Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
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A consecutive series of 120 patients with infantile hydrocephalus who were submitted to ventriculo-atrial shunting was studied. The average follow-up was 11 years. There was no operative mortality; 7 patients died during the follow-up period, but only in 1 case was the cause of death a consequence of the shunt procedure. ⋯ Shunt revision was performed on 253 occasions yielding a revision rate of 2.2 per patient. Of these 253 revisions 167 (66%) took the form of elective lengthening of the atrial catheter. The number of reoperations to adjust the length of the atrial catheter or to revise the distal end of the shunting system is a major disadvantage, which actually favors ventriculo-peritoneal shunting as the primary procedure for the treatment of pediatric hydrocephalus.
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The use of a ventriculosubgaleal shunt for temporary treatment of hydrocephalus in a child with multiple recurrent shunt infections related to eczema in the neck is described. Further shunt infection was avoided, the eczema cleared, and a permanent ventriculoperitoneal shunt was inserted successfully after 2 months.
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Intracranial chordomas are rare in childhood. Only 15 cases have been reported in children less than 6 years old. Bone destruction and calcification have been stated to be characteristics of this tumor. We present the case of a 5-year-old boy with clival chordoma without bone involvement.
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A consecutive unselected series of 1812 children (up to 15 years old) admitted for head injuries over a period of 8.5 years was studied. The cases were divided up according to five categories of pathology: benign injury, extradural haematoma, subdural haematoma, open brain laceration and brain contusion in a broad sense. All cases of benign injury were from the Geneva area (57000 children) and 52% of the cases of severe injury were referred from other places. ⋯ Falling was the most frequent cause of injury. Benign injuries were more frequent in group I. Only 1 of 25 patients with extradural haematomas died, and there were only 8 patients with subdural haematomas, 4 in subgroup I a (babies aged less than 1 year).