The interhemispheric approach in children: our experience and review of the literature
The interhemispheric approach in children: our experience and review of the literature
复制标题
儿童大脑半球间入路：我们的经验和文献回顾
DOI：
10.1007/s00381-018-04039-2
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
J. Roth
中科院分区：
文献类型：
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作者：
J. Soleman;R. Ber;S. Constantini;J. Roth
纵裂入路（IA）已被广泛描述用于治疗位于侧脑室或第三脑室、松果体区和室周位置的病变。虽然这些解剖位置是许多儿科病理学的目标，但很少有系列分析儿童IA的发病率和结局。本研究的目的是描述我们的经验，使用IA在儿童中，强调的方法相关的morbidity.MethodsTwenty-six例患者进行了28个程序之间使用IA的2012年和2016年。对这些患者的数据进行了回顾性分析。手术和方法相关的发病率进行了收集和analysed.ResultsThe平均年龄的队列是10.1 ± 4.2岁，包括15名女性（57.7%）。在8例手术（28.6%; 7例为前IA，1例为后IA）后发生了入路相关的发病率，包括2例假性脑膜膨出（7.1%），3例持续性硬膜下积液（10.7%），其中2例局部引流，1例需要硬膜-腹膜分流，1例硬膜外出血（3.6%）自发消退，2例感染（3.6%）接受抗生素治疗。所有患者均未发生脑脊液漏、辅助运动区综合征、癫痫发作和硬膜下血肿。方法相关的并发症没有导致永久性发病率或mortals.ConclusionThe IA的病变和周围的脑室系统是可行的，并与一个低的永久性并发症发生率。在选择这种方法时，应考虑发病率，尽管很少是永久性的。
ObjectiveThe interhemispheric approach (IA) has been extensively described for treating pathologies located at the lateral or third ventricle, pineal region, and periventricular locations. While these anatomical locations are the target of many pediatric pathologies, very few series have analyzed the morbidity and outcome of the IA in children. The aim of this study is to describe our experience using the IA in children, emphasizing the approach-related morbidity.MethodsTwenty-six patients underwent 28 procedures using the IA between the years 2012 and 2016. Data for these patients was retrospectively analyzed. Surgical and approach-related morbidity were collected and analyzed.ResultsThe mean age of the cohort was 10.1 ± 4.2 years and included 15 females (57.7%). Approach-related morbidity occurred following eight surgeries (28.6%; seven with anterior IA and one with posterior IA), including two pseudomeningoceles (7.1%), three persistent subdural effusions (10.7%), of which two were locally drained and one required subduro-peritoneal shunting, one epidural bleed (3.6%) which resolved spontaneously, and two infections (3.6%) treated with antibiotics. Cerebrospinal fluid leaks, supplementary motor area syndrome, seizures, and subdural hematomas did not occur in any of the patients. None of the approach-related complications led to permanent morbidity or to mortality.ConclusionThe IA for lesions in and around the ventricular system is feasible and associated with a low permanent complication rate. When choosing this approach, the morbidity, although rarely permanent, should be considered.