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Soliman Oushy, Jonathon J. Parker, Kristen Campbell, Claire Palmer, Corbett Wilkinson, Nicholas V. Stence, Michael H. Handler, and David M. Mirsky

adjusted for hydrocephalus etiology (with the combined categories of CM-II, aqueductal stenosis, and all others), shunt setting, and corrected age. All hypothesis tests were 2-sided with significance set at 0.05. R (The R Foundation) version 3.3.1 software was used for statistical analysis. Results Study Population A total of 158 neonates underwent CSF diversion procedures between 1998 and 2015; 37 neonates were excluded based on defined study criteria. A total of 121 patients met the inclusion criteria, and 11 of these patients (9.1%) were diagnosed with MIPH. A

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David L. Kelly Jr., Jack Kushner, and William T. McLean

I ntracranial choriocarcinomas have been reported infrequently in children, but to our knowledge no case has been recorded in which the predominant lesion has been found in the brain of a newborn child. This malignant neoplasm may be derived from germinal epithelium of the testis or ovary 10, 17, 20 or from a normal placenta. However, it most often originates in the chorionic trophoblastic tissue of a hydatidiform mole. 19 Neonatal choriocarcinoma has been reported as a complication of maternal choriocarcinoma. 29 Intracranial choriocarcinoma is thought to

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Nikolas Papadakis, Jose Millan, Donald F. Grady, and Ludwig H. Segerberg

O ne of the most common intracranial tumors of childhood and adolescence is the medulloblastoma. There are few reports of the appearance of this tumor in early infancy and the neonatal period. Matson 6 reported 27 patients under 2 years of age with a diagnosis of medulloblastoma, but the youngest mentioned was 3 months old. King, 4 in a review of the literature in 1953, found only three cases where symptoms were found in the newborn and tumor suspected prior to death. He reports an additional case of a 3-month-old infant found at postmortem to have a

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Neurosurgical Forum: Letters to the Editor To The Editor Harry Kourtopoulos , M.D., Ph.D. University Hospital of Umeå Umeå, Sweden 472 473 Aneurysmal subarachnoid hemorrhage in a neonate is exceedingly uncommon. The authors report the case of a neonate with a large anterior communicating artery aneurysm, accessory left middle cerebral artery aneurysm, and left internal carotid artery (ICA) fusiform aneurysm. The neonate suffered from occlusion of the left ICA and aneurysm rupture. The large aneurysm was treated

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James P. McAllister II, Arcangela S. Wood, Martha J. Johnson, Robert W. Connelly, David J. Skarupa, Michelle Secic, Mark G. Luciano, Neil G. Harris, and Hazel C. Jones

Although neonatal hydrocephalus often results in residual neurological impairments, little is known about the cellular mechanisms responsible for these deficits. The immediate early gene, fos (c-fos), functions as a “third messenger” to regulate protein synthesis and is a good marker for neuronal activation. To identify functional changes in neurons at the cellular level, the authors quantified fos RNA expression and localized fos protein in the H-Tx rat model of congenital hydrocephalus. Tissue samples from sensorimotor and auditory regions were obtained from hydrocephalic rats and age-matched, normal litter mates at 1, 6, 12, and 21 days of age (four-six animals in each group) and processed for immunohistochemical analysis of fos and Northern blot analysis of RNA. At 12 days of age, hydrocephalic animals exhibited significant decreases in the ratio of fos immunoreactive cells to Nissl-stained neurons from both cortical regions, but no statistical differences were noted in fos expression. At 21 days of age, both the ratio of fos immunoreactive cells to Nissl-stained neurons and fos expression decreased significantly. The number of fos-positive neurons decreased in all cortical layers but was most prominent in layers V through VI. This decrease did not appear to be caused by neuronal death because examination of Nissl-stained sections revealed many viable neurons within the areas where fos immunoreactivity was absent. These results suggest that progressive neonatal hydrocephalus reduces the capacity for neuronal activation in the cerebral cortex, primarily in those neurons that provide corticofugal projections, and that this impairment may begin during relatively early stages of ventriculomegaly.

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Erik B. Vanstrum, Matthew T. Borzage, Jason K. Chu, Shuo Wang, Nolan Rea, J. Gordon McComb, Mark D. Krieger, and Peter A. Chiarelli

T he ductus arteriosus facilitates blood flow from the pulmonary artery (PA) to the aorta during gestation. This vascular pathway typically closes within hours after birth, but can remain patent, especially in infants of decreased gestational age. 1 , 2 An estimated 20% of premature neonates are born with a patent ductus arteriosus (PDA). 3–5 A hemodynamically significant PDA (hsPDA) can be associated with harmful alterations in vascular flow, volume, and pressure that are experienced by the brain. 6 Although there is not a consensus on defining a threshold

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Brain abscesses in neonates

A study of 30 cases

Dominique Renier, Cécile Flandin, Elizabeth Hirsch, and Jean-François Hirsch

The reported incidence of neurological sequelae varies, with up to 66% of the survivors affected. 3, 6, 29 Some publications dealing with the pathology of neonatal meningitis have emphasized the high incidence of severe widespread damage to cerebral tissue. 4, 8, 13, 33 However, instances of brain abscesses in the newborn infant have been published only as case reports or very short series. 7, 9, 10, 15, 18, 21, 26, 27, 30, 32, 35 The purpose of this paper is to describe the clinical, radiological, bacteriological, and therapeutic features of brain abscesses in

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Enrique C. G. Ventureyra and Stephanie Herder

was admitted to the Children's Hospital of Eastern Ontario in November, 1982, with a history of progressive macrocephaly since birth. The infant was the product of a full-term first pregnancy without complications in a 28-year-old woman. The child was born via a forceps-assisted vaginal delivery. The Apgar score at birth was 10, and there were no neonatal problems apart from mild jaundice which did not require treatment. The occipitofrontal head circumference was 37.5 cm at birth and increased rapidly, prompting neurosurgical consultation. Examination . On

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Neonatal intracranial hemorrhage

A clinical and serial computerized tomographic study

Richard Leblanc and Augustin M. O'Gorman

I ntracranial hemorrhage in the neonatal period is a well recognized and frequent occurrence. Three patterns are generally described: subarachnoid hemorrhage, intracerebral and intraventricular hemorrhage, and subdural hemorrhage. 21, 22 Subarachnoid hemorrhage (SAH) is commonly seen with prematurity and neonatal asphyxia. Bleeding is usually venous, and the prognosis is generally good. 21, 22 Intracerebral and intraventricular hemorrhage, also associated with prematurity, especially when bleeding arises from the germinal matrix, may now represent the most

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Glen S. Merry and Gordon Stuart

C ranial extradural hematoma in the neonate is rare. Most reported cases follow birth trauma and almost invariably have been associated with a skull fracture. We are reporting a case of extradural neonatal hematoma unrelated to skull fracture. Case Report This baby boy was born on May 5, 1978, by spontaneous normal vaginal delivery following an uncomplicated pregnancy. Birth weight was normal. The head circumference was 36.0 cm. There was slight widening of the cranial sutures, but with a soft anterior fontanel. No other abnormality was present