Background:Meningiomas are rather uncommon tumors in the pediatric population,differing significantly from those found in adults by their atypical location,higher rate of more malignant types,consequently higher risk ...Background:Meningiomas are rather uncommon tumors in the pediatric population,differing significantly from those found in adults by their atypical location,higher rate of more malignant types,consequently higher risk of recurrence and a less favorable outcome.Even in children,suprasellar meningiomas without dural matrix are rare findings mimicking more common suprasellar lesions.Case presentation:Here we describe a case of a 12-year-old girl who presented with a rapidly progressing chiasmal syndrome and was diagnosed by MRI with an unusual suprasellar tumor that could not fit the diagnoses expected in a case of a parasellar mass in a child,similar to a craniopharyngioma or optic pathway glioma.After multiple clinical investigations,the tumor etiology was still unclear,so the preferred option of treatment was surgical resection.An endoscope-assisted gross total resection through a supraorbital keyhole approach was performed uneventfully,with total vision recovery in a short time.Benign meningiomas located in the skull base without dural attachment appear to be rare,even in pediatric patients.Conclusion:Differential diagnoses of suprasellar and para sellar tumor lesions in pediatric patients can be confusing.There are peculiar features of pediatric tumor diseases that should be considered while working out the management strategy.The main principle of meningioma treatment is the highest possible extent of resection minimally affecting the quality of life.展开更多
Background:Pediatric epidural hematomas(EDH)represent a neurosurgical emergency.Both surgical and conservative treatment can lead to a good clinical outcome.The aim of the study was to review our series of pediatric E...Background:Pediatric epidural hematomas(EDH)represent a neurosurgical emergency.Both surgical and conservative treatment can lead to a good clinical outcome.The aim of the study was to review our series of pediatric EDH and to determine the clinical and radiologic factors,which can influence the final outcome.Methods:All children aged from 0 to 16 that have been treated between 2013 and 2017 for cranial EDH have been selected.Results:Thirty children have been included in the study.Seventeen cases have been treated with surgical evacuation and 13 conservatively.Six months after the trauma,the outcome was excellent(mRS 0)in 25/30(83.3%)cases,mild deficits(mRS 1-2)were present in 4/30(13.3%),and severe deficits(mRS 3-5)in 1/30(3.3%)cases.Only a GCS(Glasgow Coma Scale)below 8 at admission was significantly related to the presence of a neurologic deficit at 6 months(p=0.048).Conclusions:EDH can be managed with excellent outcomes.Even in the presence of bad initial clinical and radiologic conditions,a correct treatment strategy can lead to a good recovery.In our series,only a GCS below 8 at admission was significantly related to the presence of neurological sequelae.展开更多
文摘Background:Meningiomas are rather uncommon tumors in the pediatric population,differing significantly from those found in adults by their atypical location,higher rate of more malignant types,consequently higher risk of recurrence and a less favorable outcome.Even in children,suprasellar meningiomas without dural matrix are rare findings mimicking more common suprasellar lesions.Case presentation:Here we describe a case of a 12-year-old girl who presented with a rapidly progressing chiasmal syndrome and was diagnosed by MRI with an unusual suprasellar tumor that could not fit the diagnoses expected in a case of a parasellar mass in a child,similar to a craniopharyngioma or optic pathway glioma.After multiple clinical investigations,the tumor etiology was still unclear,so the preferred option of treatment was surgical resection.An endoscope-assisted gross total resection through a supraorbital keyhole approach was performed uneventfully,with total vision recovery in a short time.Benign meningiomas located in the skull base without dural attachment appear to be rare,even in pediatric patients.Conclusion:Differential diagnoses of suprasellar and para sellar tumor lesions in pediatric patients can be confusing.There are peculiar features of pediatric tumor diseases that should be considered while working out the management strategy.The main principle of meningioma treatment is the highest possible extent of resection minimally affecting the quality of life.
文摘Background:Pediatric epidural hematomas(EDH)represent a neurosurgical emergency.Both surgical and conservative treatment can lead to a good clinical outcome.The aim of the study was to review our series of pediatric EDH and to determine the clinical and radiologic factors,which can influence the final outcome.Methods:All children aged from 0 to 16 that have been treated between 2013 and 2017 for cranial EDH have been selected.Results:Thirty children have been included in the study.Seventeen cases have been treated with surgical evacuation and 13 conservatively.Six months after the trauma,the outcome was excellent(mRS 0)in 25/30(83.3%)cases,mild deficits(mRS 1-2)were present in 4/30(13.3%),and severe deficits(mRS 3-5)in 1/30(3.3%)cases.Only a GCS(Glasgow Coma Scale)below 8 at admission was significantly related to the presence of a neurologic deficit at 6 months(p=0.048).Conclusions:EDH can be managed with excellent outcomes.Even in the presence of bad initial clinical and radiologic conditions,a correct treatment strategy can lead to a good recovery.In our series,only a GCS below 8 at admission was significantly related to the presence of neurological sequelae.
