Pediatrics

Read the latest pediatric clinical findings in Neurosurgery Watch and improve your practice with new approaches and techniques.

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Hemorrhage risk and Radiosurgery outcomes for Pediatric AVM

March 1, 2017
Cerebrovascular, Pediatrics
By: 
Brandon G. Rocque, MD, MS
Source: 
Journal of Neurosurgery

The International Gamma Knife Research Foundation presented 2 pediatric brain arteriovenous malformations (AVM) reports: 1) the incidence and risk for hemorrhagic presentation, and 2) radiosurgery outcomes. Retrospective review of 357 patients (mean age of 12.6 years) from 7 centers: all...

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Anterior ventricular catheter entry site associated with lower shunt failure risk

March 1, 2017
Pediatrics
By: 
Brandon G. Roque, MD MS
Source: 
Journal of Neurosurgery: Pediatrics

A study by the Hydrocephalus Clinical Research Network (HCRN) used data from 3 previous trials to determine the optimal position of ventricular catheter tips in ventriculoperitoneal shunts. Positioning of ventricular catheter tips were defined with 5 parameters: tip location (frontal...

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Prospective, multicenter results of endoscopic third ventriculostomy in children

November 30, 2016
Pediatrics
By: 
Brandon G. Rocque, MD, MS
Source: 
Journal of Neurosurgery: Pediatrics

Investigators from the Hydrocephalus Clinical Research Network (HCRN) present the results of 336 patients who underwent endoscopic third ventriculostomy (ETV) between 2008 and 2013. Clinical and intraoperative data were collected prospectively, with minimum follow-up of 18 months. ETV failure was...

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Guidelines for the Management of Patients with Positional Plagiocephaly

November 30, 2016
Pediatrics
By: 
Brandon G. Rocque, MD, MS
Source: 
CNS

Guidelines for the treatment of positional plagiocephaly have recently been published after systematic reviews of evidence related to four main topics. Key points are as follows:

  1. Physical examination is recommended for diagnosis of plagiocephaly with imaging necessary only rarely
  2. ...
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Lack of efficacy of an intradural nerve anastomosis for bladder control

August 30, 2016
Pediatrics
By: 
Brandon G. Rocque, MD, MS
Source: 
Journal of Neurosurgery: Pediatrics

Chinese urologist C. G. Xiao has published extensively on an intradural nerve root transfer procedure reported to improve urinary continence and voluntary bladder control in patients with spinal cord injuries and spinal dysraphism. This month, Tuite et al report the...

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ETV vs Shunting: Results of a Prospective Multicenter Comparison

June 30, 2016
Pediatrics
By: 
Brandon G. Rocque, MD, MS
Source: 
Child's Nervous System

The International Infant Hydrocephalus Study (IIHS) is a comprehensive cohort study, with both randomized and non-randomized arms, comparing endoscopic third ventriculostomy (ETV) to CSF shunting for infants (age < 24m) with hydrocephalus caused by congenital aqueductal stenosis. It is the...

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Pediatric Moyamoya Outcomes Are Better in High Volume Centers

May 2, 2016
Pediatrics
By: 
Robert M. Starke, MD MSC
Source: 
Stroke

Comprehensive data on the optimal treatment of and outcomes in pediatric moyamoya in the US is lacking.  Titsworth et al. assessed a total of 2454 moyamoya admissions from 1997 to 2012 in the Kids Inpatient Database.  The authors found that...

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Risks for Shunt Malfunction in Pediatric Hydrocephalus

May 2, 2016
Pediatrics
By: 
Brandon G. Roque, MD MS
Source: 
Journal of Neurosurgery

The Hydrocephalus Clinical Research Network has conducted a prospective observational study of 1036 initial shunt placements at 6 institutions. They selected 21 variables a priori to evaluate as risk factors for shunt failure. Shunt failure and shunt infection were defined...

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Long-term outcomes after instrumented occipitocervical and atlantoaxial fusion in young children

February 8, 2016
Pediatrics, Spine
By: 
Brandon G. Rocque, MD, MS
Source: 
Journal of Neurosurgery: Pediatrics

Craniocervical junction instability in children is a rare problem, and occipitocervical (O-C2) or atlantoaxial (AA) fusions are the commonly accepted treatments. One of the major theoretical risks is differential growth of the fused vertebrae relative to normal spine, possibly leading...

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Long-term outcomes of patients requiring cerebrospinal fluid shunts

February 5, 2016
Pediatrics
By: 
Mark Kramer, BS
Bermans J Iskandar, MD
Source: 
Journal of Neurosurgery

Modern hydrocephalus treatment nears its sixth decade after Frank Nulsen, Eugene Spitz, John Holter and others pioneered the first successful cerebrospinal fluid shunts. Yet, since the development of these life-saving devices, the long-term impact of mechanical CSF diversion has not...

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