Adherence in Evidence-Based Neurotrauma Guidelines: A Worldwide Survey.

Background: Traumatic brain injury (TBI) management guidelines vary across regions and there is limited research on real-world adherence to these guidelines. We conducted a global survey to assess the adherence of neurosurgeons to TBI guidelines and evidence-based medicine (EBM).

Method: A 24-item survey was created using Google Forms, covering demographic information, neurotrauma training, basic knowledge of EBM, surgical and in-hospital management.

Balloon angioplasty for cerebral vasospasm in preschool children.

Background: Subarachnoid hemorrhage evolving with cerebral vasospasm and delayed cerebral ischemia may increase morbidity and mortality. Treating vasospasm with balloon percutaneous angioplasty (PTA) in adults is well known, but data in preschool children are scarce. In addition, the smaller diameters and fragility of the vessels in childhood might lead to serious complications.

Spinal Neurocutaneous Melanosis.

Neurocutaneous melanosis is characterized by melanin-producing cells within the skin, leptomeninges, or brain parenchyma. It is a severe manifestation of congenital melanocytic nevus syndrome and can develop malignant melanomas. The disorder is commonly present in pediatric patients within the first two years of life and has a poor prognosis.

Cerebrofacial Venous Metameric Syndrome Mimicking Vein of Galen Aneurysmal Malformation.

Cerebrofacial venous metameric syndrome (CVMS) is a complex low-flow vascular malformation affecting bone and soft tissues including brain, dura mater, and eye. We show images of CVMS in an 18-month-old boy presenting facial venous malformations, developmental venous anomalies, dural sinus malformations, and dilated great cerebral vein, suggesting a vein of Galen aneurysmal malformation. Although Sturge-Weber syndrome is the most known form of CVMS, its presentations are variable and include several venous malformations.

Pediatric Donut-Shaped Basilar Artery Aneurysm.

Intracranial aneurysms are uncommon in the pediatric population. We present a case of an 11-year-old boy presenting with subarachnoid hemorrhage caused by a "donut-shaped" basilar tip aneurysm. It occurs when the flow geometry produces a circumferential laminar flow into the aneurysmal sac, resulting in a central thrombosis.

Does amantadine improve cognitive recovery in severe disorders of consciousness after aneurysmal subarachnoid hemorrhage? A double-blind placebo-controlled study.

Background: Severe disorders of consciousness (sDoC) are a common sequela of aneurysmal subarachnoid hemorrhages (aSAH), and amantadine has been used to improve cognitive recovery after traumatic brain injury.

Objective: This study evaluated the effect of amantadine treatment on consciousness in patients with sDoC secondary to aSAH.

Methods: This double-center, randomized, prospective, cohort study included patients ≥ 18 years old with sDoC after aSAH from February 2020 to September 2023.

Pediatric intracranial aneurysms in a Southern Brazilian population.

Introduction: Intracranial aneurysms are rare in the pediatric population, and their diagnosis can be challenging. They differ from their adult counterparts in several aspects, and hemorrhage is the most common presentation.

Objective: To evaluate clinical data, aneurysm characteristics, and therapeutic results in a series of patients younger than 19 years of age with intracranial aneurysms.

Moyamoya Angiopathy and 15q11.2 Gene Deletion Syndrome.

Although the moyamoya angiopathy has already been associated with several genetic and chromosomal alterations, its physiopathologic mechanisms are not completely understood. We report a case of a 7-year-old male with epilepsy, autism spectrum disorder, and delayed psychomotor development whose genetic investigation showed a deletion of the 15q11.2 gene.

Angiopathy and Stroke Associated with Homocystinuria in Childhood.

A previously healthy 13 year-old boy presented with acute-onset headaches, aphasia and right-sided hemiparesis. Imaging showed cerebral ischemic infarction due to bilateral carotid occlusion, and investigation for stroke etiology diagnosed homocystinuria. Homocystinuria is an autosomal recessive condition that affects the metabolism of the amino acid methionine due to an enzyme deficiency.

Moyamoya disease and syndrome: a review.

Moyamoya disease is a chronic occlusive cerebrovascular disease that is non-inflammatory and non-atherosclerotic. It is characterized by endothelial hyperplasia and fibrosis of the intracranial portion of the carotid artery and its proximal branches, leading to progressive stenosis and occlusion, often clinically manifesting as ischemic or hemorrhagic stroke with high rates of morbidity and mortality. On cerebral angiography, the formation of collateral vessels has the appearance of a puff of smoke (moyamoya in Japanese), which became more conspicuous with the refinement of modern imaging techniques.

Choreoathetosis in Moyamoya Disease.

Moyamoya disease is a cerebral angiopathy characterized by bilateral progressive narrowing of internal carotid arteries, developing collateral vessels with the aspect of a "puff of smoke." The presentation with movement disorders is extremely rare. We present the case of an 11-year-old girl with low academic performance who complained of involuntary movements starting in her right hand.

Microanatomic Study of the Optic Canal.

Background: The continuous development of microsurgical techniques to treat lesions in and around the optic canal (OC) emphasizes the need for an accurate understanding of the microanatomy of the region.

Methods: Forty anatomic specimens were studied, with emphasis on the OC. The sphenoid bone and related structures were decalcified, added to animal gelatin, cut into 1-mm thick slices, and observed through a surgical microscope.

Endovascular treatment of P3 segment of posterior cerebral artery aneurysm with stent and coils.

Posterior cerebral artery (PCA) aneurysms are rare and usually arise from proximal portion of the artery. The distal location is even less frequent, and aneurysms in this location tend to be larger and dissecting. Although they can be treated by direct surgery, recently endovascular procedures have been preferred in some centers.

Cervical Disorders in Mucopolysaccharidosis IVA-Morquio disease.

Morquio disease or mucopolysaccharidosis type IVA (Online Mendelian Inheritance in Man No. 253000) is a rare autosomal recessive disease classified in the group of metabolism inborn errors. The glycosaminoglycans accumulate in chondrocytes, which disturbs bone growth and leads to skeletal manifestations, such as skeletal dysplasia and a short stature.