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Pediatric Neurosurgical Conditions and Treatments

Learn about neural tube defects, spina bifida, hydrocephalus, and developmental dysplasia of the hip in children. Explore treatment options and signs to watch for.

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Pediatric Neurosurgical Conditions and Treatments

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  1. Neural tube defect • Encephalocele • Meningocele • Meylomeningocele

  2. Encephaloceleبيرون زدگي مغز ومنن‍‍‍‍‍ژ از ميان نقص استخوان سر

  3. Spina bifida • 1- Spina bifida(occulta) • 2-spina bifida cystica

  4. Spina bifida نقص در تكامل تيغه خلفي ستون مهره ها • Occulta • Meningoceleبيرون زدگي پرده هاي مننژ • Meylomeningocele • بيرون زدگي پرده هاي مننژ همرا ه با شبكه نخاعي

  5. Meningocele

  6. Meylomeningocele

  7. HYDROCEPHALUS

  8. Each shunt has 3 parts: • 1- Ventricular catheter: a small flexible tube which goes in the brain, in one of the cavities where the CSF is being retained. • 2- Reservoir : a small pump which regulates the amount of fluid that goes out. Through this the doctor can also check the working state of the shunt, as well as take CSF samples, when necessary, with a needle.

  9. 3- Distal catheter: another flexible tube that will take the fluid to the place where it is going to be absorbed. It is usually left with sufficient length, thinking in the child's growth.. • The shunts regulates the draining pressure. There are different levels of pressure, as high, medium and low. There are also some differences in the design but the means is always the same.

  10. Developmental Dysplasia of the Hip(DDH) • Acetabular Dysplasia( preluxation) • Subluxation • Dislocation

  11. Figure 3. A positive Galeazzi sign in a seven-month-old girl with left hip dislocation. Note the apparent femoral shortening

  12. علامت آلیس-علامت گالزیAllis &Galleazzi sign

  13. Figure 4. A three-year-old with a left hip dislocation. Note the limited abduction.

  14. علامت ترندلنبرگ Trendelenburg sign

  15. Figure 2. A 21-month-old child with right hip dislocation. Note the asymmetric skinfolds in the upper thigh

  16. Figure 1. Tests commonly used to assess hip stability. (A) Ortolanimaneuver. A gentle upward force is applied while the hip is abducted. (B) Barlow maneuver. A gentle downward force is applied while the hip is adducted.

  17. زمان تست • ارتولانی وبارلو = تولد تا 3-2 ماهگی بهترین زمان است • بعد از این سن (10-6 هفتگی)--->ایجاد انقباضات عضلات نزدیک کننده ران ---->محو علامت ارتولانی --

  18. درمان

  19. 6 تا 18 ماهگی • کشش جا اندازی تدریجی (3هفته ) • پس از جااندازی 4-2 ما ه گچ اسپایکا

  20. کودکان بزرگتر • مشکل است (تغییرات ثانویه در مفصل وفرم پا )(به طور کل بعد از 4 سالگی جااندازی سخت است ) • بعداز 6 سالگی غیر ممکن است • تنوتومی • استئوتومی • نوتوانی

  21. Figure 7. A four-month-old child in a hip spica cast following bilateral closed reductions and adductor tenotomies

  22. Figure 6. A newborn with bilateral hip dislocations in a Pavlik harness. The harness prevents hip extension and adduction but allows flexion and abduction

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