JNS Pediatrics
本篇文献由机器智能翻译
Clinical features of pediatric patients with cerebral venous sinus thrombosis after isolated head trauma
儿童孤立性头部外伤后脑静脉窦血栓形成的临床特点
The aim of this study was to clarify the clinical outcome of cerebral venous sinus thrombosis (CVST) in children after isolated head trauma. Symptoms of pediatric patients with traumatic CVST may be prolonged compared with those without CVST, but most patients have good clinical outcomes with spontaneous recanalization following conservative treatment. These findings can be helpful for explaining the prospects of recovery for patients treated conservatively.
这项研究的目的是阐明孤立性头部外伤后儿童脑静脉窦血栓形成 (CVST) 的临床结果。与没有CVST的儿科患者相比,创伤性CVST的症状可能会延长,但是大多数患者在保守治疗后会自发再通,临床效果良好。这些发现有助于解释保守治疗患者的康复前景。
REF: Kotani S, Fujiwara G, Fuji K, et al. Clinical features of pediatric patients with cerebral venous sinus thrombosis after isolated head trauma. J Neurosurg Pediatr. Published online June 28, 2024. doi:10.3171/2024.4.PEDS24109 PMID: 38941650
Hemispherectomy at The Hospital for Sick Children: expanded indications and lessons learned over 35 years
患儿医院的半球切除术: 扩大适应症和35年的经验教训
The authors aimed to study how the outcomes of and complications associated with hemispherectomy for drug-resistant epilepsy have evolved over the last 35 years. They found that the outcomes after hemispherectomy have improved over time, the indications for which it is performed have evolved and expanded, and the complication rates have remained unchanged. They demonstrated that functional hemispherectomy is an increasingly effective treatment for drug-resistant epilepsy and can be safely applied to an expanding range of indications.
作者旨在研究在过去的35年中,与耐药性癫痫的半球切除术相关的结果和并发症如何发展。他们发现,随着时间的推移,半球切除术后的结果有所改善,其适应症已经发展和扩大,并发症发生率保持不变。他们证明,功能性半球切除术是一种越来越有效的耐药性癫痫治疗方法,可以安全地应用于扩大范围的适应症。
REF: Mithani K, Quon JL, Breitbart S, et al. Hemispherectomy at The Hospital for Sick Children: expanded indications and lessons learned over 35 years. J Neurosurg Pediatr. Published online June 28, 2024. doi:10.3171/2024.4.PEDS23475 PMID: 38941627
AXIN1 mutations in nonsyndromic craniosynostosis
非综合征性颅缝早闭中的AXIN1突变
The genetic causes of nonsyndromic craniosynostosis (CS) are largely unknown. Exome sequencing of a large cohort of patients identified mutations in AXIN1, an inhibitor of Wnt signaling, as a prevalent cause of sagittal and metopic CS, explaining 1% of cases. The results have implications for genetic testing in families with CS.
非综合征性颅缝早闭 (CS) 的遗传原因在很大程度上是未知的。大量患者的外显子组测序发现AXIN1突变是Wnt信号的抑制剂,是矢状和异位CS的常见原因,解释了1% 病例。该结果对CS家庭的基因检测有影响。
REF: Timberlake AT, Hemal K, Gustafson JA, et al. AXIN1 mutations in nonsyndromic craniosynostosis. J Neurosurg Pediatr. Published online June 21, 2024. doi:10.3171/2024.5.PEDS24115 PMID: 38905707
Effect of vagus nerve stimulation on emergency department utilization in children with drug-resistant epilepsy: a retrospective cohort study
迷走神经刺激对耐药性癫痫患儿急诊利用影响的回顾性队列研究
The objective of this study was to assess whether vagus nerve stimulation (VNS) decreased the number of seizure-related emergency department (ED) visits among children with drug-resistant epilepsy. Performing a retrospective cohort analysis of pediatric patients (n = 240) who underwent VNS between January 2009 and January 2020, the authors found no significant change in the number of seizure-related ED visits 2 years after VNS device implantation, although a higher number of antiseizure medications was associated with fewer seizure-related ED visits, suggesting a critical role for medical management and caregiver education.
这项研究的目的是评估迷走神经刺激 (VNS) 是否减少了耐药性癫痫儿童与癫痫相关的急诊 (ED) 就诊次数。作者对2009年1月至2020年1月期间接受VNS的儿科患者 (n = 240) 进行了回顾性队列分析,发现植入VNS装置2年后癫痫发作相关的ED就诊次数没有显著变化,尽管抗癫痫药物的数量较多与癫痫发作相关的ED就诊次数较少,建议医疗管理和护理人员教育的关键作用。
REF: Muthiah N, Reecher HM, Abel TJ. Effect of vagus nerve stimulation on emergency department utilization in children with drug-resistant epilepsy: a retrospective cohort study. J Neurosurg Pediatr. Published online June 21, 2024. doi:10.3171/2024.4.PEDS23310 PMID: 38905712
Reduction cranioplasty for hydrocephalic macrocephaly: a systematic review of surgical outcomes
颅骨成形术治疗大脑积水: 手术结果的系统评价
This study is a systematic review of reduction cranioplasty for hydrocephalic macrocephaly with the aim of understanding the techniques used, outcomes, and complications. Reduction cranioplasty demonstrated an improvement in postoperative head positioning, cranial cosmesis, and global neurological function, with shunt revisions being the most common complication. There was a mortality rate of 6.2%, which highlights the need for appropriate patient counseling, an experienced care team, and thorough perioperative planning for these rare and complex procedures.
这项研究是对减少颅骨成形术治疗脑积水的系统评价,目的是了解所使用的技术,结果和并发症。减少颅骨成形术显示出术后头部定位,颅骨外观和整体神经功能的改善,分流修复是最常见的并发症。有6.2% 个死亡率,这突出了需要适当的患者咨询,经验丰富的护理团队以及针对这些罕见和复杂手术的全面围手术期计划。
REF: Moura SP, Center AD, Kalluri M, et al. Reduction cranioplasty for hydrocephalic macrocephaly: a systematic review of surgical outcomes. J Neurosurg Pediatr. Published online June 21, 2024. doi:10.3171/2024.4.PEDS23486 PMID: 38905711
Treatment of hydrocephalus following fetal repair of myelomeningocele: comparing endoscopic third ventriculostomy with choroid plexus cauterization to ventricular shunting
胎儿脊髓膜膨出修补后脑积水的治疗: 比较内窥镜第三脑室造瘘术和脉络丛烧灼术与脑室分流术
Among 37 patients who developed hydrocephalus following fetal myelomeningocele repair (fMMR), the authors compared the treatment success and durability between ventriculoperitoneal shunt (VPS) placement and endoscopic third ventriculostomy and choroid plexus cauterization (ETV/CPC). Eighty-six percent of the patients who underwent VPS placement experienced shunt failure at a median time to failure (TTF) of 10 months, while 17% of ETV/CPC patients experienced failure at median TTF of 18 months. ETV/CPC may be a more effective and durable treatment for hydrocephalus following fMMR, deserving further exploration via larger, multicenter cohorts.
在37例胎儿脊髓脊膜膨出修复 (fMMR) 后出现脑积水的患者中,作者比较了脑室腹膜分流术 (VPS) 放置与内窥镜第三脑室造口术和脉络丛烧灼术 (ETV/CPC) 之间的治疗成功率和持久性。接受VPS放置的患者中有6% 名在中位失败时间 (TTF) 为10个月时经历了分流失败,而ETV/CPC患者中有17% 名在中位TTF为18个月时经历了失败。ETV/CPC可能是fMMR后脑积水的更有效和持久的治疗方法,值得通过更大的多中心队列进一步探索。
REF: Izah J, Haizel-Cobbina J, Zhao S, et al. Treatment of hydrocephalus following fetal repair of myelomeningocele: comparing endoscopic third ventriculostomy with choroid plexus cauterization to ventricular shunting. J Neurosurg Pediatr. Published online June 21, 2024. doi:10.3171/2024.5.PEDS24171 PMID: 38905709
The association of COVID-19 with increased pediatric ventriculoatrial shunt failures: a national retrospective cohort
新型冠状病毒肺炎与小儿心室心房分流失败增加的关联: 一项全国性回顾性队列研究
The authors aimed to identify a potential association of COVID-19 infection, known to induce a hypercoagulable state, and ventriculoatrial (VA) shunt complications in pediatric patients with hydrocephalus. Patients with VA shunts had a higher risk for mechanical shunt complications during the year following a positive COVID-19 test. These results aid in considerations for the clinical management of complex hydrocephalus in patients with VA shunts following the COVID-19 pandemic.
作者旨在确定小儿脑积水患者中已知会引起高凝状态的新型冠状病毒肺炎感染与脑室 (VA) 分流并发症的潜在关联。在新型冠状病毒肺炎试验呈阳性的一年中,VA分流患者发生机械分流并发症的风险更高。这些结果有助于考虑新型冠状病毒肺炎大流行后VA分流患者复杂脑积水的临床治疗。
REF: Mahajan UV, Defta D, Kaelber DC, Ahuja SP, Rothstein BD, Tomei KL. The association of COVID-19 with increased pediatric ventriculoatrial shunt failures: a national retrospective cohort. J Neurosurg Pediatr. Published online June 14, 2024. doi:10.3171/2024.4.PEDS23517 PMID: 38875726
Focal selective dorsal rhizotomy and concurrent deformity correction: a combined approach
局灶性选择性背根切断术和并发畸形矫正: 一种联合方法
The objective of this study was to describe the technique of focal selective dorsal rhizotomy, which can be combined with orthopedic deformity correction. The authors discussed the rationale for the use of this procedure and the outcomes in a preliminary cohort of 10 patients. Primary outcome measures of the modified Ashworth scale and Gait Deviation Index both improved in this cohort. The authors conclude that while further investigation is needed, this is a promising new procedure to focally reduce tone in children with spasticity.
这项研究的目的是描述局灶性选择性背根切断术的技术,该技术可以与矫形畸形矫正相结合。作者讨论了使用该程序的基本原理以及10例患者的初步队列结果。在该队列中,改良的Ashworth量表和步态偏差指数的主要结果指标均得到改善。作者得出结论,尽管需要进一步的研究,但这是一种有前途的新方法,可以集中减少痉挛儿童的音调。
REF: Gadgil N, Schwabe AL, Wright E, et al. Focal selective dorsal rhizotomy and concurrent deformity correction: a combined approach. J Neurosurg Pediatr. Published online June 14, 2024. doi:10.3171/2024.4.PEDS2432 PMID: 38875723
The role of genetics on behavioral outcomes in nonsyndromic sagittal synostosis
遗传学在非综合征性矢状突症的行为结果中的作用
Researchers investigated the role of genetic mutations on behavior in children with surgically corrected sagittal synostosis. Children with high probability of loss of function intolerant (pLI) genes had greater difficulties with aggression and externalizing problems. For children with nonhigh pLI genes, older age at surgery was associated with worse behavior. Genetics may play a role in long-term behavioral outcomes, however timing of surgical intervention may be a greater predictor for children without such genes.
研究人员调查了基因突变对手术矫正的矢状面突触儿童行为的作用。功能不耐受 (pLI) 基因丧失的可能性很高的儿童在攻击和外化问题上遇到更大的困难。对于具有非高pLI基因的儿童,手术年龄较大与不良行为相关。遗传学可能在长期行为结果中起作用,但是手术干预的时机可能是没有此类基因的儿童的更大预测指标。
REF: Alper DP, Almeida MN, Hu KG, et al. The role of genetics on behavioral outcomes in nonsyndromic sagittal synostosis. J Neurosurg Pediatr. Published online June 14, 2024. doi:10.3171/2024.4.PEDS23510 PMID: 38875721
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