Object The aim of this study was to assess outcome following decompressive craniectomy for malignant brain swelling due closed traumatic injury (TBI). Methods During a 48-month period (March 2000–March 2004), 50 967 consecutive patients with TBI experienced diffuse and underwent craniectomy, without removal clots or contusion, control intracranial pressure (ICP) reverse dangerous shifts. Diffuse demonstrated in 44 patients, an evacuated mass lesion four whom had been performed as separate...

Civilian gunshot wounds to the head (GSWH) are often deadly, but some patients with open cranial need medical and surgical management potentially good candidates for acceptable functional recovery. The authors analyzed predictors of favorable clinical outcome (Glasgow Outcome Scale scores 4 5) after GSWH over a 24-month period.The posited 2 questions: First, what percentage civilians died in state Maryland given period time? Second, were GSWH? examined demographic, clinical, imaging, acute...

Object Choroid plexus tumors (CPTs) are rare intracranial neoplasms that constitute approximately 2%–5% of all pediatric brain tumors. Most these present with severe hydrocephalus. The optimal perioperative management and oncological care remain a matter debate. authors the epidemiological clinical features CPTs from 20-year single-institutional experience. Methods A total 39 consecutive patients pathologically proven (31 choroid papillomas [CPPs] 8 carcinomas [CPCs]) were included in this...

This study investigates radiographically acquired normative ranges of anterior fontanelle closure (AFC) and surface area (SA) in healthy full-term infants.High-resolution head computed tomography (CT) scans were retrospectively reviewed for AFC AF dimensions to allow approximation SA.Between 15 23 CT per monthly age-group (0-24 months) reviewed, totaling 464 scans. frequency increased steadily from age 10 (16%) 20 months (88%), reaching higher than 50% at 16 (53%). The was closed 3% 5%...

The purpose of this study was to gain insight into the impact age at repair on relapse rates in syndromic patients undergoing cranial vault remodeling.Retrospective chart review performed for surgically treated craniosynostosis from 1990 2013. Surgical procedures were assigned a Whitaker category based need reoperation as follows: no additional surgery required (category I); minor contouring revisions (II); major (III); or failure original (IV). Age grouped younger than 6 months; aged 9 and...

Object The most common neurosurgical condition observed in preterm infants is intraventricular hemorrhage (IVH), which often results posthemorrhagic hydrocephalus (PHH). These conditions portend an unfavorable prognosis; therefore, the potential for poor neurodevelopmental outcomes necessitates a better understanding of comparative effectiveness 2 temporary devices commonly used before permanent insertion ventriculoperitoneal (VP) shunt: ventricular reservoir and ventriculosubgaleal shunt...

Background: Bronchiectasis is usually caused by pulmonary infections and bronchial obstruction. It still a serious problem in developing countries as our country. We reviewed the morbidity mortality rates outcome of surgical treatment for bronchiectasis. Patients methods: Between 1990 2000, 166 patients (92 female 74 male patients) underwent resection The mean age was 34.1 years (range, 7–70 years). Mean duration symptoms 5.7 years. Results: Symptoms were copious amount purulent sputum 135...

Endoscopic biopsy is an important minimally invasive method of diagnosis in the initial management lesions children with intraventricular and periventricular tumors. The procedure can be performed conjunction CSF-diverting procedures for obstructive hydrocephalus. authors present their single-institution experience a predominantly pediatric series respect to diagnostic efficacy, utility guiding treatment plans, safety.A retrospective review was conducted consecutive patients who underwent...

OBJECTIVE This study was conducted to evaluate outcome after decompressive craniectomy (DC) in the setting of mass evacuation with or without intracranial pressure (ICP) monitoring. METHODS Over a 48-month period (March 2000 March 2004), 54 967 consecutive head injury patients underwent DC for lesion. performed ICP monitoring 27 who required urgent decompression (group A) and did not require surgery had their monitored 1 14 days before B). RESULTS In group A, mean Glasgow Coma Scale score...

Fetoscopic myelomeningocele (MMC) repair is performed using intrauterine carbon dioxide (CO2 ) insufflation. Sheep experiments have shown that CO2 insufflation associated with significant fetal acidemia; however, corresponding data for human pregnancy are not available. We umbilical venous cord blood sampling in three patients during fetoscopic MMC at 25 + 1, 3 and 24 0 weeks' gestation, respectively. Fetal pH the beginning of was 7.36, 7.46 7.37, respectively fetuses, repeat values were...

Object Symptom response to spinal cord untethering, and the impact of duraplasty scoliosis on retethering, are poorly understood in tethering after myelomeningocele (MMC) repair. In this retrospective study, authors examined outcomes children who developed first-time following MMC The symptoms untethering role retethering explored. Methods performed a review 54 with symptomatic repair determine symptoms, dural type prevalence time retethering. Results average patient age was 10.3 ± 4.9...

Chorea is a movement disorder characterized by brief, irregular, involuntary contractions that appear to flow from 1 muscle another. There are limited number of reports in the literature have linked moyamoya disease and chorea. The authors describe their experience treating patients whom chorea developed as part clinical presentation.The conducted retrospective review consecutive series 316 children who underwent pial synangiosis revascularization for at Boston Children's Hospital.Of...

OBJECTIVE Compared with the general population, specific natural history of arteriovenous malformations (AVMs) in pediatric patients is less well understood. Furthermore, few studies have compared posttreatment hemorrhagic risk and functional outcome across different treatment modalities. The objective this study was to elucidate these points. METHODS authors retrospectively reviewed all AVMs evaluated at their institution between 1990 2013. AVM represented by during observation period. For...

OBJECTIVE Pediatric cerebral venous sinus thrombosis has been previously described in the setting of blunt head trauma; however, population demographics, risk factors for thrombosis, and risks benefits detection treatment this patient are poorly defined. Furthermore, few reports differentiate between different forms pathology. A series pediatric patients with skull fractures who underwent imaging were diagnosed intrinsic or extrinsic compression is presented. METHODS The medical records at 2...

The authors sought to evaluate the accuracy of a novel telehealth-compatible diagnostic software system for identifying craniosynostosis within newborn (< 1 year old) population. Agreement with gold standard craniometric diagnostics was also assessed.

OBJECTIVE Chiari malformation type I (CM-I) is a congenital disorder occurring in 0.1% of the population. In symptomatic cases, surgery with posterior fossa decompression (PFD) treatment choice. Surgery is, however, associated peri- and postoperative complications that may require readmission or renewed surgical intervention. Given financial costs impact on patients’ well-being, there need for predictive tools can assess likelihood such adverse events. The aim this study was therefore to...

A retrospective clinical records analysis of concurrent pediatric spinal cord deformity correction and tethered release compared with a 2-staged approach.To compare the safety efficacy single-staged approach for to conventional approach.Tethered syndrome (TCS) is frequently associated scoliosis in population. Conventional practice suggests waiting several months after untethering correction; however, some patients will experience progression their deformity. We report and/or kyphosis series...

Summary Background Moyamoya syndrome carries a high risk of cerebral ischemia, and impaired cerebrovascular autoregulation may play critical role. Autoregulation indices derived from near‐infrared spectroscopy ( NIRS ) clarify hemodynamic goals that conform to the limits autoregulation. Objectives The aims this pilot study were determine whether ‐derived could identify blood pressure ranges optimize autoregulatory function differs between anatomic sides in patients with unilateral...