; 4 years and in adolescents. Motor vehicle accidents were the leading cause of TBI-related hospitalization and mortality, often associated with alcohol involvement and low utilization of protective equipment. Violence, including blunt trauma and firearm injuries, accounted for disproportionately higher mortality rates, with firearm-related TBI deaths up to three-fold higher compared to that among white children. Disparities extended beyond the mechanism of injury, as AI/AN children were less likely to undergo advanced imaging and experienced longer hospital stays. Additionally, AI/AN children had the lowest rates of private insurance coverage and the highest reliance on Medicaid/Medicare, contributing to the limited access to rehabilitation services and post-discharge healthcare services.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;AI/AN children with TBI bear a substantial burden of healthcare disparities. The limited healthcare infrastructure, insurance disparities, and cultural barriers, in addition to the geographical isolation of those who live in the state of Alaska amplify the burden of healthcare disparities faced by these children. Addressing these disparities requires a multi-faceted approach, including improved surveillance, standardized case definitions, expansion of preventive initiativ","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":" ","pages":"1"},"PeriodicalIF":1.3,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708321","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 Endovascularly Treated Aneurysmal Subarachnoid Hemorrhage: A Twenty-Year National Inpatient Sample Study of Morbidity and Mortality.","authors":"Harshitha G Valluri, Avi A Gajjar, Tarun Prabhala, Alexandra R Paul","doi":"10.1159/000552834","DOIUrl":"https://doi.org/10.1159/000552834","url":null,"abstract":"<p><strong>Introduction: </strong>Aneurysmal subarachnoid hemorrhage (aSAH) in pediatric patients is a rare but severe disease associated with significant morbidity and mortality. While endovascular treatment is widely used in adult aSAH, its utilization and outcomes in pediatric patients remain underexplored.</p><p><strong>Methods: </strong>This retrospective cohort study used the National Inpatient Sample (NIS) to identify pediatric patients (<18 years) who underwent endovascular treatment for aSAH from 2000 to 2020. Outcomes analyzed included in-hospital mortality, nonhome discharge, length of stay, overall hospital course complications, and inflation-adjusted cost of care. Multivariable regression models assessed predictors of outcomes and healthcare resource utilization.</p><p><strong>Results: </strong>Throughout the study period, 1,923 pediatric patients underwent endovascular aSAH therapy from 2000 to 2020. The mean age was 11.9 ± 5.2 years. The overall in-hospital mortality rate was 4.1%, and 40.6% of patients required nonhome discharge. Complications at any point in hospitalization were frequent (67.7%), with pulmonary complications (64.3%) being the most common, followed by deep vein thrombosis (13.0%) and thromboembolic events (12.4%). Sepsis occurred significantly more often in boys than girls (13.2% vs. 1.6%, p = 0.011). Mean hospitalization cost was USD 108,442.93 ± USD 95,971.98. Racial disparities in morbidity and mortality were slim. The National Inpatient Sample Subarachnoid Hemorrhage Severity Score (NIS-SSS) was a significant predictor of nonhome discharge (adjusted odds ratio [aOR] 1.28, p = 0.0049) and adverse hospital course events (aOR 1.94, p = 0.0036). The South (p = 0.0029) and West (p = 0.0008) patients were significantly less likely to experience nonhome discharge than those in the Northeast.</p><p><strong>Conclusion: </strong>Endovascular therapy for pediatric aSAH has increased significantly over 2 decades, with stable hospital course complication rates and relatively low in-hospital mortality. The NIS-SSS score predicts nonhome discharge and adverse hospital course events, supporting its role in pediatric risk stratification. Despite regional differences in discharge patterns, care appears equitable across demographic and socioeconomic groups.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":" ","pages":"1-14"},"PeriodicalIF":1.3,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681131","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":"Implementation of Virtual Reality for Postoperative Recovery in an Adolescent Idiopathic Scoliosis Population.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1159/000552387","DOIUrl":"https://doi.org/10.1159/000552387","url":null,"abstract":"","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":" ","pages":"1-2"},"PeriodicalIF":1.3,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148426193","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}