Child's Nervous System最新文献

{"title":"Comparative analysis of treatment modalities for pediatric spinal cord glioblastoma: insights from a meta-analysis.","authors":"Artur Henrique Galvao Bruno Da Cunha, Pedro Lucas Negromonte Guerra, Inaê Carolline Silveira da Silva, Deoclides Lima Bezerra Júnior, Eduardo Vieira de Carvalho Júnior","doi":"10.1007/s00381-024-06729-6","DOIUrl":"https://doi.org/10.1007/s00381-024-06729-6","url":null,"abstract":"<p><strong>Introduction: </strong>Glioblastomas (GBM) are aggressive tumors that make up about 7% of central nervous system tumors in children. Spinal GBMs (sGBMs) are extremely rare, accounting for less than 1% of pediatric spinal tumors. sGBMs are difficult to treat due to their infiltrative nature and cause significant morbidity. While there is extensive literature on treatment outcomes for cranial GBMs, there is limited research on pediatric sGBMs. This meta-analysis aims to assess the impact of available treatments on overall survival (OS) and progression-free survival (PFS) in pediatric sGBM patients and to identify prognostic factors.</p><p><strong>Methodology: </strong>A comprehensive review of pediatric sGBM cases up to June 2024 was conducted using PubMed and Mendeley. Inclusion criteria were case series and case reports of pediatric sGBM, excluding those with metastatic sGBM or aggregated patient data. A total of 2202 articles were identified, with 46 meeting the inclusion criteria. Data on demographics, tumor characteristics, extent of resection, and treatments were collected. Kaplan-Meier and Cox proportional hazards models were used for statistical analysis.</p><p><strong>Results: </strong>The data was collected from 81 patients, 43 females and 38 males, with an average age of 10.7 years. The majority of tumors were found in the cervical region (32%). Subtotal resection (STR) was performed in 53% of cases, and 59% of patients received both chemotherapy (QT) and radiotherapy (RT). The average progression-free survival (PFS) was 10.95 months, with RT significantly improving PFS (15.2 months vs. 2.1 months, p = 0.001). The average OS was 13.4 months, with RT and QT being significant protective factors (p < 0.05). Age over seven years and cervical tumor location were associated with worse OS.</p><p><strong>Conclusion: </strong>This study highlights the significance of radiation therapy and chemotherapy in enhancing overall survival and progression-free survival in pediatric patients with spinal cord glioblastoma. Specifically, RT significantly improves PFS, while advanced age and tumor location in the cervical region are associated with worse outcomes. These findings can help shape treatment approaches and ultimately enhance the quality of life for pediatric sGBM patients.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"91"},"PeriodicalIF":1.3,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982748","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 encephalocele in newborns: prenatal diagnosis, management and outcome.","authors":"Suhair Qudsieh, Moh'd M Barbarawi, Hana' Qudsieh, Lara Barbaraw","doi":"10.1007/s00381-025-06750-3","DOIUrl":"https://doi.org/10.1007/s00381-025-06750-3","url":null,"abstract":"<p><strong>Background: </strong>A giant encephalocele associated with Chiari malformation is a rare congenital anomaly from a cephalad neural tube defect. Early prenatal diagnosis and parental counseling are essential; as early surgical intervention can improve outcomes.</p><p><strong>Methods: </strong>Between 2010 and 2023, twenty-seven newborns out of 43,815 delivered at our institution were diagnosed with encephaloceles, including seven cases of giant encephalocele associated with Chiari malformation type III. These seven cases were included in the study, and their medical records were reviewed retrospectively to assess clinical, radiological, surgical, and postoperative follow-up data.</p><p><strong>Results: </strong>Seven newborns with giant occipital encephalocele and Chiari malformation type III were treated at our institution, including five females and two males. All cases were diagnosed prenatally via ultrasound, and none of the mothers had taken folic acid regularly. Six infants underwent surgical resection with duroplasty within 48 h, achieving good outcomes. The seventh infant, with respiratory difficulties, hypotonia, and large ventricular septal defect(VSD), was unfit for surgery and passed away at two weeks. Long-term follow-up up to 24 months showed all surviving infants met developmental milestones, though mild delays in walking, speech, and unsteady gait were noted.</p><p><strong>Conclusion: </strong>Giant encephalocele with Chiari malformation is a rare condition that requires a multidisciplinary approach for effective management. Unlike smaller encephaloceles, giant ones may have a better prognosis due to the large volume of cerebrospinal fluid (CSF) in the herniated sac, which helps prevent further neural tissue herniation. Prenatal diagnosis is essential, and folic acid supplementation should be encouraged. Early surgical intervention is crucial for optimal outcomes.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"89"},"PeriodicalIF":1.3,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964140","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":"Long-term epidemiological trends in (primary) pediatric central nervous system tumors: a 25-year cohort analysis in Western Mexico.","authors":"Víctor Ulises Rodríguez-Machuca, Eduardo Jahir Ángulo-De La Cruz, Ana Lucía Gaxiola-Sarmiento, Juan Antonio Ramírez-Corona, David Fernández-Sánchez, Luis Angel Arredondo-Navarro, Héctor Velázquez-Santana, Santiago Nuñez-Velasco, Regina Mallinalli Navarro-Martín Del Campo, Felipe De Jesús Bustos-Rodríguez, Jorge Román Corona-Rivera, Lucina Bobadilla-Morales, Alfredo Corona-Rivera","doi":"10.1007/s00381-024-06715-y","DOIUrl":"https://doi.org/10.1007/s00381-024-06715-y","url":null,"abstract":"<p><strong>Background: </strong>Central nervous system tumors (CNSTs) represent a significant oncological challenge in pediatric populations, particularly in developing regions where access to diagnostic and therapeutic resources is limited.</p><p><strong>Methods: </strong>This research investigates the epidemiology, histological classifications, and survival outcomes of CNST in a cohort of pediatric patients aged 0 to 19 years within a 25-year retrospective study at the Civil Hospital of Guadalajara, Mexico, from 1999 to 2024.</p><p><strong>Results: </strong>Data was analyzed from 273 patients who met inclusion criteria, revealing a higher incidence in males (51.6%) with a mean age at diagnosis of 8.2 years. Histological analysis revealed gliomas as the most common type (52.7%), followed by embryonal tumors (28.6%). High-grade tumors (WHO grade 4) comprised 49.8% of cases, demonstrating significantly poorer survival outcomes (median overall survival of 13.5 months) compared to lower-grade tumors (up to 57 months). The predominance of tumors in the supratentorial region and the notable differences in survival outcomes by tumor type underscore the varied impact of geographical and socioeconomic factors on pediatric oncology in Mexico.</p><p><strong>Conclusion: </strong>This study highlights the critical need for improved healthcare infrastructure and early diagnosis initiatives, as well as the importance of targeted research to address disparities in treatment and outcomes for pediatric CNST in this region.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"90"},"PeriodicalIF":1.3,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964141","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":"Transcranial electrical evoked muscle potentials for pediatric neurosurgery: scoping review of stimulation techniques and success rates.","authors":"Axel Fudickar, Kai Berndt, Klaus Novak","doi":"10.1007/s00381-024-06739-4","DOIUrl":"10.1007/s00381-024-06739-4","url":null,"abstract":"<p><strong>Purpose: </strong>The background of this scoping review is that pediatric neurosurgery in the vicinity of motor pathways is associated with the risk of motor tract damage. By measuring transcranial electrical evoked potentials in muscles (electromyogram) or from the spinal cord (epidural D-wave) functional disorders and impending damage can be detected during surgery and countermeasures can be initiated. The objective was to summarize stimulation techniques of transcranial electrical stimulation and the success rate of motor evoked potentials exclusively in children undergoing neurosurgery.</p><p><strong>Methods: </strong>The data source was a literature search for reports meeting the suitability criteria (original articles and case series including motor evoked potentials and pediatric neurosurgery).</p><p><strong>Results: </strong>Twenty-four articles meeting suitability criteria were retrieved. The most common primary electrode positions for electrical stimulation were at C3 vs. C4 and C1 vs. C2 according to the 10-20-system of EEG. Single trains of 1 to 9 pulses with voltages from 160 to 900 V and pulse durations from 50 to 500 µs were applied for voltage-controlled stimulation. Interstimulus intervals ranged from 0.1 to 9.9 ms. Signals were filtered with high-pass filters between 1.5 and 300 Hz and low-pass filters between 500 and 5000 Hz. The overall rate of successful stimulation and measurement was 90.5% (N = 769).</p><p><strong>Conclusion: </strong>A broad range of stimulation parameters was used for transcranial electrical evoked potentials. Measurable potentials were obtained in most patients. Consideration of safety precautions is an important implication to avoid adverse events by application of high voltage to the motor cortex.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"88"},"PeriodicalIF":1.3,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945604","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":"Description of a monstrous little girl born in the Verona area on June 14, 1789.","authors":"Carlo Mazza, Francesca Siddi, Francesco Sala","doi":"10.1007/s00381-024-06746-5","DOIUrl":"https://doi.org/10.1007/s00381-024-06746-5","url":null,"abstract":"","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"87"},"PeriodicalIF":1.3,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945583","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":"Survival and toxicity outcomes of hypofractionated conformal radiotherapy compared to conventionally fractionated radiotherapy in the treatment of diffuse intrinsic pontine gliomas.","authors":"Abhilash Dagar, Adrija Ghosh, Aashita, Akash Kumar, Yousra Izzuddeen K N, Karun Kamboj, Aman Sharma, Jaswin Raj, Dayanand Sharma, Supriya Mallick","doi":"10.1007/s00381-024-06700-5","DOIUrl":"https://doi.org/10.1007/s00381-024-06700-5","url":null,"abstract":"<p><strong>Introduction: </strong>Diffuse intrinsic pontine gliomas are associated with dismal survival outcomes. Conventional fractionation radiation to a dose of 60 Gy is the standard of treatment. This retrospective review aims to compare survival and toxicity outcomes of patients treated with conventional fractionation (CF) and hypofractionation (HF) radiotherapy.</p><p><strong>Materials and methods: </strong>Treatment-naïve diffuse intrinsic pontine glioma patients undergoing radical radiation were analyzed. CF was delivered to a dose of 50-60 Gy in 25-30 fractions, while HF was delivered as 38-40 Gy in 12-15 fractions. All patients were planned via the volumetric modulated arc therapy (VMAT) technique.</p><p><strong>Results: </strong>A total of 64 patients were eligible for analysis. The median age of presentation was 10 years. Motor deficit was the most common presenting complaint in 51.6% of the patients, with a median symptom duration of 2 months. The pons was the most frequent site of disease epicenter in 71.8% of the patients. After a median follow-up of 9.45 months (range 0.23-72.63 months), 23 patients died, and 28 patients experienced disease progression. The unadjusted hazard ratio (HR) for death in patients treated with HF as compared to CF was 1.330 (95% CI 0.522-3.386) (p-value 0.550, by Cox regression analysis). The median OS for the entire cohort was 13.9 months, while it was 9.7 months (95% CI 5.65-13.74) and 15.1 months (95% CI 9.02-21.18) (p-value = 0.547) with CF and HF, respectively. On multivariate analysis, disease epicenter in the pons was the only significant factor associated with PFS. Hypofractionation was associated with a significantly higher aspiration rate and Ryle's tube requirement (p-value 0.027).</p><p><strong>Conclusion: </strong>Hypofractionated radiation can be considered for diffuse intrinsic pontine glioma with optimum supportive care.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"85"},"PeriodicalIF":1.3,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945585","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 survey of paediatric epilepsy surgery in Asia and Australasia.","authors":"Peter Heppner","doi":"10.1007/s00381-024-06710-3","DOIUrl":"https://doi.org/10.1007/s00381-024-06710-3","url":null,"abstract":"<p><strong>Purpose: </strong>In this study, we aimed to define the scope of paediatric epilepsy surgery performed in Asia and Australasia.</p><p><strong>Methods: </strong>Representative surgeons from each county were emailed a survey about paediatric epilepsy surgery as it is practiced in their country. The survey covered topics including what investigations, operations and number of surgeries are performed and by whom (adult or paediatric neurosurgeons).</p><p><strong>Results: </strong>Epilepsy surgery programmes are for the most part more common in larger countries and countries with a higher gross domestic product (GDP). Countries performing epilepsy surgery commonly have access to the full range of investigations except magneto-encephalography (MEG). Intraoperative electrocorticography (ECOG) and stereotaxy are typically available and most have access to extra-operative monitoring. There is limited availability of laser interstitial therapy (LIT) and responsive neuro-stimulation (RNS). China performs approximately 4000 paediatric epilepsy cases per year which is more than all of the other countries combined. Epilepsy surgery case numbers range from 0.2 to 22/ million population per year, and there is a correlation between the number of cases performed and the countries' GDP. A large number of children have no access to epilepsy surgery.</p><p><strong>Conclusion: </strong>There is a wide variation in access to epilepsy surgery in Asia and Australasia. Some counties have surgical numbers comparable with high volume Western countries, while hundreds of millions of children have no access to surgery at all.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"86"},"PeriodicalIF":1.3,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945577","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":"Meningeal melanocytoma of the central nervous system in children.","authors":"Lukasz Antkowiak, Jerzy Luszawski, Wieslawa Grajkowska, Joanna Trubicka, Marek Mandera","doi":"10.1007/s00381-024-06718-9","DOIUrl":"10.1007/s00381-024-06718-9","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to summarize the existing English-language literature on central nervous system (CNS) meningeal melanocytomas in children, and additionally describe our institutional case report.</p><p><strong>Methods: </strong>PubMed database was screened on September 2, 2024, for English-language papers reporting on pediatric patients with CNS meningeal melanocytoma.</p><p><strong>Results: </strong>A total of 17 papers reporting on 18 patients with 19 CNS meningeal melanocytomas were found in the literature. Additionally, we reported on a 15-year-old male patient with C2-C6 meningeal melanocytoma. Pediatric cohort analysis showed nearly equal sex distribution and a mean age at diagnosis of 11.9 years. There were fifteen intracranial (75%) and five spinal tumors (25%). Four lesions (20%) were diagnosed as intermediate-grade melanocytomas, while the remaining sixteen (80%) were benign meningeal melanocytomas. Most tumors were hyperintense on T1-weighted imaging (85%) and hypointense on T2-weighted imaging (73%). All tumors showed positivity for S100 and Melan-A. Most tumors were characterized by a lack of CNS invasion (91%). Gross-total resection (GTR) was performed in 61% of tumors. Adjuvant radiotherapy (RT) was applied in 50% of patients with incomplete tumor resection. Postoperatively, 62% of patients achieved a favorable outcome. We found 1, 2, 3, and 4-year overall survival of 80%, 71%, 71%, and 50%, respectively. The recurrence rate was 15% after a mean time of 10 months.</p><p><strong>Conclusions: </strong>Meningeal melanocytomas constitute a rare subgroup of CNS tumors. Surgical tumor removal aiming at maximally safe GTR remains a standard approach, resulting in favorable postoperative outcomes. Considering high recurrence rate, long-term follow-up is needed.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"82"},"PeriodicalIF":1.3,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930633","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":"Letters to editor regarding the article \"Outcomes of surgical revascularization for pediatric moyamoya disease and syndrome\".","authors":"Ruirui Liu, Zhe Hu, Yuge Chen, Shangkuan Liu","doi":"10.1007/s00381-024-06749-2","DOIUrl":"https://doi.org/10.1007/s00381-024-06749-2","url":null,"abstract":"","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"83"},"PeriodicalIF":1.3,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subdural hematoma as a complication of endoscopic third ventriculostomy in a pediatric patient: a case report and literature review.","authors":"Rafael Tiza Fernandes, Rui Sobrinho, Miguel Azevedo, Mário Matos, Amets Sagarribay, Dalila Forte","doi":"10.1007/s00381-024-06726-9","DOIUrl":"https://doi.org/10.1007/s00381-024-06726-9","url":null,"abstract":"<p><strong>Background: </strong>Subdural hematoma (SDH) typically occurs due to traumatic brain injury but can arise as a rare complication of procedures like endoscopic third ventriculostomy (ETV).</p><p><strong>Case presentation: </strong>We report an unusual case in a 9-year-old male with previous resection of a fourth-ventricle ependymoma at 2 years of age. Seven years post-surgery, he presented with worsening hydrocephalus and underwent ETV. One month later, he developed severe headaches and motor difficulties. Imaging revealed a significant right SDH, necessitating urgent drainage. Postoperative recovery was uneventful, and follow-up imaging showed resolution of the hematoma.</p><p><strong>Literature review and discussion: </strong>ETV is generally preferred for obstructive hydrocephalus due to lower complication rates compared to shunt procedures. However, cases of SDH post-ETV remain reported, albeit rarely. Potential mechanisms include altered cerebrospinal fluid dynamics and intraoperative vessel injury. This case aligns with literature findings and reinforces the importance of postoperative monitoring and prompt intervention in symptomatic cases to prevent complications.</p><p><strong>Conclusion: </strong>Clinicians should consider SDH in pediatric patients with new symptoms post-ETV. Further research should focus on understanding the risk factors and mechanisms for SDH development.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"81"},"PeriodicalIF":1.3,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926567","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}