Comprehensive approach to Chiari malformation in pediatric patients.

Abstract:

:Chiari malformation is a developmental disorder that is often associated with other abnormalities of the cerebrospinal axis. Despite widespread recognition of this association, there is relatively little information on the treatment of these coexisting disorders in the setting of cerebellar tonsillar ectopia. In an effort to improve the care provided to pediatric patients with Chiari malformations the authors reviewed their management practices over the last 20 years. Specifically, they recorded presenting symptoms, radiological studies, comorbidities, and management (surgical and nonsurgical) of 112 patients (all < 20 years of age) with Chiari malformation without myelodysplasia. They found an associated syrinx in 29% of patients, basilar invagination in 17%, and scoliosis in 14%. The basal angle varied from 120 to 190 degrees and Boogard's angle varied from 120 to 220 degrees ; both angles were larger than those measured in normal controls. The vertical height of the posterior fossa was shortened and the volume decreased as compared with normal controls. The surgical management of this group of patients included posterior decompressive (44%), combined transoral and posterior decompressive (31%), combined posterior decompressive and posterior fusion (8%), and multiple posterior decompressive procedures in the same patient (5%). The authors conclude that pediatric patients with a Chiari malformation should be specifically examined for evidence of additional craniovertebral malformations so that procedures are directed at correcting both the comorbidities and the herniation of the cerebellar tonsils through the foramen.

journal_name

Neurosurg Focus

journal_title

Neurosurgical focus

authors

Greenlee J,Garell PC,Stence N,Menezes AH

doi

10.3171/foc.1999.6.6.5

subject

Has Abstract

pub_date

1999-06-15 00:00:00

pages

e4

issue

6

issn

1092-0684

pii

060604

journal_volume

6

pub_type

杂志文章
  • Stereotactic radiosurgery boost to the resection bed for oligometastatic brain disease: challenging the tradition of adjuvant whole-brain radiotherapy.

    abstract:OBJECT:Whole-brain radiation therapy (WBRT) has been the traditional approach to minimize the risk of intracranial recurrence following resection of brain metastases, despite its potential for late neurotoxicity. In 2007, the authors demonstrated an equivalent local recurrence rate to WBRT by using stereotactic radiosu...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2009.9.FOCUS09191

    authors: Karlovits BJ,Quigley MR,Karlovits SM,Miller L,Johnson M,Gayou O,Fuhrer R

    更新日期:2009-12-01 00:00:00

  • Minimally invasive decompression for lumbar stenosis and disc herniation.

    abstract::For decades, lumbar disc herniation and lumbar stenosis have been treated surgically via traditional open techniques. With recent emphasis on minimally invasive approaches in spine surgery, a number of new techniques has been introduced that are aimed at treating these 2 common pathological conditions. Currently the m...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/FOC/2008/25/8/E11

    authors: Armin SS,Holly LT,Khoo LT

    更新日期:2008-01-01 00:00:00

  • Transcortical surgery for lateral ventricular tumors.

    abstract:OBJECT:Tumors of the lateral ventricle can be removed via two major approaches: the transcallosal or the transcortical route. The purpose of this study is to discuss the techniques and outcomes in transcortical surgery of tumors located in the lateral ventricle. METHODS:An experience with 29 consecutive lateral ventri...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/foc.2001.10.6.3

    authors: Ellenbogen RG

    更新日期:2001-06-15 00:00:00

  • Neurobehavioral outcomes in patients with myelomeningocele.

    abstract::This paper describes some of the more common patterns in neurobehavioral deficits and their underlying neuroanatomical basis in myelomeningocele (MMC). Patients with MMC can face a lifetime of specific organ system dysfunction, chief among them spinal cord malformations, orthopedic issues, hydrocephalus, and urologica...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2019.7.FOCUS19445

    authors: Foss S,Flanders TM,Heuer GG,Schreiber JE

    更新日期:2019-10-01 00:00:00

  • Expanding indications for the extended endoscopic endonasal approach to hypothalamic gliomas: preliminary report.

    abstract::Object In the last decade the indications for the endoscopic endonasal approach have been progressively expanded to include lesions that have not been traditionally considered amenable to resection through the transsphenoidal route. In this study, the authors analyze their experience with hypothalamic gliomas treated ...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2014.7.FOCUS14317

    authors: Zoli M,Mazzatenta D,Valluzzi A,Marucci G,Acciarri N,Pasquini E,Frank G

    更新日期:2014-01-01 00:00:00

  • Craniofacial reconstruction with a fast resorbing polymer: a 6- to 12-month clinical follow-up review.

    abstract:OBJECT:Resorbable polymer implants have become a compelling option in the treatment of acquired and congenital craniofacial deformities. In particular, the resorbable polylactide and polyglycolide polymers have demonstrated excellent safety profiles in multiple in vitro, animal, and clinical studies and are currently b...

    journal_title:Neurosurgical focus

    pub_type: 临床试验,杂志文章

    doi:10.3171/foc.2004.16.3.13

    authors: Cohen SR,Holmes RE,Meltzer HS,Levy ML,Beckett MZ

    更新日期:2004-03-15 00:00:00

  • Demographic factors, outcomes, and patient access to transsphenoidal surgery for Cushing's disease: analysis of the Nationwide Inpatient Sample from 2002 to 2010.

    abstract::OBJECT Cushing's disease (CD) is a potentially lethal neuroendocrinopathy that often requires specialized multidisciplinary treatment to achieve optimized outcomes. The authors analyzed data pertaining to patient, hospital, and admission characteristics as they relate to outcomes following transsphenoidal surgery (TSS...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2014.11.FOCUS14694

    authors: Wilson D,Jin DL,Wen T,Carmichael JD,Cen S,Mack WJ,Zada G

    更新日期:2015-02-01 00:00:00

  • Ossification of the posterior longitudinal ligament in non-Asians: demographic, clinical, and radiographic findings in 43 patients.

    abstract:OBJECT:Ossification of the posterior longitudinal ligament (OPLL) is a disorder afflicting as many as 2% of East Asians. However, reports of OPLL in non-Asians have been sporadic in the medical literature. This study describes clinical and radiographic findings with OPLL in non-Asians at a tertiary care center treating...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2010.12.FOCUS10277

    authors: Wang MY,Thambuswamy M

    更新日期:2011-03-01 00:00:00

  • Minimally invasive approach to resection of paraspinal schwannoma.

    abstract::In this video, the authors demonstrate a minimally invasive approach and resection of a paraspinal schwannoma. Using an expandable retractor, the authors were able to identify important adjacent bony landmarks and hence visualize and remove this peripheral nerve sheath tumor. While a tubular retractor is commonly used...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2018.1.FocusVid.17572

    authors: Paullus P,Wilson TA,Lee P,Gunasekaran A,Kazemi N

    更新日期:2018-01-01 00:00:00

  • A review of the pathogenesis of ankylosing spondylitis.

    abstract::Ankylosing spondylitis (AS) is a chronic, progressive inflammatory rheumatic disease involving primarily the sacroiliac joints and the axial skeleton. The main clinical features are back pain and progressive stiffness of the spine. Oligoarthritis of the hips and shoulders, enthesopathy, and anterior uveitis are common...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/FOC/2008/24/1/E2

    authors: Dakwar E,Reddy J,Vale FL,Uribe JS

    更新日期:2008-01-01 00:00:00

  • Pediatric sports-related traumatic brain injury in United States trauma centers.

    abstract::OBJECTIVE Traumatic brain injury (TBI) in children is a significant public health concern estimated to result in over 500,000 emergency department (ED) visits and more than 60,000 hospitalizations in the United States annually. Sports activities are one important mechanism leading to pediatric TBI. In this study, the ...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2016.1.FOCUS15612

    authors: Yue JK,Winkler EA,Burke JF,Chan AK,Dhall SS,Berger MS,Manley GT,Tarapore PE

    更新日期:2016-04-01 00:00:00

  • Expanded endonasal approach: fully endoscopic, completely transnasal approach to the middle third of the clivus, petrous bone, middle cranial fossa, and infratemporal fossa.

    abstract:OBJECT:The middle third of the clivus and the region around the petrous internal carotid artery (ICA) is a difficult area of the skull base in terms of access. This is a deep area rich with critical neurovascular structures, which is often host to typical skull base diseases. Expanded endoscopic endonasal approaches of...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:

    authors: Kassam AB,Gardner P,Snyderman C,Mintz A,Carrau R

    更新日期:2005-07-15 00:00:00

  • Petrosal approaches to posterior circulation aneurysms.

    abstract::Complex posterior circulation aneurysms are formidable lesions with an abysmal natural history. Their management continues to present a challenge to both endovascular and open microsurgical approaches. Affording an expansive, combined supra- and infratentorial exposure, the petrosal approaches are well suited for thes...

    journal_title:Neurosurgical focus

    pub_type: 历史文章,杂志文章

    doi:10.3171/2012.6.FOCUS12131

    authors: Gross BA,Tavanaiepour D,Du R,Al-Mefty O,Dunn IF

    更新日期:2012-08-01 00:00:00

  • Growing up with spina bifida: bridging the gaps in the transition of care from childhood to adulthood.

    abstract::Spina bifida is the most common nonchromosomal birth defect, resulting in permanent disability of multiple organ systems, yet compatible with long-term survival. Important advances across various disciplines have now improved survival among the spina bifida population. Although the majority of individuals living with ...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2019.7.FOCUS19441

    authors: Patel SK,Staarmann B,Heilman A,Mains A,Woodward J,Bierbrauer KS

    更新日期:2019-10-01 00:00:00

  • Review of meningioma histopathology.

    abstract::The histological appearance of a meningioma is an important predictor of tumor behavior and is frequently a factor in decisions concerning therapy. The relationship between histological features and prognosis is formalized in grading schemes such as those published by the World Health Organization (WHO), most recently...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/FOC-07/10/E3

    authors: Commins DL,Atkinson RD,Burnett ME

    更新日期:2007-01-01 00:00:00

  • Motor-evoked potential monitoring for intramedullary spinal cord tumor surgery: correlation of clinical and neurophysiological data in a series of 100 consecutive procedures.

    abstract::Resection of intramedullary spinal cord tumors carries a high risk for surgical damage to the motor pathways. This surgery is therefore optimal for testing the performance of intraoperative motor evoked potential (MEP) monitoring. This report attempts to provide evidence for the accurate representation of patients' pr...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/foc.1998.4.5.4

    authors: Kothbauer KF,Deletis V,Epstein FJ

    更新日期:1998-05-15 00:00:00

  • Evaluating the cognitive consequences of mild traumatic brain injury and concussion by using electrophysiology.

    abstract:OBJECT:Mild traumatic brain injury (MTBI), often referred to as concussion when it occurs in sports, produces persistent cognitive problems in at least 15% of patients. Unfortunately, conventional neuropsychological tests usually yield results within normal limits in this population. The main objective of this event-re...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2012.10.FOCUS12253

    authors: Gosselin N,Bottari C,Chen JK,Huntgeburth SC,De Beaumont L,Petrides M,Cheung B,Ptito A

    更新日期:2012-12-01 00:00:00

  • Conduits for cerebrovascular bypass and lessons learned from the cardiovascular experience.

    abstract::Direct cerebral revascularization is an important procedure in the treatment of certain complex aneurysms and skull base tumors when acute sacrifice of the internal carotid artery is required. It likely remains an appropriate treatment in a small subgroup of patients with cerebral ischemia refractory to maximal medica...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:

    authors: Liu JK,Kan P,Karwande SV,Couldwell WT

    更新日期:2003-03-15 00:00:00

  • Facial nerve outcomes after surgery for large vestibular schwannomas: do surgical approach and extent of resection matter?

    abstract:OBJECT:The object of this study was to evaluate facial nerve outcomes in the surgical treatment of large vestibular schwannomas (VSs; ≥ 2.5 cm maximal or extrameatal cerebellopontine angle diameter) based on both the operative approach and extent of tumor resection. METHODS:A PubMed search was conducted of English lan...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/2012.7.FOCUS12199

    authors: Gurgel RK,Dogru S,Amdur RL,Monfared A

    更新日期:2012-09-01 00:00:00

  • Postoperative radicular neuroma. Case report.

    abstract::Lumbar discectomy is the most common surgical procedure performed in neurosurgery clinics. Such a large number of procedures underscore not only the prevalence of conditions such as intervertebral disc herniation, but also the strong belief of surgeons that the operation does provide benefits to patients suffering fro...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/foc.2001.11.5.9

    authors: Erman T,Tuna M,Göçer AI,Idan F,Akgül E,Zorludemir S

    更新日期:2001-11-15 00:00:00

  • Intraoperative monitoring of cerebral blood flow by laser speckle contrast analysis.

    abstract:OBJECT:Currently, reliable low-cost and noninvasive techniques to assess cerebral perfusion in the operating room are not available. The authors report on their first clinical experience with laser speckle contrast analysis (LASCA) as a complementary imaging tool for the noninvasive and dynamic assessment of cerebral b...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2009.8.FOCUS09148

    authors: Hecht N,Woitzik J,Dreier JP,Vajkoczy P

    更新日期:2009-10-01 00:00:00

  • Peripheral nervous system injury after high-dose single-fraction image-guided stereotactic radiosurgery for spine tumors.

    abstract::OBJECTIVE The object of this study was to determine the percentage of high-dose (1800-2600 cGy) single-fraction stereotactic radiosurgery (SF-SRS) treatments to the spine that result in peripheral nervous system (PNS) injury. METHODS All patients treated with SF-SRS for primary or metastatic spine tumors between Janua...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2016.11.FOCUS16348

    authors: Stubblefield MD,Ibanez K,Riedel ER,Barzilai O,Laufer I,Lis E,Yamada Y,Bilsky MH

    更新日期:2017-03-01 00:00:00

  • Outpatient spine surgery: defining the outcomes, value, and barriers to implementation.

    abstract::Spine surgery is a key target for cost reduction within the United States health care system. One possible strategy involves the transition of inpatient surgeries to the ambulatory setting. Lumbar laminectomy with or without discectomy, lumbar fusion, anterior cervical discectomy and fusion, and cervical disc arthropl...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/2018.2.FOCUS17790

    authors: Pendharkar AV,Shahin MN,Ho AL,Sussman ES,Purger DA,Veeravagu A,Ratliff JK,Desai AM

    更新日期:2018-05-01 00:00:00

  • Frailty predicts worse outcomes after intracranial meningioma surgery irrespective of existing prognostic factors.

    abstract:OBJECTIVE:Frailty has been recognized as a predictor of adverse surgical outcomes across multiple surgical disciplines, but until now the relationship between frailty and intracranial meningioma surgery has not been studied. The goal of the present study was to determine the relationship between increasing frailty (det...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2020.7.FOCUS20324

    authors: Theriault BC,Pazniokas J,Adkoli AS,Cho EK,Rao N,Schmidt M,Cole C,Gandhi C,Couldwell WT,Al-Mufti F,Bowers CA

    更新日期:2020-10-01 00:00:00

  • Mini-open lateral retropleural/retroperitoneal approaches for thoracic and thoracolumbar junction anterior column pathologies.

    abstract:OBJECTIVE:Advancements in less invasive lateral retropleural/retroperitoneal approaches aim to address the limitation of posterolateral approaches and avoid complications associated with anterior open thoracotomy or thoracoabdominal approaches. METHODS:Consecutive patients treated with a mini-open lateral approach for...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2020.6.FOCUS20360

    authors: Christiansen PA,Huang S,Smith JS,Shaffrey ME,Uribe JS,Yen CP

    更新日期:2020-09-01 00:00:00

  • Cost-effectiveness of adult spinal deformity surgery in a military healthcare system.

    abstract::OBJECTIVEAdult spinal deformity surgery is an effective way of treating pain and disability, but little research has been done to evaluate the costs associated with changes in health outcome measures. This study determined the change in quality-adjusted life years (QALYs) and the cost per QALY in patients undergoing s...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2018.9.FOCUS18381

    authors: Neal CJ,Mandell K,Tasikas E,Delaney JJ,Miller CA,Schlaff CD,Rosner MK

    更新日期:2018-12-01 00:00:00

  • Tractography and the connectome in neurosurgical treatment of gliomas: the premise, the progress, and the potential.

    abstract::The ability of diffusion tensor MRI to detect the preferential diffusion of water in cerebral white matter tracts enables neurosurgeons to noninvasively visualize the relationship of lesions to functional neural pathways. Although viewed as a research tool in its infancy, diffusion tractography has evolved into a neur...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/2019.11.FOCUS19785

    authors: Henderson F,Abdullah KG,Verma R,Brem S

    更新日期:2020-02-01 00:00:00

  • Spontaneous motor cortex encephalocele presenting with simple partial seizures and progressive hemiparesis. Case report and review of the literature.

    abstract::Several cases of congenital or acquired temporal encephaloceles have been reported in the literature as the causative mechanism of simple and/or complex partial seizures. In this report the authors describe a rare case of spontaneous parietal encephalocele presenting with simple partial seizures and progressively incr...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/foc.2005.19.3.11

    authors: Fountas KN,Smith JR,Jenkins PD,Murro AM

    更新日期:2005-09-15 00:00:00

  • "Picture-in-picture" endoscopic images in the microscope.

    abstract::The authors describe a new piece of equipment that enables simultaneous monitoring of the endoscopic image and unilateral microscopic image; that is, "picture-in-picture" images for endoscope-assisted microsurgery. The system is simple and purely optical, consisting of light-weight semi-rigid fibers and a special adap...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/foc.1999.6.4.13

    authors: Seki Y,Umezu H,Usui M,Tsumanuma T,Nakatate K

    更新日期:1999-04-15 00:00:00

  • Epigenetic events in medulloblastoma development.

    abstract::Over the last decade, the analysis of genetic defects in primary tumors has been central to the identification of molecular events and biological pathways involved in the pathogenesis of medulloblastoma, the most common malignant brain tumor of childhood. Despite this, understanding of the molecular basis of the major...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/foc.2005.19.5.11

    authors: Lindsey JC,Anderton JA,Lusher ME,Clifford SC

    更新日期:2005-11-15 00:00:00