Pediatric neurosurgery
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Pediatric neurosurgery · Jan 2011
Comparative StudyProtective effects of edaravone on experimental spinal cord injury in rats.
Spinal cord injury (SCI) is a leading cause of morbidity and mortality among youth and adults. Secondary injury mechanisms within the spinal cord (SC) are well known to cause deterioration after an acute impact. Free radical scavengers are among the most studied agents in animal models of SCI. Edaravone is a scavenger of hydroxyl radicals. ⋯ Our biochemical analyses indicate that edaravone is capable of blunting the increased oxidative stress that follows SCI. We show, for the first time, that edaravone enhances the TAC in SC tissue. This beneficial effect of edaravone on antioxidant status may act to minimize the secondary neurological damage that occurs during the acute phase after SCI.
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Pediatric neurosurgery · Jan 2011
Randomized Controlled Trial Comparative StudyBenign neurological recovery with low recurrence and low peridural fibrosis rate in pediatric disc herniations after lumbar microdiscectomy.
Lumbar disc herniation (LDH) is a very rare clinical entity in the pediatric age group, therefore only a few clinical studies have until now investigated the clinical behavior of pediatric LDH. The natural clinical history, postoperative neurological recovery with radiological follow-up and quality of life related to the disorder continue to be unknown. We prospectively planned and designed two groups of LDH patients scheduled for surgery in this study. ⋯ After 3 years of follow-up, all parameters were significantly better in the pediatric LDH group with no recurrence of the disease. The pediatric LDH group was postoperatively better than the adult group both clinically and radiologically. Although LDH seems a catastrophic disease in the pediatric age group, the clinical picture and neurological recovery have a significantly more benign course than in adult patients even in operated cases.
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Pediatric neurosurgery · Jan 2011
Review Case ReportsParoxysmal autonomic instability with dystonia in a child: rare manifestation of an interpeduncular tuberculoma.
The term 'paroxysmal autonomic instability with dystonia' was first given for a group of symptoms comprising diaphoresis, intermittent agitation, hypertension, hyperthermia, tachycardia, tachypnea, and extensor posturing. This usually occurs as a complication of severe brain injury and is infrequently reported in cases of cerebral infection. We report a 1-year-old child with intracranial tuberculoma with symptoms of paroxysmal autonomic instability with dystonia. Pertinent literature is reviewed emphasizing pathophysiology and available treatment options.
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Pediatric neurosurgery · Jan 2011
Perioperative factors associated with prolonged intensive care unit and hospital length of stay after pediatric neurosurgery.
This study aims to describe the association between different postoperative complications and the length of hospital stay among children undergoing neurosurgical procedures. ⋯ In this study population, most elective neurosurgical procedures were not associated with significant complications, and morbidity and mortality were low. Some complications significantly influenced patients' outcomes and should be monitored for early diagnosis. This study may improve our understanding and identification of postoperative outcomes in pediatric neurosurgery.
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Pediatric neurosurgery · Jan 2011
Volumetric analysis of cranial vault distraction for cephalocranial disproportion.
The purpose of this study was to provide an objective analysis and quantify the intracranial volume change produced by cranial vault distraction osteogenesis. We recently published a technique to expand the cranial vault by distraction in symptomatic patients with findings of cephalocranial disproportion. Resolution of symptoms was documented in that publication. ⋯ The ability to use the same methodology to quantify ventricular volume changes was unexpected. The fact that all ventricles expanded after distraction at approximately 10% of the total intracranial volume increase indicates that compensatory mechanisms had been activated. We conclude that this occurs at the expense of cerebral blood flow.