Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
-
Comparative Study Clinical Trial
Long-term follow-up in children with functional hemispherectomy for Rasmussen's encephalitis.
Cerebral hemispherectomy has been performed for over 60 years. Multiple variations of functional hemispherectomy have been performed since its inception by Rasmussen. Long-term follow-up for these variations is lacking in the medical literature. ⋯ The length of follow-up for this cohort ranged from 13 to 23 years (mean 15.6 years). All patients experienced immediate and complete elimination of seizures. Only one patient underwent ventriculoperitoneal shunt placement. All patients are capable of ambulating on their own. Many years following their procedures, this cohort of patients remains seizure free.
-
Severe head injury in childhood is associated with considerable mortality and morbidity. In this study we determined age-related differences in the relationship between outcome and intracranial pressure (ICP) and cerebral perfusion pressure (CPP) in the first 6 h of monitoring in a large cohort of head-injured children. ⋯ There are age-related differences in the specificity of intracranial pressure and cerebral perfusion pressure in relation to outcome. These differences may be important in the clinical management of head-injured children. Thus cerebral perfusion pressures of 53, 63 and 66 mmHg should be the minimum to strive for in these three age groups respectively.
-
Comparative Study
Interleukin 1beta and interleukin 6 relationship with paediatric head trauma severity and outcome.
Based on the known inflammatory role of interleukins (IL), we evaluated IL-1beta and IL-6 expressions and their association with the severity of traumatic brain injury (TBI; Glasgow Coma Scale [GCS]) and the outcome (Glasgow Outcome Score [GOS]) recorded in a paediatric population. ⋯ The increases in IL-1beta and IL-6 expression were correlated with head injury severity and were indicative of poor clinical outcome, reflecting an endogenous neuroinflammatory response after TBI.
-
This observational, prospective pediatric human study was performed to determine the agreement between brain tissue oxygenation indices (TOI) measured by near infrared spatially resolved spectroscopy and jugular bulb oxygen saturation values (SjO(2)). ⋯ Statistically, brain TOI was in reasonable agreement with SjO(2) in pediatric patients with normal brain within the measurement range from 50 to 70%.
-
Case Reports
Split cord malformation and situs inversus totalis: case report and review of the literature.
Situs inversus is a rare condition of visceral transposition in which the spinal axis is rarely affected. ⋯ Recent compelling evidence from animal models and human case reports has lead to hypotheses that defects of the midline and laterality defects (e.g., situs inversus) are etiologically related. Confirmation from additional case reports of situs inversus and split cord malformation could prove useful in determining a genetic locus for split cord malformations or implicating various chemical agents that are known to produce situs inversus as potential causative factors in the production of split cord malformations.