Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
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Case Reports
Acute transient cerebellar dysfunction and stuttering following mild closed head injury.
A wide range of pathologies can cause cerebellar dysfunction but there have been few reports of transient dysfunction after mild head injury. There are none describing stuttering as an acute symptom after such injuries. ⋯ This is the first reported case of acute transient cerebellar dysfunction and stuttering after mild closed head injury. Neurogenic causes for stuttering are increasingly being recognised.
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Posttraumatic epilepsy in the pediatric age group is mostly seen within the first week. An acute posttraumatic epileptic fit, which may induce secondary insults, should be hindered. The aim of the study is to define the risk factors for posttraumatic early epilepsy (PTEE) and the indications for prophylactic therapy. ⋯ Those patients at or under the age of 3, with severe head injury, cerebral edema, intraparenchymal hemorrhage, or depressed skull fracture, have a higher incidence of PTEE. Moreover, because the GOS of these patients are prone to be worse, antiepileptic therapy in acute stage may be effective in preventing the secondary brain damage.
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Case Reports
Symptomatic pleural effusion without intrathoracic migration of ventriculoperitoneal shunt catheter.
Symptomatic pleural effusion following ventriculoperitoneal (VP) shunt insertion is very rare. The patient was an 8-year-old girl who had VP shunt for hydrocephalus as a result of aqueductal stenosis. Six weeks after surgery, she presented with headache, vomiting and drowsiness. She developed respiratory distress with pain in the right lower chest region and right hypochondrium on admission. ⋯ Shunt review without thoracocentesis or thoracostomy is an effective treatment of symptomatic hydrothorax following VP shunt, especially when there is no intrathoracic shunt migration.
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Comparative Study Clinical Trial
Traumatic intracranial hemorrhage in newborns.
Neonatal traumatic head injuries (NTHI) can be life-threatening and require aggressive treatment. The indications, techniques, and results of brain decompression are not well defined in the literature. ⋯ Surgical decompression of intracranial hematomas due to NTHI is often unnecessary; however, it may be required in emergency because of poor clinical tolerance. Whenever possible, percutaneous needle aspiration is the treatment of choice.
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A patient is described in which a complete osteofibrotic dorsally implanted septum was found in combination with a split cord malformation in a single dural tube. This case cannot be explained using the widely used theory as proposed by Pang et al. [Pang D, Dias MS, Ahab-Barmada M (1992) Split cord malformation, part I: A unified theory of embryogenesis for double spinal cord malformations. Neurosurgery 31:451-480] but must be regarded as a combination of type I and II split cord malformation. ⋯ The configuration of the malformation is determined by the way the median parts of the mesoderm come to development. Type I and II split cord malformation are not distinct entities.