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1.
Minerva Pediatr ; 41(8): 393-404, 1989 Aug.
Artículo en Italiano | MEDLINE | ID: mdl-2601658

RESUMEN

One hundred-sixty-one cases of children operated on for craniostenosis in the first year of life at the Neurosurgical Department of the Catholic University of Rome in the period 1982-1986 are presented. The average age at diagnosis was 6 months and at operation 7.4 months. The patients considered in the present study were subdivided into two groups according to the prevalent involvement of sagittal suture or of the anterior sutural group (coronal metopic, spheno-frontal and spheno-palatine sutures). In fact, these two groups differ considerably not only in the characteristics of the pathological process of early fusion of the cranial sutures, but also in the technique required for surgical correction. Four children with premature fusion of all cranial sutures are considered separately. Congenital malformations of the bone structures or changes in ocular motility were presented in 7.9% of 63 patients with sagittal craniostenosis and in 14.7% of the group with premature fusion of the anterior cranial sutures. Surgical correction (linear craniectomies extended to the cranial base for the group with sagittal craniostenosis, craniectomies with advancement of the supraorbital margin and rotation of the bone operculum for the group with anterior craniostenosis) proved satisfactory in the great majority of cases. Postoperative morbidity was particularly low. Apart from postsurgical anaemia which required blood transfusion on the third day in 15.5% of operated patients, the only complications were transitory hyperpyretic states observed in 6.2% of cases. Only one child died for reasons related to the surgical procedure. The low postoperative mortality (0.6% of cases) and the low percentage of bone pathology recurrence (7.4%) compared with the results of other series involving older children, seem to indicate that the early surgical correction of bone malformations does not bear additional risk for the patient, permitting at the same time normal functional development of the brain and a more gradual morphological remodelling of the skull.


Asunto(s)
Disostosis Craneofacial/cirugía , Craneosinostosis/cirugía , Craneosinostosis/diagnóstico por imagen , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Radiografía , Recurrencia
2.
Childs Brain ; 11(6): 353-68, 1984.
Artículo en Inglés | MEDLINE | ID: mdl-6510044

RESUMEN

Out of 90 children, examined because of growth failure, 15 have been treated surgically. The diagnoses were intrasellar arachnoid diverticulum or empty sella (5 cases), enlarged chiasmatic cisterns (5 cases), chronic 'occult' hydrocephalus (5 cases). Surgery was followed by an immediate increase in growth rate in almost all the cases, even if the result was persistent only in some subjects. In percentage, better results were obtained in patients with enlarged chiasmatic cisterns and chronic occult hydrocephalus than in patients with arachnoid diverticulum or empty sella. The evaluation of prolactin serum levels was demonstrated to be useful both in preoperative diagnosis and postoperative control.


Asunto(s)
Aracnoides , Quistes/complicaciones , Síndrome de Silla Turca Vacía/cirugía , Trastornos del Crecimiento/etiología , Hidrocefalia/complicaciones , Adolescente , Encefalopatías/complicaciones , Encefalopatías/cirugía , Niño , Preescolar , Quistes/cirugía , Femenino , Humanos , Hidrocefalia/cirugía , Lactante , Masculino , Quiasma Óptico
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