Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
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Neuroectodermal tumors in general demonstrate high and dense expression of the somatostatin receptor subtype 2 (sst₂). It controls proliferation of both normal and neoplastic cells. sst₂ has thus been suggested as a therapeutic target and prognostic marker for certain malignancies. ⋯ sst₂ is highly expressed in medulloblastoma and deserves further evaluation in the setting of prospective trials, given its potential utility as a prognostic marker and a therapeutic target.
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The posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) techniques are commonly used surgical methods for wide indications such as degeneration or trauma. Although they are rarely required for lumbar disk disease in younger patients, there are a few children and adolescents who are indicated for PLIF or TLIF for other reasons, such as congenital severe stenosis with or without lumbar instability that requires wide decompression or severe bony spur that need to be removed. In such cases, different pathophysiology and outcomes are expected compared with adult patients. ⋯ For adolescent patients with severe bony spur, massive central disk rupture, or severe spondylolisthesis, lumbar interbody fusion surgery has good surgical outcome with few complications.
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Comparative Study
A retrospective comparison of CT and MRI in detecting pediatric cervical spine injury.
Although clinical criteria have been applied in the assessment of pediatric cervical spine trauma, no consensus has been established when imaging is required. With the increasing prevalence of computed tomography (CT) use in pediatric trauma and the concern for radiation in children, we sought to evaluate magnetic resonance imaging (MRI) and CT in detecting pediatric cervical spine injuries. ⋯ Using CT as the standard for osseous injury, MRI had a sensitivity of 100%, specificity of 97%, negative predictive value (NPV) of 75%, and positive predictive value (PPV) of 100%. Using MRI as the standard for soft tissue injury, CT had a sensitivity of 23%, specificity of 100%, NPV of 88%, and PPV of 100%. Further studies are required to investigate the use of MRI to detect osseous injuries.
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Suprasellar arachnoid cysts can differ from other arachnoid cysts in several ways, making a separate analysis of these cysts worthwhile. Herein, we present the outcome and perform volumetric analysis of six children with suprasellar arachnoid cysts treated with endoscopic ventriculocystocisternostomy in order to evaluate the long-term outcomes. ⋯ Based on our experience, suprasellar arachnoid cyst treatment with ventriculocystocisternostomy is an adequate surgical intervention. Suprasellar and third ventricular size does respond to the surgical intervention at long-term follow-up.
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The aim of our study is to evaluate the effectiveness of endoscopic transaqueductal or interventricular stent placement into the fourth ventricle for isolated fourth ventricle (IFV) and pre-isolated fourth ventricle (PIFV), in which occlusion of the fourth ventricle outlets and dilation of the fourth ventricle are seen while the aqueduct is still patent. ⋯ The endoscopic transaqueductal or interventricular stent placement into the fourth ventricle for the treatment of IFV is considered to be effective and safe. The transaqueductal stent placement for PIFV is also considered to be effective for resolution of symptoms and prevent progression into IFV.