Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
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To evaluate the role of neuroendoscopy in the treatment of rare suprasellar and other third ventricle-related arachnoid cysts. ⋯ Third ventricle-related arachnoid cysts can be satisfactorily and safely treated by endoscopy. This approach leaves the patient shunt independent.
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Review Case Reports
Spontaneous spinal epidural abscess in a neonate. With a review of the literature.
Spinal epidural abscess is uncommon in neonates and infants, and is usually related to previous lumbar puncture or epidural anaesthesia. Diagnosis is often delayed because of the non-specific presentation. We present a 7-week-old girl who developed paraplegia 3 weeks after transient fever and a self-limiting skin rash. ⋯ The patient did not develop late spinal deformity following the decompressive laminectomy. The rapid onset of paraplegia can often be missed in such a young child but should be promptly investigated, as surgical treatment of cord compression carries an excellent prognosis for neurological recovery. We review the literature on the initial presentation, usual investigations, causative organisms and surgical management of paediatric spinal epidural abscesses.
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A child (8 years old) with a gigantic mass of intracranial hydatid cysts (95x90x75 mm) is presented. The first manifestation was difficulty in walking, which was followed by symptoms of raised intracranial pressure. A craniotomy was performed, and more than 25 hydatid cysts were removed. The literature is reviewed and the incidence of gigantic mass of cerebral hydatid cyst is compared in the published reports.
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Comparative Study
Interleukin-1beta and tumor necrosis factor-alpha in cerebrospinal fluid of children with bacterial meningitis.
Certain cytokines may contribute to the sequence of events that lead to meningeal inflammation in bacterial meningitis. The purpose of this study was to determine the levels of cytokines in the cerebrospinal fluid (CSF) of children with bacterial meningitis and aseptic meningitis of different etiologies. We determined the concentrations of interleukin-1beta (IL-1beta) and tumor necrosis factor (TNF-alpha) in the CSF of 171 specimens of 144 patients whose cases were classified as follow: bacterial meningitis (n=23), aseptic meningitis (n=26) and non-meningitis (n=95). ⋯ There was significantly more TNF-alpha than aseptic meningitis (6.85+/-17.93 pg/ml; P<0.001) or non-meningitis (7.67+/-16.07 pg/ml; P<0.001). With regard to diagnosis, measurement of IL-1beta and TNF-alpha levels showed sensitivities of 78% and 74%, respectively; specificities of 96% and 81%, respectively. It is suggested that the levels of these cytokines, especially IL-1beta and TNF-alpha, are useful markers for distinguishing bacterial meningitis from aseptic meningitis.
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Comparative Study
Assessment of intracranial pressure volume relationships in childhood: the lumbar infusion test versus intracranial pressure monitoring.
This study was undertaken to compare the results of two tests that are widely used to assess intracranial pressure-volume relationships in children: the lumbar steady state infusion test providing information about the resistance to cerebrospinal fluid (CSF) outflow (Rout), and continuous intracranial pressure (ICP) monitoring. ⋯ We found no significant correlation between Rout and mean ICP asleep. There were no significant relationships between abnormal mean ICPs during sleep (defined as either 10 or 15 mmHg) and abnormally high Rout values (defined as either 10 or 12 mmHg/ml/min), and no significant relationships between abnormally high Rout values (10 or 12 mmHg ml(-1) min(-1)) and the presence of abnormal ICP elevations (defined as either 20 or 25 mmHg and lasting 5 min). Therefore the calculation of Rout by the infusion test performed on children under general anesthesia gave no reliable prediction of abnormal ICP.