Pediatric emergency medicine trisk 4026 4026

patient may suffer from the progression of hydrocephalus with symptoms of
headaches, agitation, and obtundation. The development of cranial nerve
dysfunction necessitates neurosurgical intervention for decompression of
the posterior fossa with potential removal of hemorrhage.
Venous Infarcts. Venous infarcts are generally seen after craniotomy,
especially if the venous sinuses are involved in the surgical field. Repair of
dural sinus lacerations or prolonged compression of a sinus by an extrinsic
force places the patient at risk of venous sinus thrombosis and infarction.
Presenting symptoms include headache, nausea, vomiting, and seizures,
often resembling those caused by pseudotumor cerebri. Cerebral venous
thrombosis and/or dural sinus thrombosis can lead to venous infarction.
This infarction may present as hemorrhage and often involves the
subcortical white matter. CT scan reveals hemorrhage that may traverse the
typical arteriovascular boundaries. The component of hemorrhage or
significant mass effect resulting from cerebral edema becomes a
neurosurgical emergency. Evacuation of the clot may be necessary, as may
decompressive craniectomy.
Suggested Readings and Key References
Blumstein H, Schardt S. Utility of radiography in suspected ventricular
shunt malfunction. J Emerg Med 2009;36(1):50–54.
Brown RD Jr, Weibers DO, Forbes GS. Unruptured intracranial aneurysms
and arteriovenous malformations: frequency of intracranial hemorrhage
and relationship of lesions. J Neurosurg 1990;73(6):859–863.
Carney N, Totten AM, O’Reilly C, et al. Guidelines for the management of
severe traumatic brain injury, fourth edition. Neurosurgery 2017;80(1):6–
15.
Chandrasenan J, Klezl Z, Bommireddy R, et al. Spondylodiscitis in
children. J Bone Joint Surg Br 2011;93(8):1122–1125.
Chi JH, Fullerton HJ, Gupta N. Time trends and demographics of deaths
from congenital hydrocephalus in the United States: national center for
health Statistics data, 1979 to 1998. J Neurosurg 2005;103(2 Suppl):113–

118.