Pediatric neurosurgery
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Pediatric neurosurgery · Jan 2010
Comparative StudyVentriculosubgaleal shunting for post-haemorrhagic hydrocephalus in premature neonates.
The management of hydrocephalus secondary to intraventricular haemorrhage in neonates can be controversial. Temporary diversion of cerebrospinal fluid (CSF) is often required due to the low birth weight and high risks of shunting in these patients. Ventriculosubgaleal (VSG) CSF diversion is an effective way of achieving this goal whilst minimising the risks of complications. It is a well-described technique but is rarely used in contemporary neurosurgical practice. ⋯ VSG CSF diversion offers a simple, effective and relatively safe means of treating hydrocephalus in the neonate, with a low risk of complications and the possibility of avoiding permanent shunting.
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Pediatric neurosurgery · Jan 2010
The impact of a 'resident replacement' nurse practitioner on an Academic Pediatric Neurosurgical service.
The introduction of 80-hour workweek limitations has challenged resident training programs with creative scheduling while maintaining comprehensive training experiences. The work hour restrictions may be more adaptable to a medical service, but have been very challenging to an academic surgical program. The particular challenges include maximizing academic learning opportunities, operating room experiences and direct bedside patient care while adhering to the 80-hour restriction. This paper examines the addition of a pediatric nurse practitioner (NP) to a pediatric neurosurgical academic program in response to the resident work hour restrictions. ⋯ The addition of an NP in response to resident training changes has been a positive influence on satisfaction with the pediatric neurosurgical service while reducing the reliance on residents for bedside clinical care. Patient safety appears not to have been affected. Presumably, this response to resident work hour limitations will provide the needed time to enhance resident didactic and intraoperative training experiences.
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Pediatric neurosurgery · Jan 2010
Case ReportsTranssellar transsphenoidal encephalocele: a case report.
Basal encephaloceles are rare, accounting for about 1.5% of all encephaloceles. Transsellar transsphenoidal encephaloceles are the rarest variety of basal encephaloceles. We report a rare case of transsellar transsphenoidal encephalocele managed by a transnasal transseptal approach.
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Pediatric neurosurgery · Jan 2009
Review Case ReportsSynchronous ventriculoscopic and microsurgical resection of complex craniopharyngiomas.
Surgical resection of craniopharyngiomas may be challenging sometimes because of the size, location and tenacity. Simultaneous endoscopic and microsurgical resection is a novel way to approach such lesions. The aim of this report is to discuss the usefulness of combined endoscopic and microsurgical approaches in treating complex craniopharyngiomas along with a review of the literature. ⋯ Neuroendoscopy can complement microsurgery in approaching complex craniopharyngiomas particularly when these tumors are large and accompanied by hydrocephalus.