Combined endovascular and skull base surgical management of pediatric craniocervical pathology: a case series.

Autor:	Scoville JP; 1Department of Neurosurgery, Clinical Neurosciences Center, and., Findlay MC; 2School of Medicine, University of Utah, Salt Lake City, Utah., Joyce E; 1Department of Neurosurgery, Clinical Neurosciences Center, and., Alexiades N; 1Department of Neurosurgery, Clinical Neurosciences Center, and., Kurudza E; 1Department of Neurosurgery, Clinical Neurosciences Center, and., Taussky P; 1Department of Neurosurgery, Clinical Neurosciences Center, and., Brockmeyer DL; 1Department of Neurosurgery, Clinical Neurosciences Center, and.
Jazyk:	angličtina
Zdroj:	Journal of neurosurgery. Pediatrics [J Neurosurg Pediatr] 2023 Sep 29; Vol. 32 (6), pp. 710-718. Date of Electronic Publication: 2023 Sep 29 (Print Publication: 2023).
DOI:	10.3171/2023.7.PEDS23140
Abstrakt:	Objective: Pathological bony abnormalities of the craniocervical region in children sometimes require surgical intervention as part of their management. Rarely, abnormal skeletal or vascular anatomy can render traditional surgical techniques ineffective because of the risk of injury to the vertebral artery. To mitigate these risks, a combined endovascular and skull base approach was devised. The authors describe their experience using vertebral artery sacrifice as an adjunctive surgical method to reduce the risk of inadvertent vertebral artery injury during surgical correction of pediatric craniocervical deformity. Methods: Three patients underwent vertebral artery sacrifice for structural craniocervical pathologies (1 male, 2 females; ages 12, 14, and 3 years). One patient presented with basilar invagination odontogenic brainstem compression, and the other 2 patients presented with congenital cervical fusion. All patients underwent endovascular left vertebral artery sacrifice after passing balloon test occlusion. Results: No adverse effects from the vertebral artery sacrifice were observed. At the last follow-ups (35, 30, and 32 months), all 3 patients had a satisfactory outcome with no adverse effects as a result of their sacrificed artery. Conclusions: Endovascular vertebral artery sacrifice followed by skull base approaches can be used to effectively and safely treat craniocervical pathology from a variety of pediatric skeletal abnormalities.
Databáze:	MEDLINE
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