Pediatrics

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

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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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Continuous EEG in subclinical seizures in moderate to severe pediatric TBI

August 31, 2015
Pediatrics
By: 
Brandon G. Rocque, MD, MS
Source: 
JNS Peds

The impact of sub-clinical seizures on outcomes and management of adult head injury have been studied extensively. In this study, children with moderate or severe TBI (GCS 3-12), admitted to Children’s Hospital of Colorado, underwent at least 48 hours of...

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Improvement of Tuberous Sclerosis Epilepsy Outcomes via Resection of Symptomatic Tuber Plus Adjacent Zone

July 30, 2015
Pediatrics
By: 
Brandon G. Rocque, MD, MS
Source: 
Neurosurgery

Tuberous sclerosis complex (TSC) is a frequent etiology for childhood epilepsy surgery evaluation. A retrospective, multicenter cohort, including 78 patients from 6 centers in the United States and Canada was studied to identify predictors of seizure outcome in children with...

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No Added Benefit to Strict Rest after Mild Head Trauma in Children

May 26, 2015
Pediatrics
By: 
Brandon G. Rocque, MD, MS
Source: 
Benefits of strict rest after acute concussion: a randomized controlled trial.

Standard treatment for mild traumatic brain injury (mTBI) in children includes a period of rest.  There is no consensus regarding the duration of limited activity, and whether it includes physical rest, cognitive rest, or both. Thomas et al performed a...

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Multicenter Validation of a clinical prediction rule for pediatric abusive head trauma.

April 29, 2015
Pediatrics
By: 
Brandon G. Roque, MD MS
Source: 
Pediatrics

The decision to pursue a workup for abusive head trauma (AHT) in infants and young children can be difficult.  This study reports a prospective, multicenter, observational, cross-sectional study to validate a 4-variable abusive head trauma clinical prediction rule (AHT CPR)...

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Pediatric hydrocephalus: systematic literature review and evidence-based guidelines

November 24, 2014
Pediatrics
By: 
Brandon G. Rocque, MD, MS
Source: 
Journal of Neurosurgery: Pediatrics supplement

Pediatric hydrocephalus guidelines were recently published in a Journal of Neurosurgery: Pediatrics supplement. This is the first systematic scientific literature review to develop clinical guidelines for treating pediatric hydrocephalus.  Based on the strength of supporting evidence to indicate...

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Posterior fossa decompression with or without duraplasty in children with Type I Chiari malformation

September 4, 2014
Pediatrics
By: 
Brandon G. Rocque, MD, MS
Source: 
Child's Nervous System

Debate continues over whether adding duraplasty to bony decompression for Chiari I malformation patients increases symptomatic relief and improves syringomyelia resolution.  Lee et al. recently reported 24 months followup data on a retrospective cohort study with historical control of 65...

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Reducing complications for in utero fetal myelomeningocele closure

July 31, 2014
Pediatrics
By: 
Brandon G. Rocque, MD, MS
Source: 
Journal of Neurosurgery Pediatrics

Management of Myelomeningocele Study (MOMS) reports that in utero myelomeningocele closure is associated with lower ventricular shunting rates and higher ambulation rate, but with a higher rate of chorioamnion separation, premature rupture of membranes, and preterm delivery compared to conventional...

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