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Edgardo Schijman

Publications and source records attributed to Edgardo Schijman.

9 recordsLinked to original sources
PubMed2005

Artificial cranial deformation in newborns in the pre-Columbian Andes.

INTRODUCTION: Artificial deformation of the neonatal cranial vault is one form of permanent alteration of the body that has been performed by the human being from the beginning of history as a way of differentiating from others. These procedures have been observed on all continents, although it became widespread practice among the aborigines who lived in the Andean region of South America. It has been suggested that the expansion of this practice started with the Scythians from their original settlements in central Asia and spread toward the rest of Asia and Europe, and it is believed that Asiatic people carried this cultural custom to America when they arrived on the current coasts of Alaska after crossing the Strait of Behring. The practice of deforming newborn heads was present in the whole of the American continent, from North America to Patagonia, but cranial molding in neonates was most widely practiced in the Andean region, from Venezuela to Guyana, Colombia, Ecuador, Peru, Bolivia, Chile, and Argentina. METHODS: Intentional deformation of the head in neonates was carried out in different ways: by compression of the head with boards and pads; by compression with adjusted bindings; or by restraining the child on specially designed cradle-boards. PURPOSE: The purpose of head shaping varied according to culture and region: while in certain regions it was a symbol of nobility or separated the different social groups within society, in others it served to emphasize ethnic differences or was performed for aesthetic, magical or religious reasons. CONCLUSION: There is no evidence of any neurological impairment among indigenous groups who practiced cranial deformations in newborns.

Adult↗
PubMed2004

International survey on the management of Chiari I malformation and syringomyelia.

INTRODUCTION: The availability of magnetic resonance imaging (MRI) has resulted in an increasing number of asymptomatic, minimally symptomatic, and doubtfully symptomatic patients being diagnosed with a Chiari I malformation with or without syringomyelia. In an attempt to clarify how neurosurgeons manage these clinical problems, an international survey on the Chiari I malformation and related syringomyelia was undertaken. METHOD: A questionnaire on the expected natural course of the disease and on aspects of the surgical technique for a number of hypothetical cases relating to Chiari I malformation with and without syringomyelia was used to survey Pediatric Neurosurgeons worldwide. RESULTS: Of 246 questionnaires distributed, 76 (30.8%) were completed and returned. There was a consensus that no operation should be carried out in asymptomatic patients with a Chiari I malformation, unless there is associated syringomyelia. There was a consensus that decompression of the Chiari malformation should be performed in patients with scoliosis when syringomyelia is present, and the majority decompressed the Chiari malformation in scoliotic patients even in the absence of syringomyelia. Suboccipital decompression was the standard surgical procedure for Chiari I malformations. The majority of respondents favored routine dural opening at surgery and closure with a pericranial or synthetic patch graft. In the case of a persistent or progressive syrinx after suboccipital decompression, the majority recommended shunting of the syrinx to the subarachnoid space or to the pleural cavity. CONCLUSION: There continues to be much variation in the management of the Chiari I malformation.

Arnold-Chiari Malformation↗
PubMed2004

History, anatomic forms, and pathogenesis of Chiari I malformations.

INTRODUCTION: Chiari I malformations constitute a group of entities of congenital or acquired etiology that have in common descent of the cerebellar tonsils into the cervical spinal canal. In recent years, since the advent of magnetic resonance imaging, an increasing number of asymptomatic, doubtfully symptomatic, and minimally symptomatic patients with Chiari I malformations have been diagnosed. This has resulted in controversy about the multiple therapeutic strategies indicated for these problems. OBJECT: With the intention of updating the knowledge that we currently have on the Chiari I malformation and the related syringomyelia we review the literature and discuss the historical background, pathogenesis, anatomic forms, clinical presentation, and diagnostic procedures of these abnormalities.

Arnold-Chiari Malformation↗
PubMed2004

Management of hydrocephalus in posterior fossa tumors: how, what, when?

OBJECT: The aim of this work is to analyze the current management of hydrocephalus associated with posterior fossa (PF) tumors. METHODS: The personal perspectives of experienced pediatric neurosurgeons were presented at a virtual round table. DISCUSSION: Preoperative hydrocephalus has been reported in about 80% of patients with PF tumors and postoperative treatment is required for persistent or progressive hydrocephalus in about 25-30% of the cases. Preoperative management includes external ventricular drainage (EVD), endoscopic third ventriculostomy (ETV), shunt insertion, and no treatment at all, while ETV and ventriculo-peritoneal (V-P) shunt are recommended as treatment after PF craniotomy. CONCLUSION: There is no consensus on the way hydrocephalus should be managed before, during, and after PF surgery. While awaiting prospective multicenter trials of various management schemes the perioperative management of hydrocephalus in the context of posterior fossa tumors should be considered as options.

Attitude of Health Personnel↗
PubMed2003

Split spinal cord malformations: report of 22 cases and review of the literature.

OBJECT: The aims of this study were to describe the embryological changes that drive the formation of a split spinal cord malformation, analyse the forms of presentation, evaluate the diagnostic procedures and discuss the indications for the different forms of therapy for each case. METHODS: Clinical and radiological features of 22 cases of split spinal cord malformations (SSCM) are reported. Three groups of patients are considered: group a, patients with signs of tethered cord or scoliosis; group b, patients with midline cutaneous stigmata and group c, patients with a meningocele or meningomyelocele. CONCLUSION: While CT scan is particularly useful for the evaluation of vertebral bodies and posterior arch abnormalities and spur characteristics in SSCM, MRI gives complementary information on the anatomy of spinal cord, dural sac, conus and filum terminale and permits the exclusion of associated lesions such as hydro-syringomyelia, dermal sinus or dermoid and epidermoid cysts. Surgery should be considered indicated in all cases of SSCM, even the asymptomatic ones, except in very badly handicapped meningomyelocele patients with nonprogressive disability and type II SSCM.

Adolescent↗