首页 > 最新文献

Journal of neurosurgery. Pediatrics最新文献

英文 中文
Letter to the Editor. The young Chiari patient, an oft-forced hand?
IF 2.1 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2025-03-07 DOI: 10.3171/2024.12.PEDS24645
Aaron M Yengo-Kahn, Douglas L Brockmeyer, Robert J Bollo
{"title":"Letter to the Editor. The young Chiari patient, an oft-forced hand?","authors":"Aaron M Yengo-Kahn, Douglas L Brockmeyer, Robert J Bollo","doi":"10.3171/2024.12.PEDS24645","DOIUrl":"https://doi.org/10.3171/2024.12.PEDS24645","url":null,"abstract":"","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-2"},"PeriodicalIF":2.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparative analysis of surgical approaches in nonsyndromic multiple-suture synostosis: a systematic review and meta-analysis.
IF 2.1 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2025-03-07 DOI: 10.3171/2024.11.PEDS24364
Felipe Gutierrez Pineda, Brodus A Franklin, Anuraag Punukollu, Hsien-Chung Chen, Gustavo Giraldo Garcia, Anna Lydia Machado Silva, Mark Proctor, Esteban Quiceno

Objective: Nonsyndromic multiple-suture synostosis (MSS) is one of the rarest types of craniosynostosis. While both endoscopic and open surgical approaches have demonstrated efficacy for MSS patients, a comprehensive comparison of perioperative outcomes between the two approaches has yet to be fully explored. The aim of this systematic review and meta-analysis was to assess the available evidence among the two surgical approaches to better inform the management of complex craniosynostosis.

Methods: PubMed, Embase, and Scopus were searched for studies published from the first reports through February 2024 that reported surgical outcomes of either endoscopic or open surgery for nonsyndromic MSS. The main outcome was the reoperation rate, with secondary endpoints including transfusion rates, intraoperative complications, and overall complications, with a subgroup analysis conducted for patients with nonsyndromic bicoronal synostosis.

Results: Sixteen studies involving 310 patients were analyzed. Patients undergoing open surgery were older than those treated with endoscopy (mean age 10.39 vs 3.21 months). The pooled analysis showed a reoperation rate of 11% (95% CI 4%-23%, I2 = 25%) for endoscopic surgery compared with 22% (95% CI 14%-31%, I2 = 0) for open surgery (p = 0.11). Transfusion rates were 26% (95% CI 13%-45%, I2 = 50%) for endoscopic surgery and 50% (95% CI 22%-78%, I2 = 71%) for open surgery (p = 0.18). Intraoperative complications were similar: 17% (95% CI 7%-34%, I2 = 0%) for endoscopic vs 15% (95% CI 4%-42%, I2 = 76%) for open surgery (p = 0.85). Overall complication rates were 15% (95% CI 7%-31%, I2 = 45%) for endoscopic surgery and 20% (95% CI 9%-38%, I2 = 65%) for open surgery (p = 0.59). In the subgroup analysis of bicoronal synostosis, the reoperation rate was 10% (95% CI 4%-21%, I2 = 0%) for endoscopic surgery versus 16% (95% CI 7%-32%, I2 = 0%) for open surgery (p = 0.39).

Conclusions: While both surgical approaches are reasonable options for nonsyndromic MSS, this meta-analysis suggests that endoscopic surgery could be associated with lower morbidity when compared with open surgery. Future studies with longer follow-up periods will be needed to validate these findings and contribute to the understanding of complex craniosynostosis management.

{"title":"Comparative analysis of surgical approaches in nonsyndromic multiple-suture synostosis: a systematic review and meta-analysis.","authors":"Felipe Gutierrez Pineda, Brodus A Franklin, Anuraag Punukollu, Hsien-Chung Chen, Gustavo Giraldo Garcia, Anna Lydia Machado Silva, Mark Proctor, Esteban Quiceno","doi":"10.3171/2024.11.PEDS24364","DOIUrl":"https://doi.org/10.3171/2024.11.PEDS24364","url":null,"abstract":"<p><strong>Objective: </strong>Nonsyndromic multiple-suture synostosis (MSS) is one of the rarest types of craniosynostosis. While both endoscopic and open surgical approaches have demonstrated efficacy for MSS patients, a comprehensive comparison of perioperative outcomes between the two approaches has yet to be fully explored. The aim of this systematic review and meta-analysis was to assess the available evidence among the two surgical approaches to better inform the management of complex craniosynostosis.</p><p><strong>Methods: </strong>PubMed, Embase, and Scopus were searched for studies published from the first reports through February 2024 that reported surgical outcomes of either endoscopic or open surgery for nonsyndromic MSS. The main outcome was the reoperation rate, with secondary endpoints including transfusion rates, intraoperative complications, and overall complications, with a subgroup analysis conducted for patients with nonsyndromic bicoronal synostosis.</p><p><strong>Results: </strong>Sixteen studies involving 310 patients were analyzed. Patients undergoing open surgery were older than those treated with endoscopy (mean age 10.39 vs 3.21 months). The pooled analysis showed a reoperation rate of 11% (95% CI 4%-23%, I2 = 25%) for endoscopic surgery compared with 22% (95% CI 14%-31%, I2 = 0) for open surgery (p = 0.11). Transfusion rates were 26% (95% CI 13%-45%, I2 = 50%) for endoscopic surgery and 50% (95% CI 22%-78%, I2 = 71%) for open surgery (p = 0.18). Intraoperative complications were similar: 17% (95% CI 7%-34%, I2 = 0%) for endoscopic vs 15% (95% CI 4%-42%, I2 = 76%) for open surgery (p = 0.85). Overall complication rates were 15% (95% CI 7%-31%, I2 = 45%) for endoscopic surgery and 20% (95% CI 9%-38%, I2 = 65%) for open surgery (p = 0.59). In the subgroup analysis of bicoronal synostosis, the reoperation rate was 10% (95% CI 4%-21%, I2 = 0%) for endoscopic surgery versus 16% (95% CI 7%-32%, I2 = 0%) for open surgery (p = 0.39).</p><p><strong>Conclusions: </strong>While both surgical approaches are reasonable options for nonsyndromic MSS, this meta-analysis suggests that endoscopic surgery could be associated with lower morbidity when compared with open surgery. Future studies with longer follow-up periods will be needed to validate these findings and contribute to the understanding of complex craniosynostosis management.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-11"},"PeriodicalIF":2.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Building consensus regarding the definition of abnormal craniocervical motion in pediatric patients with Chiari malformation: a modified Delphi study.
IF 2.1 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2025-03-07 DOI: 10.3171/2024.11.PEDS24478
Nikita G Alexiades, Daniela I Anderson, Amy D'Ambrosio, Rajiv Iyer, David F Bauer, Christopher M Bonfield, Sandip Chatterjee, Richard G Ellenbogen, Paul Grabb, Gerald Grant, Todd C Hankinson, Andrew Jea, David D Limbrick, Cormac Maher, Jonathan E Martin, Dominic N P Thompson, Douglas L Brockmeyer, Richard C E Anderson

Objective: Abnormal craniocervical motion (ACCM) in the setting of pediatric Chiari type 1 and 1.5 malformation (CM-1/1.5) is generally regarded to be uncommon. The focus of this modified Delphi study was to investigate and build consensus regarding the definition of ACCM in pediatric patients with CM-1/1.5 and the clinical and radiographic methods to identify it.

Methods: An international group of 14 pediatric neurosurgeons with clinical and research expertise in the management of CM was asked to participate. The study focused only on ACCM in the setting of CM-1 and excluded other types of CM. An initial survey of current practices was administered, and based on these responses, a follow-up survey of potential consensus statements was distributed. Consensus was defined as ≥ 80% of participants reaching agreement on a 4-point Likert scale (strongly agree, agree, disagree, strongly disagree). A final hybrid virtual/in-person meeting was held for discussion and to generate final consensus statements.

Results: Following the final Delphi round, 22 statements reached consensus following discussion and modification of previous statements. Statements that reached consensus included the identification of patient populations that may benefit from screening, recommended imaging for screening along with useful radiographic parameters, and a consideration of trial cervical immobilization in symptomatic patients with supportive imaging. An additional modification to all statements emphasizing the focus on ACCM was agreed upon. All participants stated that they would be willing or somewhat willing to change their practices based on consensus guidelines.

Conclusions: In this study, an international group of pediatric neurosurgeons reached consensus on 22 expert opinion-based statements regarding ACCM in pediatric patients with CM-1. Further study using a standardized approach to screening may facilitate a better understanding of the true incidence and impact of ACCM in CM-1.

{"title":"Building consensus regarding the definition of abnormal craniocervical motion in pediatric patients with Chiari malformation: a modified Delphi study.","authors":"Nikita G Alexiades, Daniela I Anderson, Amy D'Ambrosio, Rajiv Iyer, David F Bauer, Christopher M Bonfield, Sandip Chatterjee, Richard G Ellenbogen, Paul Grabb, Gerald Grant, Todd C Hankinson, Andrew Jea, David D Limbrick, Cormac Maher, Jonathan E Martin, Dominic N P Thompson, Douglas L Brockmeyer, Richard C E Anderson","doi":"10.3171/2024.11.PEDS24478","DOIUrl":"https://doi.org/10.3171/2024.11.PEDS24478","url":null,"abstract":"<p><strong>Objective: </strong>Abnormal craniocervical motion (ACCM) in the setting of pediatric Chiari type 1 and 1.5 malformation (CM-1/1.5) is generally regarded to be uncommon. The focus of this modified Delphi study was to investigate and build consensus regarding the definition of ACCM in pediatric patients with CM-1/1.5 and the clinical and radiographic methods to identify it.</p><p><strong>Methods: </strong>An international group of 14 pediatric neurosurgeons with clinical and research expertise in the management of CM was asked to participate. The study focused only on ACCM in the setting of CM-1 and excluded other types of CM. An initial survey of current practices was administered, and based on these responses, a follow-up survey of potential consensus statements was distributed. Consensus was defined as ≥ 80% of participants reaching agreement on a 4-point Likert scale (strongly agree, agree, disagree, strongly disagree). A final hybrid virtual/in-person meeting was held for discussion and to generate final consensus statements.</p><p><strong>Results: </strong>Following the final Delphi round, 22 statements reached consensus following discussion and modification of previous statements. Statements that reached consensus included the identification of patient populations that may benefit from screening, recommended imaging for screening along with useful radiographic parameters, and a consideration of trial cervical immobilization in symptomatic patients with supportive imaging. An additional modification to all statements emphasizing the focus on ACCM was agreed upon. All participants stated that they would be willing or somewhat willing to change their practices based on consensus guidelines.</p><p><strong>Conclusions: </strong>In this study, an international group of pediatric neurosurgeons reached consensus on 22 expert opinion-based statements regarding ACCM in pediatric patients with CM-1. Further study using a standardized approach to screening may facilitate a better understanding of the true incidence and impact of ACCM in CM-1.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-11"},"PeriodicalIF":2.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Letter to the Editor. Gender disparity: batten down the hatches, fair winds and following seas!
IF 2.1 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2025-02-28 DOI: 10.3171/2024.12.PEDS24612
Noor Ul Huda Maria, Noor Ul Ain Fatima, Qurrat Ul Ain Siddiq
{"title":"Letter to the Editor. Gender disparity: batten down the hatches, fair winds and following seas!","authors":"Noor Ul Huda Maria, Noor Ul Ain Fatima, Qurrat Ul Ain Siddiq","doi":"10.3171/2024.12.PEDS24612","DOIUrl":"https://doi.org/10.3171/2024.12.PEDS24612","url":null,"abstract":"","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-2"},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Optimal management of hydrocephalus in children with posterior fossa tumors: an international retrospective multicenter study.
IF 2.1 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2025-02-28 DOI: 10.3171/2024.12.PEDS24424
Kasper Amund Henriksen, Arani Kulamurugan, Maia Poon, Harishchandra Lalgudi Srinivasan, Adam J Fleming, Sheila K Singh, Gorm Von Oettingen, Jane Skjøth-Rasmussen, Conor Mallucci, René Mathiasen, Jon Foss-Skiftesvik

Objective: Hydrocephalus in children with posterior fossa tumors (PFTs) is commonly treated with extraventricular drain (EVD) placement, endoscopic third ventriculostomy (ETV), or tumor resection alone. However, the optimal treatment approach remains undetermined. Therefore, the objective of this study was to investigate the relationship between management of preoperative hydrocephalus in children with PFTs and the need for early postoperative CSF diversion and permanent drainage.

Methods: This international multicenter retrospective cohort study included all pediatric patients (aged < 18 years) who underwent primary resection of a posterior fossa tumor at Alder Hey Children's Hospital, United Kingdom, 2008-2018; Rigshospitalet University Hospital, Denmark, 2011-2020; Aarhus University Hospital, Denmark, 2011-2020; and McMaster University Medical Centre, Canada, 2003-2020. The primary outcome was early postoperative CSF diversion (ETV, EVD, or shunt of any kind within 30 days of tumor resection). The secondary outcome was the permanent drainage (ventriculoperitoneal shunt) rate within 30 days after resection. Univariate and multivariate logistic regression analyses were performed.

Results: In total, 310 children with PFTs were included, of whom 234 (75.5%) had preoperative hydrocephalus. Preoperative hydrocephalus was successfully treated in more than 85%. Thirty-eight children (12.3%) required permanent drainage, with a higher incidence in those treated with preoperative EVD. However, no statistically significant association was found between choice of preoperative hydrocephalus management (EVD vs ETV vs tumor resection alone) and persistent hydrocephalus requiring either early postoperative CSF diversion surgery or permanent CSF drainage.

Conclusions: This large international multicenter study did not demonstrate a significant association between choice of management of preoperative hydrocephalus (EVD, ETV, or tumor resection alone) and persisting hydrocephalus requiring surgical intervention after tumor resection.

目的:后窝肿瘤(PFTs)患儿的脑积水治疗通常采用脑室外引流管(EVD)置入术、内镜下第三脑室造口术(ETV)或单纯肿瘤切除术。然而,最佳治疗方法仍未确定。因此,本研究旨在探讨 PFTs 患儿术前脑积水处理与术后早期 CSF 转移和永久引流需求之间的关系:这项国际多中心回顾性队列研究纳入了 2008-2018 年在英国 Alder Hey 儿童医院、2011-2020 年在丹麦 Rigshospitalet 大学医院、2011-2020 年在丹麦奥胡斯大学医院和 2003-2020 年在加拿大麦克马斯特大学医学中心接受后窝肿瘤初次切除术的所有儿童患者(年龄小于 18 岁)。主要结果是术后早期脑脊液转流(肿瘤切除术后30天内的ETV、EVD或任何形式的分流)。次要结果是切除术后30天内的永久引流(脑室腹腔分流术)率。进行了单变量和多变量逻辑回归分析:共纳入 310 名患有 PFT 的儿童,其中 234 名(75.5%)在术前患有脑积水。85%以上的患儿在术前成功治疗了脑积水。38名患儿(12.3%)需要永久引流,术前接受 EVD 治疗的患儿发生率更高。然而,在术前脑积水处理方法的选择(EVD vs ETV vs 单纯肿瘤切除术)与术后需要早期脑脊液转流手术或永久性脑脊液引流术的持续性脑积水之间,并没有发现有统计学意义的关联:这项大型国际多中心研究并未证明术前脑积水处理方法的选择(EVD、ETV 或单纯肿瘤切除术)与肿瘤切除术后需要手术干预的持续性脑积水之间存在显著关联。
{"title":"Optimal management of hydrocephalus in children with posterior fossa tumors: an international retrospective multicenter study.","authors":"Kasper Amund Henriksen, Arani Kulamurugan, Maia Poon, Harishchandra Lalgudi Srinivasan, Adam J Fleming, Sheila K Singh, Gorm Von Oettingen, Jane Skjøth-Rasmussen, Conor Mallucci, René Mathiasen, Jon Foss-Skiftesvik","doi":"10.3171/2024.12.PEDS24424","DOIUrl":"https://doi.org/10.3171/2024.12.PEDS24424","url":null,"abstract":"<p><strong>Objective: </strong>Hydrocephalus in children with posterior fossa tumors (PFTs) is commonly treated with extraventricular drain (EVD) placement, endoscopic third ventriculostomy (ETV), or tumor resection alone. However, the optimal treatment approach remains undetermined. Therefore, the objective of this study was to investigate the relationship between management of preoperative hydrocephalus in children with PFTs and the need for early postoperative CSF diversion and permanent drainage.</p><p><strong>Methods: </strong>This international multicenter retrospective cohort study included all pediatric patients (aged < 18 years) who underwent primary resection of a posterior fossa tumor at Alder Hey Children's Hospital, United Kingdom, 2008-2018; Rigshospitalet University Hospital, Denmark, 2011-2020; Aarhus University Hospital, Denmark, 2011-2020; and McMaster University Medical Centre, Canada, 2003-2020. The primary outcome was early postoperative CSF diversion (ETV, EVD, or shunt of any kind within 30 days of tumor resection). The secondary outcome was the permanent drainage (ventriculoperitoneal shunt) rate within 30 days after resection. Univariate and multivariate logistic regression analyses were performed.</p><p><strong>Results: </strong>In total, 310 children with PFTs were included, of whom 234 (75.5%) had preoperative hydrocephalus. Preoperative hydrocephalus was successfully treated in more than 85%. Thirty-eight children (12.3%) required permanent drainage, with a higher incidence in those treated with preoperative EVD. However, no statistically significant association was found between choice of preoperative hydrocephalus management (EVD vs ETV vs tumor resection alone) and persistent hydrocephalus requiring either early postoperative CSF diversion surgery or permanent CSF drainage.</p><p><strong>Conclusions: </strong>This large international multicenter study did not demonstrate a significant association between choice of management of preoperative hydrocephalus (EVD, ETV, or tumor resection alone) and persisting hydrocephalus requiring surgical intervention after tumor resection.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-7"},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The AANS/CNS Section on Pediatric Neurological Surgery domestic traveling fellowship: history and survey results of past recipients.
IF 2.1 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2025-02-28 DOI: 10.3171/2024.11.PEDS24455
Eric M Thompson, Agnieszka Stadnik, Jason E Blatt, Edward S Ahn

Objective: The American Association of Neurological Surgeons (AANS) and Congress of Neurological Surgeons (CNS) Section on Pediatric Neurological Surgery domestic traveling fellowship was created to cover the travel and living expenses for a North American neurosurgery resident for 1 month at another institution to gain experience in pediatric neurosurgery. The objective of this work was to guide future direction by surveying past recipients about the fellowship and its impact on their training and career.

Methods: Historical data have been maintained by the AANS/CNS Executive Committee and past and current chairs of the Traveling Fellowship Subcommittee. A 10-question REDCap survey was emailed to all previous fellowship recipients.

Results: There have been 58 recipients of the traveling fellowship since 1998. The most common host program was Boston Children's Hospital (n = 21), followed by The Hospital for Sick Children (n = 12). Excluding recent recipients after 2017 who may still be working toward certification, 20 of 38 (53%) recipients have been certified by the American Board of Pediatric Neurological Surgery (ABPNS). Twenty-four of 49 (49%) recipients completed the survey. Twenty (83.3%) respondents were either ABPNS certified or planning to seek certification, 17 (70.8%) respondents' practices consisted of > 50% patients aged ≤ 21 years, and 18 (75%) spent 4-8 weeks at the host program, which was longer than the 1 month funded by the stipend. Twenty-two (91.7%) respondents would recommend the traveling fellowship to a resident interested in pediatric neurosurgery, and 18 (75%) believed the traveling fellowship helped them decide to pursue a career in pediatric neurosurgery, while 17 (70.8%) found that the professional connections they made were the most useful aspect of the fellowship. Fifteen (62.5%) respondents believed that the stipend of $2500 was inadequate to cover the cost of traveling and housing.

Conclusions: The majority of respondents are currently practicing pediatric neurosurgeons, would recommend the traveling fellowship to residents interested in neurosurgery, and believed that the experience helped them decide to pursue a career in pediatric neurosurgery. Opportunities for improvement include increasing the stipend to more appropriately fund rotations that have mostly been longer than 1 month.

目的:美国神经外科医师协会(AANS)和美国神经外科医师大会(CNS)小儿神经外科分会设立了国内巡回奖学金,用于支付北美神经外科住院医师在其他机构学习一个月的旅费和生活费,以获得小儿神经外科方面的经验。方法:AANS/CNS 执行委员会和旅行奖学金小组委员会的前任和现任主席保存了历史数据。通过电子邮件向所有以往的研究金获得者发送了一份包含 10 个问题的 REDCap 调查问卷:结果:自 1998 年以来,共有 58 位旅行奖学金获得者。最常见的主办项目是波士顿儿童医院(21 人),其次是病童医院(12 人)。剔除2017年后可能仍在努力争取认证的近期获得者,38名获得者中有20人(53%)已获得美国小儿神经外科委员会(ABPNS)的认证。49 位受助者中有 24 位(49%)完成了调查。20名(83.3%)受访者已获得 ABPNS 认证或计划申请认证,17 名(70.8%)受访者的诊疗项目中,年龄小于 21 岁的患者占 50%以上,18 名(75%)受访者在主办项目中工作了 4-8 周,超过了津贴资助的 1 个月时间。22名受访者(91.7%)会向对小儿神经外科感兴趣的住院医师推荐巡回研究金,18名受访者(75%)认为巡回研究金帮助他们决定从事小儿神经外科事业,17名受访者(70.8%)认为他们建立的专业联系是研究金最有用的方面。15位受访者(62.5%)认为2500美元的津贴不足以支付旅费和住宿费用:大多数受访者目前都是执业小儿神经外科医生,他们会向对神经外科感兴趣的住院医师推荐巡回奖学金,并认为这次经历有助于他们决定从事小儿神经外科工作。需要改进的地方包括增加津贴,以便更合理地资助大部分时间超过 1 个月的轮转。
{"title":"The AANS/CNS Section on Pediatric Neurological Surgery domestic traveling fellowship: history and survey results of past recipients.","authors":"Eric M Thompson, Agnieszka Stadnik, Jason E Blatt, Edward S Ahn","doi":"10.3171/2024.11.PEDS24455","DOIUrl":"https://doi.org/10.3171/2024.11.PEDS24455","url":null,"abstract":"<p><strong>Objective: </strong>The American Association of Neurological Surgeons (AANS) and Congress of Neurological Surgeons (CNS) Section on Pediatric Neurological Surgery domestic traveling fellowship was created to cover the travel and living expenses for a North American neurosurgery resident for 1 month at another institution to gain experience in pediatric neurosurgery. The objective of this work was to guide future direction by surveying past recipients about the fellowship and its impact on their training and career.</p><p><strong>Methods: </strong>Historical data have been maintained by the AANS/CNS Executive Committee and past and current chairs of the Traveling Fellowship Subcommittee. A 10-question REDCap survey was emailed to all previous fellowship recipients.</p><p><strong>Results: </strong>There have been 58 recipients of the traveling fellowship since 1998. The most common host program was Boston Children's Hospital (n = 21), followed by The Hospital for Sick Children (n = 12). Excluding recent recipients after 2017 who may still be working toward certification, 20 of 38 (53%) recipients have been certified by the American Board of Pediatric Neurological Surgery (ABPNS). Twenty-four of 49 (49%) recipients completed the survey. Twenty (83.3%) respondents were either ABPNS certified or planning to seek certification, 17 (70.8%) respondents' practices consisted of > 50% patients aged ≤ 21 years, and 18 (75%) spent 4-8 weeks at the host program, which was longer than the 1 month funded by the stipend. Twenty-two (91.7%) respondents would recommend the traveling fellowship to a resident interested in pediatric neurosurgery, and 18 (75%) believed the traveling fellowship helped them decide to pursue a career in pediatric neurosurgery, while 17 (70.8%) found that the professional connections they made were the most useful aspect of the fellowship. Fifteen (62.5%) respondents believed that the stipend of $2500 was inadequate to cover the cost of traveling and housing.</p><p><strong>Conclusions: </strong>The majority of respondents are currently practicing pediatric neurosurgeons, would recommend the traveling fellowship to residents interested in neurosurgery, and believed that the experience helped them decide to pursue a career in pediatric neurosurgery. Opportunities for improvement include increasing the stipend to more appropriately fund rotations that have mostly been longer than 1 month.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-7"},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Optimal timing of endoscopic sagittal suturectomy.
IF 2.1 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2025-02-21 DOI: 10.3171/2024.11.PEDS24272
Patrick F O'Brien, Saige A Teti, Callum Dewar, Kristen Stabingas, Md Sohel Rana, Suresh N Magge, Daniel A Donoho, Hasan R Syed, Chima Oluigbo, John S Myseros, Gary F Rogers, Robert F Keating

Objective: Endoscopic sagittal suturectomy (ESS) is commonly offered for sagittal craniosynostosis in infants, but the optimal timing of surgery remains controversial, with many clinicians only offering ESS surgery before 3 months of age. This study investigated whether patient age predicts craniometric correction and, more specifically, whether patients > 3 months of age at surgery manifest less correction. The effects of age on blood transfusion were also investigated.

Methods: A single-center retrospective review identifying patients with sagittal craniosynostosis who underwent ESS between 2009 and 2023 at Children's National Medical Center was performed. The authors stratified patients by age groups to compare outcomes and transfusion rates. Additionally, receiver operating characteristic (ROC) area under the curve (AUC) analysis was performed to identify optimal age cutoffs.

Results: In total, 107 patients were included. Stratifying age group by 0-2 months, 2-3 months, and > 3 months revealed that the > 3-month age group was less likely to achieve the target cephalic index (CI) at the final follow-up (48.8% vs 61.5% vs 25.0%, p = 0.031) and had less mean percentage CI change at the 6-month follow-up (17% ± 8% vs 18% ± 8% vs 12% ± 6%, p = 0.011), helmet discontinuation (18% ± 9% vs 18% ± 8% vs 12% ± 6%, p = 0.008), 1-year follow-up (15% ± 9% vs 17% ± 7% vs 10% ± 7%, p = 0.005), and final follow-up (14% ± 9% vs 15% ± 7% vs 8% ± 7%, p = 0.004). There were no differences in outcomes between groups when stratified as 0-2 months versus > 2 months of age. The only difference in outcomes between groups when stratified as 0-3 months versus > 3 months of age was the mean percentage change in CI at helmet removal (18% ± 8% vs 15% ± 7%, p = 0.044). Patients requiring transfusion were likely to be younger (median age 2 vs 3 months, p = 0.028). ROC curve analysis identified an age cut-point of 3.75 months as optimal for achieving the target CI correction at the final follow-up (AUC 0.58) and 2.75 months for transfusion avoidance (AUC 0.65).

Conclusions: Patients > 3 months of age may benefit from ESS for sagittal craniosynostosis. Further investigation is warranted to identify the optimal age for surgery and to investigate other variables influencing outcomes.

{"title":"Optimal timing of endoscopic sagittal suturectomy.","authors":"Patrick F O'Brien, Saige A Teti, Callum Dewar, Kristen Stabingas, Md Sohel Rana, Suresh N Magge, Daniel A Donoho, Hasan R Syed, Chima Oluigbo, John S Myseros, Gary F Rogers, Robert F Keating","doi":"10.3171/2024.11.PEDS24272","DOIUrl":"https://doi.org/10.3171/2024.11.PEDS24272","url":null,"abstract":"<p><strong>Objective: </strong>Endoscopic sagittal suturectomy (ESS) is commonly offered for sagittal craniosynostosis in infants, but the optimal timing of surgery remains controversial, with many clinicians only offering ESS surgery before 3 months of age. This study investigated whether patient age predicts craniometric correction and, more specifically, whether patients > 3 months of age at surgery manifest less correction. The effects of age on blood transfusion were also investigated.</p><p><strong>Methods: </strong>A single-center retrospective review identifying patients with sagittal craniosynostosis who underwent ESS between 2009 and 2023 at Children's National Medical Center was performed. The authors stratified patients by age groups to compare outcomes and transfusion rates. Additionally, receiver operating characteristic (ROC) area under the curve (AUC) analysis was performed to identify optimal age cutoffs.</p><p><strong>Results: </strong>In total, 107 patients were included. Stratifying age group by 0-2 months, 2-3 months, and > 3 months revealed that the > 3-month age group was less likely to achieve the target cephalic index (CI) at the final follow-up (48.8% vs 61.5% vs 25.0%, p = 0.031) and had less mean percentage CI change at the 6-month follow-up (17% ± 8% vs 18% ± 8% vs 12% ± 6%, p = 0.011), helmet discontinuation (18% ± 9% vs 18% ± 8% vs 12% ± 6%, p = 0.008), 1-year follow-up (15% ± 9% vs 17% ± 7% vs 10% ± 7%, p = 0.005), and final follow-up (14% ± 9% vs 15% ± 7% vs 8% ± 7%, p = 0.004). There were no differences in outcomes between groups when stratified as 0-2 months versus > 2 months of age. The only difference in outcomes between groups when stratified as 0-3 months versus > 3 months of age was the mean percentage change in CI at helmet removal (18% ± 8% vs 15% ± 7%, p = 0.044). Patients requiring transfusion were likely to be younger (median age 2 vs 3 months, p = 0.028). ROC curve analysis identified an age cut-point of 3.75 months as optimal for achieving the target CI correction at the final follow-up (AUC 0.58) and 2.75 months for transfusion avoidance (AUC 0.65).</p><p><strong>Conclusions: </strong>Patients > 3 months of age may benefit from ESS for sagittal craniosynostosis. Further investigation is warranted to identify the optimal age for surgery and to investigate other variables influencing outcomes.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-6"},"PeriodicalIF":2.1,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Letter to the Editor. The challenging management of traumatic cerebral venous sinus thrombosis in children. 致编辑的信。儿童外伤性脑静脉窦血栓形成的高难度处理。
IF 2.1 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2025-02-21 DOI: 10.3171/2024.10.PEDS24546
Ioannis N Mavridis, Theodossios Birbilis
{"title":"Letter to the Editor. The challenging management of traumatic cerebral venous sinus thrombosis in children.","authors":"Ioannis N Mavridis, Theodossios Birbilis","doi":"10.3171/2024.10.PEDS24546","DOIUrl":"https://doi.org/10.3171/2024.10.PEDS24546","url":null,"abstract":"","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1"},"PeriodicalIF":2.1,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Letter to the Editor. Occipital bone mass for C1-2 intra-articular fusion.
IF 2.1 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2025-02-14 DOI: 10.3171/2024.8.PEDS24436
Qiang Jian, Shuangzhu Yue, Tao Fan
{"title":"Letter to the Editor. Occipital bone mass for C1-2 intra-articular fusion.","authors":"Qiang Jian, Shuangzhu Yue, Tao Fan","doi":"10.3171/2024.8.PEDS24436","DOIUrl":"https://doi.org/10.3171/2024.8.PEDS24436","url":null,"abstract":"","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-2"},"PeriodicalIF":2.1,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Morphology and outcomes in combined sagittal and unilateral coronal synostosis.
IF 2.1 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2025-02-14 DOI: 10.3171/2024.10.PEDS24245
Damini Tandon, Jackson S Burton, Madeline Karsten, Gary B Skolnick, Sybill D Naidoo, Mark R Proctor, Matthew D Smyth, Kamlesh B Patel

Objective: Combined sagittal and unilateral coronal synostosis is an uncommon multisuture synostosis. The objective of this study was to describe patient demographics, characterize craniofacial morphology, and report surgical outcomes for patients with combined sagittal and unilateral coronal synostosis undergoing surgical repair.

Methods: This was a retrospective cohort study performed as a joint effort between two US pediatric tertiary care institutions. Between 2003 and 2021, 10 patients with combined sagittal and unilateral coronal synostosis who underwent surgical repair were identified. Open repair involved fronto-orbital advancement and calvarial remodeling. Endoscopic repair involved endoscopy-assisted strip craniectomy of fused sutures with subsequent helmet therapy until 12 months of age. Craniofacial morphology was characterized from CT scans with parameters including the cephalic index (CI), orbital index (OI) asymmetry, nasal tip deviation, chin deviation, and anterior cranial fossa area ratio (ACFR). All patients had preoperative CT scans, and postoperative CT scans were analyzed when performed. Demographics, operative details, and complications were obtained via chart review.

Results: Patients were predominantly male (70%) with fusion of left coronal suture (80%). Four patients (40%) underwent open repair, and 6 patients (60%) underwent endoscopic repair. The median operation length was 87 minutes for endoscopic repair and 226 minutes for open repair. Two endoscopic patients (33%) and 2 open patients (50%) required blood transfusion. Four patients (3 endoscopic, 1 open) underwent secondary operations. Preoperatively (n = 10), patients had a median CI of 0.75, with OI asymmetry (median -35%), nasal tip (median 6.9°) and chin deviation (median 9.5°) contralateral to the involved coronal suture, and cranial base asymmetry (median ACFR 0.63). Postoperatively (n = 6), patients had improved CI (median CI 0.81), OI asymmetry (median -22%), chin deviation (median 5.1°), and cranial base asymmetry (median ACFR 0.75) but slightly worse nasal tip deviation (median 8.5°).

Conclusions: Combined sagittal and unilateral coronal synostosis resembles its isolated component phenotypes. Open and endoscopic repairs are safe. Morphological parameters trended toward improvement postoperatively.

{"title":"Morphology and outcomes in combined sagittal and unilateral coronal synostosis.","authors":"Damini Tandon, Jackson S Burton, Madeline Karsten, Gary B Skolnick, Sybill D Naidoo, Mark R Proctor, Matthew D Smyth, Kamlesh B Patel","doi":"10.3171/2024.10.PEDS24245","DOIUrl":"https://doi.org/10.3171/2024.10.PEDS24245","url":null,"abstract":"<p><strong>Objective: </strong>Combined sagittal and unilateral coronal synostosis is an uncommon multisuture synostosis. The objective of this study was to describe patient demographics, characterize craniofacial morphology, and report surgical outcomes for patients with combined sagittal and unilateral coronal synostosis undergoing surgical repair.</p><p><strong>Methods: </strong>This was a retrospective cohort study performed as a joint effort between two US pediatric tertiary care institutions. Between 2003 and 2021, 10 patients with combined sagittal and unilateral coronal synostosis who underwent surgical repair were identified. Open repair involved fronto-orbital advancement and calvarial remodeling. Endoscopic repair involved endoscopy-assisted strip craniectomy of fused sutures with subsequent helmet therapy until 12 months of age. Craniofacial morphology was characterized from CT scans with parameters including the cephalic index (CI), orbital index (OI) asymmetry, nasal tip deviation, chin deviation, and anterior cranial fossa area ratio (ACFR). All patients had preoperative CT scans, and postoperative CT scans were analyzed when performed. Demographics, operative details, and complications were obtained via chart review.</p><p><strong>Results: </strong>Patients were predominantly male (70%) with fusion of left coronal suture (80%). Four patients (40%) underwent open repair, and 6 patients (60%) underwent endoscopic repair. The median operation length was 87 minutes for endoscopic repair and 226 minutes for open repair. Two endoscopic patients (33%) and 2 open patients (50%) required blood transfusion. Four patients (3 endoscopic, 1 open) underwent secondary operations. Preoperatively (n = 10), patients had a median CI of 0.75, with OI asymmetry (median -35%), nasal tip (median 6.9°) and chin deviation (median 9.5°) contralateral to the involved coronal suture, and cranial base asymmetry (median ACFR 0.63). Postoperatively (n = 6), patients had improved CI (median CI 0.81), OI asymmetry (median -22%), chin deviation (median 5.1°), and cranial base asymmetry (median ACFR 0.75) but slightly worse nasal tip deviation (median 8.5°).</p><p><strong>Conclusions: </strong>Combined sagittal and unilateral coronal synostosis resembles its isolated component phenotypes. Open and endoscopic repairs are safe. Morphological parameters trended toward improvement postoperatively.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-7"},"PeriodicalIF":2.1,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Journal of neurosurgery. Pediatrics
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1