An analysis of strategic treatment interruptions during imatinib treatment of chronic myelogenous leukemia with imatinib-resistant mutations.

Chronic myelogenous leukemia (CML) is a cancer of the white blood cells that results from increased and uncontrolled growth of myeloid cells in the bone marrow and the accumulation of these cells in the blood. The most common form of treatment for CML is imatinib, a tyrosine kinase inhibitor. Although imatinib is an effective treatment for CML and most patients treated with imatinib do attain some form of remission, imatinib does not completely eradicate all leukemia cells, and if treatment is stopped, all patients eventually relapse (Cortes, 2005).

Suboccipital decompression during posterior cranial vault remodeling for selected cases of Chiari malformations associated with craniosynostosis.

Object: The optimal management of Chiari malformations in the setting of craniosynostosis is not well established. In this report the authors describe their outcomes with the combined technique of simultaneous suboccipital decompression (SOD) during posterior cranial vault remodeling (PCVR).

Methods: A retrospective review was performed of all patients undergoing PCVR and simultaneous SOD.

Intracerebral schwannomas: a rare disease with varying natural history.

Although intracerebral schwannomas are typically regarded as benign intracranial tumors, malignancy and recurrence have been reported among patients harboring such neoplasms. The available literature consists of case reports and small series that present variable characteristics distinguishing these unusual lesions. Little advancement has been made to further the understanding and management of these tumors.

Limited reduction cranioplasty for the treatment of hydrocephalic macrocephaly.

Background: Hydrocephalic macrocephaly, occurring despite adequate cerebrospinal fluid shunting, is rare, and most publications advocate near-total cranial vault reduction procedures. The authors reviewed our series of limited reductions (designed to minimize complications while still providing functional benefits) to evaluate outcomes.

Methods: All patients undergoing posterior reduction cranioplasties were retrospectively reviewed for outcomes, including operative data, length of stay, preoperative and postoperative anthropometrics, and complications.

Equivalence of fusion rates after rigid internal fixation of the occiput to C-2 with or without C-1 instrumentation.

Object: The object of this study was to assess a multiinstitutional experience with pediatric occipitocervical constructs to determine whether a difference exists between the fusion and complication rates of constructs with or without direct C-1 instrumentation.

Methods: Seventy-seven cases of occiput-C2 instrumentation and fusion, performed at 9 children's hospitals, were retrospectively analyzed. Entry criteria included atlantooccipital instability with or without atlantoaxial instability.

Secondary nocturnal enuresis caused by central sleep apnea from Chiari malformation type 1.

Objective: To report a novel cause of nocturnal enuresis (NE) and highlight the literature giving insight into this novel mechanism.

Patient: A 12-year-old morbidly obese female with 2-year history of nightly secondary monosymptomatic NE.

Results: On evaluation, a history of severe sleep disturbed breathing was elicited.

Screw fixation of the upper cervical spine in the pediatric population. Clinical article.

Object: Rigid fixation of the upper cervical spine has become an established method of durable stabilization for a variety of craniocervical pathological entities in children. In children, specifically, the use of C1-2 transarticular screws has been proposed in recent literature to be the gold standard configuration for pathology involving these levels. The authors reviewed the use of rigid fixation techniques alternative to C1-2 transarticular screws in children.

Robotically guided radiosurgery for children.

Background: A robotically guided linear accelerator has recently been developed which provides frameless radiosurgery with high precision. Potential advantages for the pediatric population include the avoidance of the cognitive decline associated with whole brain radiotherapy, the ability to treat young children with thin skulls unsuitable for frame-based methods, and the possible avoidance of general anesthesia. We report our experience with this system (the "Cyberknife") in the treatment of 21 children.

Total vertex craniopagus with crossed venous drainage: case report of successful surgical separation.

Case Report: Twin boys joined at the head in a total vertex configuration were born in Egypt in June 2001. At 12 months, they were transported to Dallas for evaluation and eventual surgical separation. In Dallas, a large multidisciplinary team of health care providers from two pediatric hospitals was assembled to care for the boys.

Reoperation for Chiari malformations.

Background: We undertook this study to characterize those patients who required reoperations for Chiari malformation and to determine whether modifications in surgical technique at the initial procedure might have obviated the need for repeat surgery.

Methods: We reviewed the hospital records, imaging studies, operative reports, and follow-up data of those patients who were undergoing a second operation as part of a consecutive series of Chiari decompressions carried out by one neurosurgeon over a 14-year period. We wished to determine whether type of Chiari malformation, age at initial surgery, the presence of associated bony anomalies, or initial operative technique contributed to the need for reoperation.