Pediatric epilepsy surgery: could age be a predictor of outcomes?

OBJECTIVE Like adults, many children suffering from intractable seizures benefit from surgical therapy. Although various reports indicate that early intervention may avoid severe developmental consequences often associated with intractable epilepsy, surgery is still considered a last option for many children. In this retrospective study, the authors aimed to determine whether pediatric epilepsy surgery, in particular during the first years of life, relates to measurable benefits.

Proteus syndrome revealing itself after the treatment of a bilateral subdural haematoma.

Introduction: Hypertrophy of the calvarium has different aetiologies, among them the rare Proteus syndrome.

Case Report: We report here the case of a young girl initially treated for relapsing right then left large chronic subdural haematoma, who progressively developed craniofacial hypertrophy consistent with the diagnosis of Proteus syndrome. Calvarium hypertrophy was shaved and remodelled combining midface advancement, essentially for cosmetic purposes.

A reminder for a very rare entity: massive tongue swelling after posterior fossa surgery.

Objective: The purpose of this study is to report a case of presumably neurogenic macroglossia that occurred after surgical trapping of a vertebral artery (VA)-posteroinferior cerebellar artery aneurysm, and to analyze its potential pathogenesis.

Clinical Presentation: A 53-year-old woman who suffered from headaches and intermittent loss of consciousness but without evidence of subarachnoid hemorrhage was admitted. Magnetic resonance imaging and angiography showed an irregular aneurysm in the fourth segment of a left dominant VA.

Neuropsychological outcome after extra-temporal epilepsy surgery.

Background: The neuropsychological results of temporal lobe epilepsy surgery are well reported in the literature. The aim of this study was to analyse the neuropsychological outcome in a consecutive series of patients with extra-temporal epilepsy.

Methods: We retrospectively analysed the data of patients operated between 1996 and 2008 for extra-temporal epilepsy.

How I do it: cervical lateral mass screw fixation.

Background: Cervical lateral mass screw fixation is indicated for the treatment of cervical subaxial C3-C7 lesions associated with instability.

Method: The authors first describe the surgical anatomy of the subaxial cervical posterior approach. Then the Magerl technique is detailed.

Primary leptomeningeal melanocytosis in a 10-year-old girl: a challenging diagnosis with a poor prognosis.

Primary leptomeningeal melanocytosis is rarely encountered in the pediatric population. Despite being considered a nonmalignant condition, it uniformly carries a poor prognosis given the ineluctable progression of meningeal infiltration. The case of a previously healthy 10-year-old girl who was first thought to suffer from recurrent hemiplegic migraine is reported.

[Hemorrhagic strokes in children: etiology and management].

Pediatric particularities and management of pediatric hemorrhagic strokes are reviewed. Etiologies of hemorrhagic strokes in children are quite different than in adults. Arterio-venous malformations are much more frequently encountered than aneurysms, cavernous malformations and other non structural causes.

Symptomatic syringomyelia occurring as a late complication of posterior fossa medulloblastoma removal in infancy in a boy also suffering from scaphocephaly.

Introduction: The association of a medulloblastoma and a syringomyelia has been already described in rare instances albeit without symptoms related to the syrinx.

Case Report: The case of a 23-year-old man operated in infancy for a medulloblastoma and then treated solely with adjuvant chemotherapy is reported. He was also operated in infancy for a scaphocephaly.