Publications by authors named "Regan M Shanahan"
Article Synopsis
- The understanding of pediatric AVMs is complicated by various gene mutations that have been identified, with potential implications for targeted gene therapies in treatment.
- Treatment options include open microsurgery, radiosurgery, and endovascular embolization, with increasing evidence of their synergistic effects in improving patient outcomes.
Article Synopsis
- Rubinstein-Taybi syndrome (RTS) is a rare genetic disorder characterized by unique physical traits, and this case series focuses on the neurosurgical care of RTS patients at Children's Hospital of Pittsburgh.
- A retrospective review of RTS cases from 2010 to 2023 found that 95% of patients had a genetic variant linked to RTS type 1, with many presenting issues such as tethered cord syndrome and Chiari malformations.
- The study highlights a notably high occurrence of Chiari I malformation requiring surgery, illustrating the need for neurosurgical intervention in RTS management.
Background: Intra-axial brain tumors persist as significant clinical challenges. Aggressive surgical resection carries risk of morbidity, and the blood-brain barrier (BBB) prevents optimal pharmacological interventions. There is a clear clinical demand for innovative and less invasive therapeutic strategies for patients, especially those that can augment established treatment protocols.
View Article and Find Full Text PDFBackground And Objectives: Pleomorphic xanthoastrocytoma (PXA) is a rare low-grade glial tumor primarily affecting young individuals. Surgery is the primary treatment option; however, managing residual/recurrent tumors remains uncertain. This international multi-institutional study retrospectively assessed the use of stereotactic radiosurgery (SRS) for PXA.
View Article and Find Full Text PDFManagement of intracranial aneurysms (IAs) is determined by patient age, risk of rupture, and comorbid conditions. While endovascular and microsurgical interventions offer solutions to mitigate the risk of rupture, pharmacological management strategies may complement these approaches or serve as alternatives in appropriate cases. The pathophysiology of IAs allows for the targeting of inflammation to prevent the development and rupture of IAs.
View Article and Find Full Text PDFPurpose: Clival metastatic cancer is rare and has limited literature to guide management. We describe management of clival metastasis with Gamma Knife radiosurgery (GKRS). We augment our findings with a systematic review of all forms of radiation therapy for clival metastasis.
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- In 1994, interfacet spacer placement was introduced for joint distraction and fixation, and this case highlights the use of cervical facet cages (CFC) for a pediatric patient with basilar invagination.
- A 12-year-old boy with Wiedemann-Steiner syndrome experienced neck jerking and guarding, leading to surgery involving occiput to C3 fusion and C1-C2 CFC fixation, resulting in significant radiographic improvement.
- Postoperatively, the patient had some dysphagia but all neck symptoms resolved, showing that CFC can be a safe option for atlantoaxial fixation in children, alongside other materials highlighted in the literature.
Background: The placement of an external ventricular drain (EVD) for the treatment of acute hydrocephalus is one of the most common life-saving procedures that neurosurgeons perform worldwide. There are many well-known complications associated with EVD placement, including tract hemorrhages, intra-parenchymal and subdural hemorrhages, infection, and catheter misplacement. Given the variety of complications associated with EVD placement and the inconsistent findings on the relationship of accuracy to complications, the present study reviewed short- and long-term complications related to EVD placement at our institution.
View Article and Find Full Text PDFRudimentary meningoceles of the spine with dural extension are very rare and warrant surgical excision to prevent infection and long-term neurological deficits in pediatric patients. We present the case of a 5-month-old infant with a tethered spinal cord secondary to a rudimentary meningocele. The patient presented shortly after birth with a midline cervical dimple that was evaluated for a suspected dermal sinus tract.
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