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  • Journal of Neurosurgery: Pediatrics x
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Malgosia A. Kokoszka, Patricia E. McGoldrick, Maite La Vega-Talbott, Hillary Raynes, Christina A. Palmese, Steven M. Wolf, Cynthia L. Harden and Saadi Ghatan

notes, pathology findings, and neurology and neurosurgery follow-up notes. Patients with the following diagnoses: autism; Asperger syndrome; Rett syndrome with autistic features; and pervasive developmental disorder, not otherwise specified (PDD-NOS) were included, regardless of etiology. These patients are collectively referred to throughout this report as those with autism spectrum disorder (ASD), based on recent changes in the Diagnostic and Statistical Manual, 5th Edition (DSM-5) guidelines for autism diagnosis. 1 , 2 Study Participants Fifty

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Michael L. Levy, Karen M. Levy, Dayna Hoff, Arun Paul Amar, Min S. Park, Jordan M. Conklin, Lissa Baird and Michael L. J. Apuzzo

A utism spectrum disorders are characterized by social symptoms that may include a lack of interaction with other persons, avoidance of eye contact, delayed ability in understanding the thoughts or emotions of others, and problems with emotional control. Persons with autism usually have difficulty with communication and may exhibit repetitive behaviors. In addition, mental retardation and seizures are sometimes noted in persons with ASD. 19 An estimated 5–38% of children with autism also have epilepsy. 15 The same brain dysfunction associated with autism

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Rolf W. Gruber and Bernd Roehrig

C erebral spinal fluid overdrainage induced by hydrostatic suction in the vertical shunt system during mobilization of a patient is regarded as a major cause of shunt dysfunction in pediatric hydrocephalus shunt therapy. 4 , 8 , 9 , 16–19 , 27 , 29 , 40 , 52 In 1973 the ASD (Integra NeuroSciences) was invented to inhibit hydrostatic suction and prevent overdrainage. 17 , 18 , 40 Although hydrostatic suction as the major cause of the SVS is disputed, neurosurgical interests unfortunately seem more occupied with the treatment of SVS complications than with

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Kai Arnell, Lars-Owe D. Koskinen, Jan Malm and Anders Eklund

C erebrospinal fluid shunt implantation is the standard therapy for hydrocephalus in children and adults. The modern CSF shunt is a complex construction, often including an ASD and the possibility of adapting the opening pressure postoperatively. Hence, knowledge of the basic hydrodynamics of the CSF shunt is required for implantation and accurate handling of complications and revision surgeries. To obtain clearance to sell their shunts, manufacturers must show that the medical device is in accordance with US Food and Drug Administration and European Union

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Mayur Jayarao, Kristin Sohl and Tomoko Tanaka

I n 1891, Hans Chiari documented 3 cases of congenital defects of the rhombencephalon, classified as types I, II, and III. 5 A Chiari I malformation, or Chiari malformation Type I (CM-I), is the mildest form and is associated with ectopia of the cerebellar tonsils through the foramen magnum, which can occur to various degrees. Diagnosis of CM-I is currently best made on cranial midsagittal MRI studies, with cerebellar tonsil herniation of at least 3 mm suggesting the condition. 2 Autism spectrum disorder (ASD) is a neurodevelopmental condition

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Editorial

Antisiphon device

Harold L. Rekate

a markedly thickened skull and generally has ventricles that are smaller than normal. Gruber and Roehrig 3 report on a very long follow-up study of patients treated with the Integra Neurosciences antisiphon device (ASD) in 2 groups of patients. In 1 group all patients who required a revision underwent placement of an ASD as part of the shunt. In a second group all newborns and premature newborns treated for hydrocephalus received a shunt system containing a differential pressure valve and an ASD as the first shunt. The follow-up of these patients averaged 10

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Giuseppe Cinalli, Daniel T. Aguirre, Giuseppe Mirone, Claudio Ruggiero, Daniele Cascone, Lucia Quaglietta, Ferdinando Aliberti, Serena de’ Santi, Maria Consiglio Buonocore, Anna Nastro and Pietro Spennato

yrs, GTR) ANED  2 15 Diffuse astro No GTR Yes No 16 No ANED  3 13 Pilocytic astro Chemo, RT STR No No 108 Yes (8 yrs, GTR) ANED  4 13 Pilocytic astro Biopsy + chemo + RT STR Yes No 12 No ANED  5 12 DNT No GTR No No 4 No ANED  6 12 Ganglioglioma No STR No No 12 No ASD Thalamopeduncular tumors  7 17 Ganglioglioma PR + chemo + RT STR No Chemo 30 No ASD  8 5 Ganglioglioma No PR No No 88 Yes (6 yrs, progression to HGG, PR) DOD  9 3 Pilocytic astro No GTR Yes Chemo 36 No ANED  10 ‡ 4 Pilocytic astro No PR No Chemo 41 No ASD  11 § 12 Pilocytic astro PR GTR No RT 27 Yes LTF

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Daniel Nilsson, Johanna Svensson, Betül A. Korkmaz, Helena Nelvig and Magnus Tisell

later in life is unknown. With more balanced drainage of the ventricles and more normal growth of the skull this may have been avoided. Data on the incidence of shunt-induced craniosynostosis necessitating surgery are scarce, but the incidence of slit ventricle syndrome has been reported to range from 0.9% to as high as 37%. 2 , 3 , 11 , 13–16 However, the studies with the highest incidences of slit ventricle syndrome (24% and 37%) were both carried out primarily before antisiphon devices (ASDs) and adjustable shunts were available (1966–1984). 2 , 14 In contrast

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Bing Zhou, Xiao-Chuan Wang, Jun-Yi Xiang, Ming-Zhao Zhang, Bo Li, Hai-Bo Jiang and Xiao-Dong Lu

recanalization rate of 100%. The specific data are shown in Table 1 . TABLE 1. Clinical information and thrombectomy results Case No. Age (yrs), Sex Etiology Embolic Site No. of Thrombs Combined Technique mTICI Grade Complications 1 11, M None BA 2 None 3 None 2 7, M Heart surgery Rt ICA 2 None 2b Embolus displacement 3 13, F None Rt MCA 1 Balloon dilation 3 None 4 14, M ASD Lt MCA 2 None 2b None 5 12, M Strenuous exercise Rt ICA 2 Balloon dilation 3 None 6 8, M None BA 1 None 3 None 7 13, F Strenuous exercise Rt ACA 3 None 3 SAH ASD = atrial septal defect; BA = basilar

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Brent R. O'Neill, Alexander K. Yu and Elizabeth C. Tyler-Kabara

segments 12 yes S-2 conus, lipomyelomeningocele lipoma, suggestion of tether extra vertebral segments, anal atresia, absent kidney, hypospadias, absent radius 13 yes L3–4 conus (of 6), filum lipoma thick filum fused vertebral segments, ASD, TEF, hemibladder/phallus/scrotum 14 no L5–S1 conus, thick filum not performed TEF, fused kidneys, hydronephrosis 15 no L3–4 conus, filum lipoma L3–4 conus, filum lipoma anal atresia 16 no L-4 conus, filum lipoma L-4 conus anal atresia, ectopic kidney, hydronephrosis 17