Pediatric neurosurgery
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Pediatric neurosurgery · Jul 2003
Case ReportsSustained raised intracranial pressure implicated only by pattern reversal visual evoked potentials after cranial vault expansion surgery.
Craniosynostosis, the premature fusion of cranial sutures, may be associated with raised intracranial pressure (ICP) with or without a reduced intracranial volume. Regardless of the aetiology, raised ICP may result in optic neuropathy, the timely detection of which can prevent further visual deterioration. Raised ICP is usually treated with craniofacial surgery such as cranial vault expansion. ⋯ The amplitude of the pVEPs continued to decrease after cranial vault expansion surgery, prompting further neuroimaging that implicated a blocked ventriculo-peritoneal shunt. Only after shunt revision did the pVEP amplitude increase. Throughout the monitoring period, there was no change in the appearance of either the right or left optic disk, nor a consistent change in visual acuity.
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Pediatric neurosurgery · Jul 2003
Biography Historical ArticleThe first description of a device for repeated external ventricular drainage in the treatment of congenital hydrocephalus, invented in 1744 by Claude-Nicolas Le Cat.
An 18th century report of a device for repeated extracranial drainage of cerebrospinal fluid in the treatment of congenital hydrocephalus is reviewed. On 15th October 1744, the French surgeon Claude-Nicolas Le Cat (1700-1768) introduced a specially invented canula into the lateral ventricle of a newborn boy with hydrocephalus. The canula was used as a tap and was left in place for 5 days, until the death of the child. This procedure should be seen as the first documented description of a device for repeated ventricular taps in the treatment of hydrocephalus.
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Pediatric neurosurgery · Jul 2003
Comment Letter Case Reports'Cortical thumb sign' in X-linked hydrocephalus.
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To evaluate the clinical profiles, image findings and surgical outcome of 155 cases of spinal dysraphism. ⋯ A significant proportion of patients with open spinal dysraphism harbor an underlying SCM, an entity coined complex spina bifida (in our previous study). The incidence of hydrocephalus in spinal dysraphism is low in India in comparison to the Western world. Some patients with mild hydrocephalus on scan may not require a shunt operation. Surgical intervention should be early after entire neural axis screening by MRI.
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Pediatric neurosurgery · Feb 2003
ReviewA systematic review of brachial plexus surgery for birth-related brachial plexus injury.
Brachial plexus injury complicates 0.6-2.6 per 1,000 live births. Surgery is sometimes advocated for patients who fail to improve with conservative management. We reviewed the available literature on birth-related brachial plexus palsy in order to provide recommendations for surgical management, using evidence-based criteria. ⋯ There is no conclusive evidence showing a benefit of surgery over conservative management approaches in the treatment of patients with birth-related brachial plexus injuries. Surgery remains a valid practice option given the level III and V evidence suggesting a possible benefit of surgery.