Obstructive Sleep Apnea and Short-Term Outcomes After Pediatric Cardiac Surgery.

Obstructive sleep apnea (OSA) has been associated with negative cardiovascular effects and negative outcomes following cardiovascular surgery in the adult population. Our objective was to evaluate if there is a similar association in children. Single center retrospective matched cohort study, we collected data on patients aged 1-18 who were admitted to the cardiac intensive care unit (CICU) between Jan 2012 and Dec 2021.

Characterizing a new clinical phenotype: the co-existence of cerebral venous outflow and connective tissue disorders.

Background: There is increasing recognition of connective tissue disorders and their influence on disease in the general population. A conserved clinical phenotype involving connective tissue disorders and idiopathic intracranial hypertension (IIH) and associated cerebral venous outflow disorders (CVD) has not been previously described.

Methods: A single-institution retrospective review of a prospectively maintained database of patients with connective tissue disorders and CVD was performed.

Craniotomies at an overseas military treatment facility: Maintaining readiness for the unit and the surgeon.

Introduction: Craniotomy and craniectomy are common neurosurgical procedures with wide applications in both civilian and military practice. Skill maintenance for these procedures is required for military providers in the event they are called to support forward deployed service members suffering from combat and non-combat injuries. The presents investigation details the performance of such procedures at a small, overseas military treatment facility (MTF).

Mechanical thrombectomy decision making and prognostication: Stroke treatment Assessments prior to Thrombectomy In Neurointervention (SATIN) study.

Background: Mechanical thrombectomy (MT) is the standard-of-care treatment for stroke patients with emergent large vessel occlusions. Despite this, little is known about physician decision making regarding MT and prognostic accuracy.

Methods: A prospective multicenter cohort study of patients undergoing MT was performed at 11 comprehensive stroke centers.

Bow hunter syndrome in rheumatoid arthritis: illustrative case.

Background: Rheumatoid arthritis (RA) frequently features degeneration and instability of the cervical spine. Rarely, this degeneration manifests as symptoms of bow hunter syndrome (BHS), a dynamic cause of vertebrobasilar insufficiency.

Observations: The authors reviewed the literature for cases of RA associated with BHS and present a case of a man with erosive RA with intermittent syncopal episodes attributable to BHS as a result of severe extrinsic left atlantooccipital vertebral artery compression from RA-associated cranial settling.

The Expanding Role of Quantitative Pupillometry in the Evaluation and Management of Traumatic Brain Injury.

Traumatic brain injury is a rapidly increasing source of morbidity and mortality across the world. As such, the evaluation and management of traumatic brain injuries ranging from mild to severe are under active investigation. Over the last two decades, quantitative pupillometry has been increasingly found to be useful in both the immediate evaluation and ongoing management of traumatic brain injured patients.

Superior Ophthalmic Vein Flow Patterns as a Marker of Venous Sinus Stenosis and Hypertension in Idiopathic Intracranial Hypertension: A Case of Emergent Transverse Sinus Stenting as Treatment of Fulminant Idiopathic Intracranial Hypertension.

Background: Fulminant idiopathic intracranial hypertension (IIH) can cause rapid vision loss. Transverse sinus stenosis is a finding commonly associated with IIH, and transverse sinus stenting has been used to rapidly reduce intracranial pressure and improve visual symptoms. Our objective was to describe a case of immediate alteration in reversed superior ophthalmic vein (SOV) flow in a fulminant IIH patient who underwent venous sinus stenting.

Incidental Finding of a Duplicated Vertebral Artery Followed by a Spinal Dural Arteriovenous Fistula on Spinal Angiography.

Duplicated origin of the vertebral artery (VA) is an extremely rare normal anatomic variant. While most often considered non-pathological, duplicated origin carries an increased risk of dissection. An association with vascular pathologies such as aneurysms, arteriovenous malformations, and AV fistulas has been suggested.

Transpacific Aeromedical Evacuation for a Ruptured Brain Arteriovenous Malformation During the COVID-19 Pandemic.

The COVID-19 pandemic has altered preexisting patient treatment algorithms and referral patterns, which has affected neurosurgical care worldwide. Brain arteriovenous malformations are complex vascular lesions that frequently present with intracerebral hemorrhage. Care for these patients is best performed at large medical centers by specialists with high volumes.

An Endovascular Surgery Experience in Far-Forward Military Healthcare-A Case Series.

Introduction: The advancement of interventional neuroradiology has drastically altered the treatment of stroke and trauma patients. These advancements in first-world hospitals, however, have rarely reached far forward military hospitals due to limitations in expertise and equipment. In an established role III military hospital though, these life-saving procedures can become an important tool in trauma care.

Native Ureter Ventriculo-Ureteral Shunt Placement for Management of Refractory Hydrocephalus in a Child With a History of Renal Transplant: Case Report and Technical Note.

This report describes the case of a 5-year-old male with intractable hydrocephalus secondary to neonatal intraventricular hemorrhage who was ultimately managed with the placement of a ventriculo-ureteral (VU) shunt. He had previously failed numerous attempts at cerebrospinal fluid shunting, choroid plexus cauterization, and endoscopic third ventriculostomy. The patient had a history of end stage renal disease, and had previously undergone renal transplant.

Extent of Spinal Cord Decompression in Motor Complete (American Spinal Injury Association Impairment Scale Grades A and B) Traumatic Spinal Cord Injury Patients: Post-Operative Magnetic Resonance Imaging Analysis of Standard Operative Approaches.

Although decompressive surgery following traumatic spinal cord injury (TSCI) is recommended, adequate surgical decompression is rarely verified via imaging. We utilized magnetic resonance imaging (MRI) to analyze the rate of spinal cord decompression after surgery. Pre-operative (within 8 h of injury) and post-operative (within 48 h of injury) MRI images of 184 motor complete patients (American Spinal Injury Association Impairment Scale [AIS] grade A = 119, AIS grade B = 65) were reviewed to verify spinal cord decompression.

Cryptic diversity in metropolis: confirmation of a new leopard frog species (Anura: Ranidae) from New York City and surrounding Atlantic coast regions.

We describe a new cryptic species of leopard frog from the New York City metropolitan area and surrounding coastal regions. This species is morphologically similar to two largely parapatric eastern congeners, Rana sphenocephala and R. pipiens.

Levator glandulae thyroideae muscle with three slips.

Anatomical variations in the musculature surrounding the thyroid gland have the potential to cause iatrogenic injuries during neck and thyroid surgical procedures. Herein is presented a unilateral case found in an 83-year-old Caucasian female cadaver during a surgical mock thyroidectomy. The thyroid gland had a small pyramidal lobe with three muscular slips of levator glandulae thryroideae (LGT) muscle and a large tributary of the inferior thyroid vein descending posteriorly along the muscular slips.

The clinical anatomy of the crista terminalis, pectinate muscles and the teniae sagittalis.

The crista terminalis (CT) is an important anatomic landmark due its close association with the sinoatrial node artery and the origin of the pectinate muscles (PM). However, the gross anatomy of the PM in relation to the CT has not been well described. The aim of our study has been to investigate the location and the morphology of PM in relation to the CT.

The clinical anatomy of the posterior gastric artery revisited.

A consensus concerning the incidence, course and distribution of the posterior gastric artery (PGA) has yet to be reached. Recent literature has explored and subsequently demonstrated the importance of the identification of this vessel in surgical procedures such as subtotal gastrectomy, splenectomy and pancreatic transplantation. The gross anatomy of the PGA was examined in 120 adult human cadavers.

Cisterna chyli: a detailed anatomic investigation.

With recent laparoscopic advancements in retroperitoneal and thoracic surgical procedures, familiarity with major lymphatic structures, such as including the cisterna chyli (CC) and thoracic duct (TD), has proven beneficial in avoiding misdiagnosis and iatrogenic intraoperative injury. In this light, the aim of our study was to explore and delineate the topography of the CC, classify the different patterns of lymphatic tributaries, and categorize its varying location with respect to the vertebral bodies. The anatomy of the CC was examined in 120 adult human cadavers.

The cardiovascular system in the pre-Hippocratic era.

Although Hippocrates has been traditionally recognized as the father of medicine and one of the major early writers regarding the cardiovascular system, very little is known of about the knowledge of the cardiovascular system in the pre-Hippocratic period. We reviewed the literature and examined available references regarding the cardiovascular system in the pre-Hippocratic era of the Chinese, Indians, Egyptians, and Ancient Greeks including Asclepios, Alcmaeon, Empedocles and Diogenes. All pre-Hippocratic civilizations attributed the illnesses and the structures of the human body to divine powers.

Superior phrenic artery: an anatomic study.

The majority of anatomical textbooks offer very little information concerning the anatomy and distribution of the superior phrenic artery (SPA). However, in the last decade, a number of reports have appeared with reference to the transcatheter arterial chemoembolization of the collateral arterial supply of hepatic carcinoma (HC). Considering the potential role of the SPA as a source of collateral blood supply to HC, the aim of this study was to identify the origin and distribution of the SPA.

Surgical anatomy of the accessory phrenic nerve.

Background: Reports place the frequency of phrenic nerve injury after cardiac operations between 10% and 85%, emphasizing the importance of an accurate anatomic description of the diaphragm's innervating nerves to reduce iatrogenic injury, length of hospitalization, and associated costs. The aim of our study was to explore the anatomic variations of the accessory phrenic nerve and relate these findings to phrenic nerve injury.

Methods: Eighty adult formalin-fixed cadavers were dissected, resulting in 160 nerve specimens.