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Article ; Online: Refining revascularization surgery indications for paediatric moyamoya angiopathy: Age also matters.

Kossorotoff, Manoelle / Blauwblomme, Thomas

European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society

2021 Volume 35, Page(s) A1

MeSH term(s)	Cerebral Revascularization ; Child ; Humans ; Moyamoya Disease/diagnostic imaging ; Moyamoya Disease/surgery ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2021-11-22
Publishing country	England
Document type	Editorial
ZDB-ID	1397146-3
ISSN	1532-2130 ; 1090-3798
ISSN (online)	1532-2130
ISSN	1090-3798
DOI	10.1016/j.ejpn.2021.11.013
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Article ; Online: Is the Choroid Plexus Needed?

Stricker, Sarah / Guzman, Raphael / Blauwblomme, Thomas / Danielpour, Moise

Pediatric neurosurgery

2022 Volume 57, Issue 5, Page(s) 301–305

Abstract: Background: Choroid plexectomy was first performed around 1910. Later, the technique evolved into subtotal choroid plexus cauterization (CPC) but was largely abandoned following the invention of the ventriculoperitoneal shunt. Over time, with improved ... ...

Abstract	Background: Choroid plexectomy was first performed around 1910. Later, the technique evolved into subtotal choroid plexus cauterization (CPC) but was largely abandoned following the invention of the ventriculoperitoneal shunt. Over time, with improved understanding of the pathophysiology of hydrocephalus and improvement in endoscopic techniques and equipment, the procedure of CPC was reintroduced. However, little is known about the biomolecular consequences of ablation of a significant portion of the choroid plexus on metabolic brain homeostasis, neurogenesis, and neuroimmunology. Summary: The physiological functions of choroid plexus in neurogenesis and neuroimmunology and its role in diseases, such as AD and MS, should alert to possible as yet to be determined consequences. Studies, both in children and in adults, are needed not only on the success in hydrodynamic stabilization of hydrocephalus but also on the long-term outcome, especially premature neurodegeneration and inflammatory changes and on compensatory metabolic mechanisms. Key messages: The value of CPC for treatment of hydrocephalus in medically underserved areas should be remembered, yet when alternative treatment options are available, we cannot responsibly advocate against or for the use of CPC. Therefore, perhaps a more detailed discussion of risks and benefits of a CPC with parents would be best to include the possible implications in brain development and function.
MeSH term(s)	Child ; Adult ; Humans ; Infant ; Choroid Plexus/surgery ; Ventriculoperitoneal Shunt/methods ; Hydrocephalus/surgery ; Cautery/methods ; Endoscopy
Language	English
Publishing date	2022-08-31
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	1091757-3
ISSN	1423-0305 ; 1016-2291
ISSN (online)	1423-0305
ISSN	1016-2291
DOI	10.1159/000526488
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Article ; Online: Letter to the Editor. Holmes tremor and hydrocephalus: a sign of global rostral midbrain dysfunction syndrome.

Guida, Lelio / Blauwblomme, Thomas / Cinalli, Giuseppe / Puget, Stéphanie / Sainte-Rose, Christian

Journal of neurosurgery. Pediatrics

2022 , Page(s) 1–2

Language	English
Publishing date	2022-05-20
Publishing country	United States
Document type	Journal Article ; Letter
ZDB-ID	2403985-8
ISSN	1933-0715 ; 1933-0707
ISSN (online)	1933-0715
ISSN	1933-0707
DOI	10.3171/2022.3.PEDS2299
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Article ; Online: Reliability of fast-spin echo T2-weighted three-dimensional sequences to predict endoscopic third ventriculocisternostomy patency in children.

Lefevre, Etienne / Caudron, Yohan / Beccaria, Kevin / Levy, Raphael / Dangouloff-Ros, Volodia / Blauwblomme, Thomas / Boddaert, Nathalie

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

2023 Volume 39, Issue 4, Page(s) 937–942

Abstract: Purpose: Clinical and radiological assessment of endoscopic third ventriculocisternostomy (ETV) patency can be challenging in children. The objective of our study was thus to test the accuracy and interrater reliability of 3D fast-spin echo (FSE) T2- ... ...

Abstract	Purpose: Clinical and radiological assessment of endoscopic third ventriculocisternostomy (ETV) patency can be challenging in children. The objective of our study was thus to test the accuracy and interrater reliability of 3D fast-spin echo (FSE) T2-weighted sequences to assess the patency of ETV. Methods: We included all the consecutive children who underwent surgery for ETV over a two-year period and selected the children who presented ETV dysfunction and matched them with children without dysfunction. We evaluated the Kappa interrater reliability of three experienced physicians for prediction of ETV patency using solely the flow void sign in 3D FSE T2-weighted sequences. Results: Nineteen children underwent surgery for ETV dysfunction and 12 children without dysfunction were matched. Sensitivity was 0.79, 0.89 and 0.84 and specificity was 1 for all raters. None of the patent ETV was wrongly considered to be dysfunctional. Fleiss' kappa was 0.871 (p < 0.001). The interrater reliability was excellent with respect to the patency or not of the ETV. Conclusion: FSE T2-weighted sequence is a simple and reproducible tool that can be widely used in daily practice to assess the patency of ETV. Interrater reliability of this sequence is high and accessibility in outpatient setting is acceptable.
MeSH term(s)	Humans ; Child ; Magnetic Resonance Imaging/methods ; Ventriculostomy/methods ; Reproducibility of Results ; Sensitivity and Specificity ; Imaging, Three-Dimensional/methods
Language	English
Publishing date	2023-01-27
Publishing country	Germany
Document type	Journal Article
ZDB-ID	605988-0
ISSN	1433-0350 ; 0302-2803 ; 0256-7040
ISSN (online)	1433-0350
ISSN	0302-2803 ; 0256-7040
DOI	10.1007/s00381-023-05838-y
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Article: Transient ischemia facilitates neuronal chloride accumulation and severity of seizures.

Blauwblomme, Thomas / Dzhala, Volodymyr / Staley, Kevin

Annals of clinical and translational neurology

2018 Volume 5, Issue 9, Page(s) 1048–1061

Abstract: Objective: Preceding oxygen glucose deprivation (OGD) and ongoing seizures have both been reported to increase neuronal chloride concentration ([Cl: Methods: The effects of OGD on [Cl: Results: Seizures initially increased during OGD, followed by ... ...

Abstract	Objective: Preceding oxygen glucose deprivation (OGD) and ongoing seizures have both been reported to increase neuronal chloride concentration ([Cl Methods: The effects of OGD on [Cl Results: Seizures initially increased during OGD, followed by suppression. On reperfusion, seizure frequency and [Cl Interpretation: [Cl
Language	English
Publishing date	2018-07-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	2740696-9
ISSN	2328-9503
ISSN	2328-9503
DOI	10.1002/acn3.617
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Article ; Online: A comprehensive histomolecular characterization of meningioangiomatosis: Further evidence for a precursor neoplastic lesion.

Tauziède-Espariat, Arnault / Masliah-Planchon, Julien / Sievers, Philipp / Sahm, Felix / Dangouloff-Ros, Volodia / Boddaert, Nathalie / Hasty, Lauren / Aboubakr, Oumaima / Métais, Alice / Chrétien, Fabrice / Roux, Alexandre / Pallud, Johan / Blauwblomme, Thomas / Beccaria, Kévin / Bourdeaut, Franck / Puget, Stéphanie / Varlet, Pascale

Brain pathology (Zurich, Switzerland)

2024 , Page(s) e13259

Abstract: Meningioangiomatosis (MAM) remains a poorly understood lesion responsible for epileptic disease. In the past, MAM was primarily described in the context of neurofibromatosis type 2 before being mainly reported sporadically. Moreover, the malformative or ... ...

Abstract	Meningioangiomatosis (MAM) remains a poorly understood lesion responsible for epileptic disease. In the past, MAM was primarily described in the context of neurofibromatosis type 2 before being mainly reported sporadically. Moreover, the malformative or tumoral nature is still debated. Because a subset of MAM are associated with meningiomas, some authors argue that MAM corresponds to an infiltration pattern of these tumors. For these reasons, MAM has not been added to the World Health Organization (WHO) Classification of Central Nervous System Tumors as a specific entity. In the present study, we characterized a series of pure MAM (n = 7) and MAM associated with meningiomas (n = 4) using histopathology, immunohistochemistry, genetic (fluorescent in situ and DNA sequencing analyses), and epigenetic (DNA-methylation profiling) data. We evidenced two distinct morphological patterns: MAM with a fibroblastic-like pattern having few lesional cells, and MAM with a more cellular pattern. A subset was associated with the genetic alterations previously reported in meningiomas (such as a KMT2C mutation and a hemizygous deletion of chromosome 22q including the NF2 gene). The DNA-methylation profile, using a t-distributed stochastic neighbor embedding analysis, evidenced that MAM (pure or associated with meningiomas) clustered in a separate group from pediatric meningiomas. The present results seem to suggest that MAM represents a neoplastic lesion and encourage the further study of similar additional series so that it may be included in a future WHO classification.
Language	English
Publishing date	2024-04-02
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	1051484-3
ISSN	1750-3639 ; 1015-6305
ISSN (online)	1750-3639
ISSN	1015-6305
DOI	10.1111/bpa.13259
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Article ; Online: Predicting endoscopic third ventriculostomy success in pediatric shunt dysfunction: a monocentric retrospective case series of 70 consecutive children, systematic review, and meta-analysis.

Guida, Lelio / Grenier-Chartrand, Flavie / Benichi, Sandro / James, Syril / Paternoster, Giovanna / Bourgeois, Marie / Dangouloff-Ros, Volodia / Messina, Antonio / Boddaert, Nathalie / Puget, Stéphanie / Beccaria, Kevin / Blauwblomme, Thomas

Journal of neurosurgery. Pediatrics

2023 Volume 32, Issue 6, Page(s) 638–648

Abstract: Objective: The outcome of endoscopic third ventriculostomy (ETV) in children who had previously received shunts and who were experiencing shunt dysfunction is still discussed in terms of efficacy (success rate from 40% to 80%) and safety (0%-32.5% of ... ...

Abstract	Objective: The outcome of endoscopic third ventriculostomy (ETV) in children who had previously received shunts and who were experiencing shunt dysfunction is still discussed in terms of efficacy (success rate from 40% to 80%) and safety (0%-32.5% of complications). Reported predictive factors of secondary ETV failure are age, early onset of hydrocephalus, and prematurity. The best surgical strategy in the different subgroups of patients with shunt dysfunction is still debated. Therefore, the authors aimed to identify subgroups of patients in whom shunt treatment was associated with favorable outcome of ETV, to define the role of ETV in patients with global rostral midbrain dysfunction syndrome. Methods: This study was a monocentric retrospective case series and a meta-analysis of children who had previously received shunts and who underwent secondary ETV for shunt dysfunction between 2012 and 2022. Clinical and MRI features were examined, along with surgical outcome, etiology of hydrocephalus, and preoperative ETV Success Score. Univariate and multivariate analyses were performed to find predictors of outcome of secondary ETV. Youden's J index was calculated on age distribution to find an optimal age cutoff. Systematic review of the literature and a meta-analysis were performed according to the PRISMA statement. Results: Seventy consecutive patients were included. The overall success rate of secondary ETV was 63%. Primary obstructive hydrocephalus, age ≥ 36 months, and the presence of aqueductal obstruction were predictors of ETV success. Multivariate analysis found that age < 36 months, primary inflammatory hydrocephalus, and presence of fourth ventricular obstruction were associated with ETV failure. All patients with global rostral midbrain dysfunction syndrome experienced clinical and radiological improvement after ETV. The meta-analysis showed that postinflammatory etiology and age < 36 months were predictors of ETV failure. Conclusions: ETV is safe and effective for children with obstructive hydrocephalus experiencing shunt dysfunction, notably in cases of primary obstructive hydrocephalus with aqueductal stenosis, and among children whose age was ≥ 36 months who had postinflammatory hydrocephalus.
MeSH term(s)	Child ; Child, Preschool ; Humans ; Infant ; Hydrocephalus/diagnostic imaging ; Hydrocephalus/etiology ; Hydrocephalus/surgery ; Neuroendoscopy/adverse effects ; Retrospective Studies ; Third Ventricle/diagnostic imaging ; Third Ventricle/surgery ; Treatment Outcome ; Ventriculostomy/adverse effects
Language	English
Publishing date	2023-09-29
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Review ; Systematic Review
ZDB-ID	2403985-8
ISSN	1933-0715 ; 1933-0707
ISSN (online)	1933-0715
ISSN	1933-0707
DOI	10.3171/2023.9.PEDS23208
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Article ; Online: Cerebral ischemia: a frequent complication of large traumatic epidural hematoma in infants.

Landart, Matthieu / Benichi, Sandro / Guida, Lelio / Lazarescu, Marilena / Bourgeois, Marie / Sauvé-Martin, Hélène / Levy, Raphael / Roux, Charles-Joris / James, Syril / de Saint-Denis, Timothée / Vergnaud, Estelle / Paternoster, Giovanna / Beccaria, Kevin / Blauwblomme, Thomas

Journal of neurosurgery. Pediatrics

2023 , Page(s) 1–5

Abstract: Objective: Epidural hematoma (EDH) has rarely been studied specifically in infants. The objective of this study was to investigate the outcomes of patients aged < 18 months (infants) with EDH.: Methods: The authors conducted a single-center ... ...

Abstract	Objective: Epidural hematoma (EDH) has rarely been studied specifically in infants. The objective of this study was to investigate the outcomes of patients aged < 18 months (infants) with EDH. Methods: The authors conducted a single-center retrospective study of 48 infants aged less than 18 months who underwent an operation for a supratentorial EDH in the last decade. Clinical, radiological, and biological variables were used in a statistical analysis to identify factors predictive of radiological and clinical outcome. Results: Forty-seven patients were included in the final analysis. Seventeen children (36%) had cerebral ischemia on postoperative imaging, either due to stroke (cerebral herniation) or by local compression. Factors associated with ischemia after multivariate logistic regression were the presence of an initial neurological deficit (76% vs 27%, p = 0.03), low platelet count (mean 192 vs 267 per mm3, p = 0.01), low fibrinogen level (mean 1.4 vs 2.2 g/L, p = 0.04) and long intubation time (mean 65.7 vs 10.1 hours, p = 0.03). Cerebral ischemia on MRI was predictive of a poor clinical outcome. Conclusions: Infants with EDH have a low mortality rate but a high risk of cerebral ischemia, along with long-term neurological sequelae.
Language	English
Publishing date	2023-03-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	2403985-8
ISSN	1933-0715 ; 1933-0707
ISSN (online)	1933-0715
ISSN	1933-0707
DOI	10.3171/2023.1.PEDS22324
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Article: Laser interstitial thermal therapy is effective and safe for the treatment of brain tumors in NF1 patients after cerebral revascularization for moyamoya angiopathy: a report on two cases.

Guida, Lelio / Beccaria, Kevin / Benichi, Sandro / Kossorotof, Manoelle / Naggara, Olivier / Bourgeois, Marie / Bourdeaut, Franck / Abbou, Samuel / Dangouloff-Ros, Volodia / Boddaert, Nathalie / Blauwblomme, Thomas

Frontiers in neurology

2023 Volume 14, Page(s) 1291207

Abstract: Background: The co-occurrence of moyamoya vasculopathy and extra-optic pathway tumors is rare in neurofibromatosis type 1 (NF1), with only four cases described in the literature. Brain surgery in these patients may be challenging because of the risk of ... ...

Abstract	Background: The co-occurrence of moyamoya vasculopathy and extra-optic pathway tumors is rare in neurofibromatosis type 1 (NF1), with only four cases described in the literature. Brain surgery in these patients may be challenging because of the risk of brain infarction after skin and dural incision. Given its percutaneous and minimally invasive nature, laser interstitial thermal therapy (LITT) is an ideal option for the treatment of brain tumors in these patients. Here, we report on two patients with NF1 and moyamoya syndrome (MMS) treated for a brain glioma with LITT, after cerebral revascularization. Cases: The first patient, with familial NF1, underwent bilateral indirect revascularization with multiple burr holes (MBH) for symptomatic MMS. Two years later, she was diagnosed with a left temporal tumor, with evidence of radiologic progression over 10 months. The second patient, also with familial NF1, developed unilateral MMS when he was 6 years old and was treated with MBH. At the age of 15 years, MRI showed a right cingular lesion, growing on serial MRIs. Both patients underwent LITT with no perioperative complications; they are progression free at 10 and 12 months, respectively, and the tumors have decreased in volume. Discussion: While the association of extra-optic neoplasm and moyamoya angiopathy is seldom reported in NF1, tumor treatment is challenging in terms of both avoiding stroke and achieving oncological control. Here, we show in 2 cases, that LITT could be a safe and effective option in these rare conditions.
Language	English
Publishing date	2023-12-08
Publishing country	Switzerland
Document type	Case Reports
ZDB-ID	2564214-5
ISSN	1664-2295
ISSN	1664-2295
DOI	10.3389/fneur.2023.1291207
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Article ; Online: The Management of Hydrocephalus in Midline Posterior Fossa Cystic Collections: Surgical Outcome From a Retrospective Single-Center Case Series of 54 Consecutive Pediatric Patients.

Guida, Lelio / Benichi, Sandro / Bourgeois, Marie / Paternoster, Giovanna / James, Syril / De Saint Denis, Timothée / Dangouloff Ros, Volodia / Beccaria, Kevin / Blauwblomme, Thomas

Neurosurgery

2023 Volume 93, Issue 3, Page(s) 576–585

Abstract: Background: Hydrocephalus frequently occurs with midline posterior fossa cystic collections. The classification of this heterogeneous group of developmental anomalies, including Dandy-Walker malformation, persisting Blake's pouch, retrocerebellar ... ...

Abstract	Background: Hydrocephalus frequently occurs with midline posterior fossa cystic collections. The classification of this heterogeneous group of developmental anomalies, including Dandy-Walker malformation, persisting Blake's pouch, retrocerebellar arachnoid cysts, and mega cisterna magna, is subject of debate. The absence of diagnostic criteria is confusing regarding the ideal management of PFCC-related hydrocephalus. Objective: To decipher the surgical strategy for the treatment of children with PFCC-related hydrocephalus through a retrospective analysis of the surgical outcome driven by their clinical and radiological presentation. Methods: This study enrolled patients operated of symptomatic PFCC-related hydrocephalus. Clinical and MRI features were examined, as well as the surgical outcome. Unbiased subgroup classification of the patients was performed with multiple component analysis as a function of imaging characteristics and hierarchical clustering on principal component. Outcome was assessed with binomial logistic regression and Kaplan-Meier analysis. Results: Fifty-four patients were included between 2007 and 2021. Multiple component analysis suggested that cerebellar and vermian hypoplasia, vermian rotation, basal-tentorial angle, and fastigial angle were strongly correlated. Hierarchical clustering and the distribution of the patients in the bidimensional plot showed the clear segregation of 3 major clusters, which correlated with the radiological diagnosis ( P < .01). Binomial logistic regression and survival analysis showed that endoscopic third ventriculostomy was an effective treatment for patients with persisting Blake's pouch, while failing to control hydrocephalus in most of patients with Dandy-Walker malformation. Conclusion: Preoperative MRI in patients with PFCC-related hydrocephalus is essential to better define the diagnosis. The choice of treatment strategy notably relies on correct radiological diagnosis.
MeSH term(s)	Humans ; Child ; Dandy-Walker Syndrome/complications ; Dandy-Walker Syndrome/diagnostic imaging ; Dandy-Walker Syndrome/surgery ; Retrospective Studies ; Hydrocephalus/diagnostic imaging ; Hydrocephalus/etiology ; Hydrocephalus/surgery ; Arachnoid Cysts ; Cerebellum ; Magnetic Resonance Imaging/methods ; Cranial Fossa, Posterior/diagnostic imaging ; Cranial Fossa, Posterior/surgery
Language	English
Publishing date	2023-03-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	135446-2
ISSN	1524-4040 ; 0148-396X
ISSN (online)	1524-4040
ISSN	0148-396X
DOI	10.1227/neu.0000000000002450
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