Reported incidence and treatment modalities of giant cerebral aneurysms in the pediatric population: A systematic review and illustrative case report

Scurvy is generated by lack of vitamin C; although it is considered a rare and past disease, scurvy continues to be detected in children with neurodevelopmental disorders and with selective diet habits. Identifying scurvy can be demanding due to the perceived rarity of the condition, and it can become a tricky diagnostic question given to the variety of nonspecific symptoms, including gingival manifestations. This study aims to identify most common clinical features in order to provide a complete picture of the signs and symptoms, and to offer clinicians the diagnostic tools for identifying patients suffering from scurvy. We present a case report of a child affected by scurvy; it has also been performed as a systematic review about scurvy in pediatric population. A search yielded 107 relevant studies since 1990. Most of the identified cases have shown oral, musculoskeletal and cutaneous manifestation that improved within a few days of starting vitamin C therapy. Identifying scurvy’s characteristic clinical features allows a timely diagnosis, thus avoiding invasive investigations. Pediatric dentists should possess adequate knowledge and experience to identify the main characteristics of scurvy. This can help facilitate a prompt diagnosis in order to provide timely intervention to the patient that is relatively ease and safe.

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Management of oculomotor nerve schwannoma: Systematic review of literature and illustrative case

Surgical Neurology International ◽

10.25259/sni-75-2019 ◽

2019 ◽

Vol 10 ◽

pp. 40 ◽

Cited By ~ 4

Author(s):

Sajjad Muhammad ◽

Mika Niemelä

Keyword(s):

Systematic Review ◽

Nerve Palsy ◽

Combined Treatment ◽

Oculomotor Nerve ◽

High Rate ◽

Treatment Modalities ◽

Oculomotor Nerve Palsy ◽

Subtotal Resection ◽

Illustrative Case ◽

Review Of Literature

Background: Oculomotor nerve schwannoma (ONS) is an extremely rare intracranial benign tumor. Till date, there is no standard treatment of oculomotor schwannoma. Here, we present an illustrative case report of ONS, perform a systematic review of literature on surgically and radiosurgically treated cases and morbidity related to both treatment modalities. Methods: We performed a systematic review of literature for cases with ONS treated with surgery or radiosurgery using PubMed/Ovid Medline. Results: Till date, there are 60 reported cases of ONS (45 treated surgically and seven radiosurgically) with the dominance of female gender (53%) and mean age of 35.2 years (Range 1–66). In 8% of the cases, there was no involvement of cranial nerve (CN) III and 92% of the cases CN III alone or together with CN II, IV, V, and VI. In 67% of the cases a complete resection and 33% a partial resection performed. In 73% of the cases, postoperative third nerve palsy was documented, 22% improved after surgery and in around 5% of cases, the outcome was not described. In the radiosurgically treated cases of nonvestibular schwannoma including ONS, the progression-free interval of approximately 2 years was above 90%. Conclusion: Due to the high rate of postoperative complete oculomotor nerve palsy, a subtotal resection avoiding the nerve injury seems to be a feasible option. Radiosurgery is another option to treat small size schwannoma. A combined treatment with microsurgery followed by radiosurgery may allow effective treatment for large size oculomotor schwannoma.

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Cerebral vasculopathy and strokes in a child with COVID-19 antibodies: illustrative case

Journal of Neurosurgery: Case Lessons ◽

10.3171/case21160 ◽

2021 ◽

Vol 2 (3) ◽

Author(s):

Chase H. Foster ◽

Anthony J. Vargas ◽

Elizabeth Wells ◽

Robert F. Foster ◽

Suresh N. Magge

Keyword(s):

Case Report ◽

Pediatric Patient ◽

Pediatric Population ◽

Preschool Age ◽

Illustrative Case ◽

Neurological Sequelae ◽

Immune Mediated ◽

International Data ◽

Neurological Effects

BACKGROUND The ability of coronavirus disease 2019 (COVID-19) to cause neurological insults in afflicted adults is becoming increasingly understood by way of an ever-growing amount of international data. By contrast, the pandemic illness’s neurological effects in the pediatric population are both poorly understood and sparsely reported. OBSERVATIONS In this case, the authors reported their experience with a preschool-age child with hydrocephalus who suffered multiterritory strokes presumed secondary to immune-mediated cerebral vasculopathy as a result of asymptomatic COVID-19 infection. LESSONS Growing evidence indicates that COVID-19 can cause neurological sequelae such as encephalitis and strokes. In this case report, the authors discussed a case of cerebral vasculopathy and strokes in a pediatric patient who was positive for COVID-19.

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Adult cerebellar glioblastoma: case report and review of the literature/strong

American Journal of BioMedicine ◽

10.18081/2333-5106/016-3/42-53 ◽

2020 ◽

Vol 8 (1) ◽

pp. 1-12

Author(s):

Gabriel Castelluccio ◽

Gonzalo Bertullo

Keyword(s):

Systematic Review ◽

Brain Tumor ◽

Prognostic Factors ◽

Case Report ◽

Primary Brain Tumor ◽

Treatment Modalities ◽

Pathological Features ◽

Review Of The Literature ◽

Clinical Hospital ◽

Cerebellar Glioblastoma

Glioblastoma is the most common and malignant primary brain tumor but its occurrence in the cerebellum is very rare. Giving its low occurrence the treatment modalities and outcome of this glioblastoma location are still poorly understood. We present the case of an adult woman with a cerebellar glioblastoma treated at the Clinical Hospital of Montevideo, and we perform a non-systematic review of the literature concerning the clinical, radiological and pathological features of this tumor, as well as its treatment modalities, prognostic factors and outcome.

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Facial disfigurement due to osteitis fibrosa cystica or brown tumor from secondary hyperparathyroidism in patients on dialysis: A systematic review and an illustrative case report

Hemodialysis International ◽

10.1111/hdi.12298 ◽

2015 ◽

Vol 19 (4) ◽

pp. 583-592 ◽

Cited By ~ 7

Author(s):

Rafael M. Baracaldo ◽

Dashi Bao ◽

Pichet Iampornpipopchai ◽

Joshua Fogel ◽

Sofia Rubinstein

Keyword(s):

Systematic Review ◽

Case Report ◽

Secondary Hyperparathyroidism ◽

Osteitis Fibrosa ◽

Illustrative Case ◽

Brown Tumor ◽

Osteitis Fibrosa Cystica ◽

Facial Disfigurement

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Noncurative microsurgery for cerebral aneurysms: a systematic review and meta-analysis of wrapping, residual, and recurrence rates

Journal of Neurosurgery ◽

10.3171/2021.9.jns211698 ◽

2021 ◽

pp. 1-11

Author(s):

Derrek Schartz ◽

Thomas K. Mattingly ◽

Redi Rahmani ◽

Nathaniel Ellens ◽

Sajal Medha K. Akkipeddi ◽

...

Keyword(s):

Systematic Review ◽

Publication Bias ◽

Meta Analysis ◽

Cerebral Aneurysms ◽

Final Analysis ◽

Treatment Modalities ◽

Cochrane Library ◽

Recurrence Rates ◽

Total Occlusion ◽

Statistical Heterogeneity

OBJECTIVE Microsurgery for cerebral aneurysms is called definitive, yet some patients undergo a craniotomy that results in noncurative treatment. Furthermore, the overall rate of noncurative microsurgery for cerebral aneurysms is unclear. The objective of this study was to complete a systematic review and meta-analysis to quantify three scenarios of noncurative treatment: aneurysm wrapping, postclipping remnants, and late regrowth of completely obliterated aneurysms. METHODS A PRISMA-guided systematic literature review of the MEDLINE and Cochrane Library databases and meta-analysis was completed. Studies were included that detailed rates of aneurysm wrapping, residua confirmed with imaging, and regrowth after confirmed total occlusion. Pooled rates were subsequently calculated using a random-effects model. An assessment of statistical heterogeneity and publication bias among the included studies was also completed for each analysis, with resultant I2 values and p values determined with Egger’s test. RESULTS Sixty-four studies met the inclusion criteria for final analysis. In 41 studies, 573/15,715 aneurysms were wrapped, for a rate of 3.5% (95% CI 2.7%–4.2%, I2 = 88%). In 43 studies, 906/13,902 aneurysms had residual neck or dome filling, for a rate of 6.4% (95% CI 5.2%–7.6%, I2 = 93%). In 15 studies, 71/2568 originally fully occluded aneurysms showed regrowth, for a rate of 2.1% (95% CI 1.2%–3.1%, I2 = 58%). Together, there was a total rate of noncurative surgery of 12.0% (95% CI 11.5%–12.5%). Egger’s test suggested no significant publication bias among the studies. Meta-regression analysis revealed that the reported rate of aneurysm wrapping has significantly declined over time, whereas the rates of aneurysm residua and recurrence have not significantly changed. CONCLUSIONS Open microsurgery for cerebral aneurysm results in noncurative treatment approximately 12% of the time. This metric may be used to counsel patients and as a benchmark for other treatment modalities. This investigation is limited by the high degree of heterogeneity among the included studies.

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Pipeline embolization of cerebral aneurysms in pediatric patients: combined systematic review of patient-level data and multicenter retrospective review

Journal of Neurosurgery Pediatrics ◽

10.3171/2020.10.peds20324 ◽

2021 ◽

pp. 1-9

Author(s):

Nathan A Shlobin ◽

Eytan Raz ◽

Maksim Shapiro ◽

Luke Moretti ◽

Donald R Cantrell ◽

...

Keyword(s):

Systematic Review ◽

Scale Score ◽

Retrospective Review ◽

Pediatric Patients ◽

Pediatric Population ◽

Cerebral Aneurysms ◽

Patient Level Data ◽

Patient Level ◽

Level Data

OBJECTIVE Cerebral aneurysms in the pediatric population are rare and optimal treatment strategies are not as well characterized as in adults. The Pipeline embolization device (PED) is an endoluminal flow diverter that is commonly used to treat aneurysms in adults, but experience with this device in children is limited. The authors sought to further characterize PED use and outcomes in this specific population by performing both a systematic review of patient-level data from studies reporting the use of the PED to treat pediatric aneurysms and a retrospective review of their experience. METHODS A systematic review of the PubMed, Embase, and Scopus databases was performed to identify studies reporting the use of the PED in pediatric patients (age ≤ 18 years). Disaggregated data regarding demographics, aneurysm characteristics, treatment, and outcomes were collected. Retrospective data from the authors’ two institutions were also included. RESULTS Thirty studies comprising patient-level data on 43 pediatric patients with 47 aneurysms were identified. An additional 9 patients with 9 aneurysms were included from the authors' institutions for a total of 52 patients with 56 aneurysms. The mean patient age was 11.1 years. Presentations included aneurysm rupture (17.3%) and symptomatic mass effect (23.1%). Aneurysms were located in the anterior circulation in 55.4% of cases, and 73.2% were described as nonsaccular. Imaging follow-up was available for 89.3% with a mean follow-up of 13.3 months. Aneurysm occlusion was reported in 75%, with 1 case each (1.8%) demonstrating significant in-stent stenosis and parent vessel occlusion. Clinical follow-up was reported in 90.4% with a mean follow-up of 14.7 months. Good functional outcomes (modified Rankin Scale score of 0–1 or Glasgow Outcome Scale score of 5) were reported in 65.4% of the total population. Two major complications were reported, including 1 death. CONCLUSIONS Despite substantial differences in aneurysm location and type between published pediatric and adult patient populations treated with the PED, the use of the PED in the pediatric population appears to be safe. While the short-term effectiveness is also similar to that of adults, additional studies are needed to further characterize the long-term outcomes and better define the use of this device in pediatric patients.

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Management strategies for pediatric patients with tectal gliomas: a systematic review

Neurosurgical Review ◽

10.1007/s10143-021-01653-8 ◽

2021 ◽

Author(s):

Megan M. J. Bauman ◽

Archis R. Bhandarkar ◽

Clark R. Zheng ◽

Cecile Riviere-cazaux ◽

Cynthia J. Beeler ◽

...

Keyword(s):

Systematic Review ◽

Pediatric Population ◽

Obstructive Hydrocephalus ◽

Management Strategies ◽

Treatment Strategies ◽

Treatment Modalities ◽

Management Options ◽

Csf Diversion ◽

Aggressive Tumors ◽

Level I

AbstractPediatric tectal gliomas generally have a benign clinical course with the majority of these observed radiologically. However, patients often need treatment for obstructive hydrocephalus and occasionally require cytotoxic therapy. Given the lack of level I data, there is a need to further characterize management strategies for these rare tumors. We have therefore performed the first systematic review comparing various management strategies. The literature was systematically searched from January 1, 2000, to July 30, 2020, to identify studies reporting treatment strategies for pediatric tectal gliomas. The systematic review included 355 patients from 14 studies. Abnormal ocular findings—including gaze palsies, papilledema, diplopia, and visual field changes—were a common presentation with between 13.6 and 88.9% of patients experiencing such findings. CSF diversion was the most performed procedure, occurring in 317 patients (89.3%). In individual studies, use of CSF diversion ranged from 73.1 to 100.0%. For management options, 232 patients were radiologically monitored (65.4%), 69 received resection (19.4%), 30 received radiotherapy (8.4%), and 19 received chemotherapy (5.4%). When examining frequencies within individual studies, chemotherapy ranged from 2.5 to 29.6% and radiotherapy ranged from 2.5 to 28.6%. Resection was the most variable treatment option between individual studies, ranging from 2.3 to 100.0%. Most tectal gliomas in the pediatric population can be observed through radiographic surveillance and CSF diversion. Other forms of management (i.e., chemotherapy and radiotherapy) are warranted for more aggressive tumors demonstrating radiological progression. Surgical resection should be reserved for large tumors and/or those that are refractory to other treatment modalities.

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