Physical and psychological health concerns have been raised due to either spine deformity or orthotic treatment in adolescents with idiopathic scoliosis. To determine whether orthotic bracing duration affects psychological stress and health-related quality of life, a sample of 46 patients (8M, 38F, aged 11–17 years, regularly treated with bracing) with moderate or moderate to severe idiopathic scoliosis were separated into two groups based on whether their treatment duration was up to six months or longer. The brace-related levels of stress and quality of life were investigated in both groups by using the Bad Sobernheim Stress Questionnaire and the Italian Spine Youth Quality of Life, respectively. The questionnaire scores were categorized as low, mean, and high. Our statistical analysis considered the proportion of patients falling into the three categories and the difference in crude score rates between the two groups. Values were considered significant at p < 0.05. The proportion of patients with brace-related stress and impaired quality of life was significantly lower in the group treated longer compared to the group that had only received treatment for up to six months (chi-square test, p < 0.0001). Overall, mean ± SD BSSQ scored 8.72 ± 4.91 and 12.89 ± 4.65 in group 1 and group 2, respectively (Mann–Whitney U test, p = 0.008), while ISYQoL scored 19.94 ± 8.21 and 16.07 ± 6.12, respectively. We argue that the differences could depend on both the physical and psychological adaptation patients make to their brace and that more support should be provided to patients when they start to wear their brace.

Background/Objectives: Post-varicella arteriopathy (PVA) is a significant cause of pediatric arterial ischemic stroke (AIS) that typically involves previously healthy children within 12 months of primary varicella infection, mostly with a monophasic course. Diagnosis is based on clinical and imaging findings, and cerebrospinal fluid analysis may confirm it; treatment is empirical and heterogeneous. We describe a typical case of PVA and present a systematic review of its clinical, radiological, therapeutic, and outcome features. Methods: Following PRISMA 2020 and AMSTAR-2 guidelines, data on demographics, clinical presentation, imaging, laboratory confirmation, treatment, and outcomes were extracted across databases (PubMed, Embase, Scopus). Results: Forty-seven studies, encompassing 312 pediatric patients, were included. Mean age was 4 years with a median latency of 3.82 months from varicella to neurologic symptoms. Common presentation included hemiparesis, language impairment, and seizures. Imaging findings showed unilateral focal involvement of anterior circulation arteries, basal ganglia infarctions, and, rarely, bilateral or posterior circulation involvement. CSF VZV-DNA PCR and anti-VZV IgG were positive in 39% and 48% of tested patients. Treatment included intravenous acyclovir (34%), corticosteroids (20%), and low-dose aspirin (77%); two patients underwent acute reperfusion therapy (rt-PA or thrombectomy). Outcomes tended to be moderately favorable: 43% achieved full recovery, 45% had residual deficit, and 11% experienced recurrence. Prothrombotic state was reported, and it may influence disease severity. Conclusions: PVA is a rare distinct cause of pediatric stroke, with a generally favorable prognosis quoad vitam. Standardized guidelines and prospective studies are needed to establish evidence-based management. Clinicians should maintain a high suspicion for its diagnosis.

Papilledema is a potentially vision-threatening finding in children, often diagnosed during routine ophthalmological evaluation in asymptomatic subjects, which requires prompt diagnostic evaluation to exclude intracranial pathology. The available literature suggests that a significant proportion of cases with confirmed idiopathic intracranial hypertension (IIH) may present without headache or other manifestations of increased intracranial pressure. Current diagnostic criteria for pediatric IIH include lumbar puncture (LP) as a mandatory step following neuroimaging. However, the invasive nature of this procedure raises critical questions regarding the identification of patients who truly require this investigation. Indeed, the challenge of distinguishing true papilledema from pseudopapilledema represents the critical diagnostic prerequisite, requiring an expert pediatric neuro-ophthalmologist to ensure appropriate patient selection and avoid unnecessary tests. Evidence regarding the management of asymptomatic IIH is limited. Most published cohorts report treatment with acetazolamide despite the absence of symptoms, probably based on concerns regarding potential visual deterioration rather than prospective data. Currently, data from pediatric populations characterizing the natural history of untreated patients are lacking, and there is no consensus regarding treatment duration, tapering strategies, or long-term follow-up for this group. This narrative review summarizes the current literature on the diagnostic and therapeutic strategies for asymptomatic pediatric papilledema. It focuses on the role of lumbar puncture, the importance of differentiating papilledema from pseudopapilledema, and the uncertainties surrounding treatment decisions. Nevertheless, significant knowledge gaps persist regarding the optimal management of these patients, highlighting the need for prospective studies.