Pediatric Neurosurgery最新文献_第10页

Intracranial Aneurysm in Pediatric Population: A Single-Center Experience 颅内动脉瘤在儿科人群:单中心经验

IF 0.7 4区医学

Pediatric Neurosurgery Pub Date : 2022-04-08 DOI: 10.1159/000524523

G. D. de Aguiar, A. Ozanne, A. Elawady, T. Samoyeau, H. Niknejad, J. Caroff, Jeickson Vergara Martinez, C. Mihalea, S. Gallas, V. Chalumeau, L. Ikka, J. Moret, L. Spelle

{"title":"Intracranial Aneurysm in Pediatric Population: A Single-Center Experience","authors":"G. D. de Aguiar, A. Ozanne, A. Elawady, T. Samoyeau, H. Niknejad, J. Caroff, Jeickson Vergara Martinez, C. Mihalea, S. Gallas, V. Chalumeau, L. Ikka, J. Moret, L. Spelle","doi":"10.1159/000524523","DOIUrl":"https://doi.org/10.1159/000524523","url":null,"abstract":"Purpose: Pediatric intracranial aneurysms (PIA) are rarer and more complex when compared to adult aneurysms. In general, the clinical presentation of PIA is due to a mass effect, but the presenting symptoms can be also related to ischemia, subarachnoid hemorrhage (SAH), or in a combination of different symptoms. This paper aimed to report a single-center experience with clinical and angiographic aspects of brain aneurysm in children. Methods: We retrospectively reviewed our prospectively maintained database for patients with intracranial aneurysms in our institution from July 2015 to February 2021. Among these, all patients under 18 years of age submitted to a diagnostic or therapeutic procedure for an intracranial aneurysm were included. Results: Twelve patients were submitted to diagnostic or therapeutic procedures in our department. Three of them had multiple aneurysms, and in total, 17 intracranial aneurysms were assessed in this study. The most frequent location was in the middle cerebral artery (7 cases/41%). Five out of twelve children (42%) presented SAH due to ruptured aneurysm. Three patients (25%) had symptoms due to the mass effect from large aneurysms, with compression of cranial nerves or brainstem. Aneurysms diameters ranged from 1.5 mm to 34 mm (mean 14.2 mm), with six aneurysms being giant and eight being nonsaccular/fusiform. Twelve aneurysms were submitted to endovascular treatment, with one treatment-related clinical complication and later death. Conclusion: PIAs are rare diseases that can arise from a variety of different underlying pathological mechanisms. The management of these conditions requires a detailed understanding of the pathology and a multidisciplinary approach. Despite the availability of new technologies, parent vessel occlusion remains a valid option for aneurysms in the pediatric population.","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":"57 1","pages":"270 - 278"},"PeriodicalIF":0.7,"publicationDate":"2022-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48449660","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}

引用次数: 4

The Eyebrow Approach for the Management of Pediatric Frontal Epidural Abscesses Secondary to Diffuse Sinusitis 眉入路治疗小儿额部弥漫性鼻窦炎继发硬膜外脓肿

IF 0.7 4区医学

Pediatric Neurosurgery Pub Date : 2022-04-08 DOI: 10.1159/000524537

Hana Hallak, Hussam Abou-Al-Shaar, A. Mallela, M. Mcdowell, Noel Jabbour, R. Padia, S. Greene, I. Pollack

{"title":"The Eyebrow Approach for the Management of Pediatric Frontal Epidural Abscesses Secondary to Diffuse Sinusitis","authors":"Hana Hallak, Hussam Abou-Al-Shaar, A. Mallela, M. Mcdowell, Noel Jabbour, R. Padia, S. Greene, I. Pollack","doi":"10.1159/000524537","DOIUrl":"https://doi.org/10.1159/000524537","url":null,"abstract":"Background: Minimally invasive approaches to the anterior cranial fossa have evolved over the past few decades. The management of frontal epidural abscesses (EDAs) secondary to diffuse sinusitis in the pediatric population using minimally invasive techniques is scarcely reported in the literature. Herein, we report the utilization of a minimally invasive eyebrow approach for multidisciplinary concurrent evacuation of frontal EDA secondary to diffuse sinusitis and trephination of the frontal sinus in three pediatric patients. Case Reports: Three pediatric patients presented to the emergency room with severe headaches, visual changes, somnolence, and significant facial and periorbital swelling. Imaging revealed diffuse sinusitis with focal frontal epidural extension. In all cases, progressive clinical deterioration along with the radiographic findings mandated urgent surgical intervention. The eyebrow approach allowed for concomitant evacuation of the frontal EDA and trephination of the frontal sinus followed by functional endoscopic sinus surgery in the same setting. All patients tolerated the procedure well with complete resolution of their symptoms at the completion of antibiotic therapy and complete resolution of the EDA. Conclusion: The eyebrow approach is a minimally invasive technique that should be considered as part of the armamentarium in the management of select EDA in the pediatric population. It allows for multidisciplinary collaboration between neurosurgeons and otolaryngologists for concomitant evacuation of the EDA and trephination of the frontal sinus. This approach is a feasible, safe, and effective minimally invasive technique that can be employed for the management of EDA secondary to diffuse sinusitis in the pediatric population.","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":"57 1","pages":"213 - 221"},"PeriodicalIF":0.7,"publicationDate":"2022-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46133933","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}

引用次数: 1

Xanthogranulomatous Colloid Cyst in a 13-Year-Old Boy: A Case Report and Surgical Implications 13岁男童黄色肉芽肿性胶体囊肿1例及手术意义

IF 0.7 4区医学

Pediatric Neurosurgery Pub Date : 2022-04-05 DOI: 10.1159/000524480

G. Tyagi, G. Singh, M. Beniwal, Dwarakanath Srinivas

{"title":"Xanthogranulomatous Colloid Cyst in a 13-Year-Old Boy: A Case Report and Surgical Implications","authors":"G. Tyagi, G. Singh, M. Beniwal, Dwarakanath Srinivas","doi":"10.1159/000524480","DOIUrl":"https://doi.org/10.1159/000524480","url":null,"abstract":"Introduction: Colloid cysts are relatively uncommon lesions in the pediatric population. The xanthogranulomatous (XG) variant is very rare with less than 30 reported cases. Case Report: In this report, the patient was a 13-year-old boy who presented with transient episodes of headache with blurring of vision. His MRI brain showed a T2 hyperintense well-defined cystic lesion, with an eccentrically located T2 hypointense partially enhancing nodule, at the foramen of Monro. He underwent middle frontal gyrus transcortical, transchoroidal gross total excision of the cyst. The histopathology of the lesion revealed an XG colloid cyst. The patient recovered well from the procedure and was relieved of the symptoms. Conclusion: XG colloid cyst may present with altered radiological features compared to the normal variant. This can pose a diagnostic dilemma, and it is important to differentiate it from a craniopharyngioma or a parasitic cyst, as in our case. When considered preoperatively, surgeons should be conscious to review their surgical strategies. Stereotactic aspiration of the XG cyst should be avoided as contents are thicker and heterogeneous than the usual. The spillage of cyst contents should be prevented. Also, the XG cysts are likely to have a poor cyst-fornix or -choroid plexus interface due to inflammation limiting complete resection.","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":"57 1","pages":"202 - 206"},"PeriodicalIF":0.7,"publicationDate":"2022-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48056958","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}

引用次数: 0

Cervicomedullary Gliomas in Pediatric Age: A Systematic Review of the Literature and Tertiary Care Center Experience 儿童年龄的颈髓核胶质瘤：文献和三级护理中心经验的系统回顾

IF 0.7 4区医学

Pediatric Neurosurgery Pub Date : 2022-03-18 DOI: 10.1159/000524165

A. Trezza, Camilla de Laurentis, V. Biassoni, G. Carrabba, E. Schiavello, F. Canonico, P. Remida, Alessandra Moretto, M. Massimino, C. Giussani

{"title":"Cervicomedullary Gliomas in Pediatric Age: A Systematic Review of the Literature and Tertiary Care Center Experience","authors":"A. Trezza, Camilla de Laurentis, V. Biassoni, G. Carrabba, E. Schiavello, F. Canonico, P. Remida, Alessandra Moretto, M. Massimino, C. Giussani","doi":"10.1159/000524165","DOIUrl":"https://doi.org/10.1159/000524165","url":null,"abstract":"Introduction: Cervicomedullary gliomas (CMGs) are usually low-grade tumors often found in the pediatric age. Histological findings, treatments, and classification have been much the same for 40 years, although histological and molecular classifications have largely been developed for other pediatric CNS tumors. The management and treatment of pediatric CMG are still conducted by many authors according to their anatomical location and characteristics, independently from histology. Methods: We conducted a literature review in PubMed (Medline) to identify relevant contributions about pediatric CMG published until December 31, 2021. We also analyzed a series of 10 patients with CMG treated from 2006 to 2021 at IRCCS Istituto Nazionale dei Tumori. The aim of the present review was to see whether and how the diagnosis, treatment, and classification of CMGs in children have developed over time, especially in the context of molecular advancements, and to analyze our single-center experience in the last 15 years. Results: Thirty articles have been included in the review. Articles have been divided into two historical periods (1981–2000 and 2001–2021) and data from different series were analyzed to see how much the management and treatment of pediatric CMG have changed during years. Analysis of our series of 10 patients affected by CMG was also performed to compare it with the literature. Discussion: Management and classification of CMG in children have not dramatically changed during years. However, new insight from molecular diagnostics and target therapies and the development of radiological, neurophysiological, and radiotherapy techniques have updated treatment modalities in the last 20 years. Treatment modalities and their innovations have been reviewed and discussed. Further studies are needed to standardize and customize treatment protocols for these tumors.","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":"57 1","pages":"149 - 160"},"PeriodicalIF":0.7,"publicationDate":"2022-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42939627","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}

引用次数: 1

Crouzon’s Syndrome with a Dominant Sinus Pericranii Draining Transverse Sinus: Report of a Rare Association and Review of Literature 克鲁松综合征伴优势鼻窦围壁引流横鼻窦:罕见关联报告及文献回顾

IF 0.7 4区医学

Pediatric Neurosurgery Pub Date : 2022-03-18 DOI: 10.1159/000524134

S. Kumari, S. Verma, P. Singh

引用次数: 0

The Challenges of Making Comparisons between Research and Clinical Cohorts 在研究和临床队列之间进行比较的挑战

IF 0.7 4区医学

Pediatric Neurosurgery Pub Date : 2022-03-17 DOI: 10.1159/000524141

A. Houtrow

引用次数: 1

Sella Bugged! Abscess Inside a Craniopharyngioma: Case Report with Literature Review Sella Bugged！颅咽管瘤内脓肿1例报告并文献复习

IF 0.7 4区医学

Pediatric Neurosurgery Pub Date : 2022-03-09 DOI: 10.1159/000523977

G. Tyagi, Santhosh Kumar S A, Sandeep Kandregula, Radhika Mhatre, A. Uppar

{"title":"Sella Bugged! Abscess Inside a Craniopharyngioma: Case Report with Literature Review","authors":"G. Tyagi, Santhosh Kumar S A, Sandeep Kandregula, Radhika Mhatre, A. Uppar","doi":"10.1159/000523977","DOIUrl":"https://doi.org/10.1159/000523977","url":null,"abstract":"Introduction: Abscess within a craniopharyngioma (CPG) is extremely rare and only 8 such cases have been reported in literature. Most patients present with hypopituitarism and visual disturbances. We report the first ever case of a CPG with abscess in a pediatric patient. Case Report: A 10-year-old girl presented with visual deterioration and bitemporal hemianopia. Her CT and MRI brain suggested of a sellar-suprasellar CPG. Due to ill-developed sino-nasal anatomy, a transcranial approach was made for the lesion. The lesion was well capsulated, thick walled, and appeared inflamed. Upon incising the wall, thick yellowish pus was drained out in a controlled manner. This was followed by a partial resection of the CPG wall and eccentric, adhered, calcified residue was left behind with an Ommaya drain. The abscess culture grew Enterococcus species and histopathology revealed adamantinomatous CPG. Patient underwent culture sensitive antibiotics course followed by radiation for the residue. She was doing well at 1-year follow-up with clinical and radiological improvement. Conclusion: This is the first report of a pediatric case with secondary abscess in CPG. Operative management of such a case includes controlled drainage of pus without dissemination into the surrounding arachnoid space. The tumor and abscess have to be addressed as separate surgical entities; infection control and wherever complete resection is not feasible, partial safe resection followed by radiotherapy is a viable option.","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":"57 1","pages":"191 - 195"},"PeriodicalIF":0.7,"publicationDate":"2022-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48606927","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}

引用次数: 0

Retained Medullary Cord Associated with Terminal Myelocystocele and Intramedullary Arachnoid Cyst 终末髓囊性囊肿和髓内蛛网膜囊肿相关的保留髓索

IF 0.7 4区医学

Pediatric Neurosurgery Pub Date : 2022-03-08 DOI: 10.1159/000523976

Ai Kurogi, N. Murakami, N. Mukae, T. Shimogawa, T. Shono, Satoshi O. Suzuki, T. Morioka

{"title":"Retained Medullary Cord Associated with Terminal Myelocystocele and Intramedullary Arachnoid Cyst","authors":"Ai Kurogi, N. Murakami, N. Mukae, T. Shimogawa, T. Shono, Satoshi O. Suzuki, T. Morioka","doi":"10.1159/000523976","DOIUrl":"https://doi.org/10.1159/000523976","url":null,"abstract":"Introduction: The retained medullary cord (RMC) is a newly defined entity of closed spinal dysraphism that is thought to originate from regression failure of the medullary cord during the last phase of secondary neurulation. The terminal myelocystocele (TMC) is an unusual type of closed spinal dysraphism, characterized by localized cystic dilatation of the terminal part of the central canal that then herniates through a posterior spinal bifida. The co-occurrence of RMC and TMC is extremely rare. Case Presentation: We treated a baby girl with a huge sacrococcygeal meningocele-like sac with two components. Untethering surgery and repair surgery for the sac revealed that RMC, associated with intramedullary arachnoid cyst (IMAC), was terminated at the bottom of the rostral cyst, forming the septum of the two cystic components, and the caudal cyst was TMC derived from the central canal-like ependymal lining lumen (CC-LELL) of the RMC at the septum. IMAC within the RMC communicated with TMC, and both contained xanthochromic fluid with the same properties. Conclusion: We speculated that the mass effect of the coexistent IMAC impeded the flow of cerebrospinal fluid in the CC-LELL within the RMC and eventually formed a huge TMC. In surgical strategies for such complex pathologies, it is important to identify the electrophysiological border between the functional cord and nonfunctional RMC and the severe RMC to untether the cord, as with a typical or simple RMC.","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":"57 1","pages":"184 - 190"},"PeriodicalIF":0.7,"publicationDate":"2022-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47540535","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}

引用次数: 1

MicroRNA-138 Regulates Spinal Cord Development by Activating the Shh in Fetal Rats. MicroRNA-138通过激活胎鼠Shh调控脊髓发育。

IF 0.7 4区医学

Pediatric Neurosurgery Pub Date : 2022-01-01 DOI: 10.1159/000527587

Zheng Ma, Cui-Yun Li, Li-Juan Wang, Yan Xia, Cheng-An Feng, Yu-Fang Peng, Yan-Bing Han, Yan Fan, Ying-Chun Ba

{"title":"MicroRNA-138 Regulates Spinal Cord Development by Activating the Shh in Fetal Rats.","authors":"Zheng Ma, Cui-Yun Li, Li-Juan Wang, Yan Xia, Cheng-An Feng, Yu-Fang Peng, Yan-Bing Han, Yan Fan, Ying-Chun Ba","doi":"10.1159/000527587","DOIUrl":"https://doi.org/10.1159/000527587","url":null,"abstract":"Introduction: Dysregulation of spinal cord development can lead to serious neuronal damage and dysfunction, causing significant health problems in newborns. MiRNA-138 appears to be crucial for proliferation, differentiation, and apoptosis of cells. However, the regulation of miRNA-138 and downstream molecules in embryonic spinal cord development remain elusive. The aim of this experiment is to determine whether overexpression of miRNA-138 or RNA interference (RNAi) can regulate the development of spinal cord in fetal rats.Methods: Two plasmid vectors including pLenti-III-mico-GFP (miRNA-138 open reading frame [ORF]) and pLenti-III-miR-Off (miRNA-138 short hairpin) were constructed and injected into the tail vein of rats on the 14th day of pregnancy. Hematoxylin-eosin (HE) staining was used to observe the cell morphology. QRT-PCR, Western blot, and immunostaining confirmed the regulatory relationship between miRNA-138 and downstream molecules sonic hedgehog (Shh).Results: Overexpression of miRNA-138 increased neuron regeneration significantly and decreased neuronal apoptosis when compared with the control. Silencing of miRNA-138 increased neuronal apoptosis and spinal cord atrophy significantly. Furthermore, miRNA-138 ORF treatment effectively increased the expression level of miRNA-138 and also upregulated the level of Shh. Comparatively, knockdown of miRNA-138 downregulated Shh levels in myelodysplastic regions.Conclusion: These findings indicated that miRNA-138 overexpression could protect the spinal cord development of fetal rats, and the underlying mechanisms were associated with Shh expression. The present study provides a novel strategy to promote the molecular mechanism of embryonic spinal cord development.","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":"57 6","pages":"407-421"},"PeriodicalIF":0.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9251751","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}

引用次数: 0

Pediatric Cerebral Meningioma: A Single-Center Study with 10 Children Not Associated with Neurofibromatosis Type 2 and Literature Review. 儿童脑膜瘤:10例与2型神经纤维瘤病无关的儿童的单中心研究和文献综述

IF 0.7 4区医学

Pediatric Neurosurgery Pub Date : 2022-01-01 DOI: 10.1159/000526541

Isabella Opoku, Liu Yang, Peng Sun, Mading Zhou, Yutong Liu, Jian Ren, Jianxin Du, Ling Feng, Gao Zeng

{"title":"Pediatric Cerebral Meningioma: A Single-Center Study with 10 Children Not Associated with Neurofibromatosis Type 2 and Literature Review.","authors":"Isabella Opoku, Liu Yang, Peng Sun, Mading Zhou, Yutong Liu, Jian Ren, Jianxin Du, Ling Feng, Gao Zeng","doi":"10.1159/000526541","DOIUrl":"https://doi.org/10.1159/000526541","url":null,"abstract":"Introduction: Pediatric meningiomas (PMs) are rare tumors; they differ from their adult counterparts by their atypicality of location, higher rates of malignant change, male preponderance, recurrence, and sometimes, their association with neurofibromatosis. This case series analyzes the clinical behavior, pathological presentation, location, and its association with neurofibromatosis type 2 (NF2).Methods: This case series consists of pediatric patients between the ages of 4 and 16 years who were hospitalized in the neurosurgical department of our hospital from 2012 to 2021 with different neurological symptoms and a literature review using the PubMed/MEDLINE database.Results: Sixty percent of the patients were males, while 40% were females. The most common neurological manifestations were signs of increased intracranial pressure. NF2 was absent in all patients. The predominant histopathology subtypes are atypical and WHO grade II, representing 30% and 40%, respectively.Conclusion: This study supports the relationship between NF2 and pediatric cerebral meningioma but at a lower concomitant rate from 0 to 13%, taking into consideration our original data and the literature review, contrasting some reported cases, which suggest rates as high as 33%, 50%, and 100% in a very small number of patients. Gross total resection without postoperative radiation therapy for nonmalignant and non-NF2-associated PM proved to be a sufficient and a good treatment option.","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":"57 6","pages":"422-433"},"PeriodicalIF":0.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10688965","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}

引用次数: 1