Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
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Comparative Study Clinical Trial
Surgical evacuation of acute subdural hematoma improves cerebral hemodynamics in children: a transcranial Doppler evaluation.
The objective was to evaluate cerebral hemodynamics in young children with acute subdural hematoma (SDH) and the impact of surgical treatment using transcranial Doppler (TCD). ⋯ Children with acute bilateral HSD have a high incidence of increased intracranial pressure as assessed by TCD. Surgical evacuation improves cerebral hemodynamics. TCD could be used for assessing the need for, and the efficiency of surgical drainage.
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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.
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Comparative Study Clinical Trial
CSF shunts in children: endoscopically-assisted placement of the distal catheter.
Ventriculoperitoneal shunting is the most common treatment for hydrocephalus. Repeated shunt revisions and other previous surgical procedures can complicate the placement of the distal catheter. Occasionally, when conventional sites like the abdominal cavity and the right atrium are used up or unavailable, a ventriculopleural shunt can be inserted. ⋯ Laparoscopic and thoracoscopic assistance in the placement of the distal catheter has the benefit of allowing a safe and precise insertion with visual control of shunt function, even in patients with prior surgical interventions. Additionally, this minimally invasive technique appears to prevent new adhesions arising in the peritoneal cavity.
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Sinus thrombosis following a closed mild head injury is rare. A case of dural sinus thrombosis following a mild closed head injury due to an uncommon cause is reported. ⋯ The role of inherited and acquired procoagulant factors in the aetiology of sinus thrombosis is increasingly being recognized. When a patient presents with sinus thrombosis after a closed mild head injury, it is necessary to investigate for the presence of risk factors for thrombophilia as it has implications for the long-term management of the patient.
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Comparative Study
Analysis of TGF-beta2 and TGF-beta3 expression in the hydrocephalic H-Tx rat brain.
Transforming growth factor-beta (TGF-beta) is an important cytokine with modulatory actions in the nervous system. The development of hydrocephalus in mouse models resulting from the overexpression of TGF-beta1 has previously been described, but the mechanism by which this occurs remains obscure. ⋯ These results suggest that TGF-beta2 and TGF-beta3 expression may be modulated differently in the hydrocephalus, and TGF-beta3 may contribute to the development of hydrocephalus in this rat model.