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Brain Sciences
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Neurosurgery in Pediatrics
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Neurosurgery in Pediatrics

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Neurosurgery and Neuroanatomy".

Deadline for manuscript submissions: closed (15 December 2022) | Viewed by 7287

Special Issue Editors

Dr. Ayataka Fujimoto

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Guest Editor
Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, Hamamatsu 430-8558, Japan
Interests: epilepsy; neurosurgery; pediatrics; neuroscience; adult; geriatrics; involuntary movement; tuberous sclerosis complex; brain tumor
Special Issues, Collections and Topics in MDPI journals
Dr. Tohru Okanishi

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Guest Editor
Department of Child Neurology, Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, Hamamatsu 430-8558, Japan
Interests: epilepsy; pediatric epilepsy; epilepsy surgery; corpus callosotomy; epileptic spasms; tuberous sclerosis; EEG analysis; seizure semiology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The central nervous system (CNS) in children differs from that in adults. Characteristics of brain tumors, brain plasticity, the different mechanisms of head trauma, incidence rate of hydrocephalus, different types of epilepsy, different types of stroke, CNS infection, etc. are good examples of the varieties of “Neurosurgery of Pediatrics”.

On the one hand, due to the small population of pediatric patients in some countries, the volume of pediatric neurosurgery performed might be limited. One the other hand, due to the large population of pediatric patients in other countries, sufficient medical services might not be given to the entire pediatric patient population. This might lead to a global disparity in neurosurgical treatments, neurosurgical education, and neurosurgical research in pediatrics.

For this Special Issue, we welcome submissions including, but not limited to, the above-mentioned clinical issues including brain tumors, epilepsy, stroke, head trauma, spinal lesions, and neuroimaging, as well as global disparity.

Dr. Ayataka Fujimoto
Dr. Tohru Okanishi
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Brain Sciences is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • pediatric neurosurgery
  • hydrocephalus
  • epilepsy surgery
  • brain tumor
  • head trauma
  • spinal lesion
  • CNS infection
  • surgical procedures
  • neurosurgical education in pediatrics

Published Papers (4 papers)

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10 pages, 5250 KiB  
Article
Hemispherotomy in Infants with Hemimegalencephaly: Long-Term Seizure and Developmental Outcome in Early Treated Patients
by Chiara Pepi, Alessandro De Benedictis, Maria Camilla Rossi-Espagnet, Simona Cappelletti, Martina Da Rold, Giovanni Falcicchio, Federico Vigevano, Carlo Efisio Marras, Nicola Specchio and Luca De Palma
Brain Sci. 2023, 13(1), 73; https://doi.org/10.3390/brainsci13010073 - 30 Dec 2022
Cited by 2 | Viewed by 2105
Abstract
Hemimegalencephaly (HME) is a rare brain congenital malformation, consisting in altered neuronal migration and proliferation within one hemisphere, which is responsible for early onset drug-resistant epilepsy. Hemispherotomy is an effective treatment option for patients with HME and drug-resistant epilepsy. Surgical outcome may be [...] Read more.
Hemimegalencephaly (HME) is a rare brain congenital malformation, consisting in altered neuronal migration and proliferation within one hemisphere, which is responsible for early onset drug-resistant epilepsy. Hemispherotomy is an effective treatment option for patients with HME and drug-resistant epilepsy. Surgical outcome may be variable among different surgical series, and the long-term neuropsychological trajectory has been rarely defined using a standardized neurocognitive test. We report the epileptological and neuropsychological long-term outcomes of four consecutive HME patients, operated on before the age of three years. All patients were seizure-free and drug-free, and the minimum follow-up duration was of five years. Despite the excellent post-surgical seizure outcome, the long-term developmental outcome is quite variable between patients, ranging from mild to severe intellectual disabilities. Patients showed improvement mainly in communication skills, while visuo-perceptive and coordination abilities were more impaired. Epileptological outcome seems to be improved in early treated patients; however, neuropsychological outcome in HME patients may be highly variable despite early surgery. Full article
(This article belongs to the Special Issue Neurosurgery in Pediatrics)
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12 pages, 1279 KiB  
Article
Can Presurgical Interhemispheric EEG Connectivity Predict Outcome in Hemispheric Surgery? A Brain Machine Learning Approach
by Chiara Pepi, Mattia Mercier, Giusy Carfì Pavia, Alessandro de Benedictis, Federico Vigevano, Maria Camilla Rossi-Espagnet, Giovanni Falcicchio, Carlo Efisio Marras, Nicola Specchio and Luca de Palma
Brain Sci. 2023, 13(1), 71; https://doi.org/10.3390/brainsci13010071 - 30 Dec 2022
Cited by 3 | Viewed by 1418
Abstract
Objectives: Hemispherotomy (HT) is a surgical option for treatment of drug-resistant seizures due to hemispheric structural lesions. Factors affecting seizure outcome have not been fully clarified. In our study, we used a brain Machine Learning (ML) approach to evaluate the possible role of [...] Read more.
Objectives: Hemispherotomy (HT) is a surgical option for treatment of drug-resistant seizures due to hemispheric structural lesions. Factors affecting seizure outcome have not been fully clarified. In our study, we used a brain Machine Learning (ML) approach to evaluate the possible role of Inter-hemispheric EEG Connectivity (IC) in predicting post-surgical seizure outcome. Methods: We collected 21 pediatric patients with drug-resistant epilepsy; who underwent HT in our center from 2009 to 2020; with a follow-up of at least two years. We selected 5-s windows of wakefulness and sleep pre-surgical EEG and we trained Artificial Neuronal Network (ANN) to estimate epilepsy outcome. We extracted EEG features as input data and selected the ANN with best accuracy. Results: Among 21 patients, 15 (71%) were seizure and drug-free at last follow-up. ANN showed 73.3% of accuracy, with 85% of seizure free and 40% of non-seizure free patients appropriately classified. Conclusions: The accuracy level that we reached supports the hypothesis that pre-surgical EEG features may have the potential to predict epilepsy outcome after HT. Significance: The role of pre-surgical EEG data in influencing seizure outcome after HT is still debated. We proposed a computational predictive model, with an ML approach, with a high accuracy level. Full article
(This article belongs to the Special Issue Neurosurgery in Pediatrics)
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14 pages, 1089 KiB  
Article
Changes in CSF Surface Tension in Relation to Surfactant Proteins in Children with Intraventricular Hemorrhage
by Rieka M. Reger, Anton Meinicke, Wolfgang Härtig, Matthias Knüpfer, Ulrich Thome, Stefan Schob and Matthias Krause
Brain Sci. 2022, 12(11), 1440; https://doi.org/10.3390/brainsci12111440 - 26 Oct 2022
Cited by 1 | Viewed by 1086
Abstract
The regulation of surface tension (ST) by surfactants plays an important role in the human respiratory system but is largely unexplored in brain homeostasis. The aim of this study was to evaluate changes in ST in relation to surfactant proteins (SPs) in children [...] Read more.
The regulation of surface tension (ST) by surfactants plays an important role in the human respiratory system but is largely unexplored in brain homeostasis. The aim of this study was to evaluate changes in ST in relation to surfactant proteins (SPs) in children with intraventricular hemorrhage (IVH). CSF samples from 93 patients were analyzed for ST with a force tensiometer and SP-A-D and -G with ELISA assays. Patients belonged to six groups: (i) IVH before primary intervention (PI), (ii) IVH 4–28 days after PI, (iii) IVH 44–357 days after PI, (iv) hydrocephalus, (v) sepsis and (vi) controls. We found indirect correlations and significant differences in ST and SPs (all p < 0.001; except for SP-C, p = 0.007). Post hoc analyses showed significantly decreased ST in IVH patients before PI compared with patients with hydrocephalus, sepsis or controls (p < 0.001), but it increased in IVH patients over time. All SPs were significantly elevated when comparing IVH patients before PI with controls (all p < 0.001; except for SP-C, p = 0.003). Children suffering from IVH displayed an increase in SPs and a decrease in ST as coping mechanisms to preserve CSF flow. The increase in ST over time could serve as prognostic marker for the healing process. Full article
(This article belongs to the Special Issue Neurosurgery in Pediatrics)
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8 pages, 2828 KiB  
Case Report
Unexplained Progressive Neurological Deficits after Corpus Callosotomy May Be Caused by Autoimmune Encephalitis: A Case of Suspected Postoperative Anti-NMDAR Encephalitis
by Keisuke Hatano, Ayataka Fujimoto, Keishiro Sato, Takamichi Yamamoto, Hiroshi Sakuma and Hideo Enoki
Brain Sci. 2023, 13(1), 135; https://doi.org/10.3390/brainsci13010135 - 12 Jan 2023
Cited by 1 | Viewed by 1906
Abstract
The main causes of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis are ovarian teratoma and herpes simplex virus (HSV) encephalitis. We present a rare case of suspected anti-NMDAR encephalitis caused by corpus callosotomy (CC). An 18-year-old woman with Lennox-Gastaut syndrome underwent CC. Although left hemiplegic due [...] Read more.
The main causes of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis are ovarian teratoma and herpes simplex virus (HSV) encephalitis. We present a rare case of suspected anti-NMDAR encephalitis caused by corpus callosotomy (CC). An 18-year-old woman with Lennox-Gastaut syndrome underwent CC. Although left hemiplegic due to cerebral hemorrhage and impaired consciousness due to cerebral venous sinus thrombosis (CVST) appeared postoperatively, anticoagulant therapy quickly improved CVST and impaired consciousness. However, various unexplained symptoms such as insomnia, hallucination, impulsivity, impaired consciousness, and a new type of drug-resistant cluster seizures gradually developed over a 2-month period. Magnetic resonance imaging revealed the gradual extension of a hyperintense area from the right frontal lobe on fluid-attenuated inversion recovery images. Intravenous methylprednisolone pulse was initiated from postoperative day (POD) 74, followed by intravenous immunoglobulin (IVIg) therapy, although white blood cell counts were normal in all three cerebrospinal fluid (CSF) examinations. After IVIg therapy, the above unexplained symptoms promptly improved. On POD 103, antibodies against NMDAR were revealed in both the serum and CSF collected before these immunotherapies. The patient was transferred to a rehabilitation hospital due to residual left hemiplegia. Psychiatric symptoms and a new onset of drug-resistant seizures may be suggestive of postoperative anti-NMDAR encephalitis, even if CSF findings are mild. Full article
(This article belongs to the Special Issue Neurosurgery in Pediatrics)
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