Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
-
One of the goals of cranial vault expansion performed in patients with craniosynostosis (CS) is to reduce the harmful effects associated with elevated intracranial pressure (ICP). Until now, clear guidelines on when cranial vault expansion should take place have not been established except in unacceptable cosmetic deformities. ⋯ Although we cannot clearly define the indications and establish normal pediatric ICP values from the result of this study because of the small number of cases and some other limitations, this is a new approach to define ICP increase as a potential indication for surgery in CS.
-
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.
-
We report a case of 4-year-old boy patient, who developed after a streptococcal pharyngitis a painful, pulsatile, and growing right-sided mass in the neck. Imaging studies revealed an extracranial right internal carotid artery pseudoaneurysm. The patient was successfully treated with stent-graft deployment. After 18 months of follow-up, the pseudoaneurysm is excluded from the circulation, the carotid artery is patent, and the patient is free from any neurological deficit. ⋯ Covered stents might be considered as a valid therapeutic option to treat carotid artery pseudoaneurysms.
-
Virtual reality simulation is a promising alternative to training surgical residents outside the operating room. It is also a useful aide to anatomic study, residency training, surgical rehearsal, credentialing, and recertification. ⋯ Virtual simulators with realistic graphics and force feedback have been developed for ventriculostomy, intraventricular surgery, and transsphenoidal pituitary surgery, thus allowing preoperative study of the individual anatomy and increasing the safety of the procedure. The authors also present experiences with their own virtual simulation of endoscopic third ventriculostomy.