Child's Nervous System最新文献

{"title":"Timeliness of surgical repair among infants with myelomeningocele in a tertiary care hospital in Addis Ababa, Ethiopia.","authors":"Kibruyisfaw Zewdie, Bethelehem Yesehak, Amanda Dorsey, Yemisirach Bizuneh Akililu, Addisalem Belete, Yordanos Ashagre, Yakob Ahmed, Patricia O O'Neill, Vijaya Kancherla","doi":"10.1007/s00381-025-06801-9","DOIUrl":"https://doi.org/10.1007/s00381-025-06801-9","url":null,"abstract":"<p><strong>Purpose: </strong>Ethiopia has a high prevalence of myelomeningocele (open spina bifida), a severe and often fatal birth defect affecting the spinal cord in the newborn. Timely surgery is associated with improved health outcomes and survival among those affected. Recent studies on timeliness of myelomeningocele closure surgery and factors associated with it are lacking in Ethiopia.</p><p><strong>Methods: </strong>We conducted an observational study using data from structured electronic medical records stored at the largest surgical and treatment referral hospital for spina bifida care in Ethiopia. We used surgical information on patients with myelomeningocele from January 2020 to June 2022. Surgical timeliness was dichotomized as \"timely\" if the repair occurred within 3 days after birth and \"delayed\" after the 3rd day of birth. Prevalence of timely spina bifida surgery was assessed. Selected demographic and clinical factors associated with timeliness of the repair surgery were examined using logistic regression analysis.</p><p><strong>Results: </strong>Of the 279 eligible patients who received myelomeningocele closure surgery during the study period, only 45 (16.1%) were timely. Family residence in Addis Ababa was significantly associated with a timely repair surgery (delayed surgery aOR = 0.25; 95% CI = 0.11, 0.57), after adjusting for the year of surgery, infant sex, presence of cerebrospinal fluid leak, and spina bifida lesion level.</p><p><strong>Conclusion: </strong>Less than a quarter of patients with myelomeningocele received timely repair surgery in a large tertiary care referral hospital in Addis Ababa, Ethiopia. Promoting timely closure of myelomeningocele while providing equitable access to optimal surgical care for patients will improve health outcomes and prevent mortality.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"142"},"PeriodicalIF":1.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735658","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":"Beyond the expected: a supratentorial ependymoma imitating a meningioma.","authors":"Hafsah Binte Sohail, Noman Ahmed, Muhammad Shahzad Shamim, Naureen Mushtaq","doi":"10.1007/s00381-025-06803-7","DOIUrl":"https://doi.org/10.1007/s00381-025-06803-7","url":null,"abstract":"<p><strong>Introduction: </strong>Supratentorial ependymomas are rare tumors, particularly in adults, and can present similarly to more common extra-axial masses like meningiomas on imaging. Differentiating between these lesions is crucial for appropriate management.</p><p><strong>Case presentation: </strong>A 16-year-old girl presented with a 1.5-year history of headaches, occasional blurring of vision, and a recent seizure. MRI revealed a 4.7 × 4.0 × 6.9 cm dural-based, extra-axial lesion in the left parietal-temporal region, initially presumed to be a meningioma. The patient underwent a neuronavigation-guided craniotomy with excision of the lesion. Intraoperative findings described a soft, vascular, solid-cystic extra-axial mass, which was initially diagnosed as a meningioma based on preoperative imaging but later confirmed to be a supratentorial ependymoma, ZFTA fusion-positive, CNS WHO grade 3, through histopathological and molecular analysis. Postoperatively, the patient showed no neurological deficits, and a residual tumor was identified on follow-up imaging.</p><p><strong>Discussion: </strong>This case illustrates the diagnostic challenge posed by the rare presentation of supratentorial, extra-axial ependymomas mimicking meningiomas. Although meningiomas are the most common extra-axial intracranial tumors, some radiological features such as cystic appearance and multiloculation on imaging should raise suspicion for ependymoma or other mimics. However, a definitive diagnosis can only be made through histopathological examination.</p><p><strong>Conclusion: </strong>Supratentorial, extra-axial masses are often misdiagnosed as meningiomas. Such ependymomas can closely resemble meningiomas on imaging. This case underscores the importance of maintaining a broad differential diagnosis for extra-axial masses and highlights the role of certain radiological features that can help with accurate diagnosis or at least raise suspicion of meningioma mimics.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"141"},"PeriodicalIF":1.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708888","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":"Inpatient outcomes in pediatric diffuse axonal injury: high mortality in severe TBI and limited impact of Grade III DAI.","authors":"Sean Inzerillo, Mert Karabacak, Peter Morgenstern, Konstantinos Margetis","doi":"10.1007/s00381-025-06802-8","DOIUrl":"https://doi.org/10.1007/s00381-025-06802-8","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigates key prognostic factors influencing morbidity and mortality in pediatric diffuse axonal injury (DAI) using nationally collected data from the American College of Surgeons (ACS) Trauma Quality Program (TQP) to inform clinical practice and future research.</p><p><strong>Methods: </strong>The ACS-TQP database (2019-2021) was analyzed for pediatric DAI cases, excluding those with intracranial hemorrhages or pre-admission deaths. Demographics and clinical characteristics were compared across age groups (0-3, 4-12, 13-17), and multivariate regression identified predictors of mortality, complications, intensive care unit (ICU) stay, and ventilator duration.</p><p><strong>Results: </strong>Among 533 pediatric DAI patients, the mortality rate was 20.3%, highest in the 0-3 age group (29%) compared to 4-12 (20.8%) and 13-17 (19%) (p = 0.016). Severe traumatic brain injury (TBI) (Glasgow Coma Scale 3-8) and systolic blood pressure < 90 mm Hg were strong mortality predictors (OR 56.9, p < 0.001; OR 9.2, p < 0.001). Prolonged coma (> 24 h) increased mortality odds (OR 7.4, p = 0.018) but did not meet the adjusted threshold. Complications occurred in 16.3% of patients, with severe TBI increasing complication odds (OR 4.1, p = 0.005). ICU stay was longer with surgery (p < 0.001), and prolonged coma predicted longer ventilation (p < 0.001). Grade III DAI was not linked to worse outcomes.</p><p><strong>Conclusion: </strong>Severe TBI and hypotension were significant predictors of mortality and morbidity in pediatric DAI. Grade III DAI was not associated with worse outcomes, highlighting the need for further research to refine prognostic factors.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"140"},"PeriodicalIF":1.3,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708891","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":"A pre-operative gastrointestinal optimization protocol to improve outcomes after intrathecal baclofen pump surgery.","authors":"Amanda M Mosher, Emma K Hartman, Marcella Ruppert-Gomez, Steven J Staffa, Kristin Buxton, Ann Morgan, Sangeeta Muskar, Scellig Stone, Weston T Northam","doi":"10.1007/s00381-025-06797-2","DOIUrl":"https://doi.org/10.1007/s00381-025-06797-2","url":null,"abstract":"<p><strong>Purpose: </strong>Pediatric cerebral palsy patients carry frequent medical comorbidities and disproportionately consume hospital resources after neurosurgical procedures. We implemented an institutional pre-operative gastrointestinal (GI) optimization protocol to improve outcomes and decrease resource utilization.</p><p><strong>Methods: </strong>All 323 intrathecal baclofen surgeries from 2000 to 2023 were categorized relative to protocol implementation on July 1, 2017. Outcomes and resource utilization were compared.</p><p><strong>Results: </strong>The protocol change resulted in significantly fewer hospital readmissions (p = 0.001) for constipation, eliminating them and GI-related emergency visits. There was a reduction of 27 hospital days for constipation-related readmission (median 1 day per patient, IQR 1, 2 days). No differences were reported between the experimental groups including demographics or GI comorbidities. Post-operative complications within 30 days were comparable between groups regarding urinary tract infections, surgical-site infections, and spinal fluid leak. There were no differences in post-operative length of stay between groups.</p><p><strong>Conclusion: </strong>A GI optimization protocol can eliminate a frequent source of hospital readmissions and GI-related emergency department visits after baclofen pump surgery, even accounting for baseline GI comorbidities. Preventing readmissions and emergency visits translates to lower hospital resource utilization and improves quality of care. Future efforts are warranted to improve outcomes and care efficiency for our most complex and resource-intensive patients.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"139"},"PeriodicalIF":1.3,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691218","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":"Maintenance of construct integrity with subaxial cervical pedicle screws when crossing the cervicothoracic junction in complex pediatric deformity: an international multicenter study.","authors":"David B Kurland, Ritt R Givens, Alondra Concepción-González, Alexander Eremiev, Yosef Dastagirzada, Nikita Alexiades, Benjamin D Roye, Michael G Vitale, Richard C E Anderson","doi":"10.1007/s00381-025-06791-8","DOIUrl":"https://doi.org/10.1007/s00381-025-06791-8","url":null,"abstract":"<p><strong>Objective: </strong>In cases of complex pediatric spinal deformity, posterior spinal instrumentation crossing the cervicothoracic junction (CTJ) may be required. This is most frequently encountered for revision surgery to address proximal junctional kyphosis (PJK). In the cervical spine, lateral mass screws are most commonly used, although they may result in biomechanically weak proximal constructs and predispose to instrumentation failure. The use of supplemental anterior constructs has recently been reported with promising results, but this necessitates an additional surgical procedure. Subaxial cervical pedicle screws can provide good biomechanical fixation without the need for an anterior approach, but outcome data have been very limited. The purpose of this study was to assess radiographic and clinical outcomes at two years in pediatric patients who have undergone posterior spinal instrumentation and fusion (PSIF) crossing the CTJ using subaxial cervical spine pedicle screws.</p><p><strong>Methods: </strong>The Pediatric Spine Study Group (PSSG) registry was queried to identify patients ≤ 21 years old who underwent PSIF crossing the CTJ with two-year minimum clinical and radiographic follow-up. Patients were excluded if they had a history of anterior stabilization or if their fusion construct with subaxial pedicle screws started below C6. Clinical, surgical, and radiographic parameters were assessed, and measurements were compared statistically.</p><p><strong>Results: </strong>Then, 8 patients (6 female and 2 male) met inclusion criteria, with a mean age at surgery of 11.2 ± 3.3 years. All patients underwent PSIF crossing the CTJ (mean levels fused 15.6 ± 6.6). The mean density of subaxial cervical pedicle screws was 61.9% ± 27.8 (range 28.5 to 100%). The major coronal curve averaged 54.7° ± 19.6 preoperatively and 34.5° ± 13.6 postoperatively (41.5% ± 26.5 correction; p = 0.03). The average major sagittal curve was 55.9° ± 20.6 preoperatively and 29.6° ± 9.6 (44.2% ± 18.0 correction; p = 0.01) postoperatively. There were no major intraoperative or postoperative complications. Deformity parameters remained stable without radiographic evidence of PJK in 8/8 patients at minimum 2-year follow-up.</p><p><strong>Conclusions: </strong>In this small preliminary international series of pediatric patients with spinal deformity, the inclusion of subaxial cervical pedicle screws in constructs that span the cervicothoracic junction resulted in good clinical and radiographic outcomes without major complications. Subaxial cervical spine pedicle screws provide enhanced biomechanical stability and may eliminate the need for additional anterior support in pediatric patients.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"138"},"PeriodicalIF":1.3,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691222","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":"Management of pediatric quadrigeminal arachnoid cysts: a systematic review and illustrative case report.","authors":"Emmanuel K Adjei Osei, Kwadwo Darko, Pearl Tenkorang, Maame A D Boateng, Nana A B O Sekyere, Bernice Limann, Oluruntoba Ogunfolaji, Sean O'Leary, Umaru Barrie, Teddy Totimeh","doi":"10.1007/s00381-025-06796-3","DOIUrl":"https://doi.org/10.1007/s00381-025-06796-3","url":null,"abstract":"<p><strong>Introduction: </strong>Quadrigeminal arachnoid cysts (QACs) are often incidental but may present with compressive symptoms on surrounding brain structures. This study evaluates management strategies and outcomes in the literature and highlights the feasibility and importance of neuroendoscopic treatment in resource-limited settings using an illustrative case.</p><p><strong>Methods: </strong>Our systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using PubMed, Google Scholar, Embase, and SCOPUS databases to identify and assess primary articles exploring pediatric QAC cases. Additionally, we present an illustrative case report.</p><p><strong>Results: </strong>We identified 32 articles for analysis. Males constituted 57.4% (128/223) of cases. Most patients (98.1%, 208/212) were symptomatic. Common symptoms included macrocephaly (49.6%, 117/236) and hydrocephalus (24.5%, 56/229). Endoscopic approaches included ETV alone (7.1%, 15/211), ETV with cyst fenestration (ETV/CF) (28%, 59/211), and cyst fenestration alone (13.7%, 29/211). Cyst reduction was achieved in 80.5% (136/169) of cases. Postoperative cyst recurrence was low (1.3%, 3/226), as were complications such as intraoperative bleeding (1.9%, 3/159) and infections (drain infection, 1.9%; meningitis, 0.6%). The mortality rate was 1.3% (3/237). VP shunting (16.3%, 22/135) and ETV (8.9%, 12/135) were the most common reintervention procedures.</p><p><strong>Conclusion: </strong>ETV-only and ETV/CF are reasonable options in the surgical management of QACs, with reported low rates of complications and comparable reintervention rates. Although access to neuroendoscopy is limited in the subregion, this review and illustrative case report shed light on the potential impact neuroendoscopy can have on the care of such cases.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"137"},"PeriodicalIF":1.3,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691230","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 frontonasal encephalocele: surgical considerations through a clinical case and literature review.","authors":"Gisela Pascuetín, Guido Gromadzyn, Yamila Basilotta Márquez, Rodrigo Blanco, Juan Asselborn, Romina Argañaraz","doi":"10.1007/s00381-025-06780-x","DOIUrl":"https://doi.org/10.1007/s00381-025-06780-x","url":null,"abstract":"<p><strong>Introduction: </strong>Encephalocele is a congenital malformation of the central nervous system (CNS) characterized by the protrusion of neural tissue through a cranial defect. The frontonasal variant has a reported incidence of approximately 0.8 to 3 cases per 10,000 live births, making it a rare condition.</p><p><strong>Case report: </strong>We present the case of a newborn girl prenatally diagnosed with a giant nasofrontal encephalocele without associated pathologies. Following complementary studies for surgical planning, she underwent surgery at 72 h of life, performed by a multidisciplinary team, to prevent significant functional sequelae and promote normal growth and development.</p><p><strong>Conclusion: </strong>Nasofrontal encephalocele is a rare type of neural tube defect, posing a significant challenge for the interdisciplinary team responsible for its management.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"136"},"PeriodicalIF":1.3,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662912","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":"Cerebellar tonsillar contusion in traumatic brain injury: an atypical presentation of previously undiagnosed Chiari I malformation.","authors":"Debajyoti Datta, David McAuley, Albert Tu","doi":"10.1007/s00381-025-06795-4","DOIUrl":"https://doi.org/10.1007/s00381-025-06795-4","url":null,"abstract":"<p><p>Chiari I malformation is often seen in children and may be asymptomatic. Acute neurological injury following trauma in children with Chiari I malformation has been reported in literature. Traumatic contusion involving the cerebellar tonsils is rarely described in children and usually occurs in patients with Chiari I malformation/cerebellar tonsillar ectopia. It is unknown if activity restriction should be advised in children with asymptomatic Chiari I malformation given the potential for this injury. We describe a case of cerebellar tonsillar contusion in a child with concomitant skull vault fracture and review the literature for similar cases. We also propose a plausible mechanism to explain tonsillar contusion in patients with Chiari I malformation.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"135"},"PeriodicalIF":1.3,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662894","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":"Cost of pediatric traumatic brain injury in developing countries: a retrospective cohort study.","authors":"Aisha Nasser Al Fudhaili, Sara Salim Al Mashrafi, Ahad Nasser Al Ghammari, Aisha Khalifa Al Saadi, Fatema Taheri Boriawala, Tariq Al-Saadi","doi":"10.1007/s00381-025-06782-9","DOIUrl":"https://doi.org/10.1007/s00381-025-06782-9","url":null,"abstract":"<p><strong>Introduction: </strong>Traumatic brain injury (TBI) is a known health burden worldwide; however, no literature is available on its economic burden in developing countries, this study aims to highlight the cost of pediatric TBI and compare mild, moderate, and severe cases.</p><p><strong>Methods: </strong>A retrospective study was conducted in the neurosurgery department of a tertiary hospital in a developing country. Data on pediatric cases presenting with TBI from January 2015 to December 2019 was collected from electronic medical records; this included patients' demographics, neuro-vital signs, mechanism of TBI, intervention, diagnosis on imaging, investigations, medications, duration of hospital and intensive care unit stay. Costs of interventions, investigations, and hospital stay were retrieved from the hospital finance division, total costs were calculated, and analysis was done to compare the relation of age, diagnosis, mechanism of injury, and intervention to total cost.</p><p><strong>Results: </strong>The sample included 921 cases (M: F, 1.7:1), with 67.1% aged less than 5 years. Falls and motor vehicle collisions had the highest total costs. Cases with normal radiological findings and skull fractures constituted 35.9% and 30.2%, respectively, and consequently had the highest costs; epidural hematoma followed in highest costs. TBI severity, surgical intervention, age < 5 years old, and longer hospital stays were significantly associated with higher total costs (P < 0.001).</p><p><strong>Conclusions: </strong>Pediatric TBI is a health and economic burden, most notably in children less than 5 years old and those with severe injuries. Programs advocating children's safety and hospital guidelines for the diagnosis and appropriate timely management need to be implemented.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"134"},"PeriodicalIF":1.3,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656416","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":"Endoscopic endonasal versus open approach for craniopharyngioma treatment: a systematic review of clinical characteristics.","authors":"Geena Jung, Joshua M Cohen, David Oriko, Emery Buckner-Wolfson, Timothy Kim, Genesis Liriano, Andrew J Kobets","doi":"10.1007/s00381-025-06788-3","DOIUrl":"10.1007/s00381-025-06788-3","url":null,"abstract":"<p><strong>Background: </strong>Craniopharyngiomas are rare tumors found in the suprasellar region of the brain. Untreated, they have the potential to cause debilitating complications, including vision loss and cognitive decline. Craniopharyngiomas can be resected through several surgical options including endoscopic endonasal (EEA) and open, transcranial approaches, cystic drainage, and ventricular neuroendoscopic approaches. Here, we seek to review the literature and compare characteristics of lesions resected by the EEA versus open approach.</p><p><strong>Methods: </strong>A comprehensive database search was performed on PubMed, Google Scholar, and Embase using key terms. Included studies utilized both EEA and open approaches for craniopharyngioma resection.</p><p><strong>Results: </strong>No studies reported a significant difference in tumor location, consistency, pathology, or presence of calcification. One study reported an increased preoperative tumor volume with the open approach. The open approach was significantly associated with a longer follow-up period (4/16) and hospital length of stay (2/16), as well as a greater rate of recurrence (2/16) and mortality (1/16). New-onset diabetes insipidus (3/16) and vision deterioration (3/16) following surgery were significantly more common following an open approach.</p><p><strong>Conclusion: </strong>Inherent in the surgical decision-making regarding approach are the anatomical considerations of the tumor. Through our literature search, we found tumors were not substantially different for the different approaches, consistent with our clinical experience. This may be related to the refinement of endonasal techniques, allowing larger, suprasellar tumors to be amenable to GTR more than in the past.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"131"},"PeriodicalIF":1.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647508","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}