Laser speckle imaging to improve clinical outcomes for patients with trigeminal neuralgia undergoing radiofrequency thermocoagulation.

Objective: Percutaneous treatments for trigeminal neuralgia are safe, simple, and effective for achieving good pain control. Procedural risks could be minimized by using noninvasive imaging techniques to improve the placement of the radiofrequency thermocoagulation probe into the trigeminal ganglion. Positioning of a probe is crucial to maximize pain relief and to minimize unwanted side effects, such as denervation in unaffected areas.

Diffusion tensor imaging in pediatric Chiari type I malformation.

Aim: Chiari type I malformation (C1M) may be symptomatic or asymptomatic as an incidental finding. In this retrospective study, we applied diffusion tensor imaging (DTI) to study the brainstem and cerebellar white matter tracts in C1M.

Method: Diffusion tensor imaging (DTI) data were acquired on a 1.

Computer-aided design and manufacturing in craniosynostosis surgery.

Background: Considerable operative time is expended during the planning, shaping, and reconfiguring of the cranial vault in the pursuit of symmetry during open craniosynostosis surgery. Computer-aided design and manufacturing has recently been implemented in orthognathic surgery and complex craniomaxillofacial reconstruction as a means of optimizing operative accuracy and efficiency. In this report, we highlight our growing experience with this promising modality for the preoperative planning and intraoperative execution of cranial vault remodeling in patients with both simple and complex forms of craniosynostosis.

Glycerol rhizotomy and radiofrequency thermocoagulation for trigeminal neuralgia in multiple sclerosis.

Object: Patients with trigeminal neuralgia due to multiple sclerosis (TN-MS) and idiopathic TN (ITN) who underwent glycerol rhizotomy (GR) and radiofrequency thermocoagulation with glycerol rhizotomy (RFTC-GR) were compared to investigate the effectiveness of these percutaneous ablative procedures in the TN-MS population.

Methods: Between 1998 and 2010, 822 patients with typical TN were evaluated; 63 (8%) had TN-MS and 759 (92%) had ITN. Pain relief comparisons were made between 22 GR procedures in patients with TN-MS and 470 GR procedures in patients with ITN; 50 RFTC-GR procedures in patients with TN-MS and 287 RFTC-GR procedures in patients with ITN were compared.

Treatment of choroid plexus tumors: a 20-year single institutional experience.

Object: Choroid plexus tumors (CPTs) are rare intracranial neoplasms that constitute approximately 2%-5% of all pediatric brain tumors. Most of these tumors present with severe hydrocephalus. The optimal perioperative management and oncological care remain a matter of debate.

Effectiveness of repeat glycerol rhizotomy in treating recurrent trigeminal neuralgia.

Background: Percutaneous glycerol rhizotomy (GR) is used to treat trigeminal neuralgia (TN), with satisfactory pain relief lasting 2 to 3 years in most patients after the first intervention. The efficacy of subsequent GRs, however, has not been studied.

Objective: To compare the pain relief and durability achieved by the first GR with those obtained after subsequent GRs in a retrospective cohort of TN patients.

Surgical treatment of pediatric trigeminal neuralgia: case series and review of the literature.

Purpose: Pediatric trigeminal neuralgia (TN) is a rare entity. The purpose of this study was to retrospectively analyze a small series of pediatric patients diagnosed with TN and surgically treated with microvascular decompression (MVD) at a single center.

Methods: Nine patients were identified who presented with TN symptoms that began before the age of 18.

Surgical decompression for lumbar stenosis in pediatric achondroplasia.

Background: Spinal stenosis is a common complication of achondroplasia. To our knowledge, no study has evaluated a greater than 2-year outcome after surgical intervention for spinal stenosis in such children or compared decompression with and without instrumentation in relation to revision surgery. Our purpose was to assess the efficacy of lumbar decompression and instrumentation for symptomatic stenosis in children with achondroplasia.

Harvey Cushing's contributions to motor mapping: 1902-1912.

This review examined Dr. Harvey Cushing's cases in the surgical records of Johns Hopkins Hospital, from 1896 to 1912. 41 patients who underwent cortical stimulation for intra-operative motor mapping were selected for further analysis.

Prognostic factors in pediatric high-grade astrocytoma: the importance of accurate pathologic diagnosis.

To characterize a population of pediatric high-grade astrocytoma (HGA) patients by confirming the proportion with a correct diagnosis, and determine prognostic factors for survival in a subset diagnosed with uniform pathologic criteria. Sixty-three children diagnosed with HGA were treated at the Johns Hopkins Hospital between 1977 and 2004. A single neuropathologist (P.

Disparities in access to pediatric neurooncological surgery in the United States.

Objective: The objective of this study was to investigate whether disparities in access to high-volume centers for neurooncological care existed in the United States in 1988-2005.

Methods: A retrospective analysis of the Nationwide Inpatient Sample (1988-2005) was performed, with additional factors incorporated from the Area Resource File (2006). International Classification of Diseases, Ninth Revision, diagnosis/procedure coding was used to identify patients.

Incidence of symptomatic retethering after surgical management of pediatric tethered cord syndrome with or without duraplasty.

Background: Cord retethering and other postoperative complications can occur after the surgical untethering of a first-time symptomatic tethered cord. It is unclear if using duraplasty vs. primary dural closure in the initial operation is associated with decreased incidence of either immediate postoperative complications or subsequent symptomatic retethering.

Angiocentric glioma: a case series.

Object: Angiocentric glioma was recently recognized as a distinct clinicopathological entity in the 2007 World Health Organization Classification of Tumours of the Central Nervous System. The authors present the first 3 pediatric cases of angiocentric glioma encountered at their institution and review the literature of reported cases to elucidate the characteristics and outcomes of pediatric patients with this novel tumor.

Methods: The children in the 3 cases of angiocentric glioma were 10, 10, and 13 years old.

Magnetic resonance imaging characteristics of pilomyxoid astrocytoma.

Objective: Pilomyxoid astrocytoma (PMA) is a recently identified pediatric low-grade neoplasm that was previously classified as pilocytic astrocytoma (PA), yet demonstrates unique histological features and more aggressive behavior. These tumors have been shown to have significantly shorter progression-free and overall survival probability than classical low-grade astrocytomas, as well as a high rate of cerebrospinal fluid (CSF) dissemination. This paper describes the radiographic features of PMA.

Outcome analysis of childhood low-grade astrocytomas.

Background: We aimed to determine the long-term natural history of low-grade astrocytomas (LGA) in children, with respect to pathology, and to evaluate influence of treatment on survival.

Patients And Methods: A consecutive cohort of patients < or =21 years with surgically confirmed LGA from 1965 to 1996 was assembled. All available pathology specimens were reviewed, masked to original diagnosis, patient data, and neuroimaging.

Catheters for chronic administration of drugs into brain tissue.

Methods to infuse drugs into the parenchyma of the central nervous system (CNS) have been reported as inconsistent or unpredictable. The source of variability appears to be a compromised seal between the tissue and the outer surface of the cannula. Failure of the tissue to seal to the cannula creates a path of least resistance.

Antibiotic-impregnated shunt catheters for the treatment of infantile hydrocephalus.

Introduction: Antibiotic-impregnated shunt (AIS) components decrease shunt infections by preventing bacterial colonization that occurs during implantation. Despite studies showing improved efficacy in preventing infection however, concern still exists regarding using AIS components in infants, especially premature ones. In this study, clinical outcomes were assessed in infants with hydrocephalus (<1 year) following AIS placement.

Spinal stenosis surgery in pediatric patients with achondroplasia.

Object: Achondroplasia is a hereditary form of dwarfism caused by a defect in endochondral bone formation, resulting in skeletal abnormalities including short stature, shortened limb bones, macrocephaly, and small vertebral bodies. In the pediatric population, symptomatic spinal stenosis occurs at all spinal levels due to the abnormally narrow bone canal. In this study, clinical outcomes were assessed in children with achondroplasia after spinal canal decompression.

Early presentation of spinal stenosis in achondroplasia.

One third of patients with achondroplasia develop spinal stenosis requiring surgical intervention. However, this condition rarely develops before the age of 15 years. The goal of the current study was to identify anatomical factors and clinical symptoms associated with early presentation of lumbar stenosis in such patients.

PIK3CA gene mutations in pediatric and adult glioblastoma multiforme.

The phosphatidylinositol 3-kinases (PI3K) are a family of enzymes that relay important cellular growth control signals. Recently, a large-scale mutational analysis of eight PI3K and eight PI3K-like genes revealed somatic mutations in PIK3CA, which encodes the p110alpha catalytic subunit of class IA PI3K, in several types of cancer, including glioblastoma multiforme. In that report, 4 of 15 (27%) glioblastomas contained potentially oncogenic PIK3CA mutations.

Local infusion therapy in the monkey brainstem: technical considerations.

This chapter assesses the safety of freehand placement of an infusion catheter (outer diameter, 0.3 mm) in brainstems of cynomolgus monkeys (Macaca fascicularis) for local infusion therapy. A posterior midline approach through the cerebellum and roof of the fourth ventricle was used to implant catheters into a pontine target area.

The Strata programmable valve for shunt-dependent hydrocephalus: the pediatric experience at a single institution.

Background And Objective: The Medtronic PS Medical Strata valve has pressure flow characteristics that are noninvasively adjusted with a magnetic tool. The objective of this study was to examine its efficacy during our initial experience with it in shunt-dependent children.

Materials And Methods: A retrospective review of 53 children with a median age of 2.