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  • Journal of Neurosurgery: Pediatrics x
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Hector E. James and John S. Bradley

C erebrospinal fluid shunts are commonly placed to treat hydrocephalus and other conditions, and the most frequent complications are malfunction and infection. The incidence of shunt infection reported in the literature is 1.5–41%, 44 and multiple treatment modalities are currently in use. 1 , 9 , 20 , 36 , 43 , 44 Most authors agree that antibiotic therapy should be administered intravenously to obtain high concentrations of the same in the CSF, but there is very limited consensus as to the duration of therapy, the need for and manner of administration

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Mandeep S. Tamber, Paul Klimo Jr., Catherine A. Mazzola and Ann Marie Flannery

C erebrospinal fluid shunt infection is one of the most common and serious complications of CSF shunt therapy. Infection admissions number approximately 2300 per year in the United States and, in aggregate, account for more than 50,000 hospital days. 29 Total hospital charges related to the management of CSF shunt infection were nearly $250 million in 2003 adjusted dollars. 29 Within 24 months after insertion, infections complicate approximately 11% of initial CSF shunt placements. 28 Despite the high incidence of this complication, the optimal

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Mark M. Souweidane, Justin F. Fraser, Lisa M. Arkin, Dolan Sondhi, Neil R. Hackett, Stephen M. Kaminsky, Linda Heier, Barry E. Kosofsky, Stefan Worgall, Ronald G. Crystal and Michael G. Kaplitt

G ene therapy has long held the great potential to provide novel treatment options for neurological diseases. While the initial promise of this general field was tempered by slow progress, in recent years there has been a resurgence in the enthusiasm for gene therapy. This revival has been led by several new human clinical trials for a variety of neurodegenerative disorders including Parkinson, Alzheimer, and Canavan disease. 2 , 5 , 9 , 14 , 15 , 28 One of the unique limitations of CNS gene therapy is the blood-brain barrier, which prevents current

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Atilio E. Palma, Robert T. Wicks, Gautam Popli and Daniel E. Couture

invasive procedures performed using endoscopy or stereotactic radiation have been described. 8 , 17 Conceived in the 1980s, MR-guided laser interstitial thermal therapy (MRg-LITT), a common treatment for ablation of small (< 3 cm) tumors, has experienced increasing popularity for the treatment of focal epileptogenic lesions. 21 The advent of MRI thermography during the 1990s made MRg-LITT a conventional and useful treatment modality for a variety of pathologies. During the procedure, a lesion is localized using neuroimaging and neuronavigation techniques, and a

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James Tait Goodrich

I read with interest this follow-up study by Dr. Jimenez and Dr. Barone on their surgical treatment of coronal synostosis. 1 The study reviews a 16-year experience with 115 patients who were surgically treated with an endoscopy-assisted craniectomy supplemented with postoperative cranial orthosis therapy (helmet-assisted recontouring of the skull deformity). I have been familiar with this work since its beginning and have participated in a number of panel discussions with Dr. Jimenez at national and international meetings over the years. As a result I am

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Erin C. Peterson, Kamlesh B. Patel, Gary B. Skolnick, Kristin D. Pfeifauf, Katelyn N. Davidson, Matthew D. Smyth and Sybill D. Naidoo

plagiocephaly and/or brachycephaly (DPB) involves active repositioning or orthotic helmeting. 7 , 12 , 16 , 22 Recent systematic analyses found helmeting often reduces cranial asymmetry faster than positioning. 25 , 32 , 34 Positioning therapy involves laying the child down in a way that avoids pressure on the flattened area and additional supervised time on their stomach. 24 , 25 Helmeting is started between 4 and 6 months of age, is worn for 22–23 hours per day for a duration of 3–6 months, and is used for moderate to severe deformations. 12 , 13 , 23 Known risks of

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Zhiwei Tang, Xiang'en Shi, K. I. Singh Khatri Chhetri and Xueling Qi

T he association between GH replacement and occurrence of malignancy has long been debated. The 2007 consensus guidelines from GH Research Society concluded that there is no evidence that GH replacement increases the risk of tumor recurrence or de novo malignancy, 11 but some reports suggest that GH replacement therapy requires ongoing surveillance to determine the therapy's long-term safety. 3 , 6 Primary intracranial germ cell tumors are typically lesions in children and adolescents and are classified into the following histological types: germinoma

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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

potential surgical management has been suggested for patients with ASD. For patients with ASD and epilepsy, early diagnosis and intervention with physical therapy, occupational therapy, and speech therapy remain the mainstay of treatment and intervention. For patients within the more severe realm of ASD with epilepsy, additional therapies include medical management. The impact of VNS on the control of seizures in patients with medically refractory epilepsy has been well documented in adults 2 , 3 , 9 , 22 , 23 as well as in children. 4 , 10 , 11 The consideration of

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Garrett K. Zoeller, Carole D. Brathwaite and David I. Sandberg

. Depending on the age of the patient and the clinical and radiographic findings, chemotherapy, radiation therapy, or observation may be considered postoperatively. 9 In general, patients with OPGs who have NF1 tend to have tumors with a more benign course than those without NF1, so particular effort is made to avoid radiation therapy in this population. Moreover, patients with NF1 and suprasellar lesions typical of OPGs do not necessarily need a biopsy specimen to prove the diagnosis, and surgery is offered only to relieve mass effect. Whereas radiographic progression

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Nicole Prendergast, Philipp R. Aldana, Ronny L. Rotondo, Lournaris Torres-Santiago and Alexandra D. Beier

rare in the pediatric population, with the majority of tumors being functional adenomas. 9 , 11 Here, we describe a child with SCA. To our knowledge, SCA in the pediatric population has not been described in the literature, nor has the use of proton therapy for SCA been described. Case Report History and Examination An otherwise healthy and developmentally normal 13-year-old boy with a 1-year history of headaches presented to his primary care physician with severe headache, nausea, and vomiting. Persistence of this headache prompted a CT scan, which revealed a large