Archives of Pediatric Neurosurgery

Outpatient clinic for children with obstetric brachial palsy admitted to a rehabilitation hospital in Brazil: 10 years of experience in a multidisciplinary approach

Ricardo de Amoreira Gepp — 2024-11-06

Introduction/Background: Obstetric brachial palsy (OBP) is characterized by flaccid paralysis secondary to injury to one or more roots of the brachial plexus during laborious labor. Specialized and systematized evaluation by a multidisciplinary team is important in the follow-up of these patients. The authors describe the ten first years of the specialized outpatient clinic in a health institution.

Methods: The medical records of all patients admitted with a brachial plexus injury that occurred during delivery at a health institution were evaluated. The children were evaluated using the Active Movement Scale (AMS) and the test score was applied at three months. Patients older than 2 years of age at the time of admission were excluded from the analysis.

Results: 454 children with PBO up to 2 years of age were admitted. Of the total, 54% of babies are female. The average age at admission was 4.7 months of age, with 56.4% being admitted at up to 3 months of age. Of the total admitted, 113 children underwent surgery to treat the brachial plexus.

Conclusions: Systematized evaluation associated with multidisciplinary monitoring allows a better evolution of the child who presented a brachial plexus injury at birth

Anatomical variations of the floor of the third ventricle in patients with hydrocephalus may affect the surgical outcome?

Humberto Belem de Aquino — 2025-01-10

Introduction: Anatomical variation of the floor membrane of the third ventricle can occurs in patients with hydrocephalus of any etiology and age and can affect the surgical outcome.

Methods: Images of the floor of the third ventricle were captured and analyzed from videos of 99 patients with hydrocephalus of different etiologies and ages who underwent endoscopic third ventriculostomy (ETV) with emphasis on the type of floor membrane.

Results: Based on the types of membranes of the floors of the third ventricle found in our study and the data described in the available literature, we can describe four “main types of membranes” with their common characteristics and “subdivisions of the main membranes” where they present common types of main membrane associated with details and/or abnormalities.

Conclusion: Anatomical variations of the floor of the third ventricle occur in patients with hydrocephalus of any etiology and age and their recognition is essential before the main surgical procedure (ETV), as they increase the risk of injuries that can affect the surgical outcome.

Surgical management and outcomes of childhood hydrocephalus in a resource-challenged setting in Northeast Nigeria

Usman Daibu — 2025-01-10

Background: Hydrocephalus is the most common neurosurgical presentation among pediatric patients in our center. The specificity of children with this condition justifies special care by a team comprising of pediatric neurosurgeons, anesthesiologist and nurses. A ventriculoperitoneal shunt is the surgical treatment we offer these patients, as facilities for other treatment options are unavailable. This study aimed to determine the outcomes of surgical management of childhood hydrocephalus in our center.

Patients and methods: A retrospective observational study that recruited all pediatric patients aged 16 years and below who had surgical intervention for hydrocephalus in our facility from January 2019 to December 2021. Data was analyzed using simple descriptive statistics.

Results: A total of 73 pediatric patients with hydrocephalus were recruited. The majority (53.4%) were males with a male-to-female ratio of 1.1:1. Most of the patients (53.4%) had acquired hydrocephalus and had ventriculoperitoneal shunt (93.2%) as surgical intervention. Nineteen point two percent (14 patients) had postoperative complications. Proximal shunt obstruction (6.9%); followed by surgical site infection (5.5%) were the most common and occurred commonly in those operated during infancy period. Mortality was higher in patients that had external ventricular drain (EVD). Overall mortality was 5.5%.

Conclusion: Acquired hydrocephalus is the most common type of hydrocephalus in children in our center. Ventriculoperitoneal shunt remains the surgical treatment employed with favorable outcomes despite limitations.

Kinsbourne syndrome: a case report

Thayanne Jacinto — 2024-09-01

Introduction/Background: Kinsbourne syndrome or opsoclonus mioclonus ataxia is a rare syndrome, commonly post viral or paraneoplastic, characterized by opsoclonus, ataxia, myoclonic jerks of trunk and limbs and behavioral disturbances. Affects both adult and pediatric ages, with greater prevalence between one and three-year-old and equal gender prevalence. Neuroblastoma, hepatoblastoma and glangioneuromas are ordinarily associated with this syndrome. This paperwork aims to present a case report concerning Kinsbourne Syndrome and review literature about it.

Case presentation: We report a case of a one-year-and-two-month-old male, with opsoclonus, gait disturbance and imbalance associated with a neuroblastoma, who has undergone therapy with prednisone 1mg/kg/day and surgical resection, evolving with complete resolution of symptoms after four years and a half of clinical following, presenting himself to the date without neurological deficits, contrary to literature statistics.

Conclusion: KS is ordinarily a post-viral or paraneoplastic rare syndrome, with higher prevalence between 1 to 3-year-old infants, nevertheless also affecting adults. araneoplastic syndrome is majorly associated with NB

Left anterior and Middle cerebral artery stroke associated with Pituitary apoplexy in an adolescent male with Giant prolactinoma: A Case Report

Omane Acheamfour Okrah — 2025-01-10

Background: Pituitary apoplexy is a life-threatening condition in which there is a hemorrhage or infarction of the pituitary gland. It can be characterized by the sudden onset of headaches, vomiting, visual impairment, endocrine deficits, and changes in consciousness. There are very few cases of pituitary apoplexy presenting as strokes in children. We report a rare occurrence of an ischemic stroke in the left anterior and middle cerebral artery territories, caused by pituitary apoplexy from a prolactinoma in a 13-year-old male which was managed medically.

Case Presentation: He presented with worsening headaches and visual acuity and later developed left oculomotor nerve palsy, right hemiplegia, and dysarthria. MRI and CT imaging confirmed an apoplectic pituitary macroadenoma with internal carotid artery encasement and infarction in the territory of the left middle and anterior cerebral arteries. The patient was treated using dopamine agonists, which led to a decrease in tumor size and serum prolactin levels without surgery.

Conclusion: This report emphasizes the need to promptly recognize pituitary apoplexy as a potential cause of stroke in children. It also illustrates successful medical management in these cases, which could be especially important in areas with limited resources

Surgical Treatment of Langerhans Cell Histiocytosis of Cervical Spine: Case-Report and Systematic Review of Literature

Breno Barbosa — 2025-01-10

Background: Langerhans cell histiocytosis (LCH) is a rare disease involving the cervical spine. This condition is present firstly in the thoracic spine, commonest, followed by the lumbar spine and cervical spine. In Langerhans cell histiocytosis there is excessive proliferation of pathologic Langerhans cells. It is commonly found in males with a ratio of 2.5:1. The etiology of LCH is unknown. There are three defined entities classified on their severities. Letterer-Siwe disease involves multiple organs, Hand-Schuller-Christian disease presents with bony lesions and endocrine abnormalities, and eosinophilic granuloma (EG) presents with isolated bony lesions. We describe a case-report a girl with Langerhans cell histiocytosis in cervical vertebrae.The objective of this study is to show the rare case of Cervical Spine Langerhans Cell Histiocytosis.

Method: We were a literature review with inclusion and exclusion criteria and we described a case-report.

Case-Report: A 9-month-old girl had neck pain associated with right upper limb weakness. Imaging showed infiltrative and expansive lesions in the vertebral body from C1 to C6 with spinal cord and root compression. The patient underwent a laminectomy from C2 to C5. Histopathological was suggestive of LCH.

Conclusion: Despite the rarity of the disease, Langerhans cell histiocytosis can be treated with a surgical approach when neurologic deficits are present.

Neuroendoscopy surgery for ventriculitis and hydrocephalus

Jairo Porfirio de Oliveira Júnior — 2024-12-03

Neuroendoscopy surgery is a minimally invasive surgical procedure that uses an endoscope to access and treat conditions within the brain. We are describing the case of a 2-month-old patient who was born extremely premature and developed complications from prematurity-related intraventricular hemorrhage. The mother had a preterm delivery due to chorioamnionitis, and the child developed neonatal sepsis and ventriculitis after birth. The child was treated conservatively from birth, without an effective response to treatment. A brain MRI showed tetraventricular hydrocephalus and several intraventricular collections. Cerebrospinal fluid analysis revealed increased cellularity with a predominance of polymorphonuclear cells, protein elevation, and glucose consumption. An exhaustive ventricular lavage, drainage of the intraventricular collections, septostomy, and third ventriculostomy were performed. The patient showed clinical and infectious improvement.

Celebrating Five Years of Archives of Pediatric Neurosurgery – 2019-2024

Ricardo Santos de Oliveira — 2025-01-10

This year marks a significant milestone for the Archives of Pediatric Neurosurgery (APN): five years since its launch in 2019. As we reflect on this journey, we are reminded of the bold vision that inspired its creation—a dedicated platform to advance knowledge, foster collaboration, and support the growth of pediatric neurosurgery in Latin America as well worldwide.

Over the past five years, the journal has published groundbreaking studies, comprehensive reviews, and insightful case reports that have informed practice and enriched the global pediatric neurosurgery community.

APN was founded in a period when the field of pediatric neurosurgery was rapidly evolving. Advances in imaging, surgical techniques, and molecular biology were transforming patient outcomes, but the need for a focused publication to curate and disseminate these developments was palpable. The journal rose to this challenge, filling a critical gap with an emphasis on high-quality, open-access publishing.

The journal has consistently adhered to the highest standards of peer review, ensuring the scientific rigor and ethics of its publications. Its prestigious editorial board has brought together diverse perspectives, bridging gaps across continents and creating a truly global platform.

APN has embraced innovation in publishing, from adopting cutting-edge digital platforms to integrating multimedia content such as surgical clinical videos . These efforts have enhanced the journal’s accessibility and utility for readers, making it a valuable resource for clinicians and educators alike.

As APN celebrates its fifth anniversary, it is a moment of gratitude and renewed purpose. We are grateful to the authors, reviewers, editorial team, and readers who have supported this endeavor. Their collective efforts have made APN a respected voice in pediatric neurosurgery.

The journey ahead is as exciting as the one behind. Emerging areas like neurogenetics, minimally invasive techniques, and AI-driven diagnostics hold promise for the future.

As we celebrate this milestone, we reaffirm our commitment to excellence, inclusivity, and service to the global pediatric neurosurgery community. Here's to many more years of advancing the care of our youngest patients, one article at a time.