Child's Nervous System最新文献

{"title":"Resective epilepsy surgery in pediatric patients with normal MRI: outcomes, challenges, and cost-effectiveness in low-resource settings.","authors":"Felipe Gutierrez-Pineda, Manuel Vicente Jaramillo-Canastero, Lucas Lozano-Garcia, Juan Felipe Alvarez-Restrepo, José Fernando Zapata-Berruecos, Héctor Alfredo Jaramillo-Betancur","doi":"10.1007/s00381-025-06814-4","DOIUrl":"https://doi.org/10.1007/s00381-025-06814-4","url":null,"abstract":"<p><strong>Background: </strong>Pediatric patients with drug-resistant epilepsy and normal preoperative MRIs present significant challenges in surgical planning. Advanced diagnostic techniques, including PET, SPECT, and intraoperative ECOG, are used to localize seizure foci, but their high cost and limited availability pose challenges, especially in low-resource settings. This study aims to evaluate the outcomes of resective epilepsy surgery in these cases and assess the role of advanced imaging in a middle-income country.</p><p><strong>Methods: </strong>This retrospective cohort study included 12 pediatric patients (mean age 10.21 years) with normal preoperative 3 T MRI who underwent resective epilepsy surgery or functional hemispherectomy between 2007 and 2021 at two centers in Medellín, Colombia. Demographic, clinical, and surgical data were collected, including the use of advanced imaging techniques (PET, SPECT) and intraoperative ECOG. Seizure outcomes were assessed using the Engel Epilepsy Surgery Outcome Scale.</p><p><strong>Results: </strong>Of the 12 patients, 10 underwent extratemporal resections, and 2 underwent temporal lobe surgery. Seven patients had advanced imaging, and 5 were evaluated with intraoperative ECOG. At 2-year follow-up, 83.3% of patients who underwent resective surgery achieved favorable outcomes (Engel Classes I and II). Temporal lobe resections had a higher rate of seizure freedom (50%) compared to extratemporal resections (30%), although the difference was not statistically significant (p = 0.47). Reoperations due to seizure recurrence were required in 30% of extratemporal resections (p = 0.02). Complications were minimal, with three superficial wound infections. Histopathology revealed cortical dysplasia in 33.3% of cases.</p><p><strong>Conclusion: </strong>Epilepsy surgery in pediatric patients with normal MRIs can yield favorable outcomes, especially with temporal lobe resections. Advanced imaging improves localization but remains costly, highlighting the need for cost-effective surgical strategies in resource-limited settings.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"152"},"PeriodicalIF":1.3,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787928","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}

{"title":"Adamantinomatous craniopharyngioma stone: is it a tumor?","authors":"Sérgio Cavalheiro, Lorena Favaro Pavon, Marcos Devanir Silva da Costa, Patrícia Alesssandra Dastoli, Rodrigo Akira Watanabe, Isaque Hyung Tong Kim, Fernando Seiji Suzuki, Flávia Borelli Nascimento, Khallil Taverna Chaim, Francisco Romero Cabral, Silvia Regina Caminada Toledo, Tatiana Tais Sibov","doi":"10.1007/s00381-025-06798-1","DOIUrl":"https://doi.org/10.1007/s00381-025-06798-1","url":null,"abstract":"<p><strong>Introduction: </strong>Adamantinomatous craniopharyngioma (ACP) is a benign epithelial tumor of the sellar and suprasellar region, and in children, it usually presents with cysts and calcifications.</p><p><strong>Methods: </strong>In this study, ACP samples were collected, and after enzymatic digestion of the calcified component of these tumors, which were placed in culture to isolate possible cellular components, in vitro and in vivo viability analysis and characterization were performed.</p><p><strong>Results: </strong>ACP-calcified component cells cultured in vitro were established showing the doubling time in 2 days, confirmed by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. Other analyses were carried out, such as ultrastructural characterization and the growth of ACP-calcified component cells in xenograft animal model by MRI monitoring. Immunocytochemistry detected cytokeratin-7 expression in the cytomembrane and cytoplasm of ACP-calcified component cells, confirming that the tumor mass established in the xenograft animal model comes from calcified component of ACP patients' cell cultures which were squamous epithelial cells.</p><p><strong>Conclusions: </strong>Thus, our results suggest that the calcifications present in ACPs have the capacity to generate a tumor, and we could only consider complete tumor excision when all calcifications have been removed. Therefore, these ACP-calcified component cell cultures may be important to study possible targets for drug therapies and help understand the progression mechanisms of this tumor and better control its spread.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"151"},"PeriodicalIF":1.3,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779210","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}

{"title":"5-Aminolevulinic acid (5-ALA) in paediatric brain tumour surgery-a systematic review and exploration of fluorophore alternatives.","authors":"Victoria G Collins, Charvi Kanodia, Qalisya Binti Yahya, Marianna Liistro, Chandrasekaran Kaliaperumal","doi":"10.1007/s00381-025-06810-8","DOIUrl":"10.1007/s00381-025-06810-8","url":null,"abstract":"<p><strong>Purpose: </strong>Paediatric brain tumours represent the most common solid malignancies in children, with extent of resection being a critical prognostic factor. Fluorescence-guided surgery using 5-aminolevulinic acid (5-ALA) is well-established for adult high-grade gliomas, but its efficacy and safety in paediatric populations remain unclear. This systematic review evaluates the utility of 5-ALA fluorescence-guided surgery in paediatric brain tumours and explores alternative fluorophores.</p><p><strong>Methods: </strong>A systematic review was conducted according to PRISMA guidelines, analysing studies from MEDLINE and EMBASE published up to October 2024. Data on patient demographics, tumour fluorescence patterns, surgical outcomes, and adverse effects were extracted. Statistical analyses assessed fluorescence differences across tumour types and administration parameters.</p><p><strong>Results: </strong>Twenty-three studies, including 281 paediatric patients (mean age, 10 years), were analysed. The most common tumours included pilocytic astrocytomas (n = 45), medulloblastomas (n = 45), glioblastomas (n = 35), and ependymomas (n = 27). Strong fluorescence was observed more frequently in high-grade gliomas compared to low-grade gliomas (p < 0.00001), non-glioma tumours (p < 0.00001), and high-grade non-glioma tumours (p = 0.000485). Adverse effects were mostly transient; rare complications included transaminitis and dermatologic reactions.</p><p><strong>Conclusion: </strong>5-ALA fluorescence-guided surgery shows promise in the resection of high-grade gliomas in paediatric patients, improving intraoperative visualisation. However, limited fluorescence in low-grade and non-glioma tumours underscores the need for tumour-specific approaches. Emerging alternatives, such as fluorescein sodium and tozuleristide, offer potential advantages. Future research should focus on optimising 5-ALA dosing, refining timing protocols, and conducting robust prospective trials to establish efficacy and safety in paediatric populations.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"150"},"PeriodicalIF":1.3,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771495","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}

{"title":"Frequency and outcomes of midline gliomas in a tertiary care hospital in Pakistan: a retrospective study.","authors":"Soha Zahid, Farrah Bashir, Ali Mustansir, Khurram Minhas, Bilal Mazhar Qureshi, Kiran Hilal, Syed Ather Enam, Eric Bouffet, Naureen Mushtaq","doi":"10.1007/s00381-025-06811-7","DOIUrl":"https://doi.org/10.1007/s00381-025-06811-7","url":null,"abstract":"<p><strong>Introduction: </strong>Midline structures in the central nervous system include the thalamus, brainstem, and spinal cord. Within the midline tumors, Diffuse midline gliomas (DMGs) and diffuse intrinsic pontine gliomas (DIPG) have a poor prognosis. DMGs are inclusive of all diffuse intrinsic pontine gliomas (DIPG), previously usually used for only pontine gliomas, to emphasize that these lesions are not solely centered in the pons/brainstem. In this retrospective review, we aim to report the frequency and outcomes of midline gliomas amongst all midline tumors in a tertiary care setup.</p><p><strong>Methods: </strong>Data were collected retrospectively from the medical records at Aga Khan University Hospital between 2013 and 2023. All patients aged 18 and younger with tumors in midline locations were reviewed, and 102 patients were included. A few tumor samples were also sent to SickKids, Toronto, for molecular testing.</p><p><strong>Results: </strong>Our cohort represents 102 patients with midline tumors, a median age of 11 years (interquartile range (IQR): 7.75-15 years), and a similar male-to-female ratio. Most patients presented with limb weakness and headache (median duration: 1.5 months, IQR: 1-4 months). The most common site of tumors was the brainstem, followed by the spine and thalamus. Sixty-six patients had surgery: 2 DIPGs, 15 low-grade gliomas, 13 ependymomas, 8 high-grade gliomas, 12 diffuse midline glioma, and 16 other tumors were identified. All of the patients diagnosed with DMG had H3K27 alteration on immunohistochemistry. Thirty-six patients were diagnosed via radiology: 33 DIPG and 3 tectal plate glioma. Only 10 patients received chemotherapy, and radiation therapy was given to 24 patients. Overall survival for all midline tumors was 53.9%, with 47 events.</p><p><strong>Conclusion: </strong>Our study depicts poor survival outcomes at one year of patients diagnosed with DMG (16.7%) and DIPG (14.3%) amongst all midline tumors, regardless of radiation therapy or concurrent chemoradiotherapy. To improve the care and survival of all midline tumors, there is a dire need for affordable diagnostic techniques in specialized centers across low- and middle-income countries.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"148"},"PeriodicalIF":1.3,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762524","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}

{"title":"The state of targeted therapeutic pharmacological approaches in pediatric neurosurgery: report from the European Society for Pediatric Neurosurgery (ESPN) Consensus Conference 2024.","authors":"P Frassanito, U W Thomale, M Obersnel, A Romano, P Leblond, F Knerlich-Lukoschus, B J Due-Tønnessen, D Thompson, F Di Rocco","doi":"10.1007/s00381-025-06799-0","DOIUrl":"10.1007/s00381-025-06799-0","url":null,"abstract":"<p><strong>Objective: </strong>The development of novel targeted therapies is opening new perspectives in the treatment of pediatric brain tumors. Their precise role in therapeutic protocols still needs still to be defined. Thus, these novel pharmacological approaches in pediatric neurosurgery were the topic of the European Society for Pediatric Neurosurgery (ESPN) Consensus Conference held in Lyon (France) in January 25-27, 2024.</p><p><strong>Method: </strong>The paper reviews the current knowledge about targeted therapy as well as the current literature published on the topic. The conference aimed for an interdisciplinary consensus debate among pediatric oncologists and pediatric neurosurgeons on the following questions. Question 1: What is the current role for targeted therapies as neoadjuvant treatments before pediatric brain tumor removal? Question 2: What are the benefits, cost/efficiency, and long-term side effects of targeted therapies in the treatment of pediatric brain tumors? Question 3: Based on contemporary data, at which stage and in which pathologies do targeted therapies play a significant role?</p><p><strong>Results: </strong>Ninety-two participants answered consensus polls on the state of the art of targeted therapies, the ethical issues related to their use, and the evolving change in the role of pediatric neurosurgeons. The neoadjuvant role of targeted therapies is difficult to define as there are many different entities to consider. Despite the recently reported potential benefits, questions regarding the use of targeted therapies are manifold, in particular regarding sustainable benefits and long-term side effects. Additionally, challenging cost issues is a limiting factor for the broader availability of these drugs. Studies have demonstrated superiority of targeted therapy compared to chemotherapy both in randomized trials and compared to historical cohorts in the management of a subset of low-grade gliomas. The same drug combinations, BRAFi and MEKi, may be effective in HGG that have relapsed, progressed, or failed to respond to first-line therapy. Similar conclusions on efficacy may be drawn for mTORi in TSC and selumetinib in plexiform neurofibromas. For other tumors, the picture is still obscure due to the lack of data or even the lack of suitable targets. In conclusion, targeted treatment may not always be the best option even when a target has been identified. Safe surgery remains to be a favorable option in the majority of cases.</p><p><strong>Conclusion: </strong>The constantly evolving drug technology and the absence of long-term safety and efficacy studies made it difficult to reach a consensus on the predefined questions. However, a report of the conference is summarizing the present debate and it might serve as a guideline for future perspectives and ongoing research.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"149"},"PeriodicalIF":1.3,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771498","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}

{"title":"Can the BIG score reliably predict outcomes in pediatric traumatic brain ınjury?","authors":"Abdulrahman Özel, Servet Yüce, Esma Şengenç, Esra Nur İlbeği, İzzettin Kaya, Şevval Özyılmaz Gazneli, Meltem Erol","doi":"10.1007/s00381-025-06809-1","DOIUrl":"https://doi.org/10.1007/s00381-025-06809-1","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the prognostic value of the BIG score in predicting mortality and functional outcomes in pediatric patients with traumatic brain injury (TBI).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on pediatric TBI patients admitted to the Pediatric Intensive Care Unit (PICU) between 2020 and 2024 at a tertiary hospital. Functional outcomes at discharge were assessed using the Functional Status Scale (FSS). Receiver operating characteristic (ROC) analysis determined the predictive accuracy of the BIG score, Pediatric Trauma Score (PTS), Pediatric Glasgow Coma Scale (pGCS), and Pediatric Risk of Mortality III (PRISM III).</p><p><strong>Results: </strong>A total of 103 patients were included. The mortality rate was 13.6% (n = 14), and 21.4% of survivors had functional impairment at discharge. In non-survivors, the BIG score, PTS, pGCS, and PRISM III were significantly elevated (all p < 0.001). The AUC for predicting mortality was 0.966 (BIG score), 0.911 (PRISM III), 0.909 (pGCS), and 0.827 (PTS). For functional impairment, the AUC values were 0.815 (BIG score), 0.812 (pGCS), 0.715 (PRISM III), and 0.645 (PTS). Correlation analysis showed a strong association between FSS scores and mechanical ventilation duration (r = 0.786, p < 0.001) and PICU length of stay (r = 0.706, p < 0.001).</p><p><strong>Conclusion: </strong>The BIG score is a rapid, reliable predictor of mortality and functional outcomes in pediatric TBI patients, outperforming pGCS in patients with an initial pGCS of 3. Prospective studies are needed for further validation.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"147"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751427","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}

{"title":"Diencephalic-mesencephalic junction dysplasia: case report and literature review.","authors":"Tenoch Herrada-Pineda, Ana Karen Perez-Vazquez, Salvador Manrique-Guzman, Francisco R Revilla-Pacheco, Eduardo Torres-Olivas, Maria Jose Wilches-Davalos, Tania Ivette Sanchez-Zacarias, Gilda Garza-Mayen, Jorge Arturo Cardona-Perez","doi":"10.1007/s00381-025-06808-2","DOIUrl":"https://doi.org/10.1007/s00381-025-06808-2","url":null,"abstract":"<p><p>Diencephalic-mesencephalic junction (DMJ) dysplasia is a rare congenital brain malformation characterized by a poorly defined junction between the diencephalon and mesencephalon, often associated with a butterfly-like contour of the midbrain on magnetic resonance imaging (MR). We report the case of a newborn female diagnosed prenatally with DMJ dysplasia who presented with severe ventriculomegaly, hydrocephalus, and oligohydramnios. Prenatal MRI at 32 weeks revealed a thickened interthalamic adhesion, an elongated midbrain with ventral cleft, aqueductal stenosis, and corpus callosum dysgenesis. Postnatal MRI confirmed these findings, along with the characteristic \"butterfly\" midbrain morphology. Genetic analysis revealed a pathogenic 11.9 Mb terminal deletion in the 6q25.3q27 region, encompassing candidate neurodevelopmental genes, such as DLL1, and a 3.8 Mb partial duplication in 22q13.31q13.33, of unknown significance. Parental genetic testing revealed a maternal balanced reciprocal translocation between chromosomes 6 and 22 (asymptomatic carrier), which was inherited in an unbalanced form by the proband. A ventriculoperitoneal shunt was placed within the first 48 h of life to manage hydrocephalus, with subsequent adjustments and revisions as needed. This case highlights the importance of advanced prenatal imaging and genetic testing in the diagnosis of complex brain malformations as well as the need for multidisciplinary management of rare congenital anomalies. Further research is essential to elucidate the underlying genetic mechanisms and improve the outcomes in patients with DMJ dysplasia.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"146"},"PeriodicalIF":1.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751429","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}

{"title":"Surgical management of a giant glial hamartoma in a pediatric patient: a case report.","authors":"Guive Sharifi, Elham Paraandavaji, Shahin Naghizadeh, Yalda Nilipour, Mohammad Ali Kazemi, Sajjad Khanbabazadeh, Farzad Taghizadeh-Hesary","doi":"10.1007/s00381-025-06792-7","DOIUrl":"https://doi.org/10.1007/s00381-025-06792-7","url":null,"abstract":"<p><strong>Introduction: </strong>Glial hamartomas are benign growths of glial cells, and their management is challenging due to their rarity and variable presentation. We present a case of a giant glial hamartoma in a pediatric patient, incidentally discovered during routine imaging for a planned tonsillectomy.</p><p><strong>Case description: </strong>A 7-year-old boy with no prior neurological symptoms was found to have a large glial hamartoma in the right frontal lobe, measuring 67 mm in height and 50 mm in transverse diameter. Imaging studies revealed a hyperdense mass with internal calcifications on CT, hypointense on T1-weighted MRI, and hyperintense on T2-weighted MRI. Histopathology confirmed the diagnosis, showing benign glial cells, Rosenthal fibers, and eosinophilic granular bodies. A multidisciplinary team decided on surgical resection due to the tumor's size. The tumor was resected without complications, and postoperative recovery was uneventful. Follow-up MRIs at 4 months and 2 years post-surgery showed no residual tumor or recurrence.</p><p><strong>Conclusions: </strong>This case underscores the role of radiological evaluation in identifying rare asymptomatic glial hamartomas and supports surgical resection to prevent complications. Comprehensive follow-up is essential for early detection of any recurrence.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"145"},"PeriodicalIF":1.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751457","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}

{"title":"Subdural collections in childhood.","authors":"José Roberto Tude Melo, Federico Di Rocco","doi":"10.1007/s00381-025-06812-6","DOIUrl":"https://doi.org/10.1007/s00381-025-06812-6","url":null,"abstract":"","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"144"},"PeriodicalIF":1.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751365","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}

{"title":"Giant calvarial metastasis from secondary Ewing sarcoma with chronic subdural hygroma in a childhood hematological cancer survivor - An unusual case report.","authors":"Praveen Ravichandran, Karthik Nandam, Manoranjithakumari Mani, Sangamithirai K M, Bheemanathi Hanuman Srinivas","doi":"10.1007/s00381-025-06793-6","DOIUrl":"https://doi.org/10.1007/s00381-025-06793-6","url":null,"abstract":"<p><p>We report an unusual case of a 9-year-old boy with Hodgkin lymphoma post chemoradiotherapy, who later developed Ewing sarcoma involving the eighth rib, which had metastasised to the cranial vault with meningeal and subdural involvement. Presenting with seizures, headache and hemiparesis, he underwent craniotomy and gross total tumour resection, with histopathology confirming metastatic Ewing sarcoma. Despite initial improvement, the patient presented with further cranial metastasis on follow-up. This case contributes to the limited literature on Ewing sarcoma metastasis to the CNS in patients with prior hematologic malignancies, questioning potential links between therapeutic chemoradiotherapy exposures and secondary cancer development. This case emphasises the unusual metachronous presentation of Hodgkin lymphoma and Ewing sarcoma and the high risk of recurrence and CNS involvement in cranial Ewing sarcoma, highlighting challenges in management and prognosis.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"143"},"PeriodicalIF":1.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735655","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}