Pediatric neurosurgery
-
Pediatric neurosurgery · Jan 2006
Case ReportsPenetrating craniofacial injuries in children with wooden and metal chopsticks.
Penetrating craniofacial injuries with chopsticks in children are peculiar accidents in the Oriental culture. All 10 cases previously reported were caused by wooden chopsticks that required surgical operations. However, there are no reported injuries with metal chopsticks in the past literature which should have been as common as that of wooden chopstick injuries in Asia. ⋯ We performed surgical procedure only for a child who had a wooden chopstick that had impacted into the temporal cortex. We followed up all 6 children for more than 1 year, and found that all had fully recovered to near-normal neurological status. We observed that penetrating craniofacial injuries with metal chopsticks rarely require surgical intervention and usually results in good outcome because the resultant wound is usually small without broken fragments compared to injuries with wooden chopsticks.
-
Pediatric neurosurgery · Jan 2006
Case ReportsSpontaneous acute subdural hematoma following contralateral calcified chronic subdural hematoma surgery: an unusual case.
Calcified chronic subdural hematoma (CCSDH) is a well-known disease to many neurosurgeons but only few cases have been reported regarding its surgical complications. We report a spontaneous acute subdural hematoma following contralateral CCSDH surgery in a 16-year-old boy and discuss its possible mechanisms. The first few days of the postoperative period, especially for the cerebral atrophy cases, should be monitored carefully and a control computerized tomography scan should be performed early for possible complications. To our knowledge, spontaneous acute subdural hematoma following contralateral CCSDH surgery has not been reported previously.
-
Pediatric neurosurgery · Jan 2006
Depressed skull fractures in children: Treatment using an obstetrical vacuum extractor.
A depressed skull fracture is an inward buckling of the skull bones. It is referred to as a ping-pong ball fracture in neonates; in older children, some fractures take a cup shape mimicking 'ping-pong' ball fractures. ⋯ The elevation of 'ping-pong-ball-like' or 'cup-shaped' skull fractures in older children (beyond the neonatal period) is a simple, effective and safe procedure.
-
Pediatric neurosurgery · Jan 2006
Low incidence of subdural grid-related complications in prolonged pediatric EEG monitoring.
Invasive EEG monitoring is one of the best tools available for localization of epileptogenic foci in the brain. However, published data in mixed series of adult and pediatric patients show high incidence of epidural bacterial contamination, cerebrospinal fluid leakage, and skin infection after subdural electrode implantation. We sought to determine whether the complication rate from prolonged subdural electrode implantation would be lower in a purely pediatric series. ⋯ There was no percutaneous cerebrospinal fluid leakage noted and no operation was aborted due to bleeding caused by grid placement. Our data suggest that subdural grid implantation in children is remarkably safe even for prolonged implantation, though infectious risk is significantly higher in reoperation (p = 0.019). This observation may contribute to lowering the threshold for two-stage invasive monitoring approaches in children with epilepsy.