Pediatric Neurosurgery最新文献

{"title":"Mild head trauma in a Pediatric Hospital: Analysis of the PECARN rule, traumatic lesions on head CT and functional sequelae.","authors":"Pedro Abreu, Dalila Forte, Miguel Correia, Mário Matos, Amets Sagarribay","doi":"10.1159/000547384","DOIUrl":"https://doi.org/10.1159/000547384","url":null,"abstract":"<p><p>Introduction Mild head trauma is frequent in Pediatrics and its management varies widely across clinicians. Questions regarding patients´ management, outcomes, head trauma prevention, the adequacy of computerized tomography (CT) prescription and the adherence to the Pediatric Emergency Care Applied Research Network (PECARN) rule are still discussed. Methods We performed a retrospective observational study of mild head trauma patients who underwent head CT, characterizing the presenting signs and symptoms, mechanisms of injury, head CT lesions, and outcomes. Statistical associations between signs and symptoms, CT lesions, PECARN risk groups and outcomes were explored. Results Three hundred and eleven patients were included, with 18.8% of patients under 2 years having CT traumatic lesions, against 7.9% of patients over 2 years old. The majority were aligned skull fractures. Parietal/temporal/occipital scalp haematoma, being under 3 months of age, and the presence of more than 2 vomits on admission, were associated with head CT traumatic lesions (OR 6.39, OR 2.84, OR 2.84, respectively). Clinically important lesions were rare (0.56%) and associated to the PECARN high-risk group (p=0.005). All patients had no functional sequelae. The most common causes of head trauma were bed falls and ground falls. Baby stroller/egg falls due to no retention system usage were not rare and most bicycle fall victims were not wearing an helmet. Conclusion This study reinforces the usefulness of PECARN rule guiding CT scans prescription and patients´ management. Parietal/temporal/occipital scalp haematoma, being under 3 months of age and having more than two vomits are associated traumatic CT findings. Preventable head trauma frequency underlines the need for public policies reinforcement.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":" ","pages":"1-14"},"PeriodicalIF":0.9,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683611","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":"Evaluation of association of prematurity with benign enlargement of subarachnoid space in infants referred for macrocephaly.","authors":"Fardad T Afshari, Katie Herbert, Amy Drew, Joshua Pepper, Desiderio Rodrigues","doi":"10.1159/000547283","DOIUrl":"https://doi.org/10.1159/000547283","url":null,"abstract":"<p><p>Introduction Benign enlargement of subarachnoid space(BESS) is one of the causes of macrocephaly in infants. The aetiology of this condition remains a subject of controversy, with poor cerebrospinal fluid absorption as the most commonly believed underlying theory. Prematurity has been suggested as possible risk factor however this is a topic of debate with paucity of data. In this study we investigated association of prematurity with BESS in our cohort of patient. Methods A retrospective review of patients seen in outpatient neurosurgical BESS clinic (period 2016-2023) was carried out. BESS was defined as enlarged frontal subarachnoid space diagnosed on CT or MRI brain obtained for macrocephaly. Demographics information including sex, age, prematurity/gestation at birth, grade of prematurity as well as any neurosurgical interventions were recorded. Prematurity was defined as per World Health Organisation guidelines as birth at gestation<37 weeks. Grade of prematurity was defined as <28 weeks as extreme preterm, 28-32 weeks as severe preterm, 32-34 weeks as moderate preterm and 34-37 weeks as late preterm. Results Over the period of study, 100 children with benign enlargement of subarachnoid space were seen in the outpatient clinic setting with mean age of 12.3 months (range 0.5-54 months) with M78:F22 ratio (M:F=3.5:1). Overall, 19 out of 100 children with benign enlargement of subarachnoid space were born premature (19%) with a mean age of 11.9 months at diagnosis. Premature group included 0% extreme preterm, 21% severe preterm, 15.8% moderate preterm and 63.2% late preterm. Rate of prematurity at 19% in this this cohort was 2.4-fold the rate of UK prematurity of 7.5-7.9% (p=0.023). 8 out of 100 (8%) patients had concurrent subdural collection of which one belonged to premature group. All subdural collections were managed non-operatively. There was no association between prematurity and subdural formation. No child required cerebrospinal fluid diversion. Conclusion Benign enlargement of subarachnoid space remains a poorly understood entity. Considering the baseline rate of live preterm births in UK at 7.5-7.9%, rate of prematurity in this cohort of children was significantly higher at 19%. This study may support that prematurity is a possible risk factor.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":" ","pages":"1-9"},"PeriodicalIF":0.9,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576927","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":"Novel Application of Connectomics to the Surgical Management of Pediatric Arteriovenous Malformations.","authors":"Shoaib A Syed, Fawaz Al-Mufti, Simon J Hanft, Chirag D Gandhi, Jared M Pisapia","doi":"10.1159/000547100","DOIUrl":"https://doi.org/10.1159/000547100","url":null,"abstract":"<p><p>Introduction The emergence of connectomics in neurosurgery has allowed for construction of detailed maps of white matter connections, incorporating both structural and functional connectivity patterns. The advantage of mapping cerebral vascular lesions to guide surgical approach shows great potential. We aim to identify the clinical utility of connectomics for the surgical treatment of pediatric arteriovenous malformations (AVM). Case Presentation We present two illustrative cases of the application of connectomics to the management of cerebral AVM in a 9-year-old and 8-year-old female. Using magnetic resonance anatomic and diffusion tensor imaging, a machine learning algorithm generated patient-specific representations of the corticospinal tract for the first patient, and the optic radiations for the second patient. The default mode network and language network were also examined for each patient. The imaging output served as an adjunct to guide operative decision making. It assisted with selection of the superior parietal lobule as the operative corridor for the first case. Furthermore, it alerted the surgeon to white matter tracts in close proximity to the AVM nidus during resection. Finally, it aided in risk versus benefit analysis regarding treatment approach, such as craniotomy for resection for the first patient versus radiosurgery for the second patient. Both patients had favorable neurologic outcomes at the available follow-up period. Conclusion Use of the software integrated well with clinical workflow. The output was used for planning and overlaid on the intraoperative neuro-navigation system. It improved visualization of eloquent regions, especially those networks not visible on standard anatomic imaging. Future studies will focus on expanding the cohort, conducting in pre- and post-operative connectomic analysis with correlation to clinical outcome measures, and incorporating functional magnetic resonance imaging.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":" ","pages":"1-18"},"PeriodicalIF":0.9,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499343","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":"Evaluation of the Endoscopic Third Ventriculostomy Success Score for Pediatric Hydrocephalus: Experience from a Singapore Children's Hospital.","authors":"Jensen Ang, Felicia H Z Chua, Sharmila Devi, David C Y Low, Wan Tew Seow, Sharon Y Y Low","doi":"10.1159/000546994","DOIUrl":"10.1159/000546994","url":null,"abstract":"<p><strong>Introduction: </strong>Endoscopic third ventriculostomy (ETV) is a well-established neurosurgical procedure. Concurrently, the Endoscopic Third Ventriculostomy Success Score (ETVSS) is a recognized validation tool commonly used to prognosticate the efficacy of this intervention. The main aims of this study are to review our institutional experience with ETV for pediatric hydrocephalus and evaluate its correlation with the ETVSS. Secondary aims include identification of other factors that are not part of the existing ETVSS and to corroborate our findings with contemporary literature.</p><p><strong>Methods: </strong>This is a single-institution, retrospective study. Patients under 19 years old who underwent ETV were included. Variables of interest such as patient characteristics, hydrocephalus etiology, procedural details, perioperative complications, neuroimaging features, and outcomes were collected. Radiological parameters curated from the literature such as third ventricular floor bowing, lamina terminalis bowing, third ventricular morphology index, and presence of prepontine adhesions (PPAs) are also included. For this study, the primary outcome measure is \"ETV success,\" defined as no need for shunt insertion to divert CSF at any point in time after ETV. Subsequent outcome of each ETV is correlated with the ETVSS. Additional factors are also independently assessed for their impact on the ETVSS in our study cohort.</p><p><strong>Results: </strong>Sixty-nine ETV cases were recruited for this study whereby ETV was successful in 63.8% (n = 44) cases. At 12 months' follow-up, their ETV stomas remained patent. Of note, 24.6% (n = 17) ETV failures occurred within 30 days of the procedure. In our series, ETV success correlated well with ETVSS. The ETV success rate was 0% for post-infectious and post-hemorrhagic etiologies. For the cases of ETV failure, definitive CSF diversion procedures were necessary within 3 months from their initial ETV. Logistic regression analysis showed ETVSS (odds ratio 1.068, p = 0.037) and the presence of PPA (p = 0.02) significantly correlated with ETV success.</p><p><strong>Conclusion: </strong>Our institutional experience in the use of ETV for pediatric hydrocephalus corroborates with findings from contemporary literature. In the context of our study, the ETVSS is applicable and the absence of PPA on neuroimaging demonstrates good correlation with ETV success.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":" ","pages":"1-10"},"PeriodicalIF":0.9,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369557","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":"Contralateral Transmaxillary Approach for a 13-Year-Old Boy with a Petrous Apex Cholesterol Granuloma: A Case Report.","authors":"Yasuhiro Arai, Jun Suenaga, Mitsuru Sato, Daisuke Sano, Tetsuya Yamamoto, Nobuhiko Oridate","doi":"10.1159/000546531","DOIUrl":"10.1159/000546531","url":null,"abstract":"<p><strong>Introduction: </strong>Surgical extirpation of a cholesterol granuloma in the petrous apex, located dorsal to the petrous part of the internal carotid artery (ICA), is challenging. Herein, we report a pediatric case of a cholesterol granuloma of the petrous apex treated using the endoscopic contralateral transmaxillary (CTM) approach.</p><p><strong>Case presentation: </strong>A 13-year-old boy presented with a left-sided headache, slight hypoesthesia in the left V1 area, and severe neuralgia of the left auriculotemporal nerve. Magnetic resonance imaging (MRI) revealed a high-intensity mass without gadolinium enhancement. The patient's headache was unresponsive to various medications. After careful evaluation, an endoscopic CTM approach was selected for the extirpation of the granuloma. Postoperatively, the patient did not experience headache or associated neurological complications. MRI at 46 months revealed no recurrence.</p><p><strong>Conclusion: </strong>The endoscopic CTM approach can be used for excising cholesterol granulomas of the petrous apex located posterior to the petrous part of the ICA without causing severe complications. This approach can be considered useful for pediatric cases in which granulomas are not accessible via the transnasal endoscopic transsphenoidal approach.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":" ","pages":"1-6"},"PeriodicalIF":0.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12215168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175854","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":"Cyclic Hypertonia and Hypotonia Associated with Intrathecal Baclofen Pumps: Findings and Treatments.","authors":"Megan V Ryan, Sophia Blasco, Kaitlin E Olson, Kim Sawyer, Joyce Oleszek, Swetha Sundar, Scott LeBeau, C Corbett Wilkinson","doi":"10.1159/000546529","DOIUrl":"10.1159/000546529","url":null,"abstract":"<p><strong>Introduction: </strong>Intrathecal baclofen therapy and baclofen pumps can lead to complications, including recurrent cycles of alternating hypertonia and hypotonia. The causes and optimal treatments for this issue remain unclear. This study reviews presentations, radiologic and surgical findings, treatments, and outcomes in cases of cyclic hypertonia/hypotonia.</p><p><strong>Methods: </strong>We reviewed patients with baclofen pumps treated at our hospital from 1998 to 2024 who developed cyclic hypertonia/hypotonia. Data collected included patient sex, etiology and type of tone abnormality, age at pump placement, age and weight at symptom onset, infusion rate and type at onset, side port access and catheter dye study results, treatments, surgical findings, and outcomes.</p><p><strong>Results: </strong>We identified 15 cases in 14 patients (10 females, 71%; 4 males, 29%). Among 248 patients with baclofen pumps, 38% were female. Females were significantly more likely to develop cyclic hypertonia/hypotonia (p < 0.01). The mean age at pump implantation was 10.2 years, and the mean time from last pump surgery to symptom onset was 645 days. All patients received enteric baclofen initially; 14 also had pump rate adjustments. Three patients improved without surgery, and one died during a hypotonia episode. Side port access showed patent catheters in 7 of 8 cases, with 6 of these showing good intrathecal dye dispersion. Surgery was performed in 11 cases, including two surgeries in 6 cases. Nine patients had pump replacements; 8 also had catheter revisions. Surgical findings included catheter kinks in 4 cases (36% of surgical cases) and leaks in 5 cases (45%), with 4 leaks at the pump-connector catheter connection. Six of 11 partial revisions (55%) and all 5 complete catheter replacements (100%) resulted in symptom resolution without recurrence. Replacing the pump-connector segment resolved symptoms without recurrence in 4 of 5 patients with leaks at this site. Overall, all patients undergoing surgery experienced symptom improvement without recurrence after one or two revisions.</p><p><strong>Conclusion: </strong>Adjusting pump rates and adding enteric baclofen may help some patients with cyclic hypertonia/hypotonia. If a leak at the pump-connector catheter segment is identified, segment replacement should be considered. When partial revisions fail, complete catheter replacement appears more effective, especially as a second surgery. Cyclic hypertonia/hypotonia is a treatable complication of baclofen pumps.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":" ","pages":"1-13"},"PeriodicalIF":0.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152810","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":"Multimodality Approach to a Pediatric Craniopharyngioma with Mixed Histological Features.","authors":"Sharmila Devi, Enrica E K Tan, Sze Jet Aw, Khurshid Z Merchant, Ngee Lek, Marielle V Fortier, Lee Ping Ng, Sharon Y Y Low","doi":"10.1159/000546046","DOIUrl":"10.1159/000546046","url":null,"abstract":"<p><strong>Introduction: </strong>Pediatric craniopharyngiomas (CPGs) are histologically benign but clinically complex tumors. Traditional mainstays of treatment include surgical resection and radiotherapy. Molecular insights report that children tend to have the adamantinomatous subtype that is driven by the CTNNB1 pathway, while papillary CPGs prevalent in the adult population are characterized by BRAFV600E mutations. Mixed histological subtypes are rare. We report an unusual case of a pediatric CPG with both histological subtypes and discuss the management strategies in corroboration with contemporary literature.</p><p><strong>Case presentation: </strong>A 11-year-old female presented with symptoms of panhypopituitarism, optic atrophy, and bitemporal hemianopia. Magnetic resonance imaging (MRI) of her brain demonstrated a lobulated cystic-solid sellar-suprasellar lesion. The patient had emergent stereotactic aspiration of the lesion and insertion of an Ommaya reservoir. Intraoperative cyst fluid cytology confirmed wet keratin nodules, characteristic of adamantinomatous CPG. Following that, intracystic interferon-alpha therapy was commenced with good response for approximately 7 months. However, tumor progression was noted on subsequent MRI scans, with difficulty aspirating from the Ommaya reservoir. In view of this, the patient underwent an uneventful transsphenoidal resection of the tumor. Histology reported a craniopharyngioma with mixed adamantinomatous and papillary features with BRAFV600E positivity. MRI scans performed 2 months after surgery showed tumor recurrence. Decision was made for a trial of a dabrafenib - a BRAF inhibitor. After commencement of dabrafenib monotherapy for 1 month, radiological evaluation showed good tumor response. At 24 months posttreatment, the patient was well with her tumor in remission. In addition, no treatment-related adverse side effects were observed.</p><p><strong>Conclusion: </strong>We report a unique case of pediatric craniopharyngioma with mixed histological features that were managed successfully via a multimodality approach. Emphases are on molecular profiling of the said lesion, minimizing permanent morbidity and maintenance of quality of life for a growing child. In the context of tumors with BRAFV600E mutations, the use of targeted monotherapy can be considered.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":" ","pages":"1-10"},"PeriodicalIF":0.9,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060352","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":"Development, Content Validity, and Test-Retest Reliability of a Childhood Hydrocephalus Severity Scale.","authors":"Olufemi Emmanuel Idowu, Jeuel Ogooluwa Idowu","doi":"10.1159/000544165","DOIUrl":"10.1159/000544165","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to develop and validate a reliable, multidomain scale for assessing childhood hydrocephalus severity and to enhance communication, guide treatment decisions, and improve patient care.</p><p><strong>Methods: </strong>A stepwise consensus approach informed by a modified Delphi technique was employed. Healthcare professionals participated in anonymous surveys and face-to-face meetings to define the core domains of the scale. Content validity, internal consistency, and inter-rater reliability were assessed.</p><p><strong>Results: </strong>The Delphi process yielded a refined 7-item, 10-point Childhood Hydrocephalus Severity Scale (CHS) focusing on age, Evans index, associated malformations, neurological deficit, intraventricular hemorrhage, and mid-arm circumference. Content validity analysis using the Content Validity Index (CVI) demonstrated strong agreement (mean I-CVI = 0.91) among experts regarding the relevance of CHS items. All individual item CVI scores exceeded 0.8, supporting the inclusion of each factor. The CHS exhibited excellent internal consistency (Cronbach's alpha = 0.988). High intraclass correlation coefficients (ICCs) were observed for both single measures (ICC = 0.902, 95% CI: 0.862-0.931) and average measures (ICC = 0.985, 95% CI: 0.978-0.990), indicating near-perfect agreement between raters. Both ICC values were statistically significant (p < 0.001).</p><p><strong>Conclusion: </strong>The CHS demonstrates promising potential as a reliable and valid tool for childhood hydrocephalus severity assessment. This scale has the potential to enhance communication, guide treatment decisions, and improve patient care in childhood hydrocephalus.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":" ","pages":"1-8"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415716","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":"Subtotal Resection with Proton-Beam Radiotherapy for Treatment of Pineal Parenchymal Tumor of Intermediate Differentiation in a Pediatric Patient.","authors":"Daniel E Fulkerson, Abigail Heck, Natalie Hauser, Daniel H Fulkerson","doi":"10.1159/000545882","DOIUrl":"10.1159/000545882","url":null,"abstract":"<p><strong>Introduction: </strong>Pineal parenchymal tumors of intermediate differentiation (PPTIDs) are rare, pinealocyte-derived brain tumors that occur primarily in adults. The clinical prognosis fits somewhere between the benign pineocytoma and highly malignant pineoblastoma. There is very little published literature regarding this tumor in children and the existing pediatric information is enfolded with adult data in single-center reviews. The most common treatment recommendation for adults is aggressive resection, possibly followed by craniospinal irradiation (CSI) and/or chemotherapy. However, the adult literature is inconsistent, often contradictory, and does not address specific considerations in pediatric patients. To our knowledge, there are no papers specifically addressing the management and clinical considerations of PPTID in pediatric patients. As such, the optimal treatment strategy in children is unknown.</p><p><strong>Case presentation: </strong>We describe the treatment of a 6-year-old child who presented with obstructive hydrocephalus from a PPTID. The child was treated with a partial tumor resection followed by localized proton beam radiation. He has been followed for 8 years. Clinically, he is doing well, and his most recent MRI shows negligible residual tumor with no sign of recurrence.</p><p><strong>Conclusions: </strong>Our case suggests safe resection followed by proton beam radiotherapy may be effective in treating children with this exceedingly rare entity. While further study is needed, this strategy may avoid unnecessary surgical risk and the consequences of CSI on the developing pediatric nervous system.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":" ","pages":"32-37"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058559","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":"Neuroendoscopic Surgical Treatment of Cerebellar Vermis Tumors in Pediatric Patients: A Case Series.","authors":"Yu Zeng, Fang Liu, Zhuo Chen, Xiaohua Zhang, Sheng Zhao, Jian Liu, Chao Wang","doi":"10.1159/000545466","DOIUrl":"10.1159/000545466","url":null,"abstract":"<p><strong>Introduction: </strong>Neuroendoscopy is gaining traction as a minimally invasive technique for the resection of cerebellar vermis tumors. This study investigates the effectiveness and clinical experience of neuroendoscopic surgery for cerebellar vermis tumor resection.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data of 18 patients with cerebellar vermis tumors treated using the German STORZ neuroendoscope between January 2021 and January 2024 at the Department of Neurosurgery, Guizhou Provincial People's Hospital, and Guizhou Hospital of Shanghai Children's Center. The surgical outcomes, pathological diagnoses, postoperative complications, and follow-up results were analyzed.</p><p><strong>Results: </strong>Of the 18 patients, total resection was achieved in 16 cases, subtotal resection in 1 case, and biopsy in 1 case. Postoperative pathology revealed 9 cases of medulloblastoma, 3 cases of ependymoma, and 5 cases of astrocytoma (2 WHO grade I, 2 grade II, and 1 grade III), along with 1 benign cerebellar lesion. Postoperative complications included malignant arrhythmia (1 case), cerebellar mutism (4 cases), and ataxia (13 cases). During the 1-36 months of follow-up, 2 patients developed communicating hydrocephalus, which improved following ventriculoperitoneal shunt placement. Recovery of cerebellar mutism occurred within an average of 21 days, while ataxia improved on average within 50 days. Tumor recurrence was observed in 3 patients.</p><p><strong>Conclusion: </strong>Neuroendoscopic resection of cerebellar vermis tumors, performed by skilled operators, provides effective surgical exposure and offers a viable alternative to traditional microscopy with satisfactory clinical outcomes.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":" ","pages":"17-24"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712177","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}