TY - JOUR T1 - Ablative stereotactic neurosurgery for irreducible neuroaggressive disorder in pediatric patients JO - Neurocirugía (English edition) T2 - AU - Hernández Salazar,Manuel AU - Zarate Méndez,Antonio AU - Meneses Luna,Oscar AU - Ledesma Torres,Lucía AU - Paniagua Sierra,Ramón AU - Sánchez Moreno,Mary Carmen AU - Serrato Avila,Juan Leonardo SN - 25298496 M3 - 10.1016/j.neucie.2018.07.003 DO - 10.1016/j.neucie.2018.07.003 UR - https://revistaneurocirugia.com/en-ablative-stereotactic-neurosurgery-for-irreducible-articulo-S2529849618300315 AB - Introduction and objectivesThe irreducible neuroaggressive disorder (IND) is a well-described entity known to be associated with impulsive and aggressive behaviour. While various studies have assessed available pharmacological and non-pharmacological treatment regimens, patients with IND continue to pose a major threat to themselves and society. While targeted stereotactic therapy for IND has gained traction in recent years, there is a paucity of information describing comparative effectiveness of different validated anatomic regions. In this paper, we discuss the surgical results for patients with IND following targeted lesional therapy with a special focus on selection criteria and operative methods. The objective is to analyse the efficacy and safety of the different described targets for this disorder in paediatric patients. Materials and methodsEight paediatric patients met strict criteria for IND and were enrolled in this study. Electroencephalography (EEG), video electroencephalography (VEEG) and magnetic resonance imaging (MRI) were performed in all patients prior to surgery. Irreducible neuroagressive symptom was approached by lesional therapy based on most described targets for this disorder and assessed by the Overt Aggression Scale (OAS) pre-operatively and 6 months following surgery, using Wilcoxon test for statistical analysis. Results and conclusionsThe average patient age was 13 years 2 months. 7 of the 8 patients enrolled had intellectual disabilities, 1 patient suffered neurologic sequelae referable to Dandy–Walker syndrome and 7 patients had no preoperative anatomical alterations. Following surgery, patients with IND noted improvement in their OAS. On average, the OAS improved by 39.29% (p=.0156), a figure similar in comparison to studies assessing treatment of IND in adult patients. The most satisfactory results were achieved in patients whose ablative therapy involved the Amygdala in their targets. There were no deaths or permanent neurological deficits attributable to procedure. To the author's knowledge, this is the largest series described in the literature for paediatric patients with IND treated with lesional stereotactic therapy. ER -