Journal of Neurosurgery Pediatrics

OBJECTIVE Cerebral cavernous malformations (CCMs) are low-flow vascular malformations commonly found in the central nervous system with the potential to cause neurological deficits, seizures, and headache through bleeding and growth. CCMs are typically assessed with imaging such as MRI or CT. However, there is a clinical need to reduce the cost, risk (with sedation/anesthesia in children), and tr…

OBJECTIVE Pediatric intracranial abscesses are rare, life-threatening infections requiring prompt surgery and coordinated subspecialty care. Reports during COVID-19 described nationwide surges, but national operative trends and equity data remain sparse. Therefore, this study aimed to define decade-long trends in surgical management, outcomes, and racial disparities in children in the US who unde…

OBJECTIVE While studies have investigated normative ranges of anterior fontanelle (AF) closure and surface area (SA), they have focused on full-term children born without significant comorbidities that may impact the AF SA. Understanding the trends of AF SA and closure in patients with common pediatric conditions can help inform guidelines for screening the size of the AF and determining when to …

OBJECTIVE The aim of this study was to evaluate whether MRI-based anatomical factors, including fat lateralization and spinal cord rotation, are associated with postoperative retethering in pediatric spinal lipoma. METHODS This retrospective cohort study included pediatric patients (< 18 years old) who underwent spinal lipoma resection at King Chulalongkorn Memorial Hospital between 1999 and 2024…

OBJECTIVE The objective was to quantify risks of hydrocephalus, cerebrospinal fluid (CSF) shunt placement, and shunt malfunction in children < 3 years of age with congenital heart defect (CHD) versus matched controls. METHODS This was a multicenter retrospective cohort study conducted using TriNetX. Children < 3 years with CHD were propensity score matched 1:1 to controls on the basis of demograp…

OBJECTIVE Sinogenic intracranial abscess is a severe complication of sinusitis. Timely identification of patients requiring neurosurgical intervention can be challenging. This study aimed to evaluate preoperative clinical and radiographic variables to identify features that correlate with neurosurgical intervention and outcomes in pediatric patients with sinogenic intracranial infection. METHODS …

OBJECTIVE Emerging traumatic brain injury (TBI) guidelines increasingly recognize the role of blood-based biomarkers in improving diagnostic and triage accuracy, yet their integration into pediatric care remains limited and underexplored. This study examined the performance of a blood-based biomarker panel in predicting which pediatric patients with TBI received neurosurgical intervention (NSI). …

OBJECTIVE MRI is a cornerstone of pediatric spinal evaluation but frequently requires sedation or general anesthesia in young children due to prolonged scan times. This use of anesthesia introduces periprocedural risks and logistical barriers that can delay care and increase burden for families. Fast-spine MRI (fsMRI) protocols offer a motion-tolerant, abbreviated alternative that may allow nonse…

OBJECTIVE Recurrence after angiographically confirmed microsurgical obliteration of brain arteriovenous malformations (bAVMs) is considered rare but occurs more frequently in children than in adults. Reported recurrence rates vary widely. The authors aimed to determine recurrence rates at a high-volume pediatric referral center and identify clinical and radiographic predictors of recurrence. METH…

OBJECTIVE: In the US, deep brain stimulation (DBS) is accessible to pediatric patients with dystonia who are 7 years of age and older through an FDA Humanitarian Device Exemption (HDE). The aim of this study was to assess the safety, feasibility, and outcomes of DBS for dystonia in children younger than 7 years of age who are excluded from the FDA HDE. METHODS: Data were collected (February 2015-…

OBJECTIVE: The aim of this study was to evaluate the prognostic value of intraoperative EEG during corpus callosotomy (CC) in pediatric patients with drug-resistant epilepsy (DRE), with a particular focus on bisynchronization blockade and its correlation with long-term seizure outcomes. METHODS: A retrospective review was performed of pediatric patients with DRE and injurious drop attacks who und…

OBJECTIVE: Although myelomeningocele (MMC) remains a leading cause of infant disability and death in many low- and middle-income countries, data regarding access to timely neurosurgical care remain limited. The goal of this study was to characterize sociodemographic and clinical factors associated with delayed presentation for neurosurgical repair of MMC in Zambian infants. METHODS: Infants with …

OBJECTIVE Moyamoya disease (MMD) is a progressive arteriopathy of intracranial internal carotid arteries. The authors identified a characteristic angiographic finding associated with arterio-arterial collaterals in which ischemic brain recruits blood supply from the posterior circulation with robust splenial-to–anterior pericallosal artery anastomoses, manifesting as a characteristic "mustache" a…

OBJECTIVE The role of bracing in stable pediatric thoracolumbar compression fractures remains uncertain, with limited pediatric-specific evidence to guide practice. Therefore, the aim of this study was to determine the impact of prescribed bracing on symptom recovery, return to activity (RTA), radiographic remodeling, and reinjury in children and adolescents with this common injury. METHODS The a…

OBJECTIVE Posthemorrhagic hydrocephalus (PHH) is a significant complication of intraventricular hemorrhage (IVH) in preterm neonates. Neuroendoscopic lavage (NEL) is a treatment option. The authors aimed to evaluate the effectiveness and safety of NEL alone for early treatment of PHH in neonates. METHODS This systematic review and meta-analysis were conducted according to Cochrane Collaboration g…

OBJECTIVE Craniofacial distraction osteogenesis (DO) is an established technique for the management of complex craniosynostosis but remains limited by the morbidity associated with external activation ports, including infection, wound breakdown, CSF leakage, and mechanical failure. The magnet-actuated craniofacial (MAC) distraction system was developed to eliminate externalized activation compone…

OBJECTIVE Children with generalized or multifocal drug-resistant epilepsy (DRE) without a clearly localizable and safely resectable seizure focus present a significant clinical challenge, as traditional resective interventions are often not viable. Emerging evidence supports the use of neuromodulation—particularly deep brain stimulation (DBS) and responsive neurostimulation (RNS)—for generalized …

OBJECTIVE It is unclear whether shunt survival differs for infants in whom prior endoscopic third ventriculostomy with choroid plexus cauterization (ETV/CPC) failed compared with those treated initially by shunt placement. Results among four previous studies spanning a range of age groups have suggested either no effect or a protective effect of prior endoscopic treatment on shunt survival. The a…

OBJECTIVE Early referral of patients with suspected sagittal suture synostosis is important as it enables minimally invasive surgery. To encourage early referrals, the authors’ craniofacial center has increased its efforts to educate referring healthcare providers. This study evaluated the developments of timely referral and age at referral of patients with sagittal suture synostosis. METHODS Non…

OBJECTIVE Previous research has identified an association of socioeconomic status with poor health outcomes related to the treatment of pediatric hydrocephalus. However, the impact of environmental exposures and neighborhood disadvantage remains unexplored. The authors sought to determine how these factors affect hydrocephalus outcomes. METHODS This study is an analysis of prospectively collected…