Abstract:
BACKGROUND:There are currently no clear guidelines for the management and radiological monitoring of pediatric patients with epidural hematomas (EDH). We aim to compare clinical and radiographic characteristics of pediatric EDH patients managed with observation alone versus surgical evacuation and to describe results of repeat head imaging in both groups. METHODS:We performed a retrospective observational study of pediatric patients diagnosed with traumatic EDH at a level II trauma center. RESULTS:Forty-seven cases of EDH were analyzed. Sixty-two percent were managed by observation alone. Patients undergoing surgery were more likely to have an altered mental status (17 vs. 72%, p < 0.001), but there were no other significant clinical differences between the groups. The mean initial EDH thickness and volume were 8.0 mm and 8.6 ml in the observed group and 15.5 mm and 35 ml in the surgery group, respectively (p < 0.001 for both comparisons). Eighty-six percent of the observed and all surgery patients underwent repeat CT imaging. The initial repeat CT scan results led to surgery in 1 patient who was initially treated with observation. CONCLUSIONS:Most pediatric patients with EDH can be managed with observation. Mental status and radiographic findings should guide the need for surgical intervention. Multiple repeat CT scans have minimal utility in changing management.
journal_name
Pediatr Neurosurgjournal_title
Pediatric neurosurgeryauthors
Flaherty BF,Loya J,Alexander MD,Pandit R,Ha BY,Torres RA,Schroeder ARdoi
10.1159/000363143subject
Has Abstractpub_date
2013-01-01 00:00:00pages
208-14issue
4eissn
1016-2291issn
1423-0305pii
000363143journal_volume
49pub_type
杂志文章abstract::Twelve patients underwent endoscopic biopsy of a tumor involving the third ventricle. Nine patients had no significant medical history while 3 had a history of cancer. Unique characteristics of each case dictated the optimal surgical technique. Endoscopic tumor biopsy was combined with additional procedures in 9 cases...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000028994
更新日期:2000-09-01 00:00:00
abstract::Changes in spinal curvature, scoliosis, kyphosis and lordosis are associated with the growth of patients with myelomeningocele. Previous investigators have stated that progressive developmental scoliosis is related to tethered spinal cord. In order to investigate the relationship of tethered spinal cord release to pro...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000120762
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:Endoscopic third ventriculostomy (ETV) has gained wide popularity as a first-line treatment for obstructive hydrocephalus (OHC). We have been performing ETV since 1998. We report our experience with this technique in the management of OHC. METHODS:Between 1998 and 2007, we performed 49 ETV procedures in 46 ...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000257525
更新日期:2009-01-01 00:00:00
abstract::A case of a 16-year-old male with both a nasal dermoid sinus cyst (NDSC) and a third ventricle colloid cyst is presented. The NDSC was excised via a single-stage combined intracranial-extracranial approach and the third ventricle colloid cyst was resected endoscopically. The pathogenetic theories of NDSC and third ven...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000028862
更新日期:1999-10-01 00:00:00
abstract::The optimal treatment for Dandy-Walker malformation is still controversial. Ventriculoperitoneal shunting, cystoperitoneal shunting or combinations are the most common surgical options in the management of this clinical entity. Endoscopic procedures like ventriculocystostomy, 3rd ventriculostomy or endoscopy-assisted ...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000353610
更新日期:2012-01-01 00:00:00
abstract::A rare case of a patient with Laurence-Moon-Biedl syndrome associated with hypothalamic hamartoma is described. The English-language literature contains no cases of patients with this association. The clinical manifestations of this syndrome, those of hypothalamic hamartomas, and the appearance of the tumors on magnet...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章,评审
doi:10.1159/000120563
更新日期:1991-01-01 00:00:00
abstract::Ongoing research in the etiology of neural tube defects is increasingly being directed towards the molecular mechanisms at work in the formation of these complex lesions. We undertook to review the family history of patients in a large myelomeningocele/spina bifida clinic in an effort to identify genetic trends in the...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000120977
更新日期:1995-01-01 00:00:00
abstract::Malignancy potential of pleomorphic xanthoastrocytomas (PXAs) has rather been an underestimated reality. We report the case of a 13-year-old boy who presented with signs of increased intracranial pressure. The child had been epileptic since the age of 2. Computed tomography and magnetic resonance scans revealed a huge...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章,评审
doi:10.1159/000081935
更新日期:2004-07-01 00:00:00
abstract::Eighteen children under the age of 1 year underwent surgery for lipomeningocele at our institution between 1983 and 1991. All the patients had neurologic exams and urodynamic studies (UDS) including a cystometrogram and electromyography of the external urethral sphincter pre- and postoperatively. The surgical procedur...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000120741
更新日期:1993-09-01 00:00:00
abstract::The case of a child with Apert syndrome is presented in which the development and rupture of an intracranial mycotic aneurysm occurred secondary to multiple infectious complications following craniofacial surgery. An endovascular procedure was utilized in an attempt to embolize the aneurysm and parent vessel. The pati...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000050397
更新日期:2001-08-01 00:00:00
abstract::In order to determine the optimal valve pressure setting during the first weeks in neonates after implantation of programmable Hakim valves and to analyze the benefits and possible side effects of a new treatment protocol in this age group, we performed this prospective study. In 20 consecutive newborns less than 5 we...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000056052
更新日期:2002-04-01 00:00:00
abstract::Early diagnosis of skull fibrous dysplasia in children is relatively easy, based on a history of painless progressive bony bulging. The therapeutic approach is still controversial, due to the benignity of the lesion. However, the clinical course may be unpredictable, with sudden appearance of symptoms, some of which c...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000120649
更新日期:1992-01-01 00:00:00
abstract::A needle for intravenous fluid administration in a newborn was accidentally placed in the sagittal sinus and resulted in dural sinus air embolism. CT findings are described and the risks for venous air embolism are discussed. ...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000120606
更新日期:1991-01-01 00:00:00
abstract::A case is presented illustrating the usefulness of computerized tomography (CT) with 3-dimensional (3-D) reconstruction for evaluation of a subdental synchondrosis fracture in a child. Odontoid fractures in children less than 7 years of age occur at the subdental synchondrosis and are typically diagnosed with plain x-...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000121135
更新日期:1996-11-01 00:00:00
abstract::We here describe the case of a boy with an atypical teratoid-rhabdoid tumor (ATRT) of the 4th ventricle at 1 year of age and a local tumor recurrence at 19 months of age. Due to brainstem infiltration, only incomplete tumor resection was possible each time. High-dose chemotherapy, stem cell transplantation and irradia...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000092366
更新日期:2006-01-01 00:00:00
abstract::There are several treatment modalities for Langerhans' cell histiocytosis (LCH) of bone, formerly usually referred to as eosinophilic granuloma, including surgery, radiotherapy and chemotherapy. In spinal lesions, surgery is not recommended generally, because of the potential for reconstitution of vertebral height. We...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000069100
更新日期:2003-04-01 00:00:00
abstract:PURPOSE:Over 170 years ago, traumatic spondylolisthesis of the axis or hangman's fracture was described. Most descriptions of this entity have focused on adult presentations. METHODS:We review the literature on pediatric cases of hangman's fracture emphasizing the embryological as well as presentation aspects. RESULT...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章,评审
doi:10.1159/000455923
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to assess the head injury in children caused by an unusual projectile, a tear gas cartridge. The study is the only one on this subject which has been done in a teenage population. METHOD:This was a prospective study conducted over a period of 4 years in which all the patients aged ...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000314054
更新日期:2010-01-01 00:00:00
abstract::Spinal dysraphism is characterized by a lack of fusion of the vertebral arches that occurs in the absence of spinous processes with variable amounts of lamina. Here, we retrospectively present the importance of cutaneous lesions and their correlation with clinical presentation, radiological examination and urodynamic ...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000149901
更新日期:2008-01-01 00:00:00
abstract::Most cerebrospinal fluid (CSF) shunts employed in the treatment of hydrocephalus include in their designs a pump mechanism that has been used in office practice as an indicator of whether the shunt is functioning properly; however, the pumping characteristics of shunts have been shown to correlate poorly with clinical...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000121100
更新日期:1996-08-01 00:00:00
abstract::A 4-year-old child with AIDS developed encephalitis 2 months prior to death. Adenovirus was cultured from the cerebrospinal fluid. At autopsy, sections of the brain revealed complete sloughing of the intracranial ependyma, with marked gliosis and edema of the periventricular white matter. Cells with large, dark, smudg...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000120551
更新日期:1990-01-01 00:00:00
abstract::Hemifacial spasm (HFS), generally a disease of the elderly, is caused by vascular compression of the seventh nerve. Vascular compression is thought to result from atherosclerotic changes within the vessels of the posterior fossa, and therefore rarely presents in childhood. Here we describe our experience with 12 patie...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000121260
更新日期:1997-11-01 00:00:00
abstract::Focal intracranial infections due to Salmonella are rare. So far, around 80 cases have been reported in the world literature. The authors present their experience of 6 cases of intracranial Salmonella infections, mainly subdural empyema in 5 and effusion in 1. In 1 case, subdural empyema was bilateral, and in another ...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章,评审
doi:10.1159/000048342
更新日期:2002-01-01 00:00:00
abstract::Six patients with hydrocephalus who were treated with cerebrospinal fluid (CSF) shunts became refractory to serosal absorption of CSF. All were subsequently treated with ventriculo-gallbladder shunts. The surgical technique and long-term results were evaluated by retrospective review of the hospital records. Detailed ...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000121191
更新日期:1997-04-01 00:00:00
abstract::Intracranial congenital arachnoid cysts are benign intra-arachnoidal fluid collections with a wall composed of arachnoid cells encompassing a cavity containing a fluid similar to cerebrospinal fluid. This cavity frequently communicates with the subarachnoid space. Arachnoid cysts are reported to account for about 1% o...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000103314
更新日期:2007-01-01 00:00:00
abstract::Attempts at radical excision of craniopharyngioma has been made increasingly possible by the advent of neuroradiological imaging and the use of microscopic technique. Between 1977 and 1993, 62 patients of The National Hospital for Neurology and Neurosurgery, London, have undergone surgical excision of craniopharyngiom...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000120864
更新日期:1994-01-01 00:00:00
abstract::Central pontine myelinolysis (CPM) and extrapontine myelinolysis (EPM) are dire neurological disorders, characterized by severe damage to the myelin sheath of neurons, which typically result from rapid correction or overcorrection of systemic hyponatremia. For many years, both conditions have been considered universal...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章,评审
doi:10.1159/000320146
更新日期:2010-01-01 00:00:00
abstract::Craniopharyngiomas can be divided into sellar, prechiasmatic, retrochiasmatic and giant tumors. The initial approach to a craniopharyngioma should be an attempt at its removal. Only if surgical therapy fails to deal with the tumor should more conservative approaches utilizing radiotherapy be used. The use of intracyst...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章,评审
doi:10.1159/000120861
更新日期:1994-01-01 00:00:00
abstract::During the last decade, rapid progress has been made in understanding the molecular pathways underlying the proliferation of both normal and neoplastic cells. The processes by which messages to initiate protein synthesis, cell cycle progression, and even cell death are transmitted from the cell surface or the cytoplas...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章,评审
doi:10.1159/000028729
更新日期:1998-11-01 00:00:00
abstract:OBJECTIVE:Osteolytic lesions of the skull in children have a broad differential diagnosis including congenital, inflammatory and neoplastic lesions. Progressive osteolysis of the skull secondary to head trauma is rare and has been poorly characterized. METHODS:The pediatric database at our hospital was screened for ch...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章,评审
doi:10.1159/000329630
更新日期:2011-01-01 00:00:00