Pediatric neurosurgery
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Pediatric neurosurgery · May 2005
Case ReportsSpontaneous movement of bullets in the interhemispheric region.
Gunshot wounds to the head are usually mortal injuries. Their frequency has been increasing in the last years because of increasing crime and war rates. Penetrating craniocerebral injury in children and adolescents at the age of 17 or under is an increasing cause of emergent neurosurgical admissions to major metropolitan medical centers. ⋯ Spontaneous movement of bullets within the brain has been reported sporadically. The removal of intracerebral bullets is obviously warranted in patients undergoing craniotomy or craniectomy for debridement or evacuation of intracerebral clots or bone fragments if the metallic fragment is in proximity to the operative site. Before surgical removal of any intracerebral bullet, it is recommended that an intraoperative plain skull X-ray be obtained after final positioning of the head.
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Pediatric neurosurgery · Mar 2005
Case ReportsCircumferential cervical spine surgery in an 18-month-old female with traumatic disruption of the odontoid and C3 vertebrae. Case report and review of techniques. Case report and review of techniques.
A case study of an 18-month-old female with craniovertebral instability and spinal cord compression requiring circumferential stabilization. A review of surgical techniques in upper cervical spine and craniovertebral stabilization for young children is provided. ⋯ This case demonstrates the ability to achieve circumferential stabilization in the young pediatric patient. Injuries at the odontoid synchondrosis can be difficult to treat and are only complicated by having to achieve a posterior fusion at the craniovertebral junction. We present a successful case of circumferential fusion and offer a surgical technique to achieve spinal cord decompression and fusion of the upper cervical spine and craniovertebral junction in the young pediatric population.
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Pediatric neurosurgery · Mar 2005
Case ReportsHypothalamic hamartoma in association with a suprasellar arachnoid cyst: a case report.
A 5-year-old female presented with a history of precocious puberty and increased height. MRI of the brain revealed a nonenhancing hypothalamic mass and associated suprasellar arachnoid cyst. The patient underwent a right frontal craniotomy with orbital osteotomy for wide fenestration of the cyst. ⋯ For this reason, no biopsy of the wall was performed. Postoperatively, the patient remains neurologically intact and without any medication dependence. This case highlights the occurrence of a suprasellar arachnoid cyst in association with a hypothalamic hamartoma.
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Pediatric neurosurgery · Jul 2004
Case ReportsNeck mass after catheterization of a neck vein in a child with ventriculoperitoneal shunt.
There have been many reports on various mechanical complications after shunt operations in children with hydrocephalus such as catheter fracture, obstruction, disconnection, dislocation and so on. However, there are no previous reports regarding subcutaneous mass formation due to cerebrospinal fluid (CSF) pseudocyst from direct puncture injury. The authors report with a review of the literature a case of a child with ventriculoperitoneal shunt who developed a neck mass after catheterization of the neck vein. The authors also advocate that percutaneous procedures in the vicinity of shunts be avoided whenever possible to prevent the possibility of CSF leakage resulting in pseudocyst formation.