Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
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Vein of Galen aneurysmal malformations (VGAM) are rare but clinically significant intracranial arteriovenous shunt lesions that most often present in neonates and infants. ⋯ Contemporary endovascular techniques remain the preferred treatment for VGAM in all age groups. Early diagnosis and multimodality treatment are essential for the best management and treatment of the complex constellation of clinical problems often arising from this disorder.
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Frameless imaged-guided neuronavigation is a useful adjunct to neuroendoscopy in paediatric patients, especially those with abnormal or complex ventricular or cyst anatomy. The development of electromagnetic neuronavigation has allowed the use of image-guided navigation in the very young patient in whom rigid fixation in cranial pins is contraindicated. The technique and the authors' experience of its use in a series of paediatric patients are described. ⋯ Pinless, frameless electromagnetic neuronavigation was found to be a safe technique that can supplement endoscopic surgery in the very young patient. It allows the use of direct navigation of the endoscope in patients that are unable safely to undergo rigid cranial fixation in pins due to young age or thin skull vaults. This has proven to be a useful adjunct to neuroendoscopy in the subset of infants who have complicated or distorted ventricular anatomy and can improve the safety and accuracy of this type of surgery. It is also an alternative to optical neuronavigation in conjunction with neuroendoscopy in patients of any age.
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Comparative Study
Perforation holes in ventricular catheters--is less more?
Obstruction is a common cause of cerebrospinal fluid (CSF) shunt failure. Risk factors for proximal obstructive malfunction are suboptimal ventricular catheter positioning and slit-like ventricles. A new ventricular catheter design to decrease risk of obstruction was evaluated. ⋯ In narrow ventricles, we assume that catheter perforations that are located also in the tissue might be a risk for CSF shunt obstruction. Fewer amounts of perforations in the catheters with equal flow features might decrease this risk when catheters can be implanted with adequate precision.
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To analyze the clinical manifestations, radiological features, and surgical outcomes in 30 pediatric intracranial hydatid cysts. ⋯ Increased intracranial pressure is common in patients with cerebral hydatid disease. CT and MRI are the first-line diagnostic procedures. Surgery is the treatment of choice for the majority of intracranial hydatid cysts. Multiple and deep seated lesions should receive medical treatment postoperatively.