Child's Nervous System最新文献

{"title":"Development of a machine learning model for prediction of intraventricular hemorrhage in premature neonates.","authors":"Emad Saeedi, Mojtaba Mashhadinejad, Amin Tavallaii","doi":"10.1007/s00381-024-06714-z","DOIUrl":"10.1007/s00381-024-06714-z","url":null,"abstract":"<p><strong>Purpose: </strong>Intraventricular hemorrhage (IVH) is a common and severe complication in premature neonates, leading to long-term neurological impairments. Early prediction and identification of risk factors for IVH in premature neonates are crucial for improving clinical outcomes. This study aimed to predict IVH in premature neonates and determine risk factors using machine learning (ML) algorithms.</p><p><strong>Methods: </strong>This study investigated the medical records of premature neonates admitted to the neonatal intensive care unit. The patients were labeled as case (IVH) and control (No IVH). The independent variables included demographic, clinical, laboratory, and imaging data. Machine learning algorithms, including random Forest, support vector machine, logistic regression, and k-nearest neighbor, were used to train the models after data preprocessing and feature selection. The performance of the trained models was evaluated using various performance metrics.</p><p><strong>Results: </strong>Data from 160 premature neonates were collected including 70 patients with IVH. The identified risk factors for IVH were the gestational age, birth weight, low Apgar scores at 1 min and 5 min, delivery method, head circumference, and various laboratory findings. The random forest algorithm demonstrated the highest sensitivity, specificity, accuracy, and F1 score in predicting IVH in premature neonates, with a great area under the receiver operating characteristic curve of 0.99.</p><p><strong>Conclusion: </strong>This study revealed that the random forest model effectively predicted IVH in premature neonates. The early identification of premature neonates at higher risk of IVH allows for preventive measures and interventions to reduce the incidence and morbidity of IVH in these patients.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"51"},"PeriodicalIF":1.3,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827434","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":"Same-day discharge after intracranial shunt revision: a retrospective propensity-matched safety analysis.","authors":"David S Bailey, Lekhaj Daggubati, Sarah Strausser, Madelaine Fritsche, Morgan Lehman, Elias B Rizk","doi":"10.1007/s00381-024-06722-z","DOIUrl":"10.1007/s00381-024-06722-z","url":null,"abstract":"<p><strong>Objective: </strong>Patients are often observed overnight after ventricular shunt revision for hydrocephalus. We believe that a same-day discharge after a shunt revision is safe in the appropriate population. The purpose of this study was to determine the appropriate patient population and the safety profile for a same-day discharge following a ventricular shunt revision.</p><p><strong>Methods: </strong>We conducted a retrospective chart review of all shunt revisions at a single center from 2014 to 2021. We compared rates of emergency department visits, hospitalization, and revision at 30 and 90 days between same-day discharge and control patients following shunt revision. Non-parametric, logistic regression, and chi-squared testing were performed to measure statistical significance with and without propensity score matching.</p><p><strong>Results: </strong>A total of 996 patients were examined, with 56 (5.6%) patients being discharged on the same day as the surgery. Patients with a same-day discharge were older, more likely to have distal shunt failure, more likely to have undergone scheduled surgery, and less likely to have visited the emergency department in the prior 30 days. Propensity score matching compared 29 revisions in each group; all covariates were non-significant (p > 0.05), and 30-day and 90-day outcomes were not significantly different the between same-day and non-same day discharge.</p><p><strong>Conclusions: </strong>These findings validate the safety profile for the same-day discharge in post-operative shunt patients and describe our patient cohort's preferred characteristics. Scheduled, distal shunt failure patients are preferred for early discharge post-operatively. When validated by further studies, this would provide improved patient comfort and decreased healthcare expenses for a shunt failure.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"56"},"PeriodicalIF":1.3,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827586","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":"Clinical and radiologic criteria to predict endoscopic third ventriculostomy success in non-communicating pediatric hydrocephalus.","authors":"Davit Tatoshvili, Andreas Schaumann, Anna Tietze, Valentina Pennacchietti, Gesa Cohrs, Matthias Schulz, Ulrich-W Thomale","doi":"10.1007/s00381-024-06704-1","DOIUrl":"https://doi.org/10.1007/s00381-024-06704-1","url":null,"abstract":"<p><strong>Objective: </strong>Endoscopic third ventriculocisternostomy (ETV) became the relevant treatment option for non-communicating pediatric hydrocephalus. ETV success was predicted in relation to age, diagnosis, and previous shunt implantation. Radiological factors are usually taken for indication decision-making. The aim of this study is to investigate radiological signs of non-communicating hydrocephalus for ETV success in a single-center retrospective analysis.</p><p><strong>Patients and methods: </strong>ETV interventions were collected from a 10-year period (2010-2019) from our institution. Clinical patient characteristics such as prematurity, age, diagnosis, and previous shunt treatment and follow-up in terms of possible shunt implantation or revision surgeries were investigated. Radiological data was retrieved from the in-house PACS system to analyze preoperative signs for non-communicating hydrocephalus such as ventricular size, pressure gradients at the third ventricle, and any signs of obstruction from internal towards external cerebral spinal fluid communication. Fisher's test was used to demonstrate the significance of each individual predictor. A multivariable model was built using the backward elimination method with multiple logistic regression.</p><p><strong>Results: </strong>From 136 ETV interventions, 95 met the inclusion criteria (age < 18 years; > 6-month follow-up; MR image data availability, treatment goal for shunt independence). In chi-square statistical evaluation of single parameters age > 6 months (OR 32.5; 95% CI 4.8-364), ventricular width (FOHR < 0.56; OR 6.1; 95% CI 2.2-16.3) and non-post-hemorrhagic hydrocephalus as underlying diagnosis (OR 13.1; 95% CI 1.9-163) showed significant increased odds ratio for shunt independence during follow-up. Logistic regression analysis for multiple parameters showed age > 6 months (OR 29.3; 95% CI 4.1-606) together with outward bulged lamina terminalis (OR 4.6; 95% CI 1.2-19.6), smaller FOHR (continuous parameter; OR 2.83 × 10^-5; 95% CI 4.7 × 10^-9-0.045), and non-4th-ventricular-outlet obstruction (4thVOO; OR 0.31; 95% CI 0.09-1.02) as significant factors for ETV success.</p><p><strong>Conclusion: </strong>ETV has become a relevant treatment for non-communicating hydrocephalus, with typical MR image characteristics. Analyzing radiological markers as predictors for success smaller ventricular width and outward displaced lamina terminalis was relevant in combination with age > 6 months. Since the analysis is based on single-center experience, a larger cohort of patients with a multi-center approach should further investigate the combined clinical and radiological criteria.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"57"},"PeriodicalIF":1.3,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834337","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":"Spinal intradural malignant peripheral nerve sheath tumor at the foramen magnum in a non-neurofibromatosis child.","authors":"Madhivanan Karthigeyan, Goutham Varma, Debajyoti Chatterjee, Sai Shiva Tadakamalla, Pravin Salunke, Rajeev Goel","doi":"10.1007/s00381-024-06719-8","DOIUrl":"https://doi.org/10.1007/s00381-024-06719-8","url":null,"abstract":"<p><p>Primary spinal intradural malignant peripheral nerve sheath tumors (MPNSTs) are rare neoplasms, especially in children with a non-neurofibromatosis background. Scarce pediatric data exist with regard to such tumors. A 4-year-old child with a history of spastic limb weakness was operated for a foramen magnum spinal lesion (intradural and extradural) with imaging suggestive of schwannoma; the histopathology, however, was that of a MPNST. He underwent redo-surgery for recurrent infiltrating lesion, became ventilator dependent, and expired. Along with this case, we briefly discuss the relevant literature on pediatric primary spinal MPNSTs. The report represents an unusual site for spinal MPNST in a child with dual components. It is important for clinicians to consider such malignant lesions among the differentials of paediatric spinal intradural/ extradural lesions. Compared to that of adults and other regions, the prognosis for spinal intradural MPNSTs in children remains grim.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"52"},"PeriodicalIF":1.3,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827587","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":"Traumatic pediatric cervical spine injury-a proposed clearance algorithm incorporating a 24-h time delay.","authors":"Victoria E Fischer, Vaidehi M Mahadev, Jacob A Bethel, Jaime A Quirarte, Robert J Hammack, Cristian Gragnaniello, Izabela Tarasiewicz","doi":"10.1007/s00381-024-06716-x","DOIUrl":"https://doi.org/10.1007/s00381-024-06716-x","url":null,"abstract":"<p><strong>Purpose: </strong>Pediatric cervical spine injury (pCSI) is rare. Physiological differences necessitate alternate management from adults. Yet, no standardized pediatric protocols exist. Previous investigations applying adult-validated clinical decision rules (CDRs)-NEXUS Criteria (NX) and Canadian C-spine Rules (CCR)-to children are mixed. We hypothesized a combined NX + CCR approach applied at a delayed 24-h time point would enhance screening efficacy in select patients.</p><p><strong>Methods: </strong>We conducted a retrospective review of a prospectively-collected database over 15 months at a pediatric-capable Level-1 trauma center. Age and mechanism determined initial inclusion. NX and CCR criteria were collected and retroactively applied on arrival (T0) and 24 h later (T1). Statistical analyses were performed in SPSS.</p><p><strong>Results: </strong>A total of 306 patients met inclusion. Current practices compel computed tomography (CT) overuse for craniocervical evaluations: 298 (97.4%) underwent ≥ 1 CT. Of cervical spines imaged (n = 175), 161 (92.0%) underwent CT while 74 (42.3%) underwent magnetic resonance imaging with 14 (18.9%) completed after 72 h. Of collars placed on arrival (n = 181), 136 (75.1%) were cleared before discharge with 86 (63.2%) CTs denoting preferred clearance modality; CT utilization was unchanged when stratified by age < 5 years (p = 0.819). Notably, we found more patients met NX + CCR criteria at T1 versus T0 (p = 0.008) without missed pCSI resulting in imaging overutilization in 15 (8.6%) patients.</p><p><strong>Conclusion: </strong>We showed incorporating a 24-h time delay before a second CDR reapplication may enhance screening efficacy in pCSI. Our new algorithm combines these findings with other literature-based recommendations and may represent a standardizable option for evaluating pCSI in the acute trauma setting.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"58"},"PeriodicalIF":1.3,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834339","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":"Open versus endoscopic surgery with helmet molding therapy in non-syndromic patients with craniosynostosis: an updated systematic review and meta-analysis of clinical outcomes and treatment-related costs.","authors":"Omar R Ortega-Ruiz, Mauricio Torres-Martínez, Mariana Villafranca-Cantú, Rebeca Alejandra Ávila-Cañedo, Emilio Piñeyro-Cantú, Eduardo Menchaca-Welsh, Nir Shimony, George I Jallo, Javier Terrazo-Lluch, J Javier Cuéllar-Hernández","doi":"10.1007/s00381-024-06692-2","DOIUrl":"10.1007/s00381-024-06692-2","url":null,"abstract":"<p><strong>Objective: </strong>There is an ongoing debate regarding the optimal treatment for craniosynostosis as diverse factors influence the election between endoscopic and open surgery. Previous evidence favors endoscopic procedures. However, evidence remains unfulfilled by a limited number of patients and clustered in very few centers worldwide making it difficult to define it as a replicable technique in different populations. In recent years, evidence regarding endoscopic-assisted procedures has gone through a considerable spurt showing an increased interest among surgeons globally showing optimal outcomes in different populations and centers. In this systematic review and meta-analysis, we performed an updated analysis of previous reviews, including only non-syndromic patients. We also seek to provide a summary of the tendency of treatment observed in the literature. Similarly, this is the first study to include total costs within its analysis.</p><p><strong>Material and methods: </strong>Three previous meta-analyses published in 2018 yielded 11 eligible papers. We performed a systematic review and meta-analysis of the literature in MEDLINE and EMBASE databases through PubMed, Scopus, and Ovid to fill the gap of information between 2018 and 2024. Twenty-three total articles were included in the final analysis.</p><p><strong>Results: </strong>Variables analyzed were baseline characteristics, length of stay, blood loss, transfusion rates and volume, operative time, and costs. The analysis of data concluded a younger age at surgery in patients undergoing endoscopic surgery (p ≤0.00001). Blood loss, transfusion rates, and volumes depicted favored outcomes for endoscopy with less blood loss during surgery (p ≤0.00001), operative time (p ≤0.00001), and transfusion rates (p ≤0.00001) as well as lower transfused volumes (p ≤0.00001).</p><p><strong>Conclusion: </strong>Endoscopic surgery carries fewer complications than open surgery. Treatment-related costs are highly decreased in endoscopic procedures after including costs related to outpatient care. Open surgery can be considered in older children if no endoscope or experienced surgeons in endoscopic procedures are available.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"53"},"PeriodicalIF":1.3,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827583","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":"Mechanisms of hydrocephalus after intraventricular haemorrhage: a review.","authors":"Wenchao Wu, Qingsong Li","doi":"10.1007/s00381-024-06711-2","DOIUrl":"10.1007/s00381-024-06711-2","url":null,"abstract":"<p><p>Intraventricular haemorrhage (IVH) is bleeding within the ventricular system, which in adults is usually mainly secondary to cerebral haemorrhage and subarachnoid haemorrhage. Hydrocephalus is one of the most common complications of intraventricular haemorrhage, which is characterised by an increase in intracranial pressure due to an increased accumulation of cerebrospinal fluid within the ventricular system, and is closely related to the patient's prognosis. Surgical methods such as shunt surgery have been used to treat secondary hydrocephalus in recent years and have been effective in improving the survival and prognosis of patients with hydrocephalus. However, complications such as shunt blockage and intracranial infection are often faced after surgery. Moreover, little is known about the mechanism of hydrocephalus secondary to intraventricular haemorrhage. This review discusses the mechanisms regarding the occurrence of secondary hydrocephalus after intraventricular haemorrhage in adults in terms of blood clot obstruction, altered cerebrospinal fluid dynamics, inflammation, and blood composition.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"49"},"PeriodicalIF":1.3,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827463","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":"Subarachnoid puncture via the anterior fontanelle with intrathecal vancomycin for refractory purulent meningitis: a pediatric case report.","authors":"Yan Li, Xinghui Yang, Yongping Xie, Guolan Huang, Xiaohui Fang, Lisu Huang","doi":"10.1007/s00381-024-06668-2","DOIUrl":"https://doi.org/10.1007/s00381-024-06668-2","url":null,"abstract":"<p><p>This case report presents a novel treatment approach for refractory purulent meningitis in a 1-month-old infant caused by penicillin-sensitive group B Streptococcus. Despite initial treatment with intravenous antibiotics, including penicillin and vancomycin, the infant experienced persistent symptoms and bilateral subdural effusions. Conventional therapies failed to resolve these issues, leading to the use of a new technique: subarachnoid puncture via the anterior fontanelle combined with intrathecal vancomycin administration. This minimally invasive procedure allowed for targeted antibiotic delivery, significantly reducing subdural effusions and improving cerebrospinal fluid parameters. The infant showed substantial clinical improvement and was discharged after 68 days with no complications during a 3-month follow-up. This approach offers a promising alternative to more invasive treatments such as craniotomy or subdural external drainage, though further research is needed to confirm its efficacy and safety in broader clinical contexts.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"50"},"PeriodicalIF":1.3,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827589","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":"Relationship between the volume of ventricles, brain parenchyma and neurocognition in children after hydrocephalus treatment.","authors":"Qinzhu Yang, Kun Huang, Gongwei Zhang, Xianjun Li, Yi Gao, Cailei Zhao","doi":"10.1007/s00381-024-06674-4","DOIUrl":"https://doi.org/10.1007/s00381-024-06674-4","url":null,"abstract":"<p><strong>Purpose: </strong>The treatment of hydrocephalus aims to facilitate optimal brain development and improve the overall condition of patients. To further evaluate the postoperative recovery process in individuals undergoing hydrocephalus treatment, we investigated the interplay between brain parenchymal and ventricular volumes, alongside neurocognitive parameters.</p><p><strong>Methods: </strong>In this study, 52 children under the age of 10 undergoing hydrocephalus treatment were included. All participants underwent T1w MR images and Gesell developmental schedule assessments. Initially, we investigated the correlation between patients' brain development and motor assessment scores. This analysis explored the association between cognition and both brain parenchymal and ventricular sizes. Furthermore, we investigated these relationships in the contexts of communicating and obstructive hydrocephalus. Finally, to quantitatively evaluate patients' brain development using more detailed texture information from imaging, we employed three different classification models for prediction. To compare their performances, we assessed these classification frameworks using a fourfold cross-validation method.</p><p><strong>Results: </strong>Leveraging the deep learning framework, both pre- and postoperative T1w MR images have demonstrated a significant predictive value in estimating patients' brain development, with the accuracy of 0.808 for postoperative images. In the statistical analysis, we identified a correlation between developmental assessments in children with communicating hydrocephalus and postoperative brain parenchymal volume.</p><p><strong>Conclusion: </strong>The findings indicate that postoperative evaluation of brain development is more closely associated with brain parenchymal and ventricular volumes than the Evans index. Additionally, deep learning frameworks exhibit promising potential as effective tools for accurately predicting patients' postoperative recovery.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"48"},"PeriodicalIF":1.3,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824017","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 outcomes of tethered cord syndrome in patients with normal conus medullaris and filum terminale without urologic symptoms.","authors":"Alper Tabanli, Emrah Akcay, Hakan Yilmaz, Seymen Ozdemir, Mesut Mete, Mehmet Selcuki","doi":"10.1007/s00381-024-06713-0","DOIUrl":"https://doi.org/10.1007/s00381-024-06713-0","url":null,"abstract":"<p><strong>Purpose: </strong>Tethered cord syndrome (TCS) typically presents with urologic symptoms and abnormal imaging findings. However, some patients present with normal conus medullaris level and filum terminale appearance on MRI. This research seeks to assess the intended surgical results in this particular group of TCS patients who do not present with urologic complaints, under the premise that the surgical approach goes a long way in preventing the onset of urologic abnormalities.</p><p><strong>Methods: </strong>This retrospective study included 59 operated patients with tethered cord syndrome who had a normal level terminating conus medullaris and a normal looking filum terminale without urologic symptoms. Of these patients, 38 were female and 21 were male. All patients underwent somatosensory-evoked potentials (SSEPs), and magnetic resonance imaging (MRI). The surgical technique used was flavotomy, which involves cutting the filum terminale without performing a laminectomy.</p><p><strong>Results: </strong>The study population had a mean age of 22.5 years (SD = 13.2). During the mean postoperative follow-up period of 2.5 years, none of the patients developed urinary incontinence. Preoperative SSEP abnormalities included conduction block in 39 patients (66.1%), low amplitude in 12 patients (20.3%), and delayed N22 wave latency in 8 patients (13.5%). The surgical procedures were completed without morbidity or mortality, and all patients showed significant postoperative improvement in SSEP parameters.</p><p><strong>Conclusion: </strong>Our results indicate that even though the filum terminale might have a normal looking MRI, TCS can also occur due to some potential microscopic or structural abnormality. The study proves SSEP to be useful in TCS diagnosis and it also proposes that if surgery is done early before any urologic complaints arise, chances of their onset will be minimized. Such findings support the view that surgical measures should be entertained in symptomatic patients with abnormal SSEP but normal MRI.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"47"},"PeriodicalIF":1.3,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817428","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}