Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
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Review Historical Article
Past, present and future of pediatric neuroradiology.
The last century has seen the evolution of neuroimaging from nonexistent to a group of techniques that, in our eyes, appears to be highly sophisticated. The rapidity of advancement in imaging has been concentrated in the last quarter century. There is no reason to expect this continual forward expansion of neuroradiology to abate; rather it seems likely that it will continue to increase at an even faster rate. The near future is one of refinement in imaging, faster and higher resolution as well as a much greater emphasis on physiology and biochemistry.
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With creation of the many subdivisions within the field of neurosurgery, neurosurgeons have taken on different roles. It is important for neurosurgeons to understand all the different subjects involved to enable them to build up long-term goals in patient management and research. ⋯ Because pediatric neurosurgeons cover the whole range of neurosurgical diseases of infancy and childhood, the authors emphasize that their actions can be the basis for the management of general neurosurgical patients. A comparison between pediatric and adult neurosurgery is also drawn, with special reference to the interaction between pediatric and adult neurosurgeons.
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Over the past 15 years there have been significant changes in the field of interventional neuroradiology, which have led to the inclusion of this specialty in the management of pediatric patients with vascular disorders of the central nervous system. Miniaturization of the devices and improvements in the embolic materials used have made it possible to perform endovascular therapy safely on neonates, infants and children. ⋯ The role of endovascular therapy in the management of children with intracranial aneurysms is rapidly evolving, and experience with thrombolytic intra-arterial therapy for acute ischemic stroke is just gaining momentum. It is anticipated that in the future the role of endovascular therapy will continue to grow as part of the multidisciplinary team approach to the management of children presenting with complex vascular diseases of the central nervous system.