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Article ; Online: A rare occurrence of an epithelioid glioblastoma in a pediatric patient: case report and review of the literature.

Beutler, Timothy / Krishnamurthy, Satish / Tovar-Spinoza, Zulma

Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery

2021 Volume 38, Issue 5, Page(s) 1047–1050

Abstract: Epithelioid glioblastoma is a rare tumor in the pediatric population. We present a case report of a 5-year-old boy found to have a large right frontotemporal epithelioid glioblastoma. The patient was treated with maximal safe resection followed by ... ...

Abstract	Epithelioid glioblastoma is a rare tumor in the pediatric population. We present a case report of a 5-year-old boy found to have a large right frontotemporal epithelioid glioblastoma. The patient was treated with maximal safe resection followed by craniospinal radiation. He has now reached 5-year survival and does not have tumor progression. Given the rarity of epithelioid glioblastoma in the pediatric population, the literature surrounding the diagnosis and treatment options for these tumors is reviewed.
MeSH term(s)	Brain Neoplasms/diagnostic imaging ; Brain Neoplasms/surgery ; Child ; Child, Preschool ; Glioblastoma/diagnostic imaging ; Glioblastoma/surgery ; Humans ; Male
Language	English
Publishing date	2021-08-04
Publishing country	Germany
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	605988-0
ISSN	1433-0350 ; 0302-2803 ; 0256-7040
ISSN (online)	1433-0350
ISSN	0302-2803 ; 0256-7040
DOI	10.1007/s00381-021-05304-7
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Article ; Online: Equity in neurosurgery: a worldwide survey of women neurosurgeons.

Koutsouras, George W / Zhang, Lu / Zanon, Nelci / Lam, Sandi / Boop, Frederick A / Tovar-Spinoza, Zulma

Journal of neurosurgery

2022 Volume 138, Issue 2, Page(s) 550–558

Abstract: Objective: The global neurosurgery workforce does not have a defined stance on gender equity. The authors sought to study and characterize the demographic features of the international women neurosurgery community and to better understand the ... ...

Abstract	Objective: The global neurosurgery workforce does not have a defined stance on gender equity. The authors sought to study and characterize the demographic features of the international women neurosurgery community and to better understand the perceptions and reflections of their neurosurgical careers. The objective was to define and characterize the workplace inequities faced by the global women neurosurgeon community. Methods: A 58-item cross-sectional survey was distributed to the global women neurosurgery community. The survey was distributed via an online and mobile platform between October 2018 and December 2020. Responses were anonymized. The authors utilized chi-square analysis to differentiate variables (e.g., career satisfaction) between various groups (e.g., those based on academic position). The authors calculated 95% CIs to establish significance. Results: Among 237 respondents, approximately 40% were between the ages of 26 and 35 years. Within their respective departments, 45% identified themselves as the only woman neurosurgeon in their practice. Forty-three percent stated that their department supported women neurosurgeons for leadership roles. Seventy-five percent of respondents were members of organized neurosurgery professional societies; of these, 38% had been involved in leadership roles. Almost 60% of respondents postponed their decision to get pregnant because of resident or work-related influences. Conclusions: This survey provides international feedback for characterizing and understanding the experiences of women neurosurgeons worldwide. Future research should aim to understand all neurosurgeons' experiences throughout the pipeline and career life cycle of neurosurgery in order to improve the field of neurosurgery.
MeSH term(s)	Pregnancy ; Humans ; Female ; Adult ; Neurosurgeons ; Neurosurgery ; Cross-Sectional Studies ; Neurosurgical Procedures ; Surveys and Questionnaires
Language	English
Publishing date	2022-07-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	3089-2
ISSN	1933-0693 ; 0022-3085
ISSN (online)	1933-0693
ISSN	0022-3085
DOI	10.3171/2022.6.JNS22466
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Article ; Online: Single and staged laser interstitial thermal therapy ablation for cortical tubers causing refractory epilepsy in pediatric patients.

Tovar-Spinoza, Zulma / Ziechmann, Robert / Zyck, Stephanie

Neurosurgical focus

2018 Volume 45, Issue 3, Page(s) E9

Abstract: OBJECTIVE Magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) is a novel, minimally invasive treatment for the surgical treatment of epilepsy. In this paper, the authors report on clinical outcomes for a series of pediatric patients ... ...

Abstract	OBJECTIVE Magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) is a novel, minimally invasive treatment for the surgical treatment of epilepsy. In this paper, the authors report on clinical outcomes for a series of pediatric patients with tuberous sclerosis complex (TSC) and medication-refractory epileptogenic cortical tubers. METHODS A retrospective chart review was performed at SUNY Upstate Golisano Children's Hospital in Syracuse, New York. The authors included all cases involving pediatric patients (< 18 years) who underwent MRgLITT for ablation of epileptogenic cortical tubers between February 2013 and November 2015. RESULTS Seven patients with cortical tubers were treated (4 female and 3 male). The patients' average age was 6.6 years (range 2-17 years). Two patients had a single procedure, and 5 patients had staged procedures. The mean time between procedures in the staged cases was 6 months. All of the patients had a meaningful reduction in seizure frequency as reported by Engel and ILAE seizure outcome classifications, and most (71.4%) of the patients experienced a reduction in AED burden. Three of the 4 patients who presented with neuropsychiatric symptoms had some improvement in these domains after laser ablation. No perioperative complications were noted. The mean duration of follow-up was 19.3 months (range 4-49 months). CONCLUSIONS Laser ablation represents a minimally invasive alternative to resective epilepsy surgery and is an effective treatment for refractory epilepsy due to cortical tubers.
MeSH term(s)	Adolescent ; Cerebral Cortex/diagnostic imaging ; Cerebral Cortex/surgery ; Child ; Child, Preschool ; Drug Resistant Epilepsy/complications ; Drug Resistant Epilepsy/diagnostic imaging ; Drug Resistant Epilepsy/surgery ; Female ; Humans ; Laser Therapy/methods ; Male ; Retrospective Studies ; Tuberous Sclerosis/complications ; Tuberous Sclerosis/diagnostic imaging ; Tuberous Sclerosis/surgery
Language	English
Publishing date	2018-08-31
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2026589-X
ISSN	1092-0684 ; 1092-0684
ISSN (online)	1092-0684
ISSN	1092-0684
DOI	10.3171/2018.6.FOCUS18228
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Article ; Online: Spina Bifida Global Learning Collaborative: Educating the next generation of clinicians, researchers, and advocates.

Dosa, Nienke P / Ahmed, Yakob S / Alriksson-Schmidt, Ann / Castillo, Heidi / Contepomi, Silvana / Locastro, Mary M / Koning, Jan / Koutsouras, George / Kutwa, Elly / Mahorta, Anjali / MacFarland, Shade / Öhrvall, Ann-Marie / O'Neill, Patricia / Overvelde, Anneloes / Peny-Dahlstrand, Marie / Shaw, Andrea / Stockman, Jessica / Tovar-Spinoza, Zulma / Castillo, Jonathan

Journal of pediatric rehabilitation medicine

2023 Volume 16, Issue 4, Page(s) 657–663

Abstract: Purpose: This project aimed to launch an international learning community to guide the development of a spina bifida (SB) curriculum for global health trainees.: Methods: Using a descriptive study design, a convenience sample of SB curricula were ... ...

Abstract	Purpose: This project aimed to launch an international learning community to guide the development of a spina bifida (SB) curriculum for global health trainees. Methods: Using a descriptive study design, a convenience sample of SB curricula were identified in 2022-23 by members of the Spina Bifida World Congress Outreach Committee and evaluated during a series of monthly Zoom calls to discuss SB education in a global health context. Participants included (1) leadership from the ReachAnother Foundation, (2) invited panelists from the Spina Bifida World Congress Global Health Symposium, and (3) global health students and preceptors. Education initiatives in Ethiopia, Sweden, Argentina, Ecuador, and the United States were evaluated vis-à-vis format and content. Results: All of the education initiatives referenced the framework of the World Health Organization International Classification of Functioning, Disability and Health. Formats varied and included both virtual and interactive workshops, print materials, videos, and guides for small group discussion. Content addressed four domains: Folate Prevention, Neurosurgical Training, After Care, and Data Collection. A multidisciplinary approach, partnerships with families, and workforce pipeline training were identified as guiding themes for educating the next generation of SB researchers and clinicians in global health settings. Conclusion: The Spina Bifida Global Learning Collaborative is a transnational group of advocates, clinicians, and investigators whose mission is the advancement of SB-related global health education. Lessons learned from the collaborative are being leveraged to develop a global health curriculum for learners, which may improve services for individuals with SB around the globe.
MeSH term(s)	Humans ; Spinal Dysraphism ; Global Health ; Curriculum ; Argentina ; Sweden
Language	English
Publishing date	2023-12-23
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2403637-7
ISSN	1875-8894 ; 1874-5393
ISSN (online)	1875-8894
ISSN	1874-5393
DOI	10.3233/PRM-230037
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Article ; Online: Unilateral Postoperative Deep Cerebral Venous Thrombosis with Complete Recovery: A Report of 2 Cases.

Benifla, Mony / Laughlin, Suzzanne / Tovar-Spinoza, Zulma S / Rutka, James T / Dirks, Peter B

Pediatric neurosurgery

2017 Volume 52, Issue 3, Page(s) 205–210

Abstract: Postsurgical deep brain venous thrombosis has not been well described in children before. When approaching thalamic or intraventricular lesions, extra care should be taken to prevent injury to the internal cerebral veins (ICVs) and the vein of Galen. ... ...

Abstract	Postsurgical deep brain venous thrombosis has not been well described in children before. When approaching thalamic or intraventricular lesions, extra care should be taken to prevent injury to the internal cerebral veins (ICVs) and the vein of Galen. However, even when they are well preserved during surgery, postoperative hemodynamic changes, mainly in the first 24 h, or surgical manipulation can cause thrombosis of these veins. We report 2 children with unilateral postoperative ICV thrombosis; in 1 of the patients the vein of Galen was also thrombosed. Although both patients had altered sensorium initially, no anticoagulation therapy was given, and they both recovered well. When approaching thalamic or intraventricular lesions, extra care should be taken to prevent injury to the ICV and the vein of Galen. The surgeon should respect the deep brain venous system when approaching midline structures. Both the neurosurgeon and the neuroradiologist should be aware of this possible complication in order to make a prompt diagnosis and to offer proper treatment if needed.
Language	English
Publishing date	2017
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	1091757-3
ISSN	1423-0305 ; 1016-2291
ISSN (online)	1423-0305
ISSN	1016-2291
DOI	10.1159/000452803
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Article ; Online: Evidence-Based Perioperative Protocol for Ventriculoperitoneal Shunt Infection Reduction at a Single Institution.

Sweeney, Jared / Zyck, Stephanie / Tovar-Spinoza, Zulma / Krishnamurthy, Satish / Chin, Lawrence / Bodman, Alexa

World neurosurgery

2019 Volume 128, Page(s) e814–e822

Abstract: Objective: Ventriculoperitoneal shunt infections are common and result in significant morbidity, mortality, and health care expenditure. The objective of this study was to create an evidence-based perioperative shunt infection prevention protocol and ... ...

Abstract	Objective: Ventriculoperitoneal shunt infections are common and result in significant morbidity, mortality, and health care expenditure. The objective of this study was to create an evidence-based perioperative shunt infection prevention protocol and analyze its efficacy by comparing the incidence of shunt infection before and after implementation at one institution. Methods: A perioperative ventriculoperitoneal shunt surgery protocol was developed based on a systematic literature review with the goal of reducing infection rates. Patients undergoing shunt surgery at Upstate Medical University Hospital, from before and after implantation of the perioperative shunt surgery protocol, were retrospectively analyzed and compared. Retrospective data collection included shunt infection incidence as a primary outcome and clinical features of patients from both cohorts. Results: The pre-protocol and post-protocol cohorts included 226 and 285 patients, respectively. Twenty (8.8%) pre-protocol shunt infections and 16 (5.6%) post-protocol shunt infections were identified (P = 0.156). The relative risk of shunt infection between cohorts was 0.97 (95% confidence interval: 0.92-1.02). Conclusions: Although shunt infection rates pre-protocol and post-protocol were not significantly different, a trend toward fewer shunt infections was observed with protocol implementation. Suboptimal compliance at our institution may have limited accurate assessment of protocol efficacy. Similar future studies may benefit from objectively assessing protocol compliance.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Clinical Protocols ; Evidence-Based Medicine ; Female ; Guideline Adherence ; Humans ; Hydrocephalus/surgery ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Neurosurgical Procedures/methods ; Perioperative Care/methods ; Prosthesis-Related Infections/prevention & control ; Retrospective Studies ; Treatment Outcome ; Ventriculoperitoneal Shunt ; Young Adult
Language	English
Publishing date	2019-05-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2019.04.261
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Article: Unilateral Postoperative Deep Cerebral Venous Thrombosis with Complete Recovery: A Report of 2 Cases

Benifla, Mony / Laughlin, Suzzanne / Tovar-Spinoza, Zulma S. / Rutka, James T. / Dirks, Peter B.

Pediatric Neurosurgery

2017 Volume 52, Issue 3, Page(s) 205–210

Institution	Divisions of Neurosurgery, Neuroradiology, and Neurooncology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
Abstract	Postsurgical deep brain venous thrombosis has not been well described in children before. When approaching thalamic or intraventricular lesions, extra care should be taken to prevent injury to the internal cerebral veins (ICVs) and the vein of Galen. However, even when they are well preserved during surgery, postoperative hemodynamic changes, mainly in the first 24 h, or surgical manipulation can cause thrombosis of these veins. We report 2 children with unilateral postoperative ICV thrombosis; in 1 of the patients the vein of Galen was also thrombosed. Although both patients had altered sensorium initially, no anticoagulation therapy was given, and they both recovered well. When approaching thalamic or intraventricular lesions, extra care should be taken to prevent injury to the ICV and the vein of Galen. The surgeon should respect the deep brain venous system when approaching midline structures. Both the neurosurgeon and the neuroradiologist should be aware of this possible complication in order to make a prompt diagnosis and to offer proper treatment if needed.
Keywords	Postoperative deep brain venous thrombosis ; Pediatric neurosurgery ; Internal cerebral vein ; Vein of Galen ; Thrombosis
Language	English
Publishing date	2017-03-22
Publisher	S. Karger AG
Publishing place	Basel, Switzerland
Document type	Article
Note	Novel Insights from Clinical Practice
ZDB-ID	1091757-3
ISSN	1423-0305 ; 1016-2291
ISSN (online)	1423-0305
ISSN	1016-2291
DOI	10.1159/000452803
Database	Karger publisher's database

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Article ; Online: GOPC-ROS1 Fusion Due to Microdeletion at 6q22 Is an Oncogenic Driver in a Subset of Pediatric Gliomas and Glioneuronal Tumors.

Richardson, Timothy E / Tang, Karen / Vasudevaraja, Varshini / Serrano, Jonathan / William, Christopher M / Mirchia, Kanish / Pierson, Christopher R / Leonard, Jeffrey R / AbdelBaki, Mohamed S / Schieffer, Kathleen M / Cottrell, Catherine E / Tovar-Spinoza, Zulma / Comito, Melanie A / Boué, Daniel R / Jour, George / Snuderl, Matija

Journal of neuropathology and experimental neurology

2019 Volume 78, Issue 12, Page(s) 1089–1099

Abstract: ROS1 is a transmembrane receptor tyrosine kinase proto-oncogene that has been shown to have rearrangements with several genes in glioblastoma and other neoplasms, including intrachromosomal fusion with GOPC due to microdeletions at 6q22.1. ROS1 fusion ... ...

Abstract	ROS1 is a transmembrane receptor tyrosine kinase proto-oncogene that has been shown to have rearrangements with several genes in glioblastoma and other neoplasms, including intrachromosomal fusion with GOPC due to microdeletions at 6q22.1. ROS1 fusion events are important findings in these tumors, as they are potentially targetable alterations with newer tyrosine kinase inhibitors; however, whether these tumors represent a distinct entity remains unknown. In this report, we identify 3 cases of unusual pediatric glioma with GOPC-ROS1 fusion. We reviewed the clinical history, radiologic and histologic features, performed methylation analysis, whole genome copy number profiling, and next generation sequencing analysis for the detection of oncogenic mutation and fusion events to fully characterize the genetic and epigenetic alterations present in these tumors. Two of 3 tumors showed pilocytic features with focal expression of synaptophysin staining and variable high-grade histologic features; the third tumor aligned best with glioblastoma and showed no evidence of neuronal differentiation. Copy number profiling revealed chromosome 6q22 microdeletions corresponding to the GOPC-ROS1 fusion in all 3 cases and methylation profiling showed that the tumors did not cluster together as a single entity or within known methylation classes by t-Distributed Stochastic Neighbor Embedding.
MeSH term(s)	Adaptor Proteins, Signal Transducing/genetics ; Brain/pathology ; Brain Neoplasms/genetics ; Brain Neoplasms/pathology ; Carcinogenesis ; Child ; Child, Preschool ; Chromosome Deletion ; Chromosomes, Human, Pair 6/genetics ; DNA Methylation ; Epigenesis, Genetic ; Female ; Glioma/genetics ; Glioma/pathology ; Golgi Matrix Proteins/genetics ; Humans ; Male ; Oncogene Proteins, Fusion/genetics ; Protein-Tyrosine Kinases/genetics ; Proto-Oncogene Proteins/genetics
Chemical Substances	Adaptor Proteins, Signal Transducing ; GOPC protein, human ; Golgi Matrix Proteins ; Oncogene Proteins, Fusion ; Proto-Oncogene Proteins ; Protein-Tyrosine Kinases (EC 2.7.10.1) ; ROS1 protein, human (EC 2.7.10.1)
Language	English
Publishing date	2019-10-11
Publishing country	England
Document type	Case Reports ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	3088-0
ISSN	1554-6578 ; 0022-3069
ISSN (online)	1554-6578
ISSN	0022-3069
DOI	10.1093/jnen/nlz093
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Ui II Zs.134: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
Ui II Zs.194: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)

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Article ; Online: A prospective multicenter study of laser ablation for drug resistant epilepsy - One year outcomes.

Landazuri, Patrick / Shih, Jerry / Leuthardt, Eric / Ben-Haim, Sharona / Neimat, Joseph / Tovar-Spinoza, Zulma / Chiang, Veronica / Spencer, Dennis / Sun, David / Fecci, Peter / Baumgartner, James

Epilepsy research

2020 Volume 167, Page(s) 106473

Abstract: Objective: To report one-year seizure outcomes, procedural data, and quality of life scores following laser interstitial thermal therapy (LITT) of epileptogenic foci.: Methods: Data from an ongoing prospective, multi-center registry were assessed. ... ...

Abstract	Objective: To report one-year seizure outcomes, procedural data, and quality of life scores following laser interstitial thermal therapy (LITT) of epileptogenic foci. Methods: Data from an ongoing prospective, multi-center registry were assessed. Procedural information, Engel seizure outcomes, and quality of life (QoL) scores were analyzed. A responder analysis was performed to better understand potential clinical characteristics that could influence seizure outcome. Results: Sixty patients have been enrolled into LAANTERN (Laser Ablation of Abnormal Neurological Tissue Using Robotic NeuroBlate System) specifically for epilepsy treatment, of which 42 reached one year follow up. Engel I outcome was achieved in 64.3 % at one year follow up. Patients with mesial temporal lobe epilepsy (MTLE) comprised 56.7 % of this cohort of multiple epilepsy types. Other significant etiologies included focal cortical dysplasia, hypothalamic hamartoma, cavernoma, heterotopias, and tuberous sclerosis. Median length of stay was 32.7 h. At discharge, head pain score averaged 1.4 ± 2.1 on a scale from 1 to 10. Five adverse events were reported, one categorized as serious. Seizure worry and social functioning scores improved significantly in quality of life measures. Significance: Surgical treatment with LITT for epileptic foci is a safe and effective treatment option for people with drug resistant epilepsy. Our multicenter prospective seizure outcomes continue to expand published LITT experience in MTLE as well as non-MTLE epilepsies. The minimally invasive nature allows for short hospitalizations with minimal reported pain and discomfort.
MeSH term(s)	Adolescent ; Adult ; Drug Resistant Epilepsy/surgery ; Epilepsy, Temporal Lobe/surgery ; Female ; Humans ; Hyperthermia, Induced/methods ; Laser Therapy/methods ; Magnetic Resonance Imaging/methods ; Male ; Middle Aged ; Quality of Life ; Seizures/surgery ; Young Adult
Language	English
Publishing date	2020-09-22
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	632939-1
ISSN	1872-6844 ; 0920-1211
ISSN (online)	1872-6844
ISSN	0920-1211
DOI	10.1016/j.eplepsyres.2020.106473
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Article ; Online: Congenital depressed skull fracture in the absence of trauma

Tovar-Spinoza ZS / Kim PD

Research and Reports in Neonatology, Vol 2012, Iss default, Pp 11-

case report and literature review

2012 Volume 14

Abstract: Zulma S Tovar-Spinoza, Peter D KimDepartment of Neurosurgery, SUNY Upstate Medical University ...

Abstract	Zulma S Tovar-Spinoza, Peter D KimDepartment of Neurosurgery, SUNY Upstate Medical University, Syracuse NYAbstract: There are limited reports of neonatal depressed skull fractures in the absence of any known trauma or obvious risk factors. Here we describe a male neonate with a significant frontal nontraumatic depressed fracture, his course of treatment, and a literature review. A male neonate was attended for a significant congenital depressed skull fracture in the left frontal bone. He was born full term after an uncomplicated delivery to a multiparous mother who was a human immunodeficiency syndrome (HIV)-positive immigrant from sub-Saharan Africa. The pregnancy was otherwise uncomplicated. There was no history of trauma to the mother during the pregnancy or delivery. Ultrasonography had been unremarkable. No other abnormalities were noted. The patient was brought to the operating room at the age of 13 days for elevation of his fracture due to its nonreducible nature. A small linear incision was made just posterior to the coronal suture. The dura mater was stripped and a combination of Penfield and periostial elevators was used to elevate the depressed fracture. Nontraumatic depressed skull fractures are uncommon in neonates. The cause of this entity has not been identified, and many theories about its origin have been proposed. Treatment can be either surgical or conservative.Keywords: neonatal, congenital, depressed fracture, spontaneous, nontraumatic
Keywords	Pediatrics ; RJ1-570 ; Medicine ; R ; DOAJ:Pediatrics ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Language	English
Publishing date	2012-02-01T00:00:00Z
Publisher	Dove Press
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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