Get Pediatric Neurosurgery PDF

By David M. Frim, N. Gupta

ISBN-10: 1423766563

ISBN-13: 9781423766568

ISBN-10: 1570596433

ISBN-13: 9781570596438

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2 Infectious and Inflammatory Conditions Meningitis is the most common CNS infection affecting children. The diagnosis of meningitis is based on the analysis of CSF, obtained by lumbar puncture; the absence of inflammatory changes such as leptomeningeal enhancement on CT or MRI must not be used to exclude this diagnosis. Affected children present with fever, irritability, lethargy, headaches and nuchal rigidity; seizures, cranial neuropathies or stroke may develop. Imaging is performed mainly for the evaluation of children who are deteriorating neurologically despite apparently appropriate antibiotic therapy, in order to determine the cause of deterioration.

Anomalies of the caudal spine must be considered in patients with urogenital or anorectal malformations. Sagittal and coronal imaging of the entire spine with MRI is recommended to identify the location of the conus medullaris (normal level: T10 to L2), associated lipomas or syrinxes, anomalous segments of spinal cord, and anomalies of dorsal closure or segmentation. Transaxial T1- and T2-WI should be obtained from the conus through the bottom of the sacrum to assess for a fatty (T1 hyperintense on MRI) and/or thickened filum terminale.

Inferior herniation and “peg-like” configuration of the cerebellar tonsils. (sagittal T1-WI) Figure 40. Chiari II. Small posterior fossa with inferior herniation of the cerebellar tonsils, beaking of the tectum, towering of the vermis and hypoplasia of the falx. Small gray-matter heterotopias along the lateral margins of the ventricles. (sagittal T1-WI) Figure 41. Dandy-Walker malformation. High insertion of the torcula with hypoplasia of the cerebellar vermis. (sagittal T1-WI) Diagnostic Imaging in Children 53 Figure 42.

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Pediatric Neurosurgery by David M. Frim, N. Gupta

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