Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
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Unilateral hydrocephalus is a rare type of hydrocephalus caused by germinal matrix hemorrhage-intraventricular hemorrhage (GMH-IVH) in preterm infants. We present a case of posthemorrhagic unilateral hydrocephalus in a preterm infant that was successfully treated with neuroendoscopic fenestration of the foramen of Monro without septostomy. ⋯ This case demonstrates that simple repermeation of the foramen without fenestration of the septum pellucidum can successfully treat membrane-induced unilateral hydrocephalus. Also, because hydrocephalus can develop even after stabilization of GMH-IVH, close follow-up during the first year of life and beyond may reduce the likelihood of brain damage due to advanced hydrocephalus.
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Intrathecal baclofen (ITB) therapy is an accepted treatment modality for spasticity and dystonia. Several complications related to ITB have been described, including mechanical malfunctions, infections, cerebrospinal fluid fistula, and baclofen withdrawal or overdose. In this study, we present our institutional experience with ITB therapy, emphasizing complication avoidance and lessons learned. ⋯ ITB therapy is associated with complications, many of which require additional surgery. Some of these complications are avoidable by adhering to a strict surgical technique and a proper criterion for patient selection.
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Dolichoectasia describes the elongation, dilatation and tortuosity of an arterial vessel. In adults, clinical presentation of basilar dolichoectasia (BD) is most often with ischaemic stroke. True BD has been very rarely reported in childhood, but the implication is of a congenital susceptibility. ⋯ This first description of childhood BD associated with ischaemic infarction adds to the understanding of this rarely reported arteriopathy.
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This study compares endoscopic third ventriculostomy (ETV) and ventriculoperitoneal shunt (VPS) in the treatment of pediatric patients with marked obstructive hydrocephalus due to midline posterior fossa tumors. ⋯ The shorter duration of surgery, the lower incidence of morbidity, the absence of mortality, the lower incidence of procedure failure, and the significant advantage of not becoming shunt dependent make ETV be recommended as the first choice in the treatment of pediatric patients with marked obstructive hydrocephalus due to midline posterior fossa tumors.