Outcomes of head trauma in children admitted to a tertiary paediatric intensive care unit in South Wales.

Objective: This study aimed to evaluate the demographics and outcomes of major paediatric head trauma managed in our Paediatric Intensive Care Unit (PICU) in South Wales and comparison is made with the existing published literature.

Design And Setting: A retrospective review of medical records and imaging of patients identified from the paediatric neurosurgical trauma database at University Hospital Wales (UHW) from March 2013 to July 2021. We assessed the GCS at admission, mechanism of injury, CT scan, type of surgery required and GOS after 12 months.

Is postoperative high dependency care really needed for children undergoing supratentorial brain tumour surgery?

Purpose: We present our analysis of the existing Paediatric High Dependency Unit (HDU) admission policy at our institution and discuss our thoughts for its revision in the context of paediatric supratentorial tumour surgery.

Materials And Methods: We screened our prospectively maintained database of all children undergoing supratentorial craniotomy for resection of paediatric brain tumours over a fifteen-year period. The post-operative course of each patient was reviewed, assessing the number of patients who had true HDU needs in the immediate post-operative period, and the relative depth of input from paediatric HDU specialists that each patient received.

Don't make a mountain out of dermoid cysts of the anterior fontanelle.

Dermoid cysts are ectodermal inclusion lesions which can occur at the bregma, preventing complete closure of the anterior fontanelle. Various management strategies have been suggested for children presenting with such lesions. We describe the experience of managing a series of 13 consecutive patients at the University Hospital of Wales, Cardiff, including pre-operative workup, operative strategy, post operative care and follow up.

Suspected abusive head trauma in children - when do they really need to be transferred to a neurosurgical unit?

Objectives: Transferring paediatric patients with suspected abusive head trauma (AHT) to paediatric neurosurgical centres, disrupts safeguarding investigations. Therefore, it is desirable that suspected AHTs are transferred only when clinically necessary. The aim of this study was to describe referral patterns of patients referred to a tertiary paediatric neurosurgical centre with suspected AHT, with the view of informing future transfer of AHT patients.

Pre-operative dosing of dexamethasone for the management of children with posterior fossa tumours: are we getting it right?

Introduction: Posterior fossa (PF) tumours are associated with vasogenic oedema causing symptoms of raised intracranial pressure. Preoperatively this is managed with dexamethasone. To minimise steroid related complications, the lowest effective dose should be administered.

Clinical outcomes of intracranial complications secondary to acute mastoiditis: The Alder Hey experience.

Objective: Acute mastoiditis is the most common intra-temporal complication of acute otitis media. Its management remains a challenge due to potential extracranial and intracranial complications. This study was designed to evaluate the recent experience with acute mastoiditis and its associated intracranial complications at a tertiary paediatric centre.

The ventriculo-cholecystic shunt: does CSF volume matter?

Introduction: The management of hydrocephalus in paediatric patients where the peritoneum has failed can be challenging. One option is to perform a ventriculo-cholecystic shunt. However, little is known about the capacity of the gall bladder to accommodate cerebrospinal fluid (CSF).