Common Neurosurgical Conditions in the Pediatric Practice: Recognition and Management PDF
Preview Common Neurosurgical Conditions in the Pediatric Practice: Recognition and Management
Common Neurosurgical Conditions in the Pediatric Practice Recognition and Management Jeff rey P. Greenfi eld Caroline B. Long Editors 123 Common Neurosurgical Conditions in the Pediatric Practice Jeffrey P. Greenfi eld • Caroline B. Long Editors Common Neurosurgical Conditions in the Pediatric Practice Recognition and Management Editors Jeffrey P. Greenfi eld, MD, PhD Caroline B. Long, MD Associate Professor of Neurological Manhattan Pediatrics Surgery New York , NY , USA Weill Cornell Medical College New York , NY , USA ISBN 978-1-4939-3805-6 ISBN 978-1-4939-3807-0 (eBook) DOI 10.1007/978-1-4939-3807-0 Library of Congress Control Number: 2016945972 © Springer Science+Business Media New York 2017 T his work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfi lms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. T he use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. T he publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. Printed on acid-free paper This Springer imprint is published by Springer Nature The registered company is Springer Science+Business Media LLC New York Pref ace Within medicine, increasing subspecialization has created an almost impos- sible task; primary care providers are now asked to triage their patients and provide appropriate referrals within a dizzying array of diverse medical fi elds. Pediatric neurosurgery remains one of a number of highly specialized fi elds within which most pediatric practitioners including physicians, physician’s assistants, and nurse practitioners have never received any training. This fact, combined with the rarity of pediatric neurosurgical diseases, the acuity with which many of them present, the need for rapid triage and tertiary care, and parental anxiety when receiving a neurologic diagnosis, creates a challenging situation for providers caring for children with these conditions. S everal years ago, we hosted a CME event in New York City bearing the same name as this textbook. We solicited comments from attendees and were pleased that most participants felt we were fi lling a real defi ciency in medical education—the cross-fertilization between subspecialties. In fact, a recent survey of pediatricians through an AAP initiative supports our suspicion that many primary care providers felt uncomfortable managing patients with neu- rosurgical conditions. This survey also suggested a number of neurosurgical topics that pediatricians felt they wanted more assistance in managing and triaging. All of these topics, and many others, are covered from both a neuro- surgical and pediatric perspective in this textbook. In fact, this textbook was designed around a central concept: Pediatricians and subspecialists need to have a closer working relationship to make childhood medicine work seamlessly in 2016 and beyond. A pediatrician in a busy practice should not be expected to explain to a concerned parent what the differences in treatment options may be between different types of brain tumors; however all pediatric practitioners should be able to discern between benign and worrisome headaches and to decide when imaging, referral to neurology, or triage to an emergency department is war- ranted. The relationship between primary care physicians and subspecialists such as pediatric neurosurgeons is obviously at the crux of this book, but should also be at the forefront of mutual efforts to improve care of children. This textbook will never be able to replace the trust and confi dence that is built through years of communication and shared patient experiences. To highlight our belief in the strength of the relationship between primary care providers and subspecialists, this book was envisioned by and co-edited by a pediatric neurosurgeon and a pediatrician each providing the perspective v vi Preface from within the lens through which they view these common neurosurgical conditions. We hope the vignettes provide real-life fl avor to experiences many of you have had, or will have. We expect that the “red fl ags,” “pediatri- cian’s perspective,” and references will serve as focused reviews on many of these topics. When reading a newly arrived imaging report, or caring for a child with an unfamiliar diagnosis, these chapters can serve as a medical refresher before calling a parent back with unexpected news or reviewing a fi nding in the offi ce. The book is organized into parts that loosely approximate the neurologic development of a child and address issues that are commonly encountered. The fi rst part reviews neurologic development and birth-related trauma com- monly seen in the neonatal intensive care unit including issues such as brain injury, brachial plexus injury, and hematomas. The second part addresses fi ndings commonly encountered in the fi rst month of life in the pediatri- cian’s offi ce. Lumps and bumps, manifestations of neurocutaneous diseases, or tethered cord stigmata are all reviewed in depth. The third part is a com- prehensive review of hydrocephalus from birth-related intraventricular hem- orrhage through the work-up of macrocephaly and headache management. Part 4 is an important group of chapters describing up to the date thoughts on imaging the central nervous system in children from prenatal ultrasound through MRI and CT including when these different modalities are impor- tant to select and the risks associated with each. The fi fth grouping of chap- ters consists of explorations of common neurosurgical conditions that many pediatricians are uncomfortable dealing with, including brain tumors, spas- ticity, and vascular lesions to use as a reference tool when caring for a com- plex neurosurgical patient. Finally a series of chapters related to head trauma concludes the textbook, including sections on non-accidental trauma and concussion management. Most importantly, we hope the topics we cover in the ensuing chapters provide you with some measure of confi dence in dealing with conditions you may feel less comfortable with than others, and provide a framework within which you can direct subspecialized care. W e would very much like to take this opportunity to thank our mentors within medicine—Dan Cohen, Gary Edelstein, Sarah Long, Phil Stieg, and Mark Souweidane—for supporting and inspiring our careers and providing continual support and guidance through the years. Educating subsequent gen- erations of pediatricians and neurosurgeons with the lessons you taught us is your greatest legacy and we are proud to be within your lineages. T o our parents and families who instilled within us the belief that educa- tion and academics can be at the center of a rich and meaningful life, thank you for supporting our endless training and sharing pride in our demanding but fulfi lling careers. Everything we have learned began with your confi dence in us and now allows us to begin to pass this on to the next generation of pediatric physicians. F inally, we are forever indebted to Richard Lansing and Joni Fraser from Springer for seemingly unending patience as we tried to balance our busy medical careers and four young boys at home with an innocent foray into the editing and publishing world. We hope your confi dence in us is rewarded in Preface vii the impact this book will have and the children benefi ting from the shared knowledge going forward. To our readers, best of luck caring for your patients with these neurologic conditions—there is often no greater challenge in medicine but also often no greater reward! New York, NY, USA Jeffrey P. Greenfi eld Caroline B. Long Contents Part I Development of the Brain and Spine 1 Normal Development of the Skull and Brain ............................ 3 Waleed A. Azab 2 The Neurologic Exam in Neonates and Toddlers ...................... 11 Alison S. May and Sotirios T. Keros Part II Newborn Through Infancy 3 Birth Trauma to the Scalp and Skull ......................................... 27 Babacar Cisse , Ibrahim Hussain , Jeffrey P. Greenfi eld, and Caroline B. Long 4 Brachial Plexus Injuries During Birth ....................................... 35 Peter F. Morgenstern 5 Neonatal Brain Injury ................................................................. 47 Anil Sindhurakar and Jason B. Carmel 6 Evaluation of Head Shape in the Pediatric Practice: Plagiocephaly vs. Craniosynostosis ............................................ 61 Charlotte A. Beam , G. Rene Alvarez Berastegui , and Jeffrey P. Greenfi eld 7 Neurocutaneous Disorders .......................................................... 71 Kaleb H. Yohay and Matthew McCarthy 8 Cutaneous Markers of Spinal Dysraphism ................................ 93 Assem M. Abdel-Latif 9 Tethered Cord ............................................................................... 101 María Teresa Alvarado Torres 10 Lumps and Bumps: Scalp and Skull Lesions ............................ 107 Nelson Moussazadeh and Matei A. Banu ix
The list of books you might like
