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  • 1
    Electronic Resource
    Electronic Resource
    A new surgical approach to the third ventricle with interruption of the striothalamic vein (1979)
    Springer
    Acta neurochirurgica 47 (1979), S. 135-147 
    Details
    ISSN: 0942-0940
    Keywords: Third ventricle ; surgical approach ; striothalamic vein
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In the removal of tumours that develop within the third ventricle, most approaches are not entirely satisfactory. Therefore, a new approach has been devised: transfrontal exposure of the anterior portion of the frontal horn; coagulation and section of the striothalamic vein in order to open up the roof of the third ventricle; use of a blunt spatula introduced in the foramen of Monro and pushed backwards under the choroïd plexus. This approach has been used in ten cases. Postoperative mortality has been nil; the surgical approach has not apparently been responsible for any sequelae. It is simple and gives a good view of the third ventricle.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01406399
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  • 2
    Electronic Resource
    Electronic Resource
    Medulloblastoma in childhood. Survival and functional results (1979)
    Springer
    Acta neurochirurgica 48 (1979), S. 1-15 
    Details
    ISSN: 0942-0940
    Keywords: Medulloblastoma ; survival ; functional results ; side-effects of radiotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The authors report on a series of 57 medulloblastomas in children operated upon between 1964 and 1976. Among these children, 44 completed the treatment with radiotherapy to the whole central nervous system. The postoperative mortality rate is 10.5%. Postoperative deaths occurred mainly in infants or when a tumour involved the brain stem. The five-year survival rate is 54% in the whole series. It rose to 71% in the patients who completed the treatment with radiotherapy. The study shows that the life of survivals is frequently impaired by mental or behavioural disturbances. IQ varies from 70 to 90 in 58% of the children; it is below 70 in 31%. Behavioural disturbances are found in 93% of cases. 82% have defective spatial orientation, dysphasia, or dysgraphia. In order to evaluate the responsibility of X-ray therapy for the development of these sequelae, the results have been compared to those of a series of cerebellar astrocytomas surgically removed, but not irradiated. The comparison shows that radiotherapy is at least partially responsible for the mental and behavioural disturbances. No relation was found between these disturbances and a persistent ventricular dilatation or an endocrine dysfunction. However the endocrine assessment showed growth hormone deficiency in 65% of the children, short stature in 55%, and compensated hypothyroïdism in 58%.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01406016
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  • 3
    Electronic Resource
    Electronic Resource
    Antley-Bixler syndrome Description of two new cases and a review of the literature (1997)
    Springer
    Child's nervous system 13 (1997), S. 275-281 
    Details
    ISSN: 1433-0350
    Keywords: Key words Antley-Bixler syndrome ; Plagiocephaly ; Imperforate anus ; Choanal stenosis or atresia ; Craniosynostosis ; Prognosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Antley-Bixler syndrome was first described in 1975, and to date 20 cases have been reported. In addition to brachycephaly, the syndrome is associated with midface hypoplasia, often with choanal stenosis or atresia, bilateral radiohumeral synostosis, multiple joint contractures, femoral bowing and long bone fractures, ``pear-shaped'' nose, dysplastic ears and, occasionally, urogenital or cardiac defects. Survival is closely linked to upper airway obstruction. This, in addition to craniosynostosis, also affects mental prognosis. The cluster of malformations and their severity are variable, and while numerous children have died early from respiratory distress, one third of them are alive and have had quite satisfactory development. With early and effective prevention of respiratory complications and early treatment of craniosynostosis, the overall prognosis can be favorable. The mode of inheritance is probably autosomal recessive, and midtrimester prenatal diagnosis is feasible. Genetic counseling depends on accurate prognostic and therapeutic data. We describe two new cases, a 4-year-old boy with unilateral coronal synostosis and radio-humeral synostosis on the same side and an 18-month-old girl with brachycephaly and imperforate anus.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003810050082
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  • 4
    Electronic Resource
    Electronic Resource
    Acute intracranial hematomas in term neonates (1986)
    Springer
    Child's nervous system 2 (1986), S. 191-194 
    Details
    ISSN: 1433-0350
    Keywords: Neonatology ; Intracranial hematomas ; Hydrocephalus ; Dystocic deliveries ; Perinatal anoxia ; Bleeding disorders
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Acute intracranial hematomas in 17 term neonates are reported: 3 were subdural in the posterior fossa; 14 supratentorial, either subdural (8), intracerebral (1 frontal, 4 occipital) or intraventricular (1). The hematomas were aspirated in 3 cases and surgically evacuated in 10. In the remaining 4, the effusion was left in situ. Three patients died: 2 due to dramatic preoperative deterioration and 1 to hemostatic difficulties during surgery. In the 14 survivors, neurological sequellae are major in 3, nil or minor in 11. Comparison of these cases to the 110 others already published allows the following conclusions: (1) the cause of such hematomas is usually multifactorial, combining obstetrical trauma, anoxia and/or coagulation disorders; (2) early diagnosis of the hematoma requires early echography and/or tomodensitometry; (3) when the hematoma causes a midline shift, the authors advocate its early evacuation by aspiration, or craniotomy if it is clotted; (4) the prognosis is poor when there is associated severe perinatal anoxia; if there is no anoxia, the prognosis seems good, but as the follow-up is usually short, definite conclusions are difficult; (5) in our series hydrocephalus requiring treatment occurred in 2 of the 14 survivors.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00706809
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  • 5
    Electronic Resource
    Electronic Resource
    Management of craniosynostoses (2000)
    Springer
    Child's nervous system 16 (2000), S. 645-658 
    Details
    ISSN: 1433-0350
    Keywords: Keywords Craniosynostosis ; Craniofacial surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Although it is currently thought that surgery is indicated mainly for cosmetic reasons in isolated craniosynostoses, the functional aspects of the treatment must not be underestimated. Prospective studies on intracranial pressure and mental evolution of these children have shown that there were functional consequences in a significant proportion of cases even of single suture fusion. The frequency of increased intracranial hypertension and the risk of mental impairment depend on the age of the child and the type of craniosynostosis. In nonsyndromic cases, the higher risks are observed in multisutural craniosynostoses (brachycephaly, oxycephaly). In syndromic cases, the risk of intracranial hypertension is higher in Crouzon syndrome, and Apert syndrome carries the higher risk of mental retardation. The study of a personal series of 2,137 craniosynostoses shows that the functional and the cosmetic results are better after early surgery, and that the operative risks are not higher in infants than in older children.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003810000320
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  • 6
    Electronic Resource
    Electronic Resource
    Intracranial venous anomalies associated with atretic cephalocoeles (2000)
    Springer
    Pediatric radiology 30 (2000), S. 743-747 
    Details
    ISSN: 1432-1998
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background. Midline scalp lesions are frequent in children. They include soft-tissue masses and atretic meningocoeles. Their recognition is important as their treatment differs. Intracranial venous anomalies are known to be associated with atretic cephalocoeles.¶Materials and methods. A retrospective study was undertaken to assess the frequency of intracranial venous anomalies associated with atretic meningocoeles (AT). Thirty-one patients with AT were studied by MRI. There were 13 meningocoeles and 14 encephalocoeles; 4 have not yet received surgery.¶Results. Venous anomalies were found when the cephalocoeles lay above the torcular. They include absence of the straight sinus and duplication of the longitudinal sinus.¶Conclusion. Venous anomalies are frequent in atretic cephalocoeles and are part of the dysraphic state.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002470000328
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  • 7
    Electronic Resource
    Electronic Resource
    Desmoplastic supratentorial neuroepithelial tumours of childhood: Imaging in 5 patients (1996)
    Springer
    Neuroradiology 38 (1996), S. S165 
    Details
    ISSN: 1432-1920
    Keywords: Neuroepithelial tumor of childhood, supratentorial ; Desmoplastic astrocytoma ; Desmoplastic ganglioglioma ; Magnetic resonance imaging ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Desmoplastic neuroepithelial tumours are rare supratentorial neoplasms of infancy with a favourable prognosis. We characterised their imaging findings by reviewing the clinical and radiological reports of five affected children. The tumours were massive, predominantly cystic and with preferential frontal and parietal lobe involvement. The cystic component was in the white matter, with no communication with the ventricle. The solid part was superficially, abutting a meningeal surface, and showed intense contrast enhancement. A heterogeneous predominantly solid mass was observed in one patient. Thinning and deformation of the skull adjacent to the tumour was shown in four cases. Peritumoral oedema was absent or moderate. No calcification or haemorrhage were present. Angiography showed a tumour blush from the internal or external carotid arteries in one case each. Follow-up (3 months-9 years, mean 4.5 years) showed no recurrence.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02278149
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  • 8
    Electronic Resource
    Electronic Resource
    Desmoplastic supratentorial neuroepithelial tumours of childhood: imaging in 5 patients (1996)
    Springer
    Neuroradiology 38 (1996), S. S165 
    Details
    ISSN: 1432-1920
    Keywords: Key words Neuroepithelial tumor of childhood ; supratentorial ; Desmoplastic astrocytoma ; Desmoplastic ganglioglioma ; Magnetic resonance imaging ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Desmoplastic neuroepithelial tumours are rare supratentorial neoplasms of infancy with a favourable prognosis. We characterised their imaging findings by reviewing the clinical and radiological reports of five affected children. The tumours were massive, predominantly cystic and with preferential frontal and parietal lobe involvement. The cystic component was in the white matter, with no communication with the ventricle. The solid part was superficially, abutting a meningeal surface, and showed intense contrast enhancement. A heterogeneous predominantly solid mass was observed in one patient. Thinning and deformation of the skull adjacent to the tumour was shown in four cases. Peritumoral oedema was absent or moderate. No calcification or haemorrhage were present. Angiography showed a tumour blush from the internal or external carotid arteries in one case each. Follow-up (3 months–9 years, mean 4.5 years) showed no recurrence.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050944
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  • 9
    Electronic Resource
    Electronic Resource
    Intellectual outcome in children with malignant tumors of the posterior fossa: influence of the field of irradiation and quality of surgery (1995)
    Springer
    Child's nervous system 11 (1995), S. 340-345 
    Details
    ISSN: 1433-0350
    Keywords: Malignant tumors of the posterior fossa ; Intellectual outcome ; Radiotherapy to posterior fossa ; Radiotherapy to cerebral hemispheres ; Radial surgery ; Brain stem lesions
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The purpose of this study was to determine the respective parts played by cerebral hemisphere irradiation, posterior fossa irradiation, and surgery in the poor late functional results often observed in children treated for medulloblastoma. To do this we compared the intellectual outcome in a series of 59 children operated on for medulloblastoma, who had received whole-brain irradiation, to that observed in a series of 37 children operated on for ependymoma of the posterior fossa, who had received radiotherapy only on the posterior fossa. Only patients who had survived for more than 2 years without recurrence were included. At the assessment 1 year after treatment, intellectual outcome was somewhat better in the ependymoma group, but the difference was not statistically significant. At the long-term follow-ups at 5 and 10 years the results remained stable in the children treated for ependymoma, around 60% having an IQ above 90, whereas the intellectual level of the children treated for medulloblastoma was seen to have deteriorated progressively: 20% had an IQ above 90 5 years after treatment and only 10% at the 10-year followup. This progressive degradation is most likely due to the irradiation of the cerebral hemispheres, as this prophylactic irradiation constituted the only difference between the two groups. Moreover, irradiation to the posterior fossa did not seem to affect intellectual functions, since in the group of children with ependymomas the proportion of IQs above 90 was high and remained stable over the years. Surgery was certainly responsible for some poor results. The percentage of IQs above 90 observed 1–2 years after treatment was between 70 and 80 when no postoperative complications occurred, and only between 20–40% in the presence of postoperative complications. Postoperative aggravation was in most cases related to a brain-stem lesion. These results encourage the reduction, when possible, of irradiation to the cerebral hemispheres and underline the importance of the quality of surgery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00301666
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  • 10
    Electronic Resource
    Electronic Resource
    Late outcome of the surgical treatment of hydrocephalus (1998)
    Springer
    Child's nervous system 14 (1998), S. 97-99 
    Details
    ISSN: 1433-0350
    Keywords: Key words Hydrocephalus ; Infancy ; Intellectual outcome ; Scholastic integration ; Prognostic factors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The purpose of this report is to analyze the long-term outcome in hydrocephalic children treated by shunt placement and in particular their psycho-intellectual development. In the case of shunt placement postoperative mortality is virtually nil, and the overall mortality rate after 10 years of follow-up has been reduced to less than 5%. Morbidity, in contrast, is far from satisfactory. This study was conducted in 129 consecutive children with nontumorous hydrocephalus who underwent a first shunt insertion before the age of 2 years between 1979 and 1982 and who were followed up for at least 10 years. The final neurological examination revealed a motor deficit in 60%, visual or auditory deficits in 25%, and epilepsy in 30%. The final IQs were above 90 in 32% of the children, between 70 and 90 in 28%, between 50 and 70 in 19%, and lower than 50 in 21%. Integration into the normal school system was possible for 60% of the children, but half of them were 1–2 years behind their age group or having difficulties; 31% were attending special classes or were in institutions; and 9% were considered ineducable. The presence of behavioral disorders was a determinant factor for scholastic and social integration. Such disorders were frequent, and were characterized as severe in 30%. A relationship between final outcome and etiology, initial ventricular size, and epilepsy was observed. These results are used as the basis of a discussion on how morbidity might be improved.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003810050186
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