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Sarah T. Garber, Robert J. Bollo and Jay K. Riva-Cambrin

P ilomyxoid astrocytoma (PMA) is a rare, aggressive myxoid variant of pilocytic astrocytoma. In 2007, PMA was recognized as a variant of astrocytoma and classified as WHO Grade II. 13 Typically, PMAs present in the suprasellar/hypothalamic region, although they have been reported throughout the neuraxis. These tumors represent approximately 1% of all astrocytomas, whereas 85% of pediatric astrocytomas are pilocytic (WHO Grade I) in nature. 6 Pilocytic astrocytomas tend to present in slightly older children (mean age 6 years), but PMAs are largely seen in

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Brian K. Owler, Kathryn A. Browning Carmo, Wendy Bladwell, T. Arieta Fa’asalele, Jane Roxburgh, Tina Kendrick and Andrew Berry

care for patients with acute neurosurgical conditions. The Newborn and Paediatric Emergency Transport Service (NETS) is a dedicated intensive care retrieval service, using road and rotary and fixed wing vehicles ( http://www.nets.org.au ). Over 254 hospitals in NSW/ACT call on NETS to assist children up to 16 years of age. The retrieval team normally comprises a specialist intensive care nurse and doctor. While this model works well for the majority of patients, for some patients, outcome has been compromised by the lack of timely access to specialized

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Korak Sarkar, Krista Keachie, UyenThao Nguyen, J. Paul Muizelaar, Marike Zwienenberg-Lee and Kiarash Shahlaie

, 2002 23 Ommaya AK , Goldsmith W , Thibault L : Biomechanics and neuropathology of adult and paediatric head injury . Br J Neurosurg 16 : 220 – 242 , 2002 24 Ong L , Selladurai BM , Dhillon MK , Atan M , Lye MS : The prognostic value of the Glasgow Coma Scale, hypoxia and computerised tomography in outcome prediction of pediatric head injury . Pediatr Neurosurg 24 : 285 – 291 , 1996 25 Pfenninger J , Santi A : Severe traumatic brain injury in children— are the results improving? . Swiss Med Wkly 132 : 116 – 120 , 2002

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Da Li, Shu-Yu Hao, Jie Tang, Xin-Ru Xiao, Gui-Jun Jia, Zhen Wu, Li-Wei Zhang and Jun-Ting Zhang

C erebral cavernous malformations (CMs) are occult low-pressure vascular lesions, and 9%–35% of CMs are located in the brainstem. 2 Pediatric brainstem CMs are rare and account for approximately 13.3%–14.5% of all brainstem CMs according to prior studies. 1 , 2 , 36 Due to the eloquent location of brainstem CMs, hemorrhage ictus can lead to acute deterioration of neurological function and induce severe symptoms. Although adult brainstem CMs have been widely investigated, 1 , 2 , 16 , 22 , 26 , 27 , 30 , 36 , 49 surgical treatment of pediatric brainstem

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Geoffrey Appelboom, Stephen D. Zoller, Matthew A. Piazza, Caroline Szpalski, Samuel S. Bruce, Michael M. McDowell, Kerry A. Vaughan, Brad E. Zacharia, Zachary Hickman, Anthony D'Ambrosio, Neil A. Feldstein and Richard C. E. Anderson

A n estimated 1 in 10 (5.3 million) of the 54 million Americans living with disabilities have a disability caused by TBI ( www.hhs.gov ). 49 Approximately 475,000 TBIs occur among children ages 0–14 years old every year in the US ( www.cdc.gov ), and the current leading cause of death in children more than 1 year old is TBI. Different pediatric age groups experience different causes for their injury. In infants, the most common causes are falls and physical assaults. In toddlers and young children, car accidents and falls are most common. In children and

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Charles E. Mackel, Brent C. Morel, Jesse L. Winer, Hannah G. Park, Megan Sweeney, Robert S. Heller, Leslie Rideout, Ron I. Riesenburger and Steven W. Hwang

of resources, including neurosurgical coverage, 11 , 13 with the mean cost of interfacility overtriage ranging between $9206 to $12,549 per transfer. 41 , 43 Overutilization of neurosurgical coverage may be particularly acute in the pediatric transfer population. In one study, 64% of preventable transfers in the pediatric population implicated traumatic brain injury (TBI). 15 Additional studies identified that one quarter to one half of unnecessary pediatric interfacility transfers utilized neurosurgical evaluation, 15 , 24 and a neurological consult request

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Recent advances in the neurosurgical treatment of pediatric epilepsy

JNSPG 75th Anniversary Invited Review Article

Jarod L. Roland and Matthew D. Smyth

D espite the development of several new antiepileptic drugs (AEDs) over the last 30 years, there has been little change in the overall effectiveness of the treatment of epilepsy with medication. 11 However, there have been numerous advances in the neurosurgical treatment of epilepsy that have expanded treatment options for patients and reduced morbidity via less-invasive procedures. Herein we review some of the most recent advances and trends in the neurosurgical treatment of pediatric epilepsy. Expanding the Evidence in Support of Epilepsy Surgery Before

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Jeremy Wetzel, David Bray and David Wrubel

review of the literature. Furthermore, it is the first report of a CEIVH mimicking a neoplasm in a pediatric patient in the modern era of neurosurgery. Case Report Clinical Presentation A 14-year-old, previously healthy male presented with 2 days of right-sided headache, blurred vision, nausea, and vomiting. He had a normal neurological exam. No papilledema was noted. The patient was having intermittent high fevers (> 39°C) while in the hospital prior to surgery. Full infectious workup was negative, and the significance of the fevers was unclear. There was no history

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Zarina S. Ali, Robert L. Bailey, Lawrence B. Daniels, Venus Vakhshori, Daniel J. Lewis, Alisha T. Hossain, Karlyndsay Y. Sitterley, John Y. K. Lee, Phillip B. Storm, Gregory G. Heuer and Sherman C. Stein

C raniopharyngiomas are histologically benign tumors of embryonic epithelial origin, believed to arise from ectodermally derived epithelial cell remnants of Rathke's pouch and the craniopharyngeal duct. These tumors, while rare, occur much more commonly in the pediatric population than in the adult population, with an annual incidence of 5.25 cases per million, and account for 6%–13% of intracranial pediatric tumors. 10 , 13 These tumors arise within the sellar and suprasellar regions, where they abut or directly involve critical structures, including the

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Erik J. van Lindert, Sebastian Arts, Laura M. Blok, Mark P. Hendriks, Luc Tielens, Martine van Bilsen and Hans Delye

A ccurate intra- and postoperative complication rates are indispensable in providing patients and their caregivers with the proper knowledge to submit informed consent prior to surgical procedures. Complications after pediatric neurosurgical procedures (within the first 30 days) are relatively frequent (16%–20%). 10 , 25 However, very little has been published on complications that occur during pediatric neurosurgical procedures under the shared responsibility of neurosurgeon and anesthesiologist. Accurate registration of personal and institutional