Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
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Predicting length of stay in the intensive care unit (ICU) in children with Guillain-Barre syndrome may help decision-making at admission. ⋯ Using Cox proportional hazard analysis we found that lack of electrical excitability was the best predictor.
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Case Reports
Surgical treatment of hemangioblastomas of the central nervous system in pediatric patients.
Hemangioblastomas are histologically benign lesions that occur sporadically or as a manifestation of von Hippel-Lindau disease (VHL). The treatment strategy of these neoplasms is complicated by their unpredictable growth patterns and the often irreversible neurological deficits they may cause. This study aims to outline the neurosurgical treatment options and to address the ongoing debate of surgical timing in pediatric patients with VHL. ⋯ Central nervous system (CNS) hemangioblastomas in pediatric patients can be surgically treated with low morbidity. Based on our experience, we recommend considering also the surgical removal of asymptomatic hemangioblastomas with proven radiological progression to prevent the development of permanent neurological deficits. Molecular screening of every pediatric patient and family is mandatory to enable the detection of extraneurological tumors and the development of an efficient therapeutic strategy.
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Case Reports
Atlanto-axial rotatory fixation caused by spontaneous intracerebral haemorrhage in a child.
Atlanto-axial rotatory fixation is rare in children and usually associated with upper respiratory tract infection or trauma. We present a patient who developed the condition acutely as a consequence of rapidly evolving hemiplegia secondary to intracerebral haemorrhage. ⋯ In the absence of any other predisposing factor, it is postulated that the acute atlanto-axial rotatory subluxation was secondary to the acute loss of muscular tone due to the acute hemiparesis. This explains that the subluxation has not recurred a year after, while the hemiparesis has completely resolved.
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Neuronavigation has become a cornerstone of neurosurgery. Navigation systems are categorized into two main groups: those based on preoperative imaging and those based on real-time intraoperative acquired images. ⋯ In this article, we review the main neuronavigation systems and their applications, emphasizing their unique advantages and usage within the pediatric population.
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This report highlights the management of infrequently encountered massive occipital encephaloceles with herniation of large amount of apparently functional cortex into the encephalocele sac. ⋯ Giant occipital encephaloceles with significant brain parenchyma in the encephalocele sac can be considered for preservation of the herniated parenchyma and expansile cranioplasty.