Purpose: To review our experience with optic nerve sheath decompression for pe diatric pseudotumor cerebri. Design: Retrospective chart review. Participants: S eventeen eyes in 12 children younger than 16 years of age...Purpose: To review our experience with optic nerve sheath decompression for pe diatric pseudotumor cerebri. Design: Retrospective chart review. Participants: S eventeen eyes in 12 children younger than 16 years of age. All patients were eit her unresponsive or intolerant to medication. Intervention, Methods, or Testing: An optic nerve sheath fenestration was performed. Main Outcome Measures: Optic nerve appearance, visual acuity, color vision, and visual fields. Results: The a verage age at surgery was 10.1 years of age. The average follow-up was 39.6 mon ths. Headache was the most common presenting symptom. All patients showed improv ement in optic nerve edema. Visual acuity improved or stayed the same in all sur gical eyes (P=0.0078). One patient required a neurosurgical lumbar peritoneal sh unt, and 2 patients required acetazolamide on the last follow-up appointment. N o patient had postoperative infection, loss of vision, or strabismus develop. Fi ve of the patients in this study required sheath decompression on the other eye. Conclusions: Optic nerve sheath decompression in children is safe, and the resu lts are similar to those obtained in adults. Close follow-up is required, becau se 5 of 12 patients in this study required a contralateral optic nerve sheath de compression.展开更多
Objective To correlate the clinical and imaging features of the solid pseudopapillary tumor (SPPT) of the pancreas with the pathologic diagnosis. Methods The computed tomographic findings in 21 patients (18 women and ...Objective To correlate the clinical and imaging features of the solid pseudopapillary tumor (SPPT) of the pancreas with the pathologic diagnosis. Methods The computed tomographic findings in 21 patients (18 women and 3 men) with pathologically proven solid pseudopapillary tumor of the pancreas were reviewed retrospectively. Two radiologists reviewed images for location, size and morphology, capsule and margin, density, enhancement pattern, calcification, dilatation of pancreatic duct, lymphadenopathy, vascular invasion, distant metastasis, and recurrence. Results On CT, the lesion presented as solitary, round (28.57%), oval (57.14%), or lobulated (14.28%) mass in pancreatic head (47.62%) with complete capsule (85.71%). Lesions smaller than 4cm in maximum diameter (47.62%) presented as predominantly solid mass whereas lesions greater than 4cm in diameter (52.28%) presented as heterogenous mass. On contrast administration, the viable solid portion of the tumor showed mild peripheral enhancement in arterial phase [enhancement degree<20Hounsfield unit (HU)] with progressive fill in during the portal and hepatic parenchyma phase (enhancement degree 20-40HU). Eighteen lesions (85.7%) had complete capsule. Two lesions (9.5%) had areas of high density (>60HU) on plain CT which due to hemorrhage. Dilatation of the pancreatic duct was rare (25%), and distant metastasis, regional lymphadenopathy, and tumor recurrence were absent. Nine patients (42.85%) had an abdominal CT follow-up for 24.55months (range, 2-60months) post-surgery without recurrence or distant metastasis. Conclusion Solid pseudopapillary tumor of the pancreas usually occurs in young females in the pancreatic head or tail. On CT, they manifest as moderate vascular mixed tumor, progressive enhancement of the viable solid portion, distinct tumor margin with capsule formation, and absence of regional lymphadenopathy.展开更多
文摘Purpose: To review our experience with optic nerve sheath decompression for pe diatric pseudotumor cerebri. Design: Retrospective chart review. Participants: S eventeen eyes in 12 children younger than 16 years of age. All patients were eit her unresponsive or intolerant to medication. Intervention, Methods, or Testing: An optic nerve sheath fenestration was performed. Main Outcome Measures: Optic nerve appearance, visual acuity, color vision, and visual fields. Results: The a verage age at surgery was 10.1 years of age. The average follow-up was 39.6 mon ths. Headache was the most common presenting symptom. All patients showed improv ement in optic nerve edema. Visual acuity improved or stayed the same in all sur gical eyes (P=0.0078). One patient required a neurosurgical lumbar peritoneal sh unt, and 2 patients required acetazolamide on the last follow-up appointment. N o patient had postoperative infection, loss of vision, or strabismus develop. Fi ve of the patients in this study required sheath decompression on the other eye. Conclusions: Optic nerve sheath decompression in children is safe, and the resu lts are similar to those obtained in adults. Close follow-up is required, becau se 5 of 12 patients in this study required a contralateral optic nerve sheath de compression.
文摘Objective To correlate the clinical and imaging features of the solid pseudopapillary tumor (SPPT) of the pancreas with the pathologic diagnosis. Methods The computed tomographic findings in 21 patients (18 women and 3 men) with pathologically proven solid pseudopapillary tumor of the pancreas were reviewed retrospectively. Two radiologists reviewed images for location, size and morphology, capsule and margin, density, enhancement pattern, calcification, dilatation of pancreatic duct, lymphadenopathy, vascular invasion, distant metastasis, and recurrence. Results On CT, the lesion presented as solitary, round (28.57%), oval (57.14%), or lobulated (14.28%) mass in pancreatic head (47.62%) with complete capsule (85.71%). Lesions smaller than 4cm in maximum diameter (47.62%) presented as predominantly solid mass whereas lesions greater than 4cm in diameter (52.28%) presented as heterogenous mass. On contrast administration, the viable solid portion of the tumor showed mild peripheral enhancement in arterial phase [enhancement degree<20Hounsfield unit (HU)] with progressive fill in during the portal and hepatic parenchyma phase (enhancement degree 20-40HU). Eighteen lesions (85.7%) had complete capsule. Two lesions (9.5%) had areas of high density (>60HU) on plain CT which due to hemorrhage. Dilatation of the pancreatic duct was rare (25%), and distant metastasis, regional lymphadenopathy, and tumor recurrence were absent. Nine patients (42.85%) had an abdominal CT follow-up for 24.55months (range, 2-60months) post-surgery without recurrence or distant metastasis. Conclusion Solid pseudopapillary tumor of the pancreas usually occurs in young females in the pancreatic head or tail. On CT, they manifest as moderate vascular mixed tumor, progressive enhancement of the viable solid portion, distinct tumor margin with capsule formation, and absence of regional lymphadenopathy.
