Cerebral cavernous malformation with associated Streptococcus pyogenes abscess in a child: a case report and literature review.

Cerebral cavernous malformations (CCMs) are angiographically occult vascular lesions that present with a variety of neurological symptoms, including seizures, features of raised intracranial pressure and focal neurological deficits. In extremely rare circumstances, CCMs have presented with concomitant brain abscess formation. To date, five cases have previously been reported, the majority of which have affected patients aged 16 years or older.

Feasibility of comparing medical management and surgery (with neurosurgery or stereotactic radiosurgery) with medical management alone in people with symptomatic brain cavernoma - protocol for the Cavernomas: A Randomised Effectiveness (CARE) pilot trial.

Introduction: The top research priority for cavernoma, identified by a James Lind Alliance Priority setting partnership was 'Does treatment (with neurosurgery or stereotactic radiosurgery) or no treatment improve outcome for people diagnosed with a cavernoma?' This pilot randomised controlled trial (RCT) aims to determine the feasibility of answering this question in a main phase RCT.

Methods And Analysis: We will perform a pilot phase, parallel group, pragmatic RCT involving approximately 60 children or adults with mental capacity, resident in the UK or Ireland, with an unresected symptomatic brain cavernoma. Participants will be randomised by web-based randomisation 1:1 to treatment with medical management and with surgery (neurosurgery or stereotactic radiosurgery) versus medical management alone, stratified by prerandomisation preference for type of surgery.

The impact of telephone consultations due to COVID-19 on paediatric neurosurgical health services.

Purpose: The aim of the study was to evaluate the role of telephone consultations due to the pandemic in the management of paediatric neurosurgical patients and, furthermore, to examine the proportion of patients who eventually needed a face-to-face appointment and assess the underline reasons for that.

Methods: This retrospective study included all the paediatric neurosurgical patients who had a telephone appointment during a 3-month lockdown period. Overall, 319 patients (186 males and 133 females) aged 8.

The (extended) achondroplasia foramen magnum score has good observer reliability.

Background: Achondroplasia is the most common skeletal dysplasia. A significant complication is foramen magnum stenosis. When severe, compression of the spinal cord may result in sleep apnea, sudden respiratory arrest and death.

The Sensor Reservoir-does it change management?

Background: The Miethke Sensor Reservoir sits within a ventriculoperitoneal shunt system to give a reading of the pressure within the shunt. This information can guide the management of hydrocephalus patients who present frequently with headaches.

Methods: We reviewed a cohort of 12 patients who underwent implantation of a Sensor Reservoir to assess how the management of their symptoms changed over a 4-year period.

A comparison between flow-regulated and adjustable valves used in hydrocephalus during infancy.

Introduction: Ventriculoperitoneal shunt insertion during the neonatal period and early infancy is associated with a high rate of shunt failure when compared to the adult population. Furthermore, the function of flow-regulated valves and differential pressure valves may be different in neonatal hydrocephalus.

Methods: A retrospective case series of all primary shunt procedures carried out during or immediately following the neonatal period, from August 2011 to February 2018 at Sheffield Children's Hospital.

The ventriculo-cholecystic shunt: does CSF volume matter?

Introduction: The management of hydrocephalus in paediatric patients where the peritoneum has failed can be challenging. One option is to perform a ventriculo-cholecystic shunt. However, little is known about the capacity of the gall bladder to accommodate cerebrospinal fluid (CSF).

Cyclical vomiting syndrome secondary to a Chiari I malformation-a case report.

Background: Cyclical vomiting syndrome is a disorder characterised by recurrent episodes of profuse vomiting. There are no cases in the literature on the management of children with presenting with cyclical vomiting syndrome and a Chiari malformation type I.

Discussion: We report the case of a 12-year-old child diagnosed with cyclical vomiting syndrome and a Chiari malformation type I.

Does direct admission from an emergency department with on-site neurosurgical services facilitate time critical surgical intervention following a traumatic brain injury in children?

Objectives: To compare the proportion of trauma craniotomies performed within 4 hours of presentation to emergency departments (ED) with and without on-site neurosurgery.

Design: A retrospective cohort analysis of data collected prospectively between January 2005 and April 2010 from patients with traumatic brain injury who were admitted to the paediatric intensive care unit (PICU) following traumatic brain injury.

Methods: Times for admission to ED, PICU and theatre were obtained through analysis of prospectively collected data management systems.

An unusual complication following translabyrinthine resection of an acoustic neuroma.

We report the case of a 58-year old man who presented with a 4 cm right acoustic neuroma. He underwent a translabyrinthine resection. Two years later he presented with multiple strokes and progressive generalised deterioration.

Surgical treatment of post-traumatic syringomyelia.

Study Design: A retrospective study.

Objectives: To review the outcome of 40 patients with post-traumatic syringomyelia treated with laminectomy and reconstitution of the spinal subarachnoid channels.

Setting: Birmingham, United Kingdom.

Brain tissue oxygenation changes in children during the first 24 h following head injury.

Aim: The aim of this study is to assess the changes of brain tissue oxygen levels in children during the first 24 h following head injury and its correlation with changes of intracranial pressure and clinical outcome.

Method: Invasive monitoring of partial brain tissue oxygen tension (PbtO(2)) using the Licox (Integra Neurosciences, Plainsboro, NJ, USA) oxygen probe was performed in children with severe head injury requiring ventilation, during the years 2002-2005. The study focused in the recordings of the first 24 h following injury.

Lumbar subcutaneous shunt: a novel technique for therapeutic decision making in normal pressure hydrocephalus (NPH) and benign intracranial hypertension (BIH).

Selecting patients who will benefit from a permanent CSF diversion procedure in benign intracranial hypertension (BIH) or communicating hydrocephalus due to normal pressure hydrocephalus (NPH) has inherent problems. The percutaneous introduction of a lumbar subcutaneous shunt (LSS) under local anaesthesia facilitates both a prolonged CSF drainage under aseptic conditions and also elicits an adequate clinical response. We describe the technique of a lumbar subcutaneous shunt and our experience with its use in patients with BIH and NPH.

Spontaneously disappearing lumbar disc protrusion.

Spontaneous disappearance of a herniated lumbar disc is known to occur. This case study describes a 45-year-old patient whose symptoms of lumbar radiculopathy resolved and follow-up imaging showed complete disappearance of the disc prolapse. This phenomenon strengthens the role of conservative treatment in the management of lumbar disc protrusions.

Supraorbital microcraniotomy for acute aneurysmal subarachnoid haemorrhage: results of first 50 cases.

For the past 50 years the pterional craniotomy has been the standard approach for anterior circulation aneurysms. However, this is a major procedure. As the trend is towards minimally invasive surgery generally, we have been developing a minimally invasive approach for anterior circulation aneurysms - the supraorbital microcraniotomy.

Value of triple H therapy in a patient with an ischemic penumbra following subarachnoid hemorrhage: a case study.

We report the case of a 43-year-old patient with delayed ischemic neurological deficit and an ischemic penumbra, reversed with triple H therapy (hypertension, hypervolemia, and hemodilution). The patient presented with subarachnoid hemorrhage caused by an aneurysm of the anterior communicating artery. He underwent surgical clipping and developed cerebral ischemia due to vasospasm.

Elderly patients with severe head injury in coma from the outset--has anything changed?

Advancing age is known to be a determinant of outcome in head injury. We have sought to discover whether there has been any change in the outcome of elderly patients with severe head injury in Newcastle, where these patients have continued to be treated with maximum intervention. A review of prospectively collected data from the Newcastle Head Injury Database for the period 1990 to 2000 was carried out.

Pulmonary tuberculosis in Harare, Zimbabwe: analysis by spoligotyping.

Background: Over the last 10 years there has been a fourfold increase in cases of tuberculosis in Harare, Zimbabwe. The use of molecular epidemiology to understand tuberculosis transmission in this epidemic has been hampered by the availability of suitable culture facilities. A study was therefore undertaken to explore the potential of spoligotyping, a polymerase chain reaction based technique that does not require tuberculosis culture.