{"title":"Intracranial tuberculomas. An assessment of a therapeutic 4-drug trial in 35 children.","authors":"Z Domingo, J C Peter","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>35 children with suspected tuberculomas of the brain were given a therapeutic 4-drug trial of isoniazid, rifampicin, pyrazinamide and ethambutol. Their clinical and computed tomographic (CT) appearances were analysed retrospectively: 32 responded well to treatment with recognizable improvement on CT after 6 weeks. Three patients did not respond. One of these non-responders had a surgically removed temporal cystic astrocytoma. The majority presented with focal seizures and had a single hemispheral lesion. 14% had multiple lesions, 6% were in the cerebellum. Only 2 patients had raised intracranial pressure and required ventriculoperitoneal shunting.</p>","PeriodicalId":77766,"journal":{"name":"Pediatric neuroscience","volume":"15 4","pages":"161-6; discussion 166-7"},"PeriodicalIF":0.0,"publicationDate":"1989-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13630786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Management of posthemorrhagic hydrocephalus in the low-birth-weight preterm neonate.","authors":"D L Brockmeyer, L C Wright, M L Walker, R M Ward","doi":"10.1159/000120487","DOIUrl":"https://doi.org/10.1159/000120487","url":null,"abstract":"Over a period of 34 months from 1987 to 1990 we inserted ventricular catheter reservoirs (VCR) into 20 premature low-birth-weight infants who had developed progressive, symptomatic posthemorrhagic hydrocephalus following grade III or IV intraventricular hemorrhages. The mean estimated gestational age was 27.7 +/- 5.3 weeks and mean birth weight was 1,041 +/- 699 g. The ventricular catheter reservoirs were placed on day of life 30.7 +/- 29.7 and tapped for a total of 3-34 days at varying frequencies and for varying volumes. Of the 20 patients, 4 died on days of life 25, 76, 88, and 187. There were two reservoir infections, both occurring in infants who eventually died. The 16 survivors have been followed from 2 to 24 months (adjusted age). Four (25%) remain shunt-free and 3 have undergone VCR removal. There have been two shunt infections in the 12 shunted patients; ten shunt revisions have been performed overall. At the time of last follow-up, 14 patients were old enough to undergo neurodevelopmental evaluation. Five patients (36%) were 'normal' on gross neurological screening examination, 5 (36%) had 'mild developmental delay' and 4 (28%) had 'significant developmental delay'. We feel these data support the continued use of ventricular catheter reservoirs in the management of posthemorrhagic hydrocephalus and offer hope that some of these patients might remain shunt-free and most will have a normal or mildly delayed neurodevelopmental outcome.","PeriodicalId":77766,"journal":{"name":"Pediatric neuroscience","volume":"15 6","pages":"302-7; discussion 308"},"PeriodicalIF":0.0,"publicationDate":"1989-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000120487","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13634383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Efficacy of barbiturates in the treatment of resistant intracranial hypertension in severely head-injured children.","authors":"D A Bruce","doi":"10.1159/000120471","DOIUrl":"https://doi.org/10.1159/000120471","url":null,"abstract":"","PeriodicalId":77766,"journal":{"name":"Pediatric neuroscience","volume":"15 4","pages":"216"},"PeriodicalIF":0.0,"publicationDate":"1989-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000120471","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13631423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Candida albicans shunt infection.","authors":"S Shapiro, T Javed, J Mealey","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Seven cases of successfully treated Candida albicans cerebrospinal fluid shunt infections are reported. Treatment consisted of shunt removal and intravenous Amphotericin B in all cases and intraventricular Amphotericin B in 4 cases. Serious underlying medical illness, recent antibiotic therapy, indwelling intravascular and/or Foley catheters, coincident candidiasis and low birth weight prematurity are major risk factors for candida shunt infection. Candida shunt infection appears to occur by either contamination at the time of shunt placement or by hematogenous dissemination.</p>","PeriodicalId":77766,"journal":{"name":"Pediatric neuroscience","volume":"15 3","pages":"125-30"},"PeriodicalIF":0.0,"publicationDate":"1989-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13844750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Delayed cerebrospinal-fluid shunt infection in children.","authors":"S J Schiff, W J Oakes","doi":"10.1159/000120458","DOIUrl":"https://doi.org/10.1159/000120458","url":null,"abstract":"<p><p>Twelve patients with shunt infection occurring more than 6 months following shunt implantation or revision were identified and their charts reviewed. These cases were accumulated over a 9-year period, and delays from shunt surgery to detection were as long as 11 years. For 5 patients, no antecedent infection or surgery could be identified as a presumptive cause of the shunt infection. Propionibacterium species and Staphylococcus epidermidis species were the most common organisms identified. The risk of late onset of infection at this institution is less than 1% per year.</p>","PeriodicalId":77766,"journal":{"name":"Pediatric neuroscience","volume":"15 3","pages":"131-5"},"PeriodicalIF":0.0,"publicationDate":"1989-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000120458","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13844751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Stereotactic resection of pediatric vascular malformations.","authors":"M D Partington, D H Davis, P J Kelly","doi":"10.1159/000120472","DOIUrl":"https://doi.org/10.1159/000120472","url":null,"abstract":"<p><p>The technique of computer-assisted stereotactic resection of intra-axial neoplasms can also be used in the treatment of vascular malformations. We report a series of 12 pediatric patients with supratentorial lesions who underwent stereotactic resections between 1985 and 1988. There were 5 boys and 7 girls, with mean age 8 years (range 3-16). Epilepsy was the presenting symptoms in 8 children, hemorrhage in 3, and in 1 the lesion was incidentally diagnosed. Seven lesions were angiographically occult. All lesions were resected without mortality or morbidity. Seizures resolved in 7 of 8 cases, with the remaining patient experiencing a reduction in seizure frequency. Illustrative cases are presented.</p>","PeriodicalId":77766,"journal":{"name":"Pediatric neuroscience","volume":"15 5","pages":"217-22"},"PeriodicalIF":0.0,"publicationDate":"1989-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000120472","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13633565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A L Albright, J H Wisoff, P M Zeltzer, M Deutsch, J Finlay, D Hammond
{"title":"Current neurosurgical treatment of medulloblastomas in children. A report from the Children's Cancer Study Group.","authors":"A L Albright, J H Wisoff, P M Zeltzer, M Deutsch, J Finlay, D Hammond","doi":"10.1159/000120483","DOIUrl":"https://doi.org/10.1159/000120483","url":null,"abstract":"<p><p>To determine the current neurosurgical treatment of children with medulloblastomas, we reviewed the operative reports and neurosurgical report forms from 141 children with posterior fossa medulloblastomas treated on two current Children's Cancer Study Group (CCSG) protocols, CCG-921 for high-stage and CCG-923 for low-stage medulloblastoma. Most medulloblastoma operations were performed in major medical centers: 61% of the operations were performed in CCSG member institutions, 23% in CCSG affiliates and 16% in other institutions. The tumor T stage distribution was as follows: T1-4%, T2-15%, T3A-35%, T3B-36%, and T4-10%. Tumors infiltrated the brainstem in 38% of cases and were associated with hydrocephalus in 91% of cases. Hydrocephalus was managed by external ventricular drains in 50% and by shunts in 60%. Adjunctive instruments (e.g., microscope, ultrasonic aspirator) were used in 93% of the operations. Tumor removals were as follows: biopsy only 3%, partial removals 13%, subtotal removals 13%, near total removals 41% and gross total removals in 40%; 90% or more of the tumor was removed in 81% of the operations. Forty-seven percent of the operations were performed by pediatric neurosurgeons. Near total and gross total removals were performed significantly more often (p less than 0.05) by pediatric neurosurgeons than by general neurosurgeons. Postoperative morbidity was reported in 46% of cases, including neurologic morbidity in 26% of cases. There was no significant difference in patient morbidity between pediatric and general neurosurgeons.</p>","PeriodicalId":77766,"journal":{"name":"Pediatric neuroscience","volume":"15 6","pages":"276-82"},"PeriodicalIF":0.0,"publicationDate":"1989-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000120483","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13634380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Primary skin closure in large myelomeningoceles.","authors":"J F Teichgraeber, W B Riley, D H Parks","doi":"10.1159/000120435","DOIUrl":"https://doi.org/10.1159/000120435","url":null,"abstract":"<p><p>Numerous reconstructive methods have been described for the soft tissue closure of large myelomeningoceles. Recent advances in techniques of soft tissue expansion provide yet another reconstructive option. Tissue expansion allows for primary closure of the defect with surrounding tissue, resulting in minimal donor site morbidity. This report illustrates the technique of tissue expansion in the closure of a large myelomeningocele.</p>","PeriodicalId":77766,"journal":{"name":"Pediatric neuroscience","volume":"15 1","pages":"18-22"},"PeriodicalIF":0.0,"publicationDate":"1989-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000120435","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13777054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Feeding problems and lactic acidosis in a 10-week-old boy.","authors":"J Robinson, M G Norman","doi":"10.1159/000120437","DOIUrl":"https://doi.org/10.1159/000120437","url":null,"abstract":"","PeriodicalId":77766,"journal":{"name":"Pediatric neuroscience","volume":"15 1","pages":"28-35"},"PeriodicalIF":0.0,"publicationDate":"1989-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000120437","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13777055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Technique for the replacement of a peritoneal catheter.","authors":"J M Selman, L Basauri","doi":"10.1159/000120470","DOIUrl":"https://doi.org/10.1159/000120470","url":null,"abstract":"<p><p>A simple method for the replacement of a peritoneal catheter is described. The old catheter is disconnected from the valve and exteriorized from the peritoneal cavity, using a straight connector. The new catheter is anchored to the cranial or peritoneal end of the old catheter. A gentle traction allows the new catheter to follow the previous subcutaneous tunnel.</p>","PeriodicalId":77766,"journal":{"name":"Pediatric neuroscience","volume":"15 4","pages":"215"},"PeriodicalIF":0.0,"publicationDate":"1989-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000120470","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13630054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}