SNI/SNI Digital-Baghdad neurosurgery educational series.

Background: Access to high-quality neurosurgery online learning is limited in low- and middle-income countries, and Iraq is part of this category. The need for collaboration and connection of people worldwide to exchange ideas and experiences in neurosurgery is a challenge. Surgical Neurology International® (SNI)/SNI Digital stimulated the establishment of the joint effort to bring the discussion about the best experiences in neurosurgery from the United States and Iraq together in an internet meeting format.

Cost-effectiveness of short-term neurosurgical missions relative to other surgical specialties.

Background: Short-term surgical relief efforts have helped close some gaps in the provision of surgical care in remote settings. We reviewed the published literature on short-term surgical missions to compare their cost-effectiveness across subspecialties.

Methods: PubMed was searched using the algorithm ["cost-effectiveness" AND "surgery" AND ("mission" OR "volunteer")].

Correction of Chiari malformation due to closure of a concomitant thoracic meningocele.

Introduction: Chiari malformations are characterized by hindbrain herniation. Historically, some types have been linked to neural tube defects, but the causal relationship between the two conditions is still unclear.

Case Report: We report on a full-term male neonate with a prenatally diagnosed posterior thoracic meningocele, whose MRI demonstrated Chiari malformation.

Suboccipital craniotomy for Chiari I results in evoked potential conduction changes.

Background: Management of Chiari I is controversial, in part because there is no widely used quantitative measurement of decompression. It has been demonstrated that brainstem auditory evoked responses (BAER) and somatosensory evoked potentials (SSEP) have decreased conduction latencies after wide craniectomy. We analyzed these parameters in a suboccipital craniectomy/craniotomy procedure.

The International Tethered Cord Partnership: Beginnings, process, and status.

Background: Spina bifida presents a significant cause of childhood morbidity in lower- and middle-income nations. Unfortunately, there is a paucity of literature examining outcomes among children with spina bifida in these countries. The goal of the International Tethered Cord Parternship is twofold: (1) to establish an international surveillance database to examine the correlation between time of repair and clinical outcomes in children with spina bifida and tethered cord; and (2) to foster collaboration among international institutions around pediatric neurosurgical concerns.

Correction of large facial encephalocele with bilateral rare craniofacial clefts.

Treatment of Tessier number 3, 11 craniofacial clefts represent a surgical challenge with complex bone and soft tissue deficits of the lip, cheek, medial orbit, and forehead. The severity of the presenting defect will ultimately determine the number of reconstructive stages required as well as the timing of each stage. Initial surgery in infancy is aimed at functional correction.

A microfluidic platform for systems pathology: multiparameter single-cell signaling measurements of clinical brain tumor specimens.

The clinical practice of oncology is being transformed by molecular diagnostics that will enable predictive and personalized medicine. Current technologies for quantitation of the cancer proteome are either qualitative (e.g.

Clinical outcome in pediatric glial and embryonal brain tumors correlates with in vitro multi-passageable neurosphere formation.

Background: Cultured brain tumors can form neurospheres harboring tumorigenic cells with self renewal and differentiation capacities. Renewable neurosphere formation has clinical predictive value in adult malignant gliomas, yet its prognostic role for pediatric brain tumors is unknown.

Methods: Established neurosphere conditions were used for culturing samples from glial, embryonal and mixed glioneuronal tumors from 56 pediatric patients.

A case report of intraventricular gliofibroma.

Gliofibroma is a rare tumor with biphasic morphology. We report a case of a 3-month-old girl presenting with increasing head circumference. CT and MRI showed the presence of a large heterogeneous, nonenhancing tumor filling the atria and bodies of the lateral ventricles with caudal extension into the third ventricle.

Suboccipital craniotomy in the surgical treatment of Chiari I malformation.

Object: The object of this study was to present craniotomy for Chiari type I patients.

Materials And Methods: Six patients with Chiari type I underwent suboccipital craniotomy. All patients showed clinical improvement, and none had any complications.

Neurosphere formation is an independent predictor of clinical outcome in malignant glioma.

Renewable neurosphere formation in culture is a defining characteristic of certain brain tumor initiating cells. This retrospective study was designed to assess the relationship among neurosphere formation in cultured human glioma, tumorigenic capacity, and patient clinical outcome. Tumor samples were cultured in neurosphere conditions from 32 patients with glioma, including a subpopulation of 15 patients with primary glioblastoma.

Brain stem candidiasis mimicking cerebellopontine angle tumor.

Background: Infectious process can mimic cerebral tumors. We present the first report of a fugal infection in brainstem mimicking cerebral tumors in the literature.

Case Description: A 17-month-old boy presented with abnormal movements of his left arm and difficulty walking for 2 weeks.

Choroid plexus hyperplasia: surgical treatment and immunohistochemical results. Case report.

Diffuse villous hyperplasia of the choroid plexus is a rare but potential source of nonobstructive hydrocephalus. In addition to discussing the authors' staged surgical approach and medical management decisions in a patient with this rare and challenging condition, immunohistochemical studies of the choroid plexus epithelium are presented to examine the pathophysiological factors involved in abnormal cerebrospinal fluid (CSF) production in this disease. The patient, a 15-month-old girl born at 36 weeks' gestation, underwent a bilateral craniotomy with resection of the choroid plexus to treat her villous hyperplasia.

Maternal embryonic leucine zipper kinase is a key regulator of the proliferation of malignant brain tumors, including brain tumor stem cells.

Emerging evidence suggests that neural stem cells and brain tumors regulate their proliferation via similar pathways. In a previous study, we demonstrated that maternal embryonic leucine zipper kinase (Melk) is highly expressed in murine neural stem cells and regulates their proliferation. Here we describe how MELK expression is correlated with pathologic grade of brain tumors, and its expression levels are significantly correlated with shorter survival, particularly in younger glioblastoma patients.

Chiari I anatomy after ventriculoperitoneal shunting: posterior fossa volumetric evaluation with MRI.

Introduction: Cephalocranial disproportion was said to be responsible for Chiari I malformation after ventriculoperitoneal shunt. We aimed to evaluate if the volumetric characteristics of Chiari I after a ventriculoperitoneal shunt was due to a general volumetric reduction and if it is restricted to the posterior fossa.

Results: Our results show that the posterior fossa volume, cisternal, clival length, and posterior cranial fossa volume ratio were reduced in the shunted group compared to the controls (p<0.

Transcranial Doppler in infantile cerebrospinal fluid disorders: clinical validity.

The present study was designed to investigate a possible relationship between transcranial Doppler sonography (TCD) parameters with infantile hydrocephalus and other types of cerebrospinal fluid (CSF) abnonnalities, i.e. arrested hydrocephalus and essential ventriculomegaly.

Cancerous stem cells can arise from pediatric brain tumors.

Pediatric brain tumors are significant causes of morbidity and mortality. It has been hypothesized that they derive from self-renewing multipotent neural stem cells. Here, we tested whether different pediatric brain tumors, including medulloblastomas and gliomas, contain cells with properties similar to neural stem cells.

A mathematical model for self-limiting brain tumors.

It is puzzling that certain brain tumors exhibit arrested exponential growth. We have observed in pediatric low-grade astrocytomas (LGA) at a certain volume approximately 100-150 cm(3) that the tumor ceases to grow. This observation led us to develop a macroscopic mathematical model for LGA growth kinetics that assumes the flow through the surface of the astrocytoma of a triggering agent or "promoter" that is uniformly distributed throughout the tumor, thereby providing relatively homogeneous growth.

Intramedullary abscess of the spinal cord in children: a case report and review of the literature.

A case report of an intramedullary spinal cord abscess in a 13-month-old boy and a review of relevant existing pediatric literature is presented. Thirty-eight cases of pediatric intramedullary spinal cord abscess are analyzed for presenting signs and symptoms, microbiology of isolated organisms, surgical intervention, antibiotic administration and outcome. The most significant variable on outcome is timely surgical intervention, followed by appropriate antibiotic administration.

Tonsillectomy without craniectomy for the management of infantile Chiari I malformation.

Object: The authors report their experience with 15 pediatric patients who underwent resection or shrinkage of the cerebellar tonsils without craniectomy or laminectomy, for the management of Chiari I malformation.

Methods: The procedure was performed in six boys and nine girls with a mean age of 10 years. Thirteen patients presented with the congenital form of this disorder and two patients with Chiari I malformation caused by lumboperitoneal shunting.

Distal slit valve and clinically relevant CSF overdrainage in children with hydrocephalus.

Introduction: Distal slit valve (DSV) is a system designed for the treatment of hydrocephalus. It has been assumed that, by dispensing with an anti-siphon (AS) mechanism, the DSV induces a set of clinical symptoms associated with fluid overdrainage in patients. Nonetheless, there is no published evidence to support this assumption.