Pediatric neurosurgery
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Pediatric neurosurgery · Jan 2006
Review Case ReportsFatal haemorrhage in medulloblastoma following ventricular drainage. Case report and review of the literature.
Haemorrhage in medulloblastoma is reported to be very rare. The authors report a case of a 13-year-old boy who presented with headache, unsteadiness, diplopia and papilloedema due to posterior fossa medulloblastoma causing obstructive hydrocephalus. ⋯ The cause was marked upward herniation of the anterior vermis and downward herniation of the cerebellar tonsils due to massive spontaneous intratumoural haemorrhage extended into the ventricular system. This atypical clinical course of fatal haemorrhage in medulloblastoma after insertion of external ventricular drainage is reported and the literature discussed.
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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.
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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.
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Pediatric neurosurgery · Jan 2006
Central nervous system tumors in patients under three years of age: treatment results of a single institute.
Eighty-six patients under 3 years of age with central nervous system tumors were retrospectively analyzed between 1972 and 2003. Surgical resection was done in all patients except for those with optic glioma, pons glioma and pineal tumor. Three different chemotherapy regimens were used in different time periods. ⋯ OS rates were 33.7, 41.3 and 88.8% for the medulloblastoma+primitive neuroectodermal tumor groups, ependymoma and astrocytoma, respectively (p=0.0001). Most of the patients had primitive embryonic tumors (37.2%). The best prognostic factors were tumor localization and histology.