Abstract:
OBJECTIVE:Modern neuroimaging and intensive care permit precise delineation and specific treatment of head injury. Children sustaining cranial trauma associated with epidural hematoma (EDH) represent a heterogeneous group with a variety of clinical outcomes. Treatment consists of simple observation or surgical evacuation. We attempted to define radiological characteristics of the EDH patients that underwent surgical evacuation. METHODS:We reviewed the records and computed tomography scans of 33 children sustaining cranial trauma associated with EDH treated at the Children's National Medical Center between October 1990 and August 1994. The radiological and clinical characteristics of children treated surgically (n = 13) and nonsurgically (n = 20) were compared. RESULTS:Mass effect, a temporal clot location, thickness, length and volume of the clot, and midline shift (p < 0.05) differed significantly between groups. The most important radiological parameters in determining the therapeutic intervention were thickness, midline shift, mass effect, and EDH location. A thickness of the EDH > 18 mm, a midline shift >4 mm, and moderate or severe mass effect correctly predicted therapy in 29 out of 33 patients. By adding the location as a fourth parameter, therapy was accuratly predicted in 31 of 33 patients. Mechanism of injury, interval from injury to initial computed tomography scan, age, sex, Glasgow coma score on admission, or lengths of hospital and intensive care unit stays were not significantly different between groups. CONCLUSION:Although radiological criteria predict surgical intervention for larger EDH, patients harboring intermediate-size EDH will continue to require careful individualized clinical judgement.
journal_name
Pediatr Neurosurgjournal_title
Pediatric neurosurgeryauthors
Bejjani GK,Donahue DJ,Rusin J,Broemeling LDdoi
10.1159/000121144subject
Has Abstractpub_date
1996-12-01 00:00:00pages
302-8issue
6eissn
1016-2291issn
1423-0305journal_volume
25pub_type
杂志文章abstract::The authors report a 7-year-old girl who presented with progressive quadriparesis which had started a month before admission. Magnetic resonance imaging of the spine revealed an intramedullary cystic lesion extending from C(2) to C(4). After performing a C(2-5) laminectomy, the cyst was drained and anatomically fenest...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章,评审
doi:10.1159/000097527
更新日期:2007-01-01 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::Fetus in fetu (FIF) is an extremely rare congenital anomaly in the pediatric age group. It is defined by the presence of an axial skeleton and well-formed internal organs in a fetiform mass. Only about 15 cases of intracranial FIF have been reported in the literature worldwide. We report a case of temporo-occipitocerv...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000441035
更新日期:2016-01-01 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::The Chiari I malformation is associated with a hydromyelic cavity in 55-75% of patients. In the author's series (1977-1991), hydromelia occurred in 111 of 131 patients (85%). There were 35 children. Posterior fossa decompression with duraplasty and fourth ventricle to subarachnoid shunt was made in all patients with C...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章,评审
doi:10.1159/000120586
更新日期:1991-01-01 00:00:00
abstract:OBJECTIVE:We review our experience of endoscopic third ventriculocisternostomy (ETV) in children with hydrocephalus from central nervous system (CNS) infection or intraventricular hemorrhage to better elucidate success rates and predictors of success in these children. METHODS:We performed a retrospective review of 12...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000072871
更新日期:2003-11-01 00:00:00
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::Diffuse pontine tumors are highly lethal and conventional therapy with irradiation provides long-term survival to a very small proportion of the patients. We have reported promising results using high-dose chemotherapy with autologous stem cell rescue in patients with recurrent high-grade astrocytomas in other anatomi...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000121049
更新日期:1996-01-01 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::We report a 16-year-old healthy boy who presented with sudden loss of vision in both eyes, accompanied by a mild headache. Magnetic resonance imaging showed a chiasmal apoplexy. An urgent craniotomy revealed a cavernous malformation of the chiasm, which was evacuated. There was a subsequent dramatic improvement in bil...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000149911
更新日期:2008-01-01 00:00:00
abstract::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 hydro...
journal_title:Pediatric neurosurgery
pub_type: 传,历史文章,杂志文章
doi:10.1159/000070872
更新日期:2003-07-01 00:00:00
abstract::Stereotactic radiosurgery has had an increasing role in the treatment of selected intracranial lesions in pediatric patients. In our first 44 months experience, 60 of the patients (9%) treated were less than or equal to 18 years of age. Current indications for radiosurgery include primary treatment of high-risk arteri...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000120530
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:Arachnoid cysts are intra-arachnoidal cerebrospinal fluid collections most frequently seen in the middle cranial fossa. The optimal method of treatment for symptomatic arachnoid cysts remains controversial and includes cyst shunting, open craniotomy and endoscopic fenestration. All these techniques, however,...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000098833
更新日期:2007-01-01 00:00:00
abstract::Thirty-seven patients with Dandy-Walker malformation were treated between 1959 and 1989. Eighty percent of patients became symptomatic by 3 years of age, with 70% presenting within the 1st year of life. Hydrocephalus was present in 91% of patients at the time of diagnosis. Clinical presentation was most often heralded...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000120660
更新日期:1992-01-01 00:00:00
abstract::The cloverleaf skull deformity, or Kleeblattschädel, is a rare malformation caused by synostosis of multiple cranial sutures. This anomaly has been reported to carry a dismal prognosis both in terms of neurological outcome as well as cosmetic appearance if treatment is delayed. Due to the paucity of data concerning th...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000121296
更新日期:1995-01-01 00:00:00
abstract::Optimal treatment for hydrocephalus related to Dandy-Walker syndrome (DWS) remains elusive. Patients with DWS-related hydrocephalus often require combinations of shunting systems to effectively drain both the supratentorial ventricles and posterior fossa cyst. We describe an endoscopic technique, whereby a frontally p...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章,评审
doi:10.1159/000087486
更新日期:2005-09-01 00:00:00
abstract:OBJECTIVE/AIM:Hydrocephalus is defined as an incapacitating neurological disorder characterized by ventricular enlargement in children, but the effects of melatonin on this hydrocephalus have not yet been fully elucidated. In the present experiment, we attempted to investigate the effects of exogenous melatonin adminis...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000488497
更新日期:2018-01-01 00:00:00
abstract::A retrospective study of fractures of peritoneal catheters of ventriculoperitoneal shunts is described. Fracture of the peritoneal catheter accounts for 21.2% of shunt revisions. During the time period of January 1985 through July 1993, 401 PS Medical peritoneal catheters were installed and 23 fractures occurred. The ...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000120884
更新日期:1995-01-01 00:00:00
abstract::The authors studied 58 patients, under 12 years of age, admitted to the Emergency Room of the Sao Paulo University Hospital between September 1987 and November 1991 with the diagnosis of traumatic extradural hematoma. Emphasis was given to the etiology of injury, the time interval from head injury to emergency room ev...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000120814
更新日期:1994-01-01 00:00:00
abstract::Fifty consecutive children are described with spastic cerebral palsy treated with selective functional lumbar and sacral rhizotomy and followed for a minimum of 6 months. In all patients, spasticity improved postoperatively, but this was not necessarily accompanied by a functional improvement. Eighteen children who co...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000120639
更新日期:1992-01-01 00:00:00
abstract:INTRODUCTION:Traumatic posterior fossa extradural hematomas (PFEDH) are rare lesions constituting <10% of all extradural hematomas. Reliance on clinical findings alone is not recommended as these are nonspecific; for all suspicious cases, it is advisable to conduct a CT scan. Only a handful of pediatric studies have be...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000438488
更新日期:2015-01-01 00:00:00
abstract::Malignant tumors arising within dysrhaphic malformations are very rare and are mostly teratomas; so far, only one rhabdomyosarcoma has been reported in this context. We report another case of a girl with lipomyelomeningocele who developed a lumbar rhabdomyosarcoma 2 years after birth and primary closure of the neural ...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章,评审
doi:10.1159/000083742
更新日期:2004-11-01 00:00:00
abstract:OBJECTIVE:This study aims to elucidate surgical risk factors in neuromuscular scoliosis (NMS) with respect to wound site infection after spinal fusion. METHODS:A retrospective review was performed of all patients treated surgically for NMS between January 2008 and December 2016 (minimum 6 months' follow-up). A sub-coh...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000496693
更新日期:2019-01-01 00:00:00
abstract::The infratentorial supracerebellar approach is a popular technique for exposure of lesions of the superior vermis and pineal region. The cerebellomedullary fissure approach is enjoying increasing application as a technique for exposure of the fourth ventricle. Occasionally, a tumor that arises in the quadrigeminal pla...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000055962
更新日期:2000-11-01 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::A three-year old girl who initially presented at 16 months with epistaxis from an anterior skull base vascular anomaly returned with near-fatal epistaxis despite embolization of the internal maxillary artery at the time of initial presentation. Repeat angiography demonstrated blood supply to the vascular lesion coming...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000050432
更新日期:2001-11-01 00:00:00
abstract::A rare case involving multiple intracranial aneurysms with intraventricular hemorrhage (IVH) in a child, accompanied by unilateral fibromuscular dysplasia (FMD) of the renal artery, is reported. A 12-year-old girl presented with secondary hypertension and fourth-ventricle IVH. Cerebral angiography showed multiple aneu...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000180304
更新日期:2008-01-01 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:BACKGROUND:Lateral meningocele syndrome (LMS) is an exceedingly rare connective tissue disease with phenotypic anomalies similar to those seen in Marfan syndrome, Ehler-Danlos syndrome, and Loeys-Dietz syndrome. However, this syndrome is invariably associated with the presence of multiple lateral thoracolumbar spinal m...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章,评审
doi:10.1159/000504060
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:Myxopapillary ependymomas (MPEs) in children are rarely reported low-grade glial tumors; however, MPEs sometimes possess malignant characteristics such as spinal seeding/drop metastasis (SSM). We aimed to present 3 pediatric MPE cases that experienced SSM at 2 neurosurgical centers. MATERIALS AND METHODS:We ...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000509061
更新日期:2020-01-01 00:00:00