Pediatric neurosurgery
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Pediatric neurosurgery · Jan 2007
Case ReportsTransorbital orbitocranial penetrating injury due to bicycle brake handle in a child.
Transorbital orbitocranial penetrating injuries (TOPI) are relatively rare and can be caused by a variety of unusual objects. Diagnosis of TOPI should be based on a detailed history and evaluation of available investigations as the penetrating injury may be overlooked. In the present case, a child sustained a penetrating injury with the brake handle of a bicycle due to the accidental fall of the bicycle on him and was managed conservatively.
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Pediatric neurosurgery · Jan 2007
Case ReportsGiant malignant nerve sheath tumor of lumbosacral plexus with intraspinal extension in a child with neurofibromatosis type 1.
Malignant peripheral nerve sheath tumors (MPNSTs) are the leading cause of death in young adults and are one of the most frequent non-rhabdomyosarcomatous soft tissue tumors in pediatric age. These tumors usually occur in young adults from a previously recognized neurofibroma, neurofibromatosis type 1 (NF1), with a noted change in size and pain. This child reached the age of 10 without the presence of the more commonly seen manifestations of NF1. Pseudoarthrosis in children has a high rate of association with NF1, and in this case diagnosis of NF1 was supported by development of MPNST in a pre-existing plexiform neurofibroma.
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Pediatric neurosurgery · Jan 2007
Case ReportsCat scratch disease with epidural extension while on antimicrobial treatment.
We report the first case of a child with an epidural abscess caused by Bartonella henselae. This case is unique in that the diagnosis was confirmed by polymerase chain reaction (PCR) of the abscess fluid. ⋯ Magnetic resonance imaging (MRI) of the lumbar spine revealed a paraspinal soft tissue abnormality extending from the T(12) to the L(4) level, and a computed tomography (CT) scan of the lumbar spine showed osteomyelitis at the T(12) level with soft tissue changes. B. henselae serology showed an IgG titer of 1:256 and IgM of <1:16.
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Pediatric neurosurgery · Jan 2007
Review Case ReportsPosterior fossa syndrome after a vermian stroke: a new case and review of the literature.
The posterior fossa syndrome (PFS) is a well-known clinical consequence of posterior fossa surgery that has only been reported in a limited number of cases with a nontumoral etiology. It consists of transient cerebellar mutism, behavioral abnormalities and personality changes. We describe a 12-year-old child who developed transient cerebellar mutism associated with behavioral and emotional symptoms following rupture of a vermis arteriovenous malformation (AVM). ⋯ After 3 days, mutism resolved and dysarthria became apparent. Two weeks after stroke, the AVM was surgically removed and the postoperative course was uneventful. This case is the first reported in which the PFS occurred after focal nonsurgically induced cerebellar damage.
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Pediatric neurosurgery · Jan 2007
Review Case ReportsUnusual presentation of cervical spinal intramedullary arachnoid cyst in childhood: case report and review of the literature.
The authors report a 7-year-old girl who presented with progressive quadriparesis which had started a month before admission. Magnetic resonance imaging of the spine revealed an intramedullary cystic lesion extending from C(2) to C(4). After performing a C(2-5) laminectomy, the cyst was drained and anatomically fenestrated with the subarachnoid space by a 1-cm vertical median myelotomy without using a stent. ⋯ In the first month after operation, the neurological deficits disappeared gradually, except for a slight left upper paresis. Cervical spinal intramedullary arachnoid cyst is extremely rare and should be considered in the differential diagnosis of intramedullary cystic lesions in childhood. Recovery is possible after subtotal excision and fenestration of the cyst to allow communication with the subarachnoid space even if neurological deficits are present for a long time.