Pediatric Neurosurgery最新文献

筛选
英文 中文
Management of Pediatric Cavum Cysts: A Scoping Review and a Single Institution Case Series. 小儿腔隙囊肿的治疗:范围综述和单一机构病例系列。
IF 0.9 4区 医学
Pediatric Neurosurgery Pub Date : 2024-01-01 Epub Date: 2024-04-30 DOI: 10.1159/000538837
Habib Emil Rafka, Eric Scot Shaw, Brian Fabian Saway, Daniel Slade, Thomas Harold Kelly, Ramin Eskandari
{"title":"Management of Pediatric Cavum Cysts: A Scoping Review and a Single Institution Case Series.","authors":"Habib Emil Rafka, Eric Scot Shaw, Brian Fabian Saway, Daniel Slade, Thomas Harold Kelly, Ramin Eskandari","doi":"10.1159/000538837","DOIUrl":"10.1159/000538837","url":null,"abstract":"<p><strong>Introduction: </strong>Pediatric cavum cysts are a rare yet complicated pathology to manage. The literature is scarce, primarily consisting of case series, and lacking a consensus regarding clear management. In this scoping review, we aimed to compile existing information in the literature regarding the management of pediatric cavum cysts across the last 10 years. We also present our management of 19 patients, the largest case series to date, highlighting knowledge gaps surrounding the management of this salient pathology.</p><p><strong>Methods: </strong>A literature search using PubMed and SCOPUS was conducted using the following search terms: (pediatric) AND (Cavum septum pellucidum) OR (cavum vergae) OR (cavum velum interpositum) AND (management). Eligibility criteria included peer-reviewed publication published in the last 10 years, pediatric population, cavum cyst, and English language. A retrospective search was conducted for all pediatric cavum cysts between 2013 and 2023 at our institution. Clinical and radiographic characteristics as well as intervention and outcome data were collected for both the scoping review and our cases.</p><p><strong>Results: </strong>330 total articles were populated using our search. 12 articles met our inclusion criteria. 41.7% (n = 5) of the articles were case series, 33.3% (n = 4) were case reports, 8.3% (n = 1) was a technical article, 8.3% (n = 1) was a systematic review, and 8.3% (n = 1) was a case questionnaire. Resolution of symptoms was noted in all articles of our scoping review, regardless of treatment modality. The average age in our case series was 9.84 years old and average age at diagnosis was 5.53 years old. 6 patients (31.6%) were female and 13 patients (68.4%) were male. 2 out of the 19 patients (10.5%) were surgically treated.</p><p><strong>Conclusion: </strong>There is no clear consensus on the management of cavum cysts. A prospective, multicenter study is needed to create standardized pediatric cyst management guidelines. The current thought is that surgical intervention should be saved for those patients with obstructive hydrocephalus and signs of intracranial hypertension.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":" ","pages":"78-86"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11232947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873620","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
Pediatric Cervical Spine Trauma: Injury Patterns, Diagnosis, and Treatment. 小儿颈椎创伤:损伤模式、诊断和治疗》(Pediatric Cervical Spine Trauma: Injury Patterns, Diagnosis, and Treatment)。
IF 0.9 4区 医学
Pediatric Neurosurgery Pub Date : 2024-01-01 Epub Date: 2024-09-20 DOI: 10.1159/000541483
Taemin Oh, Kasey J Han, Vardhaan S Ambati, John K Yue, John F Burke, Alex Y Lu, Peter P Sun
{"title":"Pediatric Cervical Spine Trauma: Injury Patterns, Diagnosis, and Treatment.","authors":"Taemin Oh, Kasey J Han, Vardhaan S Ambati, John K Yue, John F Burke, Alex Y Lu, Peter P Sun","doi":"10.1159/000541483","DOIUrl":"10.1159/000541483","url":null,"abstract":"<p><strong>Background: </strong>Traumatic injuries to the cervical spine or spinal cord are uncommon pathologies in the pediatric population. As injury severity is disproportionately higher among children due to significant risk for debilitating long-term disability, traumatic spinal fractures in children raise greater clinical concern than comparable injuries in adults.</p><p><strong>Summary: </strong>Unlike adults, children possess unique features such as incomplete ossification of vertebrae, synchondroses, pseudo-subluxation, horizontal alignment of ligaments, and absence of lordosis, which results in greater mobility and flexibility in the pediatric spine. These features are prominent in the cervical spine, which accounts for the most common area of traumatic spinal injuries in children.</p><p><strong>Key messages: </strong>In this review, we summarize injury patterns, diagnosis, and treatment of traumatic cervical spine injuries in the pediatric population.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":" ","pages":"210-228"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301148","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
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":" ","pages":"1-13"},"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
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":" ","pages":"94-101"},"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
The Caregiver Burden of Helmet Therapy following Endoscopic Strip Craniectomy: A Phenomenological Qualitative Study. 内窥镜带状颅骨切除术后头盔疗法的护理负担:现象学定性研究。
IF 0.9 4区 医学
Pediatric Neurosurgery Pub Date : 2024-01-01 Epub Date: 2024-05-14 DOI: 10.1159/000539299
Tega Ebeye, Ayeh Hussain, Erin Brennan, Abhaya V Kulkarni, Christopher R Forrest, Johanna N Riesel
{"title":"The Caregiver Burden of Helmet Therapy following Endoscopic Strip Craniectomy: A Phenomenological Qualitative Study.","authors":"Tega Ebeye, Ayeh Hussain, Erin Brennan, Abhaya V Kulkarni, Christopher R Forrest, Johanna N Riesel","doi":"10.1159/000539299","DOIUrl":"10.1159/000539299","url":null,"abstract":"<p><strong>Introduction: </strong>This cohort study aimed to elucidate the caregiver burden of helmet therapy (HT), following endoscopic strip craniectomy (ESC) to treat craniosynostosis, in an effort to inform clinicians and future caregivers navigating this therapeutic option.</p><p><strong>Methods: </strong>Fourteen caregivers of children with positional plagiocephaly (6) and craniosynostosis treated by ESC (8) undergoing HT at a single center were recruited via convenience sampling. Using a phenomenological qualitative approach, semi-structured interviews were conducted to understand the experience of HT for caregivers. Data collection and analysis were iterative and conducted until thematic saturation was reached.</p><p><strong>Results: </strong>Emerging themes revealed five domains of caregiver burden: emotional, cognitive, physical, psychosocial, and financial. No caregiver felt the therapy was too burdensome to complete. Caregivers of both groups also expressed positive aspects of HT related to support from the team, the noninvasive nature of treatment, and the outcomes of therapy. Furthermore, caregivers report overall satisfaction with the process, stating willingness to repeat the treatment with subsequent children if required.</p><p><strong>Conclusion: </strong>HT is associated with five major domains of caregiver burden; however, none of the caregivers regret choosing this treatment option, nor was the burden high enough to encourage treatment cessation. This study will inform future prospective analyses that will quantify real-time caregiver burden throughout HT.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":" ","pages":"121-129"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11493373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140917533","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
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":" ","pages":"55-65"},"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
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":" ","pages":"35-43"},"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":" ","pages":"54"},"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":" ","pages":"102-108"},"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
Management of Pediatric Patient with Multiple Cranial, Intracranial, and Spinal Manifestations of Penttinen Syndrome: A Case Report. 彭丁能综合征多发颅内、颅内和脊柱表现的儿科患者的治疗:病例报告。
IF 0.9 4区 医学
Pediatric Neurosurgery Pub Date : 2024-01-01 Epub Date: 2024-08-12 DOI: 10.1159/000540756
Megan V Ryan, Reinier Alvarez, Ellen R Elias, Chinonye Ihekweazu, C Corbett Wilkinson
{"title":"Management of Pediatric Patient with Multiple Cranial, Intracranial, and Spinal Manifestations of Penttinen Syndrome: A Case Report.","authors":"Megan V Ryan, Reinier Alvarez, Ellen R Elias, Chinonye Ihekweazu, C Corbett Wilkinson","doi":"10.1159/000540756","DOIUrl":"10.1159/000540756","url":null,"abstract":"<p><strong>Introduction: </strong>Penttinen premature aging syndrome is caused by mutations in the PDGFRB gene. We describe the case of a 10-year-old girl with a de novo c.1994T&gt;C variant in PDGFRB who developed multiple cranial, intracranial, and spinal manifestations, including macrocephaly, enlarged convexity subarachnoid spaces crossed by numerous vascularized arachnoid trabecule, hydrocephalus, spinal epidural lipomatosis, a low conus medullaris, calvarial thinning with large anterior fontanelle, and a skull fracture with bilateral epidural hematomas. Vascularized arachnoid granulations, spinal epidural lipomatosis, and low conus medullaris have not been previously described in Penttinen syndrome.</p><p><strong>Case presentation: </strong>A female with Penttinen syndrome diagnosed at 9 years of age initially presented as an infant with cutaneous hemangiomas and macrocephaly; imaging showed enlarged convexity subarachnoid spaces. Her convexity subarachnoid spaces continued to expand, leading to subdural shunt placement. At surgery, her enlarged subarachnoid spaces were found to contain numerous abnormally thick, vascularized arachnoid trabecule. Eventually, her subdural shunt failed and her ventricles enlarged, leading to ventricular shunt placement. A large, sunken anterior fontanelle which did not diminish in size led to cranioplasty with a custom implant. She later developed chronic back pain and imaging revealed spinal epidural lipomatosis, a low conus medullaris, and mild scoliosis. At 10 years of age, a fall from a chair resulted in a depressed skull fracture and bilateral parietal epidural hematomas. Emergency left parietal craniotomy was performed for evacuation of the left hematoma, and the patient recovered without complications. Intraoperatively, it was noted that her skull was extremely thin.</p><p><strong>Conclusion: </strong>This case report highlights the clinical presentation and multifaceted neurosurgical management of a patient with Penttinen syndrome. The patient exhibited characteristic features including hypertrophic skin lesions, macrocephaly, and skeletal abnormalities. Our patient's vascularized arachnoid trabecule, spinal epidural lipomatosis, and low conus medullaris have not previously been reported in Penttinen syndrome. Her thin skull potentially contributed to the extent of her depressed skull fracture after her backwards fall and predisposed her toward developing epidural hematomas. Patients with Penttinen syndrome can have multiple cranial, intracranial, and spinal manifestations which may need the attention of a neurosurgeon.</p>","PeriodicalId":54631,"journal":{"name":"Pediatric Neurosurgery","volume":" ","pages":"165-172"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972303","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
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信