Pediatric neurosurgery
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Pediatric neurosurgery · Jan 2011
Volumetric analysis of cranial vault distraction for cephalocranial disproportion.
The purpose of this study was to provide an objective analysis and quantify the intracranial volume change produced by cranial vault distraction osteogenesis. We recently published a technique to expand the cranial vault by distraction in symptomatic patients with findings of cephalocranial disproportion. Resolution of symptoms was documented in that publication. ⋯ The ability to use the same methodology to quantify ventricular volume changes was unexpected. The fact that all ventricles expanded after distraction at approximately 10% of the total intracranial volume increase indicates that compensatory mechanisms had been activated. We conclude that this occurs at the expense of cerebral blood flow.
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Pediatric neurosurgery · Jan 2011
Randomized Controlled Trial Comparative StudyBenign neurological recovery with low recurrence and low peridural fibrosis rate in pediatric disc herniations after lumbar microdiscectomy.
Lumbar disc herniation (LDH) is a very rare clinical entity in the pediatric age group, therefore only a few clinical studies have until now investigated the clinical behavior of pediatric LDH. The natural clinical history, postoperative neurological recovery with radiological follow-up and quality of life related to the disorder continue to be unknown. We prospectively planned and designed two groups of LDH patients scheduled for surgery in this study. ⋯ After 3 years of follow-up, all parameters were significantly better in the pediatric LDH group with no recurrence of the disease. The pediatric LDH group was postoperatively better than the adult group both clinically and radiologically. Although LDH seems a catastrophic disease in the pediatric age group, the clinical picture and neurological recovery have a significantly more benign course than in adult patients even in operated cases.
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Pediatric neurosurgery · Jan 2011
ReviewEndoscopic minimally invasive neurosurgery: emerging techniques and expanding role through an extensive review of the literature and our own experience - part I: intraendoscopic neurosurgery.
Minimally invasive neurosurgery is a growing field, more so in recent decades. The modernization of tools, especially the endoscope, has allowed for critical improvements and crucial advancements in minimally invasive neurosurgery. The current classification scheme for endoscopic procedures needs to be updated to reflect these advancements. ⋯ Our proposed classification scheme for solely endoscopic procedures is presented. The role of the endoscope as an independent tool is clarified.
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Pediatric neurosurgery · Jan 2011
Review Comparative StudyDecompressive hemicraniectomy for pediatric traumatic brain injury: long-term outcome based on quality of life.
The impact of decompressive hemicraniectomy (DCH) on the overall outcome of pediatric brain injury patients has not been fully determined. In this paper, the authors performed a systematic review of patient outcome based on quality of life following DCH in a pediatric population. ⋯ Based on our findings, DCH results in a majority of pediatric patients having a good outcome based on the GOS score.
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Pediatric neurosurgery · Jan 2011
Review Case ReportsParoxysmal autonomic instability with dystonia in a child: rare manifestation of an interpeduncular tuberculoma.
The term 'paroxysmal autonomic instability with dystonia' was first given for a group of symptoms comprising diaphoresis, intermittent agitation, hypertension, hyperthermia, tachycardia, tachypnea, and extensor posturing. This usually occurs as a complication of severe brain injury and is infrequently reported in cases of cerebral infection. We report a 1-year-old child with intracranial tuberculoma with symptoms of paroxysmal autonomic instability with dystonia. Pertinent literature is reviewed emphasizing pathophysiology and available treatment options.