Journal of pediatric neuroradiology最新文献

{"title":"Developmental brain anomaly due to fetal hydrocephalus","authors":"Suman Das, K. Chattejee, J. Mazumdar, N. Sarkar, B. Aich","doi":"10.3233/PNR-13076","DOIUrl":"https://doi.org/10.3233/PNR-13076","url":null,"abstract":"Abstract In this article, the authors intend to illustrate a striking brain malformation due to early onset severe fetal hydrocephalus that superficially suggests the presence of semilobar holoprosencephaly.","PeriodicalId":89989,"journal":{"name":"Journal of pediatric neuroradiology","volume":"42 1","pages":"325 - 327"},"PeriodicalIF":0.0,"publicationDate":"2013-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88867729","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":"Spontaneous intracerebral hemorrhage: A pediatric case of undetermined etiology and review of literature","authors":"S. Pulivarthi, G. Rodriguez, E. Bershad, A. McKinney, A. Divani","doi":"10.3233/PNR-13074","DOIUrl":"https://doi.org/10.3233/PNR-13074","url":null,"abstract":"Abstract Cerebrovascular disorders, particularly intracerebral hemorrhage (ICH), rarely occur in children. The most common underlying cause for ICH in the pediatric population is arteriovenous malformation (AVM). The best approach to diagnostic evaluation of pediatric ICH is unknown due to its low incidence (2–3/100,000 children). In recent years, early discovery of underlying cause of pediatric ICH has been possible due to a more widespread use of imaging modalities such as computed tomography (CT), magnetic resonance imaging (MRI) and digital subtraction angiography (DSA). We report a case of a 5-year-old boy with a ICH of unknown etiology. He presented with left hemiparesis and left facial droop for one hour. Non-contrast CT scan demonstrated right periventricular hematoma extending to all ventricles. Follow-up MRI, CT angiography and DSA were unremarkable. Laboratory findings including liver function tests, hematologic studies were normal. Screening for hemoglobinopathies was negative. Transthoracic echocardiography was unremarkable. Surgery for ventricular drain placement and intense physical therapy were performed. During the follow ups at 1 and 6 mo of initial admission, repeat brain MRI and magnetic resonance angiography were unremarkable. The complete diagnostic evaluation in children presenting with ICH of undetermined origin is critically important, but still the etiology may not be identified in some cases. AsAVMs are the most common cause of ICHin children andmay rarely regress following hemorrhage, our patient's normal follow-up imaging may be related to such a spontaneous thrombosis of an underlying AVM.","PeriodicalId":89989,"journal":{"name":"Journal of pediatric neuroradiology","volume":"1 1","pages":"313 - 318"},"PeriodicalIF":0.0,"publicationDate":"2013-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84168339","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":"Intracranial arterial aneurysms in children and young adults","authors":"T. Abruzzo, V. Dinapoli, R. Rahme, B. Patel, K. O'brien, Lincoln M Jiménez, Ravishankar Shivashankar, J. Leach, J. Bissler, B. Jones","doi":"10.3233/PNR-13070","DOIUrl":"https://doi.org/10.3233/PNR-13070","url":null,"abstract":"Abstract Intracranial arterial aneurysms are an important cause of hemorrhagic stroke during the first two decades of life. In the pediatric population, intracranial arterial aneurysms have a diverse etiological spectrum. The clinical course, response to treatment and long-term prognosis correlate strongly with the mechanism of lesion pathogenesis. A variety of phenotypes have been characterized, having variably overlapping features and differentiated according to the mechanism of pathogenesis: (1) idiopathic, (2) traumatic, (3) infectious, (4) flow related, (5) oncotic, (6) non-infectious inflammatory, (7) arteriopathic and (8) familial. The purpose of this report is to review intracranial aneurysmal disease in the pediatric population. We discuss contemporary approaches to diagnostic evaluation and clinical management, emphasizing interventional strategies and recent advances.","PeriodicalId":89989,"journal":{"name":"Journal of pediatric neuroradiology","volume":"53 1","pages":"203 - 235"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83833339","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":"Interventional management of acute ischemic stroke in children","authors":"A. Akgoz, B. Gross, L. Lehman, M. Rivkin, D. Orbach","doi":"10.3233/PNR-13065","DOIUrl":"https://doi.org/10.3233/PNR-13065","url":null,"abstract":"Abstract The assessment and interventional management of pediatric arterial ischemic stroke (AIS) in the acute setting is a challenge, given the lack of safety and efficacy data on available treatment options and the absence of detailed guidelines specific for children. Endovascular therapy in pediatric AIS must be considered experimental and approached cautiously in order to minimize adverse outcomes, as there are no published studies or prospective clinical trials investigating the safety and efficacy of intra-arterial thrombolysis or mechanical thrombectomy in the management of pediatric AIS. Additional complicating factors include typically increased delays and increased challenge to appropriate diagnosis in children relative to adults, and underlying differences in the pathophysiology of AIS, the thrombotic cascade, and the natural history of AIS in children. Judicious extrapolation of adult data might be used for treatment of these cases with a highly individualized approach at high-volume centers, by a neurointerventional team in close collaboration with pediatric stroke neurologists. Mechanical approaches may be a safe and potentially effective therapeutic option.","PeriodicalId":89989,"journal":{"name":"Journal of pediatric neuroradiology","volume":"3 1","pages":"269 - 275"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78831137","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":"Pial non-galenic arteriovenous fistulas","authors":"Kevin J. Keenan, S. Hetts","doi":"10.3233/PNR-13068","DOIUrl":"https://doi.org/10.3233/PNR-13068","url":null,"abstract":"Abstract Pial nongalenic arteriovenous fistulas are rare vascular lesions of the brain. The recent decades have brought a new understanding of the origins and associations of these fistulas as well as improvements in diagnosis and treatment. Pediatric patients with nongalenic arteriovenous fistulas are increasingly likely to have good clinical outcomes except in the most complex cases. Recent advances and areas for further investigation will be reviewed.","PeriodicalId":89989,"journal":{"name":"Journal of pediatric neuroradiology","volume":"16 1","pages":"189 - 202"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81149594","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":"The role of digital subtraction cerebral angiography and the Wada test in the pediatric population","authors":"T. Watkins, M. Heran","doi":"10.3233/PNR-13071","DOIUrl":"https://doi.org/10.3233/PNR-13071","url":null,"abstract":"Abstract Catheter cerebral angiography in the pediatric population remains the ‘gold standard’ diagnostic modality for assessment of a number of neurovascular disorders. Although its use has declined due to advances in noninvasive imaging techniques, its ability to resolve and provide dynamic assessment of small vessels, vascular lesions and arteriovenous shunts/fistulae makes it an invaluable tool in the assessment and treatment planning for a number of cerebrovascular disorders. A number of subtle and significant differences exist between pediatric and adult cerebral catheter angiography, including methods of vascular access, catheter selection, contrast administration, and sedation requirements. Similarly, the indications for cerebral angiography are more varied compared with adults. Understanding the differences between pediatric and adult cerebral catheter angiography is essential to ensure safe and appropriate use of the investigation, and to minimize the associated risks. The selective intracarotid administration of sodium amytal (Wada) test is a tool for assessment of language dominance and memory in a select group of patients for preoperative epilepsy surgery planning. In addition to discussing the principles of the test, indications and contraindications, a number of specific issues pertaining to performing the Wada test in the pediatric population will also be addressed.","PeriodicalId":89989,"journal":{"name":"Journal of pediatric neuroradiology","volume":"35 1","pages":"293 - 300"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87982761","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":"Advances in neurointervention for pediatric neurovascular disease","authors":"T. Abruzzo","doi":"10.3233/PNR-13069","DOIUrl":"https://doi.org/10.3233/PNR-13069","url":null,"abstract":"This issue of the Journal of Pediatric Neuroradiology is dedicated to pediatric neurovascular conditions and their interventional management. With some exceptions, this category of pediatric disease is constituted by rare and exotic conditions, which remain obscure and poorly understood entities. Our understanding of these conditions, their pathogenesis, and natural history has improved in recent decades thanks to advances in neuroimaging technologies, epidemiological studies and a steady growth of the literature. Our ever-increasing fund of knowledge in this field is founded on the meticulous observations and records of early pioneers, and their contemporaries, some of who have contributed to this issue. Topics covered in this issue include childhood arterial ischemic stroke, cerebral aneurysms and neurovascular arteriovenous (AV) shunt lesions. Watkins and Heran review the role of diagnostic cerebral angiography in modern clinical neuropediatric practice. They remind us that even in the era of advanced computed tomography and magnetic resonance imaging (MRI), catheter based digital subtraction angiography (DSA) remains an irreplaceable diagnostic tool for the evaluation of numerous pediatric neurovascular conditions including vasculitis, cerebral aneurysms, and vascular malformations of the craniospinal axis. The essential role of catheter based DSA in the diagnostic evaluation of all children with hemorrhagic stroke, and many children with ischemic stroke is emphasized. The authors highlight major technical differences in peri-procedural patient care and catheter technique that are relevant to patients less than 50 kg. Watkins and Heran affirm the noted safety of neuroangiography in children, when performed by experienced specialists. The higher complication rate observed in patients less than 10 kg is addressed, and procedural modifications that have been adapted for this challenging group of patients are discussed. In their review, Watkins and Heran also discuss the continued importance of the Wada test in modern neuropediatric practice. Despite major advances, a number of challenges encountered in children with epilepsy may render functional MRI inadequate for pre-operative lateralization of language and memory. The authors address specific challenges encountered in the pediatric population undergoing Wada testing, and describe techniques they have adapted to address these challenges. Shakur and Lee give a concise update on pial AVmalformations (AVMs) of the brain presenting in childhood. *Address for correspondence: Todd A. Abruzzo, Department of Neurosurgery, 260 Stetson street, suite 2200, Cincinnati, OH 45219, USA. Tel.: +1 513 569 5214; Fax: +1 513 475 8628; E-mail: todd. abruzzo@cchmc.org. Journal of Pediatric Neuroradiology 2 (2013) 181–187 DOI 10.3233/PNR-13069 IOS Press 181","PeriodicalId":89989,"journal":{"name":"Journal of pediatric neuroradiology","volume":"120 1","pages":"181 - 187"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86260786","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":"Advances in the diagnosis and management of vein of Galen malformations","authors":"T. Abruzzo, Lincoln M Jiménez, Lauren R Ostling, C. Stevenson, Ravishankar Shivashankar, J. Leach, B. Jones","doi":"10.3233/PNR-13063","DOIUrl":"https://doi.org/10.3233/PNR-13063","url":null,"abstract":"Abstract The vein of Galen malformations are a heterogeneous group of developmental arteriovenous shunt lesions characterized by arterialization of the early embryonic choroidal venous circulation. The arteriovenous shunt lesion manifests a spectrum of age dependent clinical phenotypes each of which expresses a wide range of disease severity. Clinical presentation is determined by lesion specific, host specific and environmental factors. In recent years, patient oriented treatment strategies directed at optimizing cardiovascular and neurodevelopmental outcomes have evolved. Treatment is tailored to address specific clinical phenotypes that are differentiated according to their pathophysiology. This paper will review current approaches to the diagnosis and treatment of vein of Galen malformations patients emphasizing clinical phenotypes of the fetus, neonate and infant.","PeriodicalId":89989,"journal":{"name":"Journal of pediatric neuroradiology","volume":"84 1","pages":"237 - 261"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91380504","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":"Pediatric spinal vascular malformations: Diagnosis and treatment","authors":"P. Moftakhar, S. Hetts","doi":"10.3233/PNR-13067","DOIUrl":"https://doi.org/10.3233/PNR-13067","url":null,"abstract":"Abstract Spinal vascular malformations in children differ in several ways from those found in adults. Genetic syndromes are more common in the pediatric population. Onset of symptoms and clinical presentation is often more acute than in adults. Angioarchitecture of the various spinal vascular malformations differs from adults, with relative overrepresentation of perimedullary arteriovenous fistulas and nidal arteriovenous malformations and a dearth of dural fistulas. Fortunately, excellent results can often be obtained with endovascular or surgical intervention. This review will briefly examine the anatomy, genetics, clinical presentation, imaging, treatment, and outcomes of spinal vascular malformations in children.","PeriodicalId":89989,"journal":{"name":"Journal of pediatric neuroradiology","volume":"144 1","pages":"283 - 292"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86640820","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":"Pediatric cerebral arteriovenous malformations","authors":"S. Shakur, S. Lee","doi":"10.3233/PNR-13066","DOIUrl":"https://doi.org/10.3233/PNR-13066","url":null,"abstract":"Abstract Pial arteriovenous malformations (AVMs) of the brain are vascular abnormalities located in the subpial space that consist of direct communications from artery to vein via intervening nidus. AVMs are the most common intracranial pathology and frequent cause of intracranial hemorrhage in children. Moreover, the epidemiology and clinical findings particular to children with AVMs can be ascribed to the distinct angioarchitecture of pediatric AVMs. However, the natural history and treatment of pediatric AVMs is relatively unknown. In this article, we review current knowledge of pediatric pial AVMs.","PeriodicalId":89989,"journal":{"name":"Journal of pediatric neuroradiology","volume":"20 1","pages":"277 - 281"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78960584","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}