Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
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Comparative Study
Changes in third ventricular size in pediatric patients undergoing endoscopic third ventriculostomy.
Optimal methods of evaluating radiographic data following endoscopic third ventriculostomy (ETV) are not yet known. This study analyzes imaging parameters, including third ventricular width and cross-sectional area (CSA), in pediatric ETV patients. ⋯ Third ventricular imaging parameters (width and mid-sagittal CSA) exhibited more pronounced responses to ETV than lateral ventricular measurements in pediatric hydrocephalic patients.
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Posterior fossa tumors are the most common brain tumor of children. Aggressive resection correlates with long-term survival. A high incidence of posterior fossa syndrome (PFS), impairing the quality of life in many survivors, has been attributed to damage to bilateral dentate nucleus or to cerebellar output pathways. Using diffusion tensor imaging (DTI), we examined the involvement of the dentothalamic tracts, specifically the superior cerebellar peduncle (SCP), in patients with posterior fossa tumors and the association with PFS. ⋯ PFS can occur with bilateral injury to the outflow from dentate nuclei. In children with PFS, this may occur due to bilateral injury to the superior cerebellar peduncle. These tracts sit immediately adjacent to the wall of the ventricle and are highly vulnerable when an aggressive resection for these tumors is performed.
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The aim of this study was to report a rare pediatric case of spontaneous spinal epidural hematoma (SSEH) mimicking Guillain-Barré syndrome (GBS), secondary to an epidural arteriovenous malformation (AVM). Furthermore, a case-based update and insight into the entity is attempted. ⋯ Non-traumatic SSEH is rare in the pediatric population. Although vascular malformations are suspected, they are extremely rarely identified histopathologically. This case represents one of the very few reports of pediatric SSEH caused by a histologically proven, purely epidural AVM. High index of clinical suspicion and low threshold for MR can lead to timely diagnosis and prompt treatment with good functional outcome.
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Purely endoscopic endonasal approaches to surgical resection of pediatric suprasellar craniopharyngiomas are uncommonly performed. The aim of the study is to assess the feasibility and to describe the short-term outcomes of endonasal endoscopic approaches for the gross total resection of suprasellar craniopharyngiomas in the pediatric population. ⋯ Complete radiographic resection of pediatric craniopharyngioma can be achieved via a purely endoscopic endonasal approach. In particular, this approach can be performed safely using the "two-nostrils-four-hands" technique with intraoperative neuronavigation. This approach should be highly considered in patients with progressive visual dysfunction. Further studies are needed to characterize the long-term surgical and clinical outcome of pediatric patients treated with this surgical approach.
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We experienced a rare case of lipomyelomeningocele diagnosed at birth by magnetic resonance imaging which transformed the radiological appearance after 2 months into the transitional-type spinal lipoma with rapid increase in size of lipoma. Intraoperative findings revealed the presence of the dural sac extended dorsally outside the vertebral canal, which was characteristic of lipomyelomeningocele. Although there have been several reports showing that the size of spinal lipoma changed during development, there have been no reports which demonstrated alteration of radiological subtype with rapid increase of lipoma. Herein, we describe the first case of lumbosacral lipoma which changed radiological subtype from lipomyelomeningocele into transitional-type spinal lipoma.