Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
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Review Case Reports
Germinoma in the basal ganglia with an abnormal karyotype: case report and review of the literature.
Germ cell tumor of basal ganglia with abnormal constitutional karyotype has been rarely reported. ⋯ Intracranial germinoma, a potentially curable tumor, should be considered in children with nonspecific neurological symptoms, endocrinologic changes, and ipsilateral cerebral hemiatrophy on computed tomography or magnetic resonance. Investigation of chromosomal aberrations in those patients would clarify the tumorigenesis and lead to possibilities for novel disease-specific therapies.
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Despite the prevalence of frontal injury following traumatic brain injury (TBI) in adults and children with potentially concomitant hypothalamic and pituitary involvement, endocrine dysfunction acutely following TBI has not been well studied in children. ⋯ In summary, the cortisol response to trauma and stress in the acute period following severe TBI in the majority of children was altered, though seemingly appropriate cortisol was abnormally low in a significant percentage of children. Further study as to the significance of these findings is needed, but this study provides preliminary insight into the potential impact of severe TBI on the acute response of the hypothalamic-pituitary axis in children.
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The goal of the present study was to develop a three-dimensional (3D) geometrical model based on pre- and post-dissection Digital Imaging and Communication in Medicine (DICOM) images of both transcranial and endonasal skull base approaches. Such model was structured for either teaching surgical anatomy and to evaluate the amount of bone removal over the skull base surface through a 3D digital perspective. ⋯ Measurements of the bony landmarks as well as the visual feedback of the drilled bone over the skull base provided by our 3D model gives the opportunity to improve the tailoring of each approach to the different skull base areas.
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This study determined the statewide incidence and prevalence of acute disseminated encephalomyelitis (ADEM) and examined the course of three pediatric patients treated for tumefactive demyelination (TD) at the Blair E. Batson Children's Hospital. ⋯ These cases demonstrate that appropriate neuroradiological evaluation, treatment of acutely elevated ICP, and brain biopsy can play critical roles in the management of children with undiagnosed ADEM and TD.
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The objective of this study is to define the endoscopic anatomy of the oculomotor nerve (CN III) and its neurovascular relations in order to facilitate surgical procedures and avoid injury to this nerve during endoscopic endonasal approach to the skull base. ⋯ We defined the endoscopic anatomy of the CN III and the related neurovascular structures and proposed a new segmental classification of extraorbital oculomotor nerve. Awareness of the endoscopic anatomy and the new segmental classification of the CN III may prove helpful in avoiding the risk of nerve injury during endoscopic endonasal surgery for skull base pathologies.