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346 results on '"LoPresti, Melissa"'

3. Thoracolumbar Scoliosis in Pediatric Patients With Loeys-Dietz Syndrome: A Case Series.

Author

LoPresti, Melissa, Athukuri, Prazwal, Khan, A, Prablek, Marc, Patel, Rajan, Mayer, Rory, Bauer, David, Gerow, Frank, Morris, Shaine, Lam, Sandi, and Ravindra, Vijay

Subjects
connective tissue disorder, loeys-dietz syndrome, management, pediatrics, scoliosis
Abstract

Background Loeys-Dietz syndrome (LDS) is a genetic connective tissue disorder that predominantly affects cardiovascular, skeletal, and craniofacial structures. Associated thoracolumbar scoliosis in LDS can be challenging to manage, though other etiologies of pediatric scoliosis have better-defined management guidelines. We examined our institutional experience regarding the treatment of pediatric patients with LDS and scoliosis. Methodology In this retrospective study, all patients seen at our pediatric tertiary care center from 2004 through 2018 with a diagnosis of LDS were reviewed, and those with radiographic diagnoses of scoliosis (full-length scoliosis X-rays) were included. Demographic, clinical, and radiographic parameters were collected, and management strategies were reported. Results A total of 39 LDS patients whose ages ranged between seven and 13 years were identified. A total of nine patients were radiographically diagnosed with scoliosis, but three patients were excluded due to incomplete medical records, leaving six patients. The median age at scoliosis diagnosis was 11.5 years, with a median follow-up of 51 months. Two patients were successfully managed with observation (average initial Cobb angle (CA): 14°, average final CA: 20.5°). Two were braced, one successfully (initial CA: 15°, final CA: 30°) and one with a progressive disease requiring surgery (initial CA: 40°, final CA: 58°). Of the two who were offered surgical correction, one underwent surgery with a durable correction of spinal deformity (CA: 33° to 19°). One patient underwent a recent correction of aortic root dilatation and was not a candidate for scoliosis surgery. Conclusions Principles of adolescent idiopathic scoliosis management such as bracing for CA of 20-50° and surgery for CA of >50° can be applied to LDS patients with good outcomes. This augments our understanding of the treatment algorithm for pediatric patients with LDS.

Published
2023

4. Pediatric Brainstem Tumor Biopsy: Surgical Planning and Execution for Maximal Safety and Tissue Yield

Author

Dalmage, Mahalia, LoPresti, Melissa A., DeCuypere, Michael, Di Rocco, Concezio, Series Editor, Arraez, Miguel A., Editorial Board Member, Boop, Frederick A., Editorial Board Member, Froelich, Sebastien, Editorial Board Member, Kato, Yoko, Editorial Board Member, Pang, Dachling, Editorial Board Member, and Tu, Yong-Kwang, Editorial Board Member

Published
2024
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8. Endovascular Thrombectomy for Pediatric Acute Ischemic Stroke: A Multi-Institutional Experience of Technical and Clinical Outcomes.

Author

Ravindra, Vijay M, Alexander, Matthew, Taussky, Philipp, Bollo, Robert J, Hassan, Ameer E, Scoville, Jonathan P, Griauzde, Julius, Awad, Al-Wala, Jumaa, Mouhammad, Zaidi, Syed, Lee, Jonathan J, Hafeez, Muhammad Ubaid, Nascimento, Fábio A, LoPresti, Melissa A, Couldwell, William T, Hetts, Steven W, Lam, Sandi K, Kan, Peter, and Grandhi, Ramesh

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Pediatric, Neurosciences, Brain Disorders, Stroke, Hematology, Clinical Research, Adolescent, Child, Child, Preschool, Cohort Studies, Endovascular Procedures, Female, Humans, Ischemic Stroke, Longitudinal Studies, Male, Reperfusion, Retrospective Studies, Thrombectomy, Treatment Outcome, Cerebrovascular, Endovascular, Anticoagulation, Ischemic stroke, Pediatrics, Neurology & Neurosurgery, Clinical sciences, Biological psychology
Abstract

BackgroundEndovascular thrombectomy is a promising treatment for acute ischemic stroke in children, but outcome and technical data in pediatric patients with large-vessel occlusions are lacking.ObjectiveTo assess technical and clinical outcomes of thrombectomy in pediatric patients.MethodsWe undertook a retrospective cohort study of pediatric patients who experienced acute ischemic stroke from April 2017 to April 2019 who had immediate, 30-, and 90-d follow-up. Patients were treated with endovascular thrombectomy at 5 US pediatric tertiary care facilities. We recorded initial and postprocedural modified Thrombolysis in Cerebral Infarction (mTICI) grade ≥ 2b, initial and postprocedural Pediatric National Institutes of Health Stroke Scale (PedNIHSS) score, and pediatric modified Rankin scale (mRS) score 0 to 2 at 90 d.ResultsThere were 23 thrombectomies in 21 patients (mean age 11.6 ± 4.9 yr, median 11.5, range 2.1-19; 52% female). A total of 19 (83%) thrombectomies resulted in mTICI grade ≥ 2b recanalization. The median PedNIHSS score was 13 on presentation (range 4-33) and 2 (range 0-26) at discharge (mean reduction 11.3 ± 6.1). A total of 14 (66%) patients had a mRS score of 0 to 2 at 30-d follow-up; 18/21 (86%) achieved that by 90 d. The median mRS was 1 (range 0-4) at 30 d and 1 (range 0-5) at 90 d. One patient required a blood transfusion after thrombectomy.ConclusionIn this large series of pediatric patients treated with endovascular thrombectomy, successful recanalization was accomplished via a variety of approaches with excellent clinical outcomes; further prospective longitudinal study is needed.

Published
2021

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