Pediatric neurosurgery
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Pediatric neurosurgery · Jan 1994
ReviewCraniopharyngioma: endocrine abnormalities at presentation.
Craniopharyngioma is the most common childhood tumor to involve the hypothalamus and pituitary. Although endocrine disturbances can be found in 80-90% of patients at presentation, only a minority of subjects seek medical attention for an endocrine-related complaint. ⋯ In contrast, diabetes insipidus has been noted in only 9-17% of subjects prior to surgery. When possible, full evaluation of pituitary function should be performed; the minimum preoperative evaluation must include testing for and treatment of ACTH-adrenal insufficiency and diabetes insipidus.
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Pediatric neurosurgery · Mar 1993
ReviewAn approach to the management of arrested and compensated hydrocephalus.
Arrested hydrocephalus is defined as adequately shunted hydrocephalus while all other forms of hydrocephalus are at various levels of compensation. Compensation occurs at some cost to the child. ⋯ Close observation with objective data is mandatory if the decision is made not to shunt the young child. In the very young, less than 3 years of age, one should probably err on the side of inserting a shunt.
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The ability to detect and differentiate intracranial infection has markedly improved, first with the introduction of computed tomography and, more recently, with magnetic resonance. Enhanced magnetic resonance imaging is the procedure of choice in the evaluation of nearly all intracranial infections. ⋯ Computed tomography remains useful primarily in those infections associated with intracranial calcification, such as TORCH syndrome. This article summarizes the most recent CT and MR findings of infection involving the meninges and brain parenchyma.
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Hydrocephalus is a common problem in pediatric neurological and neurosurgical practices. In this manuscript, the common imaging appearances of hydrocephalus are discussed in relation to the underlying causes of the hydrocephalus. ⋯ Finally the imaging findings associated with treatment of hydrocephalus are discussed. In particular, analysis of shunt function, the diagnosis of shunt failure, and the complications of shunting are stressed.