Child's Nervous System最新文献_第10页

Particularities of spasticity in myelomeningocele patients. 髓母细胞瘤患者痉挛的特殊性。

IF 1.3 4区医学

Child's Nervous System Pub Date : 2024-12-01 Epub Date: 2024-10-10 DOI: 10.1007/s00381-024-06649-5

Ioannis N Mavridis, Efstratios-Stylianos Pyrgelis, Eleni Agapiou, Maria Meliou, Welege Samantha Buddhika Wimalachandra

{"title":"Particularities of spasticity in myelomeningocele patients.","authors":"Ioannis N Mavridis, Efstratios-Stylianos Pyrgelis, Eleni Agapiou, Maria Meliou, Welege Samantha Buddhika Wimalachandra","doi":"10.1007/s00381-024-06649-5","DOIUrl":"10.1007/s00381-024-06649-5","url":null,"abstract":"Objective: Myelomeningocele (MMC), a congenital neural tube defect, is the most common developmental anomaly of the central nervous system (CNS). Spasticity is among the main disabling factors in these patients, affecting up to 1/5 of children. The purpose of this article is to review the current knowledge regarding spasticity in MMC patients, mainly focusing on its manifestations and management.Methods: A literature search was conducted using the PubMed database for the terms \"myelomeningocele\" and \"spasticity.\" Data were collected by 5 independent investigators and then synthesized in a scoping format.Results: Causes of spasticity in these patients include hydrocephalus, tethered cord syndrome (TCS), syringomyelia, CNS infection, and associated congenital brain and spine anomalies. Clinical manifestations include limb spasticity and neurogenic bladder. Spasticity primarily affects muscles below the neurological level and contributes to gait impairment. Besides walking ability, spasticity also severely affects functional mobility in general, self-care, and quality of life. The majority of MMC patients experience neurogenic bladder. Treatment of spasticity can be symptomatic or target its cause. Medical and surgical options are available for both limb and bladder spasticity. Regular physiotherapy and orthotics are used to prevent contractures and the early introduction of orthoses is the cornerstone of a gait training program. Neurosurgical treatment options for spasticity include nonablative and ablative procedures such as selective dorsal rhizototmy. The urodynamic pattern guides treatment strategies, with intermittent catheterization being the best treatment option for patients with underactive detrusor and overactive sphincter muscles.Conclusion: Given the particularities of spasticity in MMC patients, a multidisciplinary team approach and early rehabilitation programs are keys for their optimal management.","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":" ","pages":"4107-4114"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399562","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

Ultrasound as a standalone tool for the management of pediatric calvarial dermoid cysts. 将超声波作为治疗小儿犊鼻皮样囊肿的独立工具。

IF 1.3 4区医学

Child's Nervous System Pub Date : 2024-12-01 Epub Date: 2024-06-29 DOI: 10.1007/s00381-024-06521-6

Samir Alsalek, Eisha A Christian, Darian R Esfahani

{"title":"Ultrasound as a standalone tool for the management of pediatric calvarial dermoid cysts.","authors":"Samir Alsalek, Eisha A Christian, Darian R Esfahani","doi":"10.1007/s00381-024-06521-6","DOIUrl":"10.1007/s00381-024-06521-6","url":null,"abstract":"Purpose: Calvarial dermoid and epidermoid cysts are benign lesions common in pediatric neurosurgery. Diagnosis is primarily clinical, with frequent but inconsistent use of imaging. Dermoids have been shown to possess distinct sonographic features, but ultrasound (US) remains underutilized in their management. The purpose of this study is to investigate the independent reliability of US in managing pediatric calvarial dermoids and distinguishing them from other calvarial lesions.Methods: A retrospective review of consecutive patients ≤ 21 years of age with surgically resected calvarial masses between 2017-2024 was performed. Demographic, clinical, and imaging data were analyzed. Pearson chi-squared tests were used for comparison of categorical variables and a binomial linear model was generated controlling for age, lesion tenderness, growth, and suture location.Results: Fifty-nine patients with 61 lesions (31 in females; median age 13 months) were included. Dermoids were more common in younger patients (median age 12 months), along suture lines, and were less likely to present with tenderness (p < 0.001) or rapid growth (p = 0.003). Ultrasound was used in 83% of cases and was the sole imaging modality in 33%. On multivariate analysis, suture location was a significant positive predictor of a dermoid diagnosis (OR = 8.08, 95% CI = 1.67-44.18), while rapid growth was a significant negative predictor (OR = 0.08, 95% CI = 0.003-0.80).Conclusion: Ultrasound presents a sensitive and reliable method for the evaluation of most pediatric calvarial lesions, especially dermoid cysts, and warrants being part of standard workup. With appropriate patient selection, US obviates the need for additional imaging in pediatric patients.","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":" ","pages":"4179-4187"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141475986","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

Primary intracranial pediatric ganglioneuroblastoma-report of two cases and review of an unusual masquerader. 原发性颅内小儿神经节神经母细胞瘤--两例病例的报告和一个不寻常的假瘤的回顾。

IF 1.3 4区医学

Child's Nervous System Pub Date : 2024-12-01 Epub Date: 2024-08-24 DOI: 10.1007/s00381-024-06578-3

Ajay Jhajharia, Sumit Thakar, Prashanth Alle, Tejus M N Rao, Apoorva Kanthaje, Nandita Ghosal

{"title":"Primary intracranial pediatric ganglioneuroblastoma-report of two cases and review of an unusual masquerader.","authors":"Ajay Jhajharia, Sumit Thakar, Prashanth Alle, Tejus M N Rao, Apoorva Kanthaje, Nandita Ghosal","doi":"10.1007/s00381-024-06578-3","DOIUrl":"10.1007/s00381-024-06578-3","url":null,"abstract":"Ganglioneuroblastoma (GNB) is a rare neurogenic tumor with a predilection for extracranial sites. Its primary intracranial occurrence is anecdotal, with less than ten cases reported in pediatric literature. We report two cases of this unusual entity. The first was a 1-year-old boy who presented with a progressive scalp swelling that radiologically appeared to be a mesenchymal tumor. The tumor was resected completely, and its histopathological examination was suggestive of a pigmented GNB. The clinico-radiological presentation and melanin pigmentation of the tumor were unique features of the case. The second case was a 7-year-old girl who presented with left hemiparesis and raised intracranial pressure due to a large right parietal intraparenchymal tumor that histologically proved to be a GNB. The child succumbed to disease progression a month after undergoing near-total resection of the tumor. Analysis of our cases in the light of a literature review reveals that pediatric intracranial GNBs have diverse clinico-radiological features and can easily be confused for commoner pathologies in both intra- and extra-axial locations.","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":" ","pages":"4289-4294"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046442","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

Complexity and complications. 复杂性和并发症。

IF 1.3 4区医学

Child's Nervous System Pub Date : 2024-12-01 Epub Date: 2024-10-05 DOI: 10.1007/s00381-024-06643-x

Serena Elisa Tempera, Mario Garcia-Conde, Paolo Frassanito

引用次数: 0

Intradural extramedullary neurenteric cyst: a case report. 硬膜外神经髓内囊肿：病例报告。

IF 1.3 4区医学

Child's Nervous System Pub Date : 2024-12-01 Epub Date: 2024-10-05 DOI: 10.1007/s00381-024-06646-8

Haman Nassourou Oumarou, Ndome Toto Orlane, Nzedzou Marguerite, Djientcheu Vdp

引用次数: 0

Malignant meningioma of the falx cerebri in a child: case report and literature review. 一名儿童的大脑镰恶性脑膜瘤：病例报告和文献综述。

IF 1.3 4区医学

Child's Nervous System Pub Date : 2024-12-01 Epub Date: 2024-09-06 DOI: 10.1007/s00381-024-06600-8

Rongzeng Guo, Changxiang Yan, Xiaojun Fu

引用次数: 0

Pre-operative clinical deterioration and long-term surgical outcomes in 41 patients with split cord malformation type 1. 41 名脊髓分裂畸形 1 型患者术前临床恶化情况和长期手术效果。

IF 1.3 4区医学

Child's Nervous System Pub Date : 2024-12-01 Epub Date: 2024-10-03 DOI: 10.1007/s00381-024-06626-y

Rajasekhar Narayanan, Vedantam Rajshekhar

{"title":"Pre-operative clinical deterioration and long-term surgical outcomes in 41 patients with split cord malformation type 1.","authors":"Rajasekhar Narayanan, Vedantam Rajshekhar","doi":"10.1007/s00381-024-06626-y","DOIUrl":"10.1007/s00381-024-06626-y","url":null,"abstract":"Purpose: To document the pre-operative rate of clinical deterioration in a cohort of patients with split cord malformation type 1 (SCM 1) and the early- and long-term surgical outcome in these patients.Methods: Data from 41 patients with SCM 1 operated upon by the same surgeon (VR) between January 2008 to June 2023 were retrospectively reviewed with respect to history of clinical deterioration prior to surgery and early and long-term surgical outcomes.Results: The mean age of the patients at presentation was 79.3 months and the male to female ratio was 1:1.93. Twelve (29%) patients had congenital deficits whereas 4 (10%) patients had no neurological deficits. Twenty-six (63%) patients had kyphoscoliosis and 25 (61%) patients had motor dysfunction. Thirty-three (81%) patients (8/12 (67%) with congenital deficits) had clinical deterioration prior to surgery. By the age of 2 years, 56% of patients had clinical deterioration. After surgery, 18 (55%) patients with progressive symptoms had improvement in one or more of their symptoms on long-term follow-up (mean, 63.4 months). There were no predictors of surgical outcome.Conclusions: Since over half of our patients with SCM 1 developed progression of congenital deficits or developed deficits by the age of 2 years, surgery should be performed as soon as possible in these children. On long-term follow-up after surgery, improvement can be expected in over half the patients.","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":" ","pages":"4065-4073"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364587","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

Technical note: durable resolution of hydrocephalus after ultrasound-guided percutaneous fenestration of giant suprasellar arachnoid cyst in a neonate. 技术说明：超声引导下经皮穿刺新生儿巨大鞍上蛛网膜囊肿后脑积水的持久缓解。

IF 1.3 4区医学

Child's Nervous System Pub Date : 2024-12-01 Epub Date: 2024-08-14 DOI: 10.1007/s00381-024-06560-z

Michael J Stuart, Joseph Yoon, Jane McEniery, Amelia J Jardim, Craig Vonhoff

{"title":"Technical note: durable resolution of hydrocephalus after ultrasound-guided percutaneous fenestration of giant suprasellar arachnoid cyst in a neonate.","authors":"Michael J Stuart, Joseph Yoon, Jane McEniery, Amelia J Jardim, Craig Vonhoff","doi":"10.1007/s00381-024-06560-z","DOIUrl":"10.1007/s00381-024-06560-z","url":null,"abstract":"Arachnoid cysts are relatively common, but rarely require intervention. While most arachnoid cysts in typical middle or posterior cranial fossa locations are seldom symptomatic, suprasellar cysts may become symptomatic due to the potential for ventricular outflow obstruction and hydrocephalus. Typical standard of care for the treatment of these lesions is endoscopic fenestration with third ventriculostomy, or the placement of ventriculoperitoneal or cystoperitoneal shunts. The surgical and anaesthetic risks of traditional interventions may be higher in the early neonatal period, including leak of cerebrospinal fluid, infection, and premature failure of ventriculostomy or shunts. This note describes a novel bedside ultrasound-guided technique to percutaneously fenestrate large suprasellar arachnoid cysts under local anaesthesia. The technique involves insertion of a 25-g spinal needle until contact with the membrane of the arachnoid cyst medially, followed by a lateral sweeping to widely incise/fenestrate the lesion into the ventricular space under continuous ultrasound visualisation. This note describes an example case which demonstrates durable radiological and clinical improvement after 2 years of follow-up. This may represent a management option to temporise, or perhaps definitively manage suprasellar arachnoid cysts in the neonatal period.","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":" ","pages":"4279-4282"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11579056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975196","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

Greater sphenoid wing reconstruction with 3D printed anatomical intracranial implant for a child with spheno-orbital encephalocele. 用三维打印的解剖颅内植入物为一名患有椎-眶脑积水的儿童重建大蝶骨翼。

IF 1.3 4区医学

Child's Nervous System Pub Date : 2024-12-01 Epub Date: 2024-09-02 DOI: 10.1007/s00381-024-06587-2

Abhishek Patel, Alok Ranjan, Murali Krishna Nama, Tarang Kamalkishore Vora

引用次数: 0

Orbital embryonal rhabdomyosarcoma: a case-based update. 眼眶胚胎性横纹肌肉瘤：基于病例的最新进展。

IF 1.3 4区医学

Child's Nervous System Pub Date : 2024-12-01 Epub Date: 2024-09-28 DOI: 10.1007/s00381-024-06583-6

Giacomo Piaser Guerrato, Francesco Maria Raimondo, Federico Bianchi, Paolo Frassanito, Gianpiero Tamburrini, Luca Massimi

{"title":"Orbital embryonal rhabdomyosarcoma: a case-based update.","authors":"Giacomo Piaser Guerrato, Francesco Maria Raimondo, Federico Bianchi, Paolo Frassanito, Gianpiero Tamburrini, Luca Massimi","doi":"10.1007/s00381-024-06583-6","DOIUrl":"10.1007/s00381-024-06583-6","url":null,"abstract":"Background: Rhabdomyosarcoma (RMS) is the most prevalent soft tissue sarcoma in children, with approximately 30% of head and neck RMS occurring in the orbit. The management of orbital RMS is complex, requiring a multidisciplinary approach and careful surgical planning. The objective of the present paper is to provide the neurosurgeon with an update on this challenging tumor.Case description: A 12-year-old boy was admitted to our department after the onset of diplopia in his right eye, associated with quickly worsening ipsilateral eyelid edema and mild proptosis. MRI revealed an anterior superomedial, extraconal, and intraorbital expansive lesion. Complete tumor removal was performed through a trans-orbital approach. Histological diagnosis of embryonal RMS was done. The patient underwent radio-chemotherapy in accordance with the EpSSG RMS2005 subgroup C protocol. The patient is alive and disease-free.Discussion and conclusion: The intricacies of treating orbital tumors necessitate meticulous planning to safeguard vital structures while guaranteeing comprehensive oncological treatment. A multidisciplinary approach with a specific protocol depending on the location and characteristics of the tumor is required. The available treatment options include surgical intervention or combination therapies, such as chemotherapy and radiotherapy. The successful management of these diseases depends on the careful coordination and application of the available techniques.","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":" ","pages":"3907-3914"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342662","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