Conservative management of acute epidural hematoma in a pediatric age group.

Objective: Craniotomy and evacuation is the standard treatment of acute epidural hematoma (EDH). Here, the authors report their experience in nonoperative management of acute EDH in children with mild head injury.

Methods: The authors retrospectively reviewed charts of patients with conservatively treated EDH at the Department of Neurosurgery, King Abdulla University Hospital, Irbid, Jordan, between August 2003 and October 2007.

Collateral blood flow patterns in patients with unilateral ICA agenesis and cerebral aneurysm.

Background: Agenesis of one or both internal carotid arteries (ICA) is usually a benign congenital anomaly. Many patients are diagnosed incidentally and remain asymptomatic, however associated cerebral aneurysms can be life-threatening and result in high morbidity and mortality rates in this population.

Material & Methods: Based on the timing of ICA agenesis, during the fetal life, we classified the collateral blood flow pattern into three major types; type I: Collateral blood flow via primitive vessels, type II: Collateral blood flow via ICA branches, and type III: collateral blood flow via branches of the external carotid artery (ECA).

Endothelial injury and inflammatory response induced by hemodynamic changes preceding intracranial aneurysm formation: experimental study in rats.

Object: Intracranial aneurysms are the leading cause of subarachnoid hemorrhage, which is associated with high morbidity and mortality rates. Despite advances in the microsurgical and endovascular treatment of intracranial aneurysms, little is known about the mechanisms by which they originate, grow, and rupture. To clarify the series of early events leading to formation of intracranial aneurysms, the authors compared aneurysmal morphological changes on vascular corrosion casts with parallel pathological changes in the cerebral arteries of rats.

The role of cine flow MRI in children with Chiari I malformation.

Introduction: Since the introduction of MRI, the incidence of Chiari I malformations (cerebellar tonsils ectopia) has increased. The clinical significance of this finding remains questionable in some instances. Recently, cine flow MRI has added to the understanding of the dynamics of cerebrospinal fluid at the craniocervical junction and to the pathophysiology of the Chiari I malformation.

Late-onset erythema along a sterile functioning ventriculoperitoneal shunt: case report and review of the literature.

Case Report: A 6-year-old boy presented with erythema along the tract of his ventriculoperitoneal shunt 6 years after its insertion; there was no associated CSF infection or shunt malfunction.

Discussion: The question of what to do in such a situation is addressed. The possible causes of the erythema are discussed, as well as its management, and the literature is reviewed.