Abstract:
BACKGROUND:Histiocytoses are rare diseases affecting mainly children and can occur in any organ of the body. They are divided into Langerhans type and non-Langerhans type. Langerhans cell histiocytosis (LCH) mainly affects skin, bones, and lymph nodes but can also affect the hematopoietic system. Bone lesions can be critical when they involve skull base, orbit, or vertebrae and can cause permanent neurological sequelae or death. Histopathological diagnosis and molecular markers are the mainstay for accurate diagnosis. Sixty percent of LCH cases show mutation in the BRAF oncogene. They are treated with multimodality treatment which includes surgery, chemotherapy, and BRAF inhibitor therapy. Owing to the rarity of the disease and paucity of cases, the understanding and standardization of treatment is still evolving. CASE REPORT:A 14-year-old boy presented with backache, and his imaging showed erosion of first sacral vertebral body with soft tissue component impinging and compressing the spinal canal. Histopathology and molecular diagnosis showed LCH which was positive for BRAF gene mutation. Adequate canal decompression and near-total removal of the disease load with fixation of weight-bearing axis resulted in symptomatic relief and good outcome. Systemic chemotherapy was given for the small residual disease due to fear of recurrence and impending neurological complications. He responded well to first-line therapy with vinblastine and prednisolone with complete resolution of disease on a follow-up scan. CONCLUSION:Accurate diagnosis with molecular markers is essential for a good outcome of LCH. Treatment of lesions at critical locations like skull base, orbit, or vertebral axis needs to be tailored to prevent permanent neurological deficits. Newer therapies in the form of BRAF inhibitors are on the way, but the efficacy and benefit need to be tested.
journal_name
Pediatr Neurosurgjournal_title
Pediatric neurosurgeryauthors
Champaneri H,Banerjee ADdoi
10.1159/000508940subject
Has Abstractpub_date
2020-01-01 00:00:00pages
169-174issue
3eissn
1016-2291issn
1423-0305pii
000508940journal_volume
55pub_type
abstract:BACKGROUND/AIMS:Scoliosis is common in patients with Chiari malformation-I (CM-I). This study examined the change in scoliosis severity after posterior fossa decompression (PFD) for CM-I. METHODS:We conducted a retrospective review at a single tertiary center for children undergoing PFD with untreated scoliosis, and i...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000485254
更新日期:2018-01-01 00:00:00
abstract::Cyanotic breath-holding spell is a benign and self-limiting disease of young children but occasionally associated with sudden, unexpected death. The authors report a rare case in a 2-year-old girl with a severe form that started after radical resection of a cervicomedullary ganglioglioma. She was admitted to our hospi...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000085163
更新日期:2005-03-01 00:00:00
abstract::Gastric perforation is a complication that can arise from ventriculo-peritoneal (VP) shunting. Careful examination of a newborn girl admitted to our department revealed several neurological problems. A VP shunt was inserted under direct visualization, leaving 20 cm of the catheter in the peritoneal cavity. The infant ...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000120834
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND/AIMS:We sought to describe pediatric "big data" publications since 2000, their statistical output, and clinical implications. METHODS:We searched 4 major North American neurosurgical journals for articles utilizing non-neurosurgery-specific databases for clinical pediatric neurosurgery research. Articles we...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章,评审
doi:10.1159/000495790
更新日期:2019-01-01 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
abstract:OBJECTIVE AND IMPORTANCE:Gorham-Stout disease is a rare entity characterized by vascular proliferation causing local destruction of bone tissue. Owing to its low incidence and variable clinical presentation, the diagnosis requires a high degree of awareness by the clinician. CLINICAL PRESENTATION:We present the case o...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000336877
更新日期:2011-01-01 00:00:00
abstract::Central pontine myelinolysis occurs inconsistently as a complication of severe and prolonged hyponatremia, particularly when corrected too rapidly. It is a concentrated, frequently symmetric, noninflammatory demyelination within the central basis pontis. We describe a head injury patient who suffered this clinical ent...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000315003
更新日期:2010-01-01 00:00:00
abstract::The object of the study are 126 children with internal hydrocephalus treated within the period 1978-1990. The children were preoperatively divided into six groups according to the etiology of the hydrocephalus. Disorders of the visual functions accompanying elevated intracranial pressure (setting sun 51, syndrome of t...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000120617
更新日期:1991-01-01 00:00:00
abstract::The incidence of pneumocephalus after supratentorial craniotomy has been reported to be as high as 100%. However, transformation of postoperative pneumocephalus into tension pneumocephalus (symptomatic intracranial air) is a rather rare phenomenon. Tension pneumocephalus after posterior fossa surgery is reported mainl...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000106394
更新日期:2007-01-01 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::Brainstem gliomas (BSG) with intrinsic and extensive brainstem involvement continue to have a poor outlook despite current treatment approaches. Neuroimaging studies have aided in the differentiation of malignant brainstem tumors from more 'benign' subgroups. A Children's Cancer Group protocol evaluating outcome in ch...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000121036
更新日期:1996-01-01 00:00:00
abstract::Intracranial schwannomas not arising from a cranial nerve are very rare. Schwannomas of the dura are even rarer; in the literature, we found only two cases: a schwannoma of the falx and one of the torcula. We report a third case of a 9-year-old girl with a schwannoma of the tentorium cerebelli. The different theories ...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000048371
更新日期:2002-03-01 00:00:00
abstract:UNLABELLED:Since 1990, 110 retrograde ventriculo-sinus (RVS) shunts were implanted; 98 patients (89.1%) benefited - 1 of them (0.9%) after shunt revision. The manifestations of high intra cranial pressure (ICP) disappeared, there were no problems related to improper cerebrospinal fluid (CSF) drainage, and the transcran...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000088733
更新日期:2005-11-01 00:00:00
abstract:BACKGROUND: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...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000335400
更新日期:2011-01-01 00:00:00
abstract::We have reviewed 16 children with extradural spinal tumors, both benign and malignant, treated from 1998 to 2006 in Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India. The duration of symptomatology, clinical signs, radiological investigations, surgical approach, outcome and histopathological var...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000120147
更新日期:2008-01-01 00:00:00
abstract::Between June 1989 and January 1994, 14 patients with recurrent (n = 11) or posttreatment residual (n = 3) medulloblastoma were enrolled in a program to evaluate the efficacy and toxicity of stereotactic radiosurgery (SR). Initial treatment consisted of subtotal surgical resection in 12 patients and complete surgical r...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000120901
更新日期:1995-01-01 00:00:00
abstract::In contrast to neoplasia, lesions of focal cerebral dysplasia are thought to be completed developmental processes of abnormal neuronal migration. We present three children with seizures resulting from brain lesions which pathologically demonstrate regions of both clearcut focal cortical dysplasia and also hypercellula...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000028662
更新日期:1998-05-01 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::The aquaporins (AQPs) are a family of water-transporting proteins that are broadly expressed in mammalian cells. Two AQPs in the central nervous system, AQP1 and AQP4, might play a role in hydrocephalus and are thus potential drug targets. AQP1 is expressed in the ventricular-facing membrane of choroid plexus epitheli...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章,评审
doi:10.1159/000452168
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVES:The treatment of symptomatic cranio-vertebral junction (CVJ) instability in children affected by CVJ abnormalities is a challenge. A series of severely symptomatic children has been reviewed to understand the controversial long-term effectiveness of the aggressive management of CVJ abnormalities, in terms of...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000202621
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:The failure rate following endoscopic third ventriculostomy (ETV) in infants younger than 2 years of age has been reported to be higher compared with that of older children, and it is unclear whether ETV might be superior to shunt placement in this age group. METHODS:Between 2003 and 2009, 23 patients young...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章,评审
doi:10.1159/000324913
更新日期:2010-01-01 00:00:00
abstract::Posterior fossa syndrome (PFS), also known as cerebellar affective syndrome, is characterized by emotional lability and decreased speech production following injury or surgery to the cerebellum. Rarely, oculomotor dysfunction has been described in association with PFS. Here, we report a case of complete ocular paresis...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000339382
更新日期:2012-01-01 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::To compare the functional development of the fourth ventricular outlet in the myeloschisis-Chiari malformation complex with that of a normal brain, the chronological development of the outlet in C57BL/6J non-neural-tube defect mouse embryos was examined as the first step. Then we compared the results with those of hom...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000121248
更新日期:1997-10-01 00:00:00
abstract:OBJECTIVE:The Delta valve is a pressure differential valve with a siphon control device. The valve mechanism is normally closed, but is designed to open in response to positive ventricular pressure, thereby avoiding overdrainage of cerebrospinal fluid (CSF). As a result, the incidence of subdural fluid collections as w...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000028988
更新日期:2000-08-01 00:00:00
abstract::Seventy pediatric patients with brain and spinal cord tumors had cytogenetic analysis of 99 samples of their tumors. Successful analysis was accomplished in 95%. Tumors included 43 gliomas, 9 medulloblastomas and a variety of other lesions. Forty-three patients had normal chromosomes; 28 of these had benign tumors and...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000120569
更新日期:1991-01-01 00:00:00
abstract::In order to describe the status of long-term survivors of brain stem glioma, neuropsychological and behavioral measures were obtained a median of 2.5 (range 1.5-5.6) years after diagnosis from 16 survivors of 51 consecutively diagnosed children with brain stem glioma between 1983 and 1991. Among 11 children with dorsa...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000120795
更新日期:1994-01-01 00:00:00
abstract::This report describes a neonatal case in whom a large interhemispheric cyst associated with agenesis of the corpus callosum was revealed by fetal ultrasonography and demonstrated by MRI to be multilobulated. Endoscopic fenestration of cysts was initially designed in view of the development of the patient's brain and s...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章,评审
doi:10.1159/000028972
更新日期:2000-07-01 00:00:00
abstract::Skull defects in children may be congenital or acquired after trauma, infection or tumor. For defects that do not close spontaneously a variety of repair (cranioplasty) materials are available including bone, metals and acrylic. Where possible calvarial autogenous bone is preferred, particularly in younger infants, bu...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000120540
更新日期:1990-01-01 00:00:00
abstract::We describe the initiation and development of a comprehensive multidisciplinary and multi-institutional program for the evaluation and management of youth with spasticity. A descriptive step-by-step process of the administrative and organizational sequence of the development of the program is delineated. The Spasticit...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.1159/000355125
更新日期:2013-01-01 00:00:00