Child's Nervous System最新文献

{"title":"Technique and protocol for bedside neuroendoscopic lavage for post-hemorrhagic hydrocephalus: technical note.","authors":"Tracy M Flanders, Misun Hwang, Nickolas W Julian, Christina E Sarris, John J Flibotte, Sara B DeMauro, David A Munson, Lauren M Heimall, Yong C Collins, Jena M Bamberski, Meghan A Sturak, Eo V Trueblood, Gregory G Heuer","doi":"10.1007/s00381-024-06697-x","DOIUrl":"10.1007/s00381-024-06697-x","url":null,"abstract":"<p><p>Neuroendoscopic lavage (NEL) is a time-limited neurosurgical intervention that removes intraventricular blood in post-hemorrhagic hydrocephalus (PHH). Preterm neonates are medically complex and fragile, often precluding neurosurgical procedures due to concerns such as extubation risk and body temperature instability during even routine clinical care. In addition, transportation to the operating room can be difficult and risky. Given these factors, our institution developed and implemented a bedside technique to facilitate safe and timely NEL in the neonatal intensive care unit for the treatment of PHH.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"39"},"PeriodicalIF":1.3,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794535","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 role of stem cells in the management of neonatal posthemorrhagic hydrocephalus.","authors":"Christodoulos Komiotis, Ioannis Mavridis","doi":"10.1007/s00381-024-06703-2","DOIUrl":"10.1007/s00381-024-06703-2","url":null,"abstract":"<p><strong>Purpose: </strong>Neonatal intraventricular hemorrhage (IVH) is a common complication of prematurity as it affects 12.4% of preterm infants weighing under 1500 g. Posthemorrhagic hydrocephalus (PHH) is an important complication of neonatal IVH and can have serious long-term consequences such as cognitive impairment and cerebral palsy. The purpose of this review is to determine whether stem cell transplantation can play a role in the treatment of neonatal IVH mainly focusing on the prevention of the catastrophic sequelae of neonatal IVH, as well as to the improve outcome of these patients.</p><p><strong>Methods: </strong>A literature search was performed using the PubMed/MEDLINE and Scopus databases, and after meticulous screening, eight articles were finally selected. The authors included both animal and human studies in this narrative review.</p><p><strong>Results: </strong>Our review included eight articles, five animal studies and three human studies, including one phase 1 clinical trial, one pilot study, and one case report. Intraventricular transplantation of mesenchymal stem cells (MSCs) early after IVH diagnosis seems to prevent the development of PHH, improve myelination, and reduce periventricular cell death, inflammation, and reactive gliosis. It also seems to be a safe and well-tolerated procedure in preterm infants.</p><p><strong>Conclusion: </strong>Animal and human study findings regarding stem cell transplantation in the treatment of IVH show promising results in reducing the risk of PHH. Further research with larger series is needed to better determine its safety and efficacy. Larger studies such as randomized controlled trials could establish the efficacy and tolerability of the treatment.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"40"},"PeriodicalIF":1.3,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799570","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":"Stereoelectroencephalography (SEEG)-guided insula resections: is it \"Reily\" worth it?","authors":"J Pepper, S Seri, A R Walsh, S Agrawal, L Macpherson, A Sudarsanam, W B Lo","doi":"10.1007/s00381-024-06661-9","DOIUrl":"https://doi.org/10.1007/s00381-024-06661-9","url":null,"abstract":"<p><strong>Objective: </strong>Stereoelectroencephalography (SEEG) is widely used to characterise epileptic networks and guide resection in paediatric epilepsy surgery programmes. The insula, with its extensive connectivity with temporal and extratemporal structures, has increasingly been seen as a possible surgical target. We report our seizure outcomes after SEEG-guided resection of the insula in a paediatric cohort.</p><p><strong>Methods: </strong>From our paediatric epilepsy surgery database of patients aged 0-19 years, we analysed demographic and clinical data of those who underwent SEEG-guided insula cortex resection.</p><p><strong>Results: </strong>In total, 11 children (7 females, 4 males) who underwent SEEG-guided resection were identified. The mean age at first SEEG was 13 years old. Mean age at seizure onset was 4.3 years; seizure frequency ranged from 50/day to 2/week. Four children required 1 SEEG study, 6 children 2 SEEG, and 1 child underwent 3 SEEG recordings. The mean follow-up duration was 2.1 years; at the latest follow-up, three children had Engel I, 2 children Engel III, and 6 children Engel IV. One child classified as an Engel IV outcome for insular surgery had Engel class I after 2 failed insula surgeries, after an occult frontal focal cortical dysplasia was later identified and resected. No major complications were noted.</p><p><strong>Conclusions: </strong>In our paediatric series, one third of the patients undergoing insula cortex surgery after SEEG became seizure free but this may require repeat SEEG implantation, repeat resective surgery and the possibility of changing hypothesis from the insula cortex to nearby foci.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"41"},"PeriodicalIF":1.3,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799565","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":"Holocord intramedullary pilocytic astrocytoma mimicking holocord spinal abscess: a case report and literature review.","authors":"Duygu Dolen, Cafer Ikbal Gulsever, Merve Erguven, Gokcen Unverengil, Pulat Akin Sabanci","doi":"10.1007/s00381-024-06699-9","DOIUrl":"10.1007/s00381-024-06699-9","url":null,"abstract":"<p><strong>Purpose: </strong>This report aims to present a case of a child with holocord pilocytic astrocytoma and review the existing literature to provide insights into current management strategies.</p><p><strong>Case presentation: </strong>An 11-month-old patient presented with progressive quadriplegia and was initially diagnosed with a spinal abscess. MRI revealed a heterogeneously enhancing cystic intramedullary lesion extending from the cervicomedullary region to the conus medullaris. The patient underwent an emergent T10-L1 total laminectomy and midline myelotomy for presumed abscess drainage. Intraoperative findings, however, were inconsistent with an abscess, suggesting a neoplastic process. Postoperative MRI indicated persistent spinal cord compression and histopathological examination showed no leukocytes or microorganisms. A second surgery the following day extended the laminectomy to T3, achieving gross total resection. Pathology confirmed a grade I pilocytic astrocytoma. Given the patient's age, chemotherapy with vincristine and carboplatin was initiated, as radiotherapy was unsuitable. Early physical therapy was commenced, resulting in significant neurological improvement to 4/5 muscle strength in all extremities according to the Medical Research Council (MRC) scale in the first year. Chemotherapy was discontinued due to systemic complications. At the 1-year follow-up, MRI demonstrated no tumor recurrence.</p><p><strong>Conclusion: </strong>The management of holocord pilocytic astrocytomas presents significant challenges, particularly in pediatric patients. While surgical resection remains the cornerstone of treatment, the role of chemotherapy requires further investigation. This case underscores the necessity of a multidisciplinary approach and highlights the potential for favorable outcomes with appropriate intervention.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"38"},"PeriodicalIF":1.3,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791217","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":"Neurophysiological identification and differentiation between the motor and sensory roots in pediatric spinal cord lipoma surgery.","authors":"Katharina Lutz, Timothy Müller, Sebastian Grunt, Cordula Scherer, Martin U Schuhmann, Mazen Zeino, Sonja Vulcu, Arsany Hakim, Jonathan Wermelinger, Pablo Abel Alvarez Abut, Katarzyna Pospieszny, Andreas Raabe, Philippe Schucht, Kathleen Seidel","doi":"10.1007/s00381-024-06673-5","DOIUrl":"10.1007/s00381-024-06673-5","url":null,"abstract":"<p><strong>Background: </strong>Radical resection of spinal cord lipomas reduces the rate of re-tethering. Current conventional neurophysiological mapping techniques are not able to differentiate between crucial motor nerve roots and sensory roots. Enhanced differentiation could contribute to complete resection. We present our experience with a double-train paradigm to differentiate between motor and sensory roots.</p><p><strong>Methods: </strong>In children undergoing spinal cord lipoma resection, the double-train mapping paradigm was used with an inter-train interval of 60 ms. Given the longer recovery time due to the H-reflex, a single muscle response was presumed to be elicited from a sensory root, and a double muscle response from a motor root. The primary endpoint was postoperative neurological outcome and bladder function at discharge.</p><p><strong>Results: </strong>We included 8 children undergoing 10 lipoma resections between 2016 and 2023. Double-train mapping was used in all cases. Motor and sensory roots were clearly differentiated in 6 cases and altered the course of surgery in 4 cases. Post-surgery, no sensory and motor function worsened within 3 months. Bladder function was stable in six and improved in two children. In two patients, bladder function worsened slightly at 3 months and 6 months, at which point one patient was re-operated on for re-tethering.</p><p><strong>Conclusion: </strong>Intraoperative mapping with the double-train paradigm reliably differentiated between motor and sensory nerve roots. Informing the surgeon on the specific function of a tethering root may help to maximize resection without risking major neurological deficits.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"37"},"PeriodicalIF":1.3,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784290","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":"Immediate postoperative course in the pediatric intensive care unit following epilepsy surgery.","authors":"Itay Ayalon, Shirley Friedman, Barak Meidan, Efraim Sadot, Shlomi Constantini, Shimrit Uliel-Sibony, Jonathan Roth","doi":"10.1007/s00381-024-06681-5","DOIUrl":"10.1007/s00381-024-06681-5","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the immediate postoperative PICU course and short-term outcomes of children undergoing various epilepsy surgeries.</p><p><strong>Methods: </strong>Single-center, retrospective observational study. All patients younger than 20 years of age who had been admitted to the PICU between 2018 and 2022 following epilepsy surgery were eligible for study entry.</p><p><strong>Results: </strong>Fifty-two children (median age 7.9 years) underwent epilepsy surgery during the study period (25 focal lesionectomies and lobectomies [FL], 10 corpus callosotomy [CC], and 17 hemispheric surgeries [HS]). The average number of preoperative antiseizure medications (ASM) was 3, and the average number of failed ASM was 6. Cortical dysplasia was the most frequent etiology (25%). Preoperative cognitive delay and motor deficits were reported in 38 (74%) and 26 (50%) patients, respectively. The median length of stay in the PICU was 1 day (5 for the HS group). No seizures occurred among 44 (85%) children during the first postoperative day nor during the entire hospital stay in 40 (77%) patients (20/25 [82%] in the FL group, 4/10 [40%] in the CC group, and 14/17 [82%] in the HS group). There were no status epilepticus events during the PICU stay. None of patients required hemodynamic support, and only 3(6%) needed respiratory support. Twenty-six patients (50%) had electrolyte abnormalities. Pain was mostly perceived as mild. Fever was present in 28 (54%) patients, most notably in the HS group (94%).</p><p><strong>Conclusion: </strong>Epilepsy surgery in children is associated with very limited immediate postoperative morbidity and low seizure burden, especially in the FL and HS groups.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"36"},"PeriodicalIF":1.3,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784285","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":"Implausible, not impossible: delayed supradiaphragmatic thoracic migration of a ventriculoperitoneal shunt in a 17-month-old.","authors":"Ioan-Alexandru Florian, Paula Topal, Teodora-Larisa Florian, Dragos Font, Ioan-Stefan Florian","doi":"10.1007/s00381-024-06670-8","DOIUrl":"10.1007/s00381-024-06670-8","url":null,"abstract":"<p><strong>Background: </strong>Intrathoracic migration of a ventriculoperitoneal shunt (VPS) is a phenomenally rare complication, with the supradiaphragmatic intercostal variant even more so. Whereas it can prove debilitating or even fatal via massive hydrothorax, the causative mechanism and proper management of this occurrence are undefined.</p><p><strong>Case presentation: </strong>A 17-month-old girl who had undergone VPS insertion at one month of age was brought to our department for somnolence and dyspnea, which had a sudden onset. Despite a previous thoracostomy provided temporary symptom relief, she had relapsed. Computed tomography (CT) of the chest showed a large loop of the right-sided VPS penetrating into the thorax through the anterior wall, as well as marked right hydrothorax. She was subjected to VPS revision and thoracostomy, with the swift, complete, and lasting remission of her complaints.</p><p><strong>Conclusion: </strong>It is possible that local reaction coupled with negative inspiratory pressure caused the catheter loop to break into the pleural cavity. Our case demonstrates an exceedingly rare event that has a favorable prognosis if diagnosed and treated quickly and appropriately.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"35"},"PeriodicalIF":1.3,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11621144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784289","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":"Bibliometric analysis of the top 100 most cited articles on the immunotherapy for glioblastoma.","authors":"Chunming He, Peng Xiong, Chuan Zeng, Xinyu Qiu, Tao Long, Haimin Song","doi":"10.1007/s00381-024-06693-1","DOIUrl":"https://doi.org/10.1007/s00381-024-06693-1","url":null,"abstract":"<p><strong>Background: </strong>The nature of immunotherapy has rendered it a focal point in the management of glioblastoma (GBM). This bibliometric analysis aimed to analyze the top 100 most cited articles about immunotherapy for GBM to expand the knowledge of research related to this therapeutic approach.</p><p><strong>Methods: </strong>The retrieval of the top 100 articles on \"Immunotherapy AND Glioblastoma\" was performed using the Web of Science Core Collection database. Relevant details were extracted for bibliometric analysis, and to gain insights, a comparison was made between older and newer articles. Categorical data underwent analysis utilizing Pearson's chi-square test, while continuous data were analyzed using the Wilcoxon rank-sum test.</p><p><strong>Results: </strong>The top 100 articles were distributed across the years 2000 to 2021, with the number of citations ranging from 135 to 1058. Among these articles, publications peaked in 2017 and 2018 (n = 12), and the most common country of correspondence was the USA (n = 73). Clinical Cancer Research was the most cited journal, and authors SAMPSON JH and LIM M had the highest number of papers (n = 6). Newer articles had significantly higher citation rates (p < 0.01), more authors (p < 0.05), more institutes (p < 0.01), and more collaborations between institutions (p < 0.01). Subspecialties showed a trend of more \"TME\" (1% vs 7%, p = 0.05945) in the before and after group comparison, although this difference was not statistically significant (p > 0.05).</p><p><strong>Conclusion: </strong>The study of the top 100 cited articles on immunotherapy for GBM shows that researchers are actively working together to develop novel approaches to GBM immunotherapy. The high citations, leading countries, journals, and authors, along with evolving research characteristics, indicate a field with great interest and potential. Immunotherapy holds significant promise in GBM treatment.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"33"},"PeriodicalIF":1.3,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779067","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":"Correction: Prevalence and associated risk factors of intraventricular hemorrhage in preterm newborns in Southwestern Iran.","authors":"Zahra Hashemi, Mohammad Safari Sarook, Roya Oboodi, Mozhgan Moghtaderi, Sara Mostafavi","doi":"10.1007/s00381-024-06701-4","DOIUrl":"https://doi.org/10.1007/s00381-024-06701-4","url":null,"abstract":"","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"34"},"PeriodicalIF":1.3,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784277","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":"Prevalence, type, and risk factors of intracranial hemorrhage in term neonates: a systematic review and meta-analysis.","authors":"Debajyoti Datta, Rikki Chisvin, Albert Tu","doi":"10.1007/s00381-024-06688-y","DOIUrl":"10.1007/s00381-024-06688-y","url":null,"abstract":"<p><strong>Introduction: </strong>Intracranial hemorrhage in the newborn poses a significant challenge to their well-being and subsequent development. In pre-term neonates, germinal matrix hemorrhage is the most common cause of intracranial hemorrhage with the prevalence varying from 20 to 59%. However, in term neonates, the prevalence and type of intracranial hemorrhage have not been well elucidated. The type of hemorrhage occurring in term neonates differs from those occurring in pre-term neonates. We conducted a systematic review to assess the prevalence, type, and risk factors of intracranial hemorrhage occurring in term neonates.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis by searching the PubMed and Embase databases. Inclusion criteria were studies reporting intracranial hemorrhage in term neonates (37 weeks or more gestational age at the time of birth). Exclusion criteria were as follows: (1) studies which examined only a specific type of hemorrhage, (2) studies which examined only a single risk factor, (3) sample size < 20, (4) not in English language, and (5) full text not accessible/available. The studies which met the eligibility criteria were assessed and evaluated by two authors, and data was extracted using a predesigned template. The risk of bias in the included studies was assessed using the Joanna Briggs Institute bias assessment tool. The meta-analysis for prevalence, type of hemorrhage, and risk factor was conducted using MetaXL extension for Microsoft Excel.</p><p><strong>Results: </strong>A total of 1226 records were identified in a database search of PubMed and Embase. After screening, 20 studies were included in the final analysis. The overall prevalence of intracranial hemorrhage in term neonates was 9.3% (95% CI, 4.9-14.9%). The prevalence of intracranial hemorrhage in asymptomatic patients was 5.8% (95% CI, 2.5-10.2%) and in symptomatic patients was 29.3% (95% CI, 15.3-44.8%). Sub-group analysis of the modality of detection shows that the prevalence of hemorrhage detection was higher with computed tomography/magnetic resonance imaging (CT/MRI) than with ultrasonography (USG). Extra-axial hemorrhage was the most common type of hemorrhage detected, comprising about 32.4% of the overall. The odds of having an intracranial hemorrhage was significantly higher with an instrumental delivery (OR = 3.75, 95% CI, 1.4-10.02).</p><p><strong>Conclusion: </strong>The present study shows that the prevalence of intracranial hemorrhage is relatively high in symptomatic and asymptomatic patients with extra-axial hemorrhage being the most common type of hemorrhage. The prevalence of hemorrhage varied according to the type of imaging used for detection and ideal imaging modality for evaluation, and the consequences of intracranial hemorrhage in term infants on development remain to be determined.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"32"},"PeriodicalIF":1.3,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766720","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}