Posts Tagged ‘Pediatric’
Free CME Article: Risk Factors for Pediatric Arachnoid Cyst Rupture/Hemorrhage
Background: As the availability of imaging modalities has increased, the finding of arachnoid cysts has become common. Accurate patient counseling regarding physical activity or risk factors for cyst rupture or hemorrhage has been hampered by the lack of definitive association studies.
Objective: This case-control study evaluated factors that are associated with arachnoid cyst rupture (intracystic hemorrhage, adjacent subdural hematoma, or adjacent subdural hygroma) in pediatric patients with previously asymptomatic arachnoid cysts.
Methods: Patients with arachnoid cysts and intracystic hemorrhage, adjacent subdural hygroma, or adjacent subdural hematoma treated at a single institution from 2005 to 2010 were retrospectively identified. Two unruptured/nonhemorrhagic controls were matched to each case based on patient age, sex, anatomical cyst location, and side. Risk factors evaluated included arachnoid cyst size, recent history of head trauma, and altitude at residence.
Ahead of Print: Risk Factors for Pediatric Arachnoid Cyst Rupture/Hemorrhage
Background: As the availability of imaging modalities has increased, the finding of arachnoid cysts has become common. Accurate patient counseling regarding physical activity or risk factors for cyst rupture or hemorrhage has been hampered by the lack of definitive association studies.
Objective: This case-control study evaluated factors that are associated with arachnoid cyst rupture (intracystic hemorrhage, adjacent subdural hematoma, or adjacent subdural hygroma) in pediatric patients with previously asymptomatic arachnoid cysts.
Methods: Patients with arachnoid cysts and intra-cystic hemorrhage, adjacent subdural hygroma, or adjacent subdural hematoma treated at a single institution from 2005 to 2010 were retrospectively identified. Two unruptured/non-hemorrhagic controls were matched to each case based on patient age, sex, anatomical cyst location, and side. Risk factors evaluated included arachnoid cyst size, recent history of head trauma, and altitude at residence.
Ahead of Print: Intracerebral Abscess with ICP Monitor
Background and Importance: Intracranial pressure (ICP) monitoring is a mainstay in the management of traumatic brain injury. Large investigations have validated the safety and efficacy of ICP monitors in comatose patients. Clinically relevant infections are extremely rare and cerebral abscess has never been reported using the Camino device. We describe an exceptional case of a life-threatening intracerebral abscess from an intraparenchymal ICP monitor.
Clinical Presentation: A 35 week old child required 7 days of ICP monitoring following a fall from a two-story window. His hospital course was complicated by severe airway edema treated, in part, with high dose corticosteroid therapy for a total of 10 days. Two weeks later the patient acutely deteriorated due to a large intracerebral abscess under the previous ICP monitor site. Urgent craniotomy with evacuation of the abscess was performed on two separate occasions. Cultures grew methicillin-sensitive Staphylococcus aureus which was treated with long-term antibiotics. At 3-month follow-up the patient was meeting age-appropriate milestones without focal deficits.
Ahead of Print: Adult and Pediatric High-grade Spondylolisthesis
Background: Although it is generally agreed upon that surgery for high-grade spondylolisthesis (HGS) is associated with more complications than low-grade spondylolisthesis, its description is primarily based on case reports and relatively small case series.
Objective: To assess short-term complication rates associated with the surgical treatment of HGS in pediatric and adult patients and to identify factors associated with increased complication rates.
Methods: All cases of HGS from the Scoliosis Research Society Morbidity and Mortality database for the year 2007 were reviewed. Patients were classified as pediatric (<=18 years) or adult (>18 years). Complications were tabulated, and the rates were compared between the patient groups and based on clinical and surgical factors.
Ahead of Print: Pediatric Temporal Lobe Surgery
Background: There is still some reluctance to refer pediatric patients for epilepsy surgery, despite evidence of success in retrospective series.
Objective: To describe surgical experience and long-term outcome in pediatric temporal lobe epilepsy (TLE) at a single institution.
Methods: Retrospective review of pediatric (< 18 years-old) TLE patients who underwent surgery between November 1996 and December 2006 at Cleveland Clinic Epilepsy Center. Cox-proportional hazard modeling was used to assess outcome predictors.
