Analysis of pediatric neurosurgical diseases: A single-center study

Abstract

Objective To summarize the clinical epidemiological characteristics of pediatric neurosurgical diseases at a single center. Methods A total of 5 790 children (≤15 years old) with neurosurgical diseases admitted to Department of Neurosurgery, Xijing Hospital, Air Force Medical University from January 2008 to June 2018 were retrospectively enrolled. Their clinical data were analyzed and included the distribution of various diseases and clinical characteristics such as age, gender and lesion location. Results All 5 790 children included 2 259 cases (39.0%) of congenital malformation, 1 561 cases of tumor (27.0%), 953 cases of trauma (16.5%), 360 cases of cerebrovascular disease (6.2%), 159 cases of inflammation (2.7%), 91 cases of functional disorder (1.6%) and 407 cases of other diseases (7.0%). The gender ratio (male ∶female) was 1.76 ∶1.00. In all kinds of diseases, the proportion of male children was higher than that of female children, and the difference was statistically significant (P<0.001). The overall peak age of onset was 0-3 years old. Congenital malformations and tumors were predominant in 0-3 years old (42.9%) and 13-15 years old (26.3%), respectively. Three most frequent congenital malformations were arachnoid cyst (29.6%), hydrocephalus (28.2%) and tethered cord syndrome (20.0%). Temporal lobe was the most common site of arachnoid cyst (45.4%). Three most common tumors were glioma (19.7%), craniopharyngioma (9.0%) and medulloblastoma (8.8%). The ratios of brain tumors to spinal canal tumors, supratentorial tumors to infratentorial tumors and low-grade tumors to high-grade tumors were 5.61 ∶1.00, 1.73 ∶1.00 and 1.67 ∶1.00, respectively. Primary brain injury(365 cases) accounted for 58.6% of traumatic diseases and 59.2% (the highest proportion) of primary brain injury was brain contusion and laceration. In cerebrovascular diseases, the proportion of spontaneous hemorrhage (27.2%) was the highest. The most common inflammatory disease was inflammatory granuloma(22.6%). In addition, with the increase of age, the incidence of congenital malformation decreased gradually, while the incidence of cerebrovascular diseases increased gradually(both P<0.001). Conclusions Pediatric neurosurgical diseases have unique clinical epidemic characteristics. Congenital malformations and tumors are more common, and the incidence of arachnoid cysts and gliomas seems to be the highest. In various diseases, the incidence of male is higher than that of female, and the peak ages are different. Key words: Child; Neurosurgery; Epidemiology; Single-center study