Pediatric Neurosurgery最新文献

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Effectiveness and Safety of Epilepsy Surgery for Pediatric Patients with Intractable Epilepsy: A Clinical Retrospective Study from a Single-Center Experience. 小儿顽固性癫痫患者癫痫手术的有效性和安全性:一项来自单中心经验的临床回顾性研究。
IF 0.7 4区 医学
Pediatric Neurosurgery Pub Date : 2024-01-01 Epub Date: 2023-11-03 DOI: 10.1159/000535023
Müge Dolgun, Duygu Dölen, Emek Uyur Yalçın, İlyas Dolaş, Tuğrul Cem Ünal, Nermin Görkem Şirin, Ayfer Sakarya Güneş, Nerses Bebek, Aydın Aydoseli, Candan Gürses, Bülent Kara, Altay Sencer
{"title":"Effectiveness and Safety of Epilepsy Surgery for Pediatric Patients with Intractable Epilepsy: A Clinical Retrospective Study from a Single-Center Experience.","authors":"Müge Dolgun, Duygu Dölen, Emek Uyur Yalçın, İlyas Dolaş, Tuğrul Cem Ünal, Nermin Görkem Şirin, Ayfer Sakarya Güneş, Nerses Bebek, Aydın Aydoseli, Candan Gürses, Bülent Kara, Altay Sencer","doi":"10.1159/000535023","DOIUrl":"10.1159/000535023","url":null,"abstract":"<p><strong>Introduction: </strong>Pediatric epilepsy surgery is an effective treatment modality for patients with drug-resistant epilepsy (DRE). Early pediatric surgery yields favorable results for DRE in terms of seizure control and neurophysiological outcome. In this study, pediatric patients were categorized based on their age (above 3 years old and below 3 years old) to demonstrate the effectiveness and safety of surgical procedures.</p><p><strong>Methods: </strong>In this retrospective, single-center study, 60 pediatric patients who underwent epilepsy surgery at Istanbul Faculty of Medicine between 2002 and 2018 were evaluated. Overall morbidity and mortality rates, as well as seizure outcomes of the patients, were assessed and compared based on two age groups: those aged 3 years old or younger and those older than 3 years old. The effectiveness of invasive monitoring was also evaluated in relation to pathological results. The postoperative seizure outcome rates were evaluated using Engel's classification, with an average follow-up period of 8.7 years.</p><p><strong>Results: </strong>Out of the total number of patients, 47 (78.4%) underwent resective surgery, while 13 (21.6%) had palliative surgery. Ten patients (16.6%) had invasive monitoring. Among all patients, 34 were classified as Engel I and II (56.6%), while 26 were classified as Engel III and IV (43.4%) postoperatively. 47% of patients who were under 3 years old, 60.4% of patients who were over 3 years old, and 50% of patients who underwent invasive monitoring had a favorable seizure outcome (Engel I-II). Postoperative morbidity and mortality rates were 35% (n = 21) and 1.6% (n = 1), respectively.</p><p><strong>Conclusion: </strong>Pediatric epilepsy surgery is an important treatment modality for preserving cognitive abilities and providing effective treatment for pediatric DRE. In our study, we claim that both invasive monitoring and epilepsy surgery lead to favorable seizure outcomes for all age groups. Further clinical studies should be conducted to provide more reliable data on the safety and effectiveness of the surgery, particularly in patients under the age of three.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71489004","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
Intracranial Arachnoid Cyst in Children: Clinical Presentation and Risk Factors for Surgical Intervention. 儿童颅内蛛网膜囊肿:临床表现和手术干预的风险因素。
IF 0.9 4区 医学
Pediatric Neurosurgery Pub Date : 2024-01-01 Epub Date: 2024-01-16 DOI: 10.1159/000536284
Raghav Talreja, Laura Daniela Fonseca, Mahesh Chikkannaiah, Gogi Kumar
{"title":"Intracranial Arachnoid Cyst in Children: Clinical Presentation and Risk Factors for Surgical Intervention.","authors":"Raghav Talreja, Laura Daniela Fonseca, Mahesh Chikkannaiah, Gogi Kumar","doi":"10.1159/000536284","DOIUrl":"10.1159/000536284","url":null,"abstract":"<p><strong>Introduction: </strong>Intracranial arachnoid cysts (IAC) in children are a common incidental finding on imaging. Most IACs are asymptomatic and can be monitored; however, a small percentage may enlarge and require surgical intervention. This study aimed to identify clinical risk factors in patients with IAC who underwent surgery versus those who did not.</p><p><strong>Methods: </strong>We conducted a retrospective chart review from 2009 to 2021 at a free-standing children's hospital. A total of 230 patients diagnosed with an IAC aged 0-21 years of age were included in the study. Data on demographics, imaging, and neurological follow-up were analyzed.</p><p><strong>Results: </strong>Out of 230 patients, 45 (19.6%) underwent surgery. At time of IAC diagnosis, the surgical patients were younger (median age 1.1 years), and their median cyst volume was larger (41.7 cm3), compared to nonsurgical patients (median age 5.9 years, volume 11.8 cm3, respectively). Headache was the most common reason for initial imaging in nonsurgical patients (54/185, 29.2%) while prenatal ultrasound (11/45, 24.4%) and macrocephaly (11/45, 24.4%) were the most common reasons for surgical patients. The majority of both surgical and nonsurgical patients had the IAC incidentally found (41/45, 91.1% and 181/185, 97.8%, respectively). Surgery relieved symptoms in 38/45 (84.4%) patients. Cyst volume and age were predictors of increased odds of having surgery.</p><p><strong>Discussion/conclusion: </strong>Patients who underwent surgery were younger and had larger cyst volumes at time of diagnosis. The majority of the IAC were found incidentally and remained stable over prolonged follow-up. The majority of the patients experienced relief of symptoms postsurgical intervention. There is a greater odds of having surgical treatment with decreased age and greater cyst volume at diagnosis, and therefore these patients should be monitored closely for development of symptoms indicating need for surgical intervention.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139479272","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
Superior Sagittal Sinus Thrombectomy in Pediatric Head Injury. 小儿颅脑损伤的上矢状窦血栓切除术
IF 0.9 4区 医学
Pediatric Neurosurgery Pub Date : 2024-01-01 Epub Date: 2024-03-12 DOI: 10.1159/000538184
Phillip Mitchell Johansen, Bronson Ciavarra, Ryan McCormack, Matthew Kole, Gary Spiegel, Stephen Alan Fletcher
{"title":"Superior Sagittal Sinus Thrombectomy in Pediatric Head Injury.","authors":"Phillip Mitchell Johansen, Bronson Ciavarra, Ryan McCormack, Matthew Kole, Gary Spiegel, Stephen Alan Fletcher","doi":"10.1159/000538184","DOIUrl":"10.1159/000538184","url":null,"abstract":"<p><strong>Introduction: </strong>Injury and subsequent thrombosis of the cerebral venous sinuses may be caused by closed head injuries secondary to a variety of different mechanisms. Skull fractures can lacerate or otherwise disrupt adjacent dural sinuses. The sequelae of such injuries may include thrombosis and either partial or total occlusion of the sinus, ultimately resulting in significant venous congestion. Sagittal sinus injury is associated with a more serious outcome due to the obligatory flow into the sinus, especially posterior to the coronal suture. In such cases, venous infarction may be a severe and life-threatening complication of head injury.</p><p><strong>Case presentation: </strong>A 2-year-old female presented with a depressed skull fracture near the midline and a thrombus in the sagittal sinus. Anticoagulation, the standard treatment cerebral venous sinus thrombosis (CVST), was contraindicated due to intracranial hemorrhage, so immediate thrombectomy was performed with successful neurologic recovery at 9-month follow-up. To our knowledge, this case is the youngest patient documented to receive mechanical thrombectomy for superior sagittal sinus (SSS) thrombosis due to trauma.</p><p><strong>Conclusion: </strong>Closed head injuries in pediatric patients may be associated with CVST, with resulting venous drainage compromise and profound neurologic sequelae. Unlike adult patients with spontaneous CVST in which anticoagulation are the standard of care, pediatric patients experiencing traumatic CVST may have contraindications to anticoagulants. If the patient has a contraindication to anticoagulation such as intracranial bleeding, endovascular mechanical thrombectomy may be an effective intervention when performed by an experienced neurointerventionalist.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140095165","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
Rare Onset of Erdheim-Chester Disease in Children and Young Adults: A Case Series and Review of the Literature. 儿童和青少年罕见的埃尔德海姆-切斯特病:病例系列和文献综述。
IF 0.7 4区 医学
Pediatric Neurosurgery Pub Date : 2024-01-01 Epub Date: 2024-01-23 DOI: 10.1159/000535898
Carmine Romano, Francesco Pegoraro, Augusto Vaglio, Chiara Spezzani, Elena Sieni, Ilaria Fotzi, Matteo Lenge, Andrea Di Rita, Simone Peraio, Alice Noris, Carla Gaggiano, Salvatore Grosso, Flavio Giordano
{"title":"Rare Onset of Erdheim-Chester Disease in Children and Young Adults: A Case Series and Review of the Literature.","authors":"Carmine Romano, Francesco Pegoraro, Augusto Vaglio, Chiara Spezzani, Elena Sieni, Ilaria Fotzi, Matteo Lenge, Andrea Di Rita, Simone Peraio, Alice Noris, Carla Gaggiano, Salvatore Grosso, Flavio Giordano","doi":"10.1159/000535898","DOIUrl":"10.1159/000535898","url":null,"abstract":"<p><strong>Introduction: </strong>Erdheim-Chester disease (ECD) is a rare histiocytic neoplasm that affects patients, predominantly males aged 40-70 years, with very heterogeneous clinical presentation and prognosis. In 2020, Goyal et al. proposed consensus recommendations for the management of patients with ECD, remarking on the exceptional presentation of the disease in the pediatric population.</p><p><strong>Case presentation: </strong>The first patient, a 20-year-old male, underwent cervical laminectomy and partial removal of a cervical spine lesion, initially apparently consistent with cervical schwannomas. The second patient, a 9-year-old female, received surgery for an extra-axial lesion of the greater sphenoid wing, radiologically consistent with a meningioma.</p><p><strong>Conclusion: </strong>At present, 15 pediatric cases have been reported in the literature with involvement of the central nervous system, with no consensus on the diagnostic and therapeutic management, as Pegoraro et al. evidenced in their pediatric multicenter case series. The present article adds two new cases of ECD with onset in childhood and young adulthood, who received the diagnosis after neurosurgical procedures.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139543346","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
Erratum. 勘误。
IF 0.7 4区 医学
Pediatric Neurosurgery Pub Date : 2024-01-01 Epub Date: 2023-12-08 DOI: 10.1159/000535255
{"title":"Erratum.","authors":"","doi":"10.1159/000535255","DOIUrl":"10.1159/000535255","url":null,"abstract":"","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138812587","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
Expanding Ventricular Diverticulum Overlying the Cerebral Hemisphere through an Open-Lip Schizencephalic Cleft: A Report of Two Pediatric Cases. 通过开唇裂隙覆盖大脑半球的扩张性脑室憩室:两例儿科病例的报告。
IF 0.9 4区 医学
Pediatric Neurosurgery Pub Date : 2024-01-01 Epub Date: 2024-01-10 DOI: 10.1159/000536188
Nobuya Murakami, Ai Kurogi, Tadahisa Shono, Michiko Torio, Takafumi Shimogawa, Nobutaka Mukae, Takato Morioka, Koji Yoshimoto
{"title":"Expanding Ventricular Diverticulum Overlying the Cerebral Hemisphere through an Open-Lip Schizencephalic Cleft: A Report of Two Pediatric Cases.","authors":"Nobuya Murakami, Ai Kurogi, Tadahisa Shono, Michiko Torio, Takafumi Shimogawa, Nobutaka Mukae, Takato Morioka, Koji Yoshimoto","doi":"10.1159/000536188","DOIUrl":"10.1159/000536188","url":null,"abstract":"<p><strong>Introduction: </strong>Open-lip-type schizencephaly is characterized by trans-cerebral clefts filled with cerebrospinal fluid (CSF) between the subarachnoid space at the hemisphere surface and the lateral ventricles. Disorders related to CSF retention, including hydrocephalus and arachnoid cysts, have reportedly been associated with open-lip schizencephaly and have induced intracranial hypertension in some cases. However, detailed neuroimaging and surgical treatment findings have rarely been described.</p><p><strong>Case presentation: </strong>We report 2 cases of open-lip schizencephaly with an expanding CSF-filled cavity overlying the ipsilateral cerebral hemisphere that manifested as signs of intracranial hypertension. Detailed three-dimensional heavily T2-weighted imaging revealed thin borders between the CSF-filled cavity and the subarachnoid space, but no separating structures between the cavity and the lateral ventricle, suggesting that the cavity was directly connected to the lateral ventricle through the schizencephalic cleft but not to the subarachnoid space. Neuroendoscopic observation in case 1 confirmed this finding. Endoscopic fenestration of the cavity to the prepontine cistern was ineffective in case 1. Shunting between the lateral ventricle (case 1) or CSF-filled cavity (case 2) and the peritoneal cavity slightly decreased the size of the CSF-filled cavity.</p><p><strong>Discussion: </strong>We speculate that the thin borders along the margin of the CSF-filled cavity are membranes that previously covered the schizencephalic cleft and are now pushed peripherally. In addition, we believe that the cavity is a ventricular diverticulum protruding through the cleft and that shunting operation is effective against such expanding cavity. Detailed magnetic resonance imaging can be useful for evaluating patients with schizencephaly associated with CSF retention disorders.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139418591","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
Traumatic Head Injuries from Ceiling Fans at a Pediatric Level I Trauma Center in the United States. 美国儿科一级创伤中心吊扇造成的颅脑创伤。
IF 0.7 4区 医学
Pediatric Neurosurgery Pub Date : 2024-01-01 Epub Date: 2023-11-18 DOI: 10.1159/000535335
Logan Muzyka, Holly Hughes Garza, Diala Merheb, Julie Sanchez, Elizabeth Tyler-Kabara, Karla A Lawson
{"title":"Traumatic Head Injuries from Ceiling Fans at a Pediatric Level I Trauma Center in the United States.","authors":"Logan Muzyka, Holly Hughes Garza, Diala Merheb, Julie Sanchez, Elizabeth Tyler-Kabara, Karla A Lawson","doi":"10.1159/000535335","DOIUrl":"10.1159/000535335","url":null,"abstract":"<p><strong>Background/objective: </strong>Several studies describe traumatic head injuries caused by ceiling fans in Australia, the Middle East, and Malaysia. Some injuries required neurosurgical intervention, especially those caused by metallic ceiling fans. This study describes traumatic head injuries caused by ceiling fans at a single pediatric level 1 trauma center in the Southern USA.</p><p><strong>Methods: </strong>Medical records were retrospectively reviewed for patients under 18 years of age who presented with a traumatic injury to the head from a ceiling fan from January 1, 2008, through December 31, 2021. The cohort of patients meeting all inclusion criteria was identified by querying multiple free-text fields derived from the electronic medical record, followed by a manual record review.</p><p><strong>Results: </strong>Of 60 children treated for traumatic head injury from a ceiling fan, the median age was 5.7 years and 53% were female. Laceration was the most common injury (80%), followed by scalp swelling/hematoma (20%), contusion (8%), and skull fracture (7%). Two patients (3%) with intracranial hemorrhage and fracture underwent neurosurgery. One neurosurgical case involved a metal ceiling fan and the other involved an outdoor ceiling fan. Nearly half of the injuries involved bunk or loft beds (47%) and young children were often injured while being lifted up by a caregiver (18%).</p><p><strong>Conclusion: </strong>Although most pediatric traumatic head injuries from ceiling fans resulted in minor injuries, our center saw a similar proportion of cases with skull fractures to what has been reported in Australia (5%). The effects of fan construction and blade material on the severity of head injury may warrant further study. Understanding the most common mechanisms for these injuries may guide injury prevention efforts.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138048811","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
Evolution of Surgical Management of Pineal Region Tumors in the Pediatric Population: A 17-Year Experience at a Single Institution. 小儿松果体区肿瘤手术治疗的演变:一家医疗机构 17 年的经验。
IF 0.9 4区 医学
Pediatric Neurosurgery Pub Date : 2024-01-01 Epub Date: 2024-04-26 DOI: 10.1159/000538745
Nirali Patel, Alexandria Marino, Tianzhi Tang, Kelsi Chesney, Jean Paul Bryant, Trae Robison, Robert F Keating, John S Myseros, Hasan R Syed
{"title":"Evolution of Surgical Management of Pineal Region Tumors in the Pediatric Population: A 17-Year Experience at a Single Institution.","authors":"Nirali Patel, Alexandria Marino, Tianzhi Tang, Kelsi Chesney, Jean Paul Bryant, Trae Robison, Robert F Keating, John S Myseros, Hasan R Syed","doi":"10.1159/000538745","DOIUrl":"10.1159/000538745","url":null,"abstract":"<p><strong>Introduction: </strong>Pineal region tumors have historically been challenging to treat. Advances in surgical techniques have led to significant changes in care and outcomes for these patients, and this is well demonstrated by our single institution's experience over a 17-year-period in which the evolution of diagnosis, treatment, and outcomes of pineal tumors in pediatric patients will be outlined.</p><p><strong>Methods: </strong>We retrospectively collected data on all pediatric patients with pineal region lesions treated with surgery at Children's National Hospital (CNH) from 2005 to 2021. Variables analyzed included presenting symptoms, presence of hydrocephalus, diagnostic and surgical approach, pathology, and adverse events, among others. IRB approval was obtained (IRB: STUDY00000009), and consent was waived due to minimal risk to patients included.</p><p><strong>Results: </strong>A total of 43 pediatric patients with pineal region tumors were treated during a 17-year period. Most tumors in our series were germinomas (n = 13, 29.5%) followed by pineoblastomas (n = 10, 22.7%). Twenty seven of the 43 patients (62.8%) in our series received a biopsy to establish diagnosis, and 44.4% went on to have surgery for resection. The most common open approach was posterior interhemispheric (PIH, transcallosal) - used for 59.3% of the patients. Gross total resection was achieved in 50%; recurrence occurred in 20.9% and mortality in 11% over a median follow-up of 47 months. Endoscopic third ventriculostomy (ETV) was employed to treat hydrocephalus in 26 of the 38 patients (68.4%) and was significantly more likely to be performed from 2011 to 2021. Most (73%) of the patients who received an ETV also underwent a concurrent endoscopic biopsy. No difference was found in recurrence rate or mortality in patients who underwent resection compared to those who did not, but complications were more frequent with resection. There was disagreement between frozen and final pathology in 18.4% of biopsies.</p><p><strong>Conclusion: </strong>This series describes the evolution of surgical approaches and outcomes over a 17-year-period at a single institution. Complication rates were higher with open resection, reinforcing the safety of pursuing endoscopic biopsy as an initial approach. The most significant changes occurred in the preferential use of ETVs over ventriculoperitoneal shunts. Though there has been a significant evolution in our understanding of and treatment for these tumors, in our series, the outcomes for these patients have not significantly changed over that time.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11232948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866217","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}
引用次数: 0
Middle Meningeal Artery Embolization in Pediatric Patients. 儿童患者的脑膜中动脉栓塞。
IF 0.9 4区 医学
Pediatric Neurosurgery Pub Date : 2024-01-01 Epub Date: 2023-10-30 DOI: 10.1159/000534895
Sima Vazquez, David A Zuckerman, Chirag Gandhi, Fawaz Al-Mufti, Carrie Muh, Justin Santarelli, Jared M Pisapia
{"title":"Middle Meningeal Artery Embolization in Pediatric Patients.","authors":"Sima Vazquez, David A Zuckerman, Chirag Gandhi, Fawaz Al-Mufti, Carrie Muh, Justin Santarelli, Jared M Pisapia","doi":"10.1159/000534895","DOIUrl":"10.1159/000534895","url":null,"abstract":"<p><strong>Background: </strong>Middle meningeal artery (MMA) embolization has been increasingly applied in adult populations for the treatment of chronic subdural hematomas (cSDH). There is a paucity of literature on the indications, safety, and outcomes of MMA embolization in the pediatric population.</p><p><strong>Summary: </strong>A systematic literature review on pediatric patients undergoing MMA embolization was performed. We also report the case of successful bilateral MMA embolization for persistent subdural hematomas following resection of a juvenile pilocytic astrocytoma. Persistent bilateral subdural hematomas following resection of a large brain tumor resolved following MMA embolization in a 13-year-old male. Indications for MMA embolization in the pediatric literature included cSDH (6/13, 46.2%), treatment or preoperative embolization of arteriovenous fistula or arteriovenous malformation (3/13, 23.1%), preoperative embolization for tumor resection (1/13, 7.7%), or treatment of acute epidural hematoma (1/13, 7.7%). Embolic agents included microspheres or microparticles (2/13, 15.4%), Onyx (3/13, 23.1%), NBCA (3/13, 23.1%), or coils (4/13, 30.8%).</p><p><strong>Key messages: </strong>Whereas MMA embolization has primarily been applied in the adult population for subdural hematoma in the setting of cardiac disease and anticoagulant use, we present a novel application of MMA embolization in the management of persistent subdural hematoma following resection of a large space-occupying lesion. A systematic review of MMA embolization in pediatric patients currently shows efficacy; a multi-institutional study is warranted to further refine indications, timing, and safety of the procedure.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71415312","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
Coexistence of Trigonocephaly and Sylvian Arachnoid Cysts: A Coincidence? 三头颅和西尔维蛛网膜囊肿并存:巧合?
IF 0.9 4区 医学
Pediatric Neurosurgery Pub Date : 2024-01-01 Epub Date: 2024-03-26 DOI: 10.1159/000538559
Federico Bianchi, Ludovico Agostini, Paolo Frassanito, Luca Massimi, Gianpiero Tamburrini
{"title":"Coexistence of Trigonocephaly and Sylvian Arachnoid Cysts: A Coincidence?","authors":"Federico Bianchi, Ludovico Agostini, Paolo Frassanito, Luca Massimi, Gianpiero Tamburrini","doi":"10.1159/000538559","DOIUrl":"10.1159/000538559","url":null,"abstract":"<p><strong>Introduction: </strong>The association between trigonocephaly and Sylvian fissure arachnoid cysts (ACs) has been occasionally reported in the literature. However, the real incidence of this association and its clinical relevance remain unknown.</p><p><strong>Methods: </strong>The authors collected and retrospectively reviewed all clinical charts and CT scans of patients surgically treated for trigonocephaly at the Pediatric Neurosurgical Department of Fondazione Policlinico Universitario \"Agostino Gemelli\" IRCCS from January 2014 to June 2023.</p><p><strong>Results: </strong>During the study period, 136 patients with trigonocephaly underwent surgery. Analysis of the clinical charts revealed that in 39.7% of the cases (54/136), preoperative CT scan depicted the presence of a Sylvian fissure AC. Of these, AC was bilateral in 23 cases and unilateral in the remaining 31. All unilateral ACs were on the left side. The ACs were classified as Galassi grade I in 52 cases (96.3%) and Galassi grade II in 2 cases (3.7%). Interestingly, in 1 case we reported a Galassi grade I AC enlargement during follow-up, thereby necessitating surgical fenestration.</p><p><strong>Conclusion: </strong>ACs and trigonocephaly are well-known conditions for pediatric neurosurgeons; however, their association is poorly defined. Despite the lack of reports on the incidence and clinical significance of this association, it is worth knowing that radiological follow-up is essential in monitoring AC evolution.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140295365","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
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