Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
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Hyperglycemia is a common secondary insult associated with an increased risk of mortality and poor outcome in traumatic brain injury (TBI), but the effect of hyperglycemia on outcomes of severe TBI in children and adolescents is less apparent. The aim of this study was to evaluate the association of hyperglycemia with mortality in pediatric patients with severe TBI. ⋯ Early hyperglycemia is associated with poor outcome, and persistent hyperglycemia is a powerful and independent predictor of mortality in children and adolescents with severe TBI.
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Though the craniovertebral junction is often abnormal in children with Crouzon's syndrome, no study had measured accurately the size of their foramen magnum (FM). ⋯ The growth of FM follows a biphasic pattern in both Crouzon's and control children. The sagittal diameter and the global size of the FM are mostly affected in children with Crouzon's syndrome. The small FM, especially its posterior part, is likely to play a key role in the physiopathology of hydrocephalus.
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The author relates how he ended up somewhat unexpectedly as a pediatric neurosurgeon and how fortunate he feels to have become a pediatric neurosurgeon. He reflects on his life and on the importance of trying to do one's best. He comments about the importance of listening, empathizing, and being compassionate as characteristics of the pediatric neurosurgeon and notes that by trying one's best to be a good pediatric neurosurgeon one adopts more of these characteristics by learning from patients and their parents. He discusses the many ways in which the practice of pediatric neurosurgery and his involvement in the International Society for Pediatric Neurosurgery have created meaning in his life, which has led to a feeling of happiness and fulfillment.
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This study evaluates the efficacy of operative skill transfer in the context of targeted pediatric outreach missions. In addition, the ability to implement surgical care improvements that are sustainable is investigated. ⋯ Effective operative skill transfer to host neurosurgeons can be accomplished with limited international team visits utilizing a targeted approach that minimizes expenditures on personnel and capital. With the priority being teaching of an operative technique, as opposed to perennially performing operations by the mission team, sustainable surgical care was achieved after missions officially concluded.