Pediatric neurosurgery
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Pediatric neurosurgery · Jan 2010
Review Case ReportsVein of Galen aneurysms: presentation and endovascular management.
We present our experience with managing 13 cases of vein of Galen aneurysm with a special focus on endovascular strategies. This clinical review deals with the multivariable clinical presentation of vein of Galen aneurysms and the role of transarterial endovascular treatment. ⋯ The transarterial approach proved to be a successful way of management of true VGAM that yielded better outcomes.
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Pediatric neurosurgery · Jan 2010
Case ReportsA novel method for confirmation of hemispheric disconnection during hemispherotomy surgery.
Hemispherotomy has become a safe and effective surgical option for patients suffering from intractable epilepsy associated with diffuse unihemispheric malformations of cortical development. However, as compared to hemispherectomy, hemispherotomy, by leaving brain tissue behind, may leave some hemispheric connections intact, therefore increasing the risk of postoperative seizures. This is especially important to consider in the case of the highly epileptogenic hemisphere in hemimegalencephaly. ⋯ Intraoperative EEG may be a useful tool to confirm hemispheric disconnection during hemispherotomy.
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Pediatric neurosurgery · Jan 2010
Comparative StudyVentriculosubgaleal shunting for post-haemorrhagic hydrocephalus in premature neonates.
The management of hydrocephalus secondary to intraventricular haemorrhage in neonates can be controversial. Temporary diversion of cerebrospinal fluid (CSF) is often required due to the low birth weight and high risks of shunting in these patients. Ventriculosubgaleal (VSG) CSF diversion is an effective way of achieving this goal whilst minimising the risks of complications. It is a well-described technique but is rarely used in contemporary neurosurgical practice. ⋯ VSG CSF diversion offers a simple, effective and relatively safe means of treating hydrocephalus in the neonate, with a low risk of complications and the possibility of avoiding permanent shunting.
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Pediatric neurosurgery · Jan 2009
Comparative StudyMagnetic resonance diffusion tensor imaging of the optic nerves to guide treatment of pediatric suprasellar tumors.
As a preoperative planning tool, conventional magnetic resonance (MR) imaging may have limited value in differentiating tumors from white matter tracts. MR diffusion tensor imaging (MRDTI) has become a useful tool for evaluating white matter tracts in relation to surrounding structures and has been used in surgical planning for brain tumors involving white matter. We investigated the use of DTI of the optic nerves in surgical planning for pediatric suprasellar tumors. ⋯ A routine 6-direction DTI of the pediatric brain at 3 T permits a detailed DTI study of the optic nerves. Optic nerve tractography can be used to aid in the evaluation and treatment of pediatric brain tumors in the area of the optic chiasm.