Preferred Parental Language and Neurodevelopmental Outcomes Among Infants With Acute Provoked Neonatal Seizures in the United States.

BACKGROUND: Parental non-English language preference (NELP) is associated with worse pediatric health outcomes. However, little is known about its relationship with developmental outcomes in infants with neonatal seizures. This study evaluated the relationship between parental NELP and neurodevelopment in a multicenter cohort of infants with neonatal seizures. METHODS: Infants in the Neonatal Seizure Registry-II were included. Parental NELP was defined by the use of a professional interpreter for research consent and survey completion. The Warner Initial Developmental Evaluation of Adaptive and Functional Skills (WIDEA-FS) assessment was conducted at age 24 months. Multivariate regression was used to examine the association between parental NELP and WIDEA-FS. Functional developmental impairment was defined as a WIDEA-FS score 2 S.D.s below the normative mean. RESULTS: Among 270 infants with neonatal seizures, 15 (6%) had parental NELP. Children with parental NELP had a WIDEA-FS score that was on average 13 points lower than that of infants without parental NELP (95% confidence interval [CI]: -27 to 1, P = 0.08) and over five times the odds of functional developmental impairment (odds ratio 4.9, 95% CI: 1.3 to 18.4, P = 0.017). CONCLUSIONS: Children with parental NELP were more likely to have functional developmental impairment at age 24 months when compared with children without parental NELP. Since parental NELP does not have a biologically plausible impact on neurodevelopment it likely reflects discriminatory experiences that affect developmental opportunities. These findings highlight the importance of identifying social drivers to decrease potential gaps in neurodevelopmental attainment for children with parental NELP

Deciphering the Natural History of

BACKGROUND AND OBJECTIVES: METHODS: In this study, we harmonized electronic medical record data from 82 individuals with RESULTS: Compared with the cohort of other known or presumed genetic epilepsies, those with DISCUSSION

NDUFS8-Related Leigh Syndrome Mimicking a Leukodystrophy.

Leigh syndrome is a progressive infantile neurodegenerative disorder of mitochondrial metabolism that often leads to decompensation in the setting of metabolic stress. It is genetically heterogenous with varied inheritance patterns. One subtype include

Long-term safety and efficacy of the FRED X flow diverter for intracranial aneurysms: a multicenter study of 154 patients.

OBJECTIVE: The Flow-Redirection Endoluminal Device X (FRED X) is a newer generation flow diverter with surface modifications aimed at minimizing thrombogenicity. At present, data on its long-term efficacy are limited. This multicenter study presents the largest series within the United States describing the device\u27s efficacy, safety, and long-term outcomes in treating cerebral aneurysms of varying morphology. METHODS: Patients treated with the FRED X for a cerebral aneurysm between February 2022 and February 2024 at 6 high-volume centers across the United States were included. Data were collected regarding demographics, clinical presentation, and procedural efficacy. Angiographic and clinical follow-up outcomes were assessed at 6 and 12 months. RESULTS: A total of 154 patients with 162 aneurysms were treated with 164 FRED X devices over the study period. Overall, 81.8% of the cohort was female with a mean age of 56.8 years. The authors observed satisfactory rates (≥ 99.3%) of device deployment and good wall apposition and neck coverage. One hundred forty-seven (95.5%) patients were functionally independent at discharge (modified Rankin Scale scores 0-2). Rates of adequate occlusion (Raymond-Roy Occlusion Scale score I or II) increased from 84.2% at 6 months to 83.5% at the 12-month follow-up, while rates of in-stent stenosis decreased. All patients (100%) who underwent follow-up were functionally independent at 6 months, and 95.9% were functionally independent at 12 months. CONCLUSIONS: This multicenter cohort study demonstrates the ease of FRED X deployment with an adequate safety profile, with low rates of procedural complications and favorable outcomes on follow-up. Rates of aneurysm occlusion increased over time, with a subsequent decrease in stent-associated complications

Analysis of Endoscope-Assisted Retrosigmoid Approach versus Modified Transjugular Approach for Microvascular Decompression of the Facial Nerve: A Comparative Cadaveric Study.

OBJECTIVE: Two main approaches for microvascular decompression for hemifacial spasm include the retrosigmoid approach (RA) and the modified transjugular-tubercular approach (MTA). This anatomical study compares both and evaluates the value of neuroendoscopy. METHODS: Dissections were performed on 4 cadaveric human heads, performing RA on one side and MTA on the other. Anatomical landmarks were determined beforehand, and the accessibility to each was evaluated by determining visibility with a microscope and 0°, 30°, and 45° endoscopes. The degree of freedom at each landmark, representing the working area afforded by each approach, was measured using vectors from the boundaries of the craniotomy to the points of interest. RESULTS: MTA yielded 90.1% greater degree of freedom (P \u3c 0.00001) at the internal acoustic canal and 118.3% greater access (P \u3c 0.001) to the facial nerve root exit zone than RA. For landmarks with sub-100% microscopic visualization, the 0° endoscope improved visualization for 15/16 (94%) landmarks with RA and 9/9 (100%) with MTA. Introducing 30° and 45° angled endoscopes improved visualization in every instance. Although MTA provided a higher visualization for some landmarks with the microscope and 0° endoscope, all discrepancies were eliminated with the 30° endoscope, while the 45° endoscope showed identical visualization. CONCLUSIONS: Despite the greater degree of freedom with MTA, visualizing and manipulating the facial nerve at the root exit zone was comparable between both approaches, with the use of angled endoscopy further improving visualization and accessibility. As such, the endoscope-assisted RA, with its smaller exposure and soft-tissue disruption, is a viable approach for microvascular decompression for hemifacial spasm