Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
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Myelomeningocele is a complex central nervous system malformation mostly associated with other neural and extraneural anomalies. A rare special feature of the forehead and skull was observed in myelomeningocele. Here, we present several patients with myelomeningocele, severe hydrocephalus, and interfrontal encephalocele accompanied by metopic suture widening and abnormally shaped frontal bones. ⋯ Anterior fontanel anomalies known as interfrontal encephalocele associated with myelomeningocele have been reported before. The patients have an open metopic suture extending widely to the nasal radix producing hypertelorism accompanied by interfrontal herniation of frontal lobes. The associated hydrocephalus exaggerates the anomaly. Treatment of accompanying hydrocephalus is advised to decrease the severity of frontal lobe herniation. Some patients may need frontal bone reconstruction surgery to provide cosmetic correction at the place of the midline frontal bone defect.
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The aim of our study is to evaluate the effectiveness of endoscopic transaqueductal or interventricular stent placement into the fourth ventricle for isolated fourth ventricle (IFV) and pre-isolated fourth ventricle (PIFV), in which occlusion of the fourth ventricle outlets and dilation of the fourth ventricle are seen while the aqueduct is still patent. ⋯ The endoscopic transaqueductal or interventricular stent placement into the fourth ventricle for the treatment of IFV is considered to be effective and safe. The transaqueductal stent placement for PIFV is also considered to be effective for resolution of symptoms and prevent progression into IFV.
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We report a case of 4-year-old boy patient, who developed after a streptococcal pharyngitis a painful, pulsatile, and growing right-sided mass in the neck. Imaging studies revealed an extracranial right internal carotid artery pseudoaneurysm. The patient was successfully treated with stent-graft deployment. After 18 months of follow-up, the pseudoaneurysm is excluded from the circulation, the carotid artery is patent, and the patient is free from any neurological deficit. ⋯ Covered stents might be considered as a valid therapeutic option to treat carotid artery pseudoaneurysms.
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Clinical Trial
Three-dimensional analysis of positional plagiocephaly before and after molding helmet therapy in comparison to normal head growth.
Stereophotogrammetry enables a simple and radiation free longitudinal analysis of skull asymmetries: in a three-dimensional coordinate system various distances (length, breadth, cephalic index, oblique diameters, ear shift, head circumference) can be analyzed. We also defined separate volume sections in order to further quantify the degree of asymmetry in the posterior and anterior components of both sides of the head. ⋯ There is a broad clinical application area for stereophotogrammetry analyzing skull morphology: In plagiocephalic infants we demonstrate impressive changes of head shape under molding therapy; in normal-looking infants we describe the extent of unperceived asymmetry.