Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
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This study aimed to determine the risk factors associated with poor outcome of decompressive craniectomy (DC) for severe traumatic brain injury (TBI) in pediatric patients. ⋯ Our study suggests that DC in children is not only a life-saving procedure, but also leads to a good functional outcome after severe injury. However, patient selection still remains an important aspect, and the above-mentioned factors should be considered while deciding for DC to improve survival. Further prospective studies on larger sample size are warranted to validate our results.
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Cerebrospinal fluid (CSF) leakage is a complication of intradural spinal surgery and is associated with poor wound healing and infection. The incidence of CSF leak is reported at ∼16% in adults, but little information is available in children. ⋯ Our results provide evidence on intraoperative factors that may predispose to CSF leaks after spinal intradural surgery and may help guide surgical practice. This study confirms that the pediatric population shares many of the same risk factors for CSF leak as in adult populations. Further research is needed to explain how specific factors are associated with CSF leaks.
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Arteriovenous malformations (AVMs) are a frequent cause of hemorrhagic stroke in children. Stereotactic radiosurgery (SRS) is an established treatment for these lesions, particularly those that are surgically inaccessible. Because only complete AVM obliteration is believed to protect against the future risk of hemorrhage, identifying lesion characteristics that predict response to therapy is an important objective. The goal of this study is to evaluate the influence of angiographic features of AVMs on the rate of obliteration following treatment with SRS. ⋯ Our study identifies AVMs in the pediatric population with a nidus diameter of <2.5 cm and a solitary draining vein as the most likely to undergo complete obliteration after SRS treatment.
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The purpose of this study was to review our experience of rigid internal fixation of craniovertebral junction in pediatric population. A new technique of reduction of basilar invagination with atlantoaxial dislocation is described. To the best of our knowledge and available scientific literature, this technique has not yet been described in younger patients. ⋯ Rigid variety of occiput/C1-C2 internal fixation is a safe and effective method in the management of variety of craniovertebral pathologies in pediatric population. This new technique of reduction of basilar invagination with atlantoaxilal dislocation from posterior approach may alleviate the need of high morbity associated with surgical procedure like transoral odontoidectomy in younger patients.