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Related Concept Videos

Disorders of Hemostasis01:24

Disorders of Hemostasis

Hemostasis, the process that stops bleeding after a blood vessel injury, is crucial for maintaining the integrity of the circulatory system. However, disorders of hemostasis can disrupt this delicate balance, leading to either excessive clotting or bleeding. These disorders can be broadly classified into thromboembolic disorders and bleeding disorders.
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
Epilepsy ll: Types01:22

Epilepsy ll: Types

Recurrent seizures, stemming from abnormal electrical activity in the brain, are the defining characteristic of epilepsy, a chronic neurological condition. Because seizure features vary greatly, epilepsy is classified using two systems: by seizure type and by epilepsy syndromes. These classifications enable clinicians to describe seizure patterns and select suitable treatment strategies.I. Classification by Seizure Type1. Focal EpilepsyFocal epilepsy begins in one hemisphere of the brain.

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Interictal High Frequency Oscillations Detected with Simultaneous Magnetoencephalography and Electroencephalography as Biomarker of Pediatric Epilepsy
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Coagulation abnormalities in children undergoing epilepsy surgery.

Donato Pacione1, Francine Blei, Orrin Devinsky

  • 1Department of Neurosurgery, Division of Pediatric Neurosurgery, NYU Langone Medical Center, New York, NY, USA.

Journal of Neurosurgery. Pediatrics
|June 3, 2011
PubMed
Summary
This summary is machine-generated.

Preoperative screening for epilepsy surgery in children may miss coagulation issues. Platelet aggregation studies are recommended for children with tuberous sclerosis complex (TSC) to detect bleeding risks.

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Area of Science:

  • Pediatric Neurology
  • Hematology
  • Surgical Oncology

Background:

  • Epilepsy surgery is a growing treatment for pediatric refractory epilepsy.
  • Preoperative evaluation aims to identify bleeding risks not apparent through standard history and physical exams.
  • Routine screening may not detect all underlying coagulation abnormalities.

Purpose of the Study:

  • To evaluate the adequacy of standard preoperative screening for coagulation abnormalities in children undergoing epilepsy surgery.
  • To identify specific patient factors associated with these abnormalities.
  • To determine if enhanced testing, such as platelet aggregation studies, is warranted in certain pediatric epilepsy populations.

Main Methods:

  • Prospective evaluation of 39 children undergoing pre-epilepsy surgery testing.
  • Detailed hematological history and extensive laboratory panel including coagulation profiles and platelet aggregation studies.
  • Analysis of patient variables: tuberous sclerosis complex (TSC), age, seizure characteristics, and medication use.

Main Results:

  • 25.6% of children had coagulation or platelet function abnormalities.
  • Platelet function abnormalities were linked to TSC (p=0.012), while coagulopathy was more common in non-TSC patients (p=0.041).
  • Two TSC patients with normal standard screening had platelet aggregation abnormalities; one experienced significant intraoperative bleeding.

Conclusions:

  • Standard preoperative screening and history are insufficient for detecting all coagulation issues in pediatric epilepsy surgery candidates.
  • Platelet aggregation studies are crucial for patients with TSC to identify potential bleeding risks.
  • Enhanced hematological evaluation may improve surgical safety in this population.