Pediatric neurosurgery
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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
Review Case ReportsGanglioglioma of the thoracolumbar spinal cord in a patient with neurofibromatosis type 1: a case report and literature review.
Gangliogliomas of the spinal cord are rare, and the conus medullaris is an extremely rare site for their occurrence. The authors present a case in which a ganglioglioma was found in the thoracolumbar spinal cord, including the conus medullaris, of a 5-year-old female patient with neurofibromatosis type 1 (NF1) who presented with paraparesis and urinary disturbance. ⋯ This is the first report to provide a pathological description of a spinal cord ganglioglioma in a patient with NF1. Because gangliogliomas usually have a good prognosis following resection, it is important to clearly distinguish them from other NF1-associated lesions, even though ganglioglioma of the thoracolumbar spinal cord, including the conus medullaris, is an extremely rare condition.
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Pediatric neurosurgery · Jan 2011
ReviewEndoscopic minimally invasive neurosurgery: emerging techniques and expanding role through an extensive review of the literature and our own experience - part I: intraendoscopic neurosurgery.
Minimally invasive neurosurgery is a growing field, more so in recent decades. The modernization of tools, especially the endoscope, has allowed for critical improvements and crucial advancements in minimally invasive neurosurgery. The current classification scheme for endoscopic procedures needs to be updated to reflect these advancements. ⋯ Our proposed classification scheme for solely endoscopic procedures is presented. The role of the endoscope as an independent tool is clarified.
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Pediatric neurosurgery · Jan 2011
Review Case ReportsInitial experience with the use of remote control monitoring and general anesthesia during radiosurgery for pediatric patients.
The demand for general anesthesia in pediatric radiosurgery has been increasing, but the issues involved are not highlighted well in the medical literature. We developed remotely controlled monitoring and anesthesia techniques, and applied our system to three pediatric patients who underwent Gamma Knife radiosurgery with automated settings. Based on the perioperative safety management, the following issues are of considerable concern: to avoid emotional trauma associated with the treatment, to secure airway patency in a variety of head positions, and to apply all standard monitors. In this report, we describe the details of our project with a comprehensive literature review.
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Pediatric neurosurgery · Jan 2011
ReviewVentriculosubgaleal shunting--a strategy to reduce the incidence of shunt revisions and slit ventricles: an institutional experience and review of the literature.
Slit ventricles and multiple episodes of shunt failure are problematic in many infants and preterm neonates shunted for hydrocephalus. We utilized ventriculosubgaleal (VSG) shunting as the initial neurosurgical intervention in neonates with hydrocephalus associated with intraventricular hemorrhage and infants with myelomeningocele. ⋯ Based on our results, initial management of selected hydrocephalic infants with a VSG shunt may prove to be advantageous in the long run for these children as the number of shunt revisions and the incidence of slit ventricles are significantly less than those reported in the literature.