Transpalpebral mini-orbitozygomatic approach for nonvascular skull base lesions: a single neurosurgeon's experience.

Objective: The authors aim to describe the advantages, utility, and disadvantages of the transpalpebral mini-orbitozygomatic (MOZ) approach for tumors of the lateral and superior orbit, orbital apex, anterior clinoid, anterior cranial fossa, middle cranial fossa, and parasellar region.

Methods: The surgical approach from skin incision to closure is described while highlighting key technical and anatomical considerations, and cadaveric dissection demonstrates the surgical steps and focuses on important anatomy. Intraoperative images were included to supplement the cadaveric dissection.

Functional and Radiographic Outcomes of Cavernous Meningiomas Based on Treatment Modality.

 Cavernous sinus meningiomas (CSMs) are challenging given their proximity to neurovascular structures. Treatments include surgery, radiation, or observation. There are little data comparing outcomes based on treatment.

Flow diverter stenting for intracranial aneurysms in the pediatric population: Two case reports and literature review.

The Pipeline Embolization Device (PED) is a flow-diverting intraluminal device that is approved for use in adults 18 years or older with internal carotid artery aneurysms. However, it can also be used off-label in pediatric patients with aneurysms that cannot be resolved with traditional endovascular treatments. Herein, we present two cases of flow diversion in the pediatric population with complete obliteration of the aneurysm and excellent outcomes.

A Novel Method for Angioscopic Imaging and Visualizing the Skull Base Using Complementary Metal Oxide Semiconductor Cameras.

Background And Objectives: Complementary metal oxide semiconductor (CMOS) electrode arrays are a novel technology for miniaturized endoscopes; however, its use for neurointervention is yet to be investigated. In this proof-of-concept study, we aimed to demonstrate the feasibility of CMOS endoscopes in a canine model by providing direct visualization of the endothelial surface, deploying stents and coils, and accessing the spinal subdural space and skull base.

Methods: Using 3 canine models, standard guide catheters were introduced into the internal carotid and vertebral arteries through the transfemoral route using fluoroscopy.

Impacts of Socioeconomic Status on Dentoalveolar Trauma.

Introduction: Children sustain dentoalveolar trauma and lose teeth at the same rate regardless of socioeconomic status; however, debate surrounds these rates in adults. It is known socioeconomic status plays a major role in access and treatment in health care. This study aims to clarify the role of socioeconomic status as a risk factor for dentoalveolar trauma in adults.

MedCDI: A technology-based documentation and quality improvement initiative in neurosurgery.

Background: Clinical documentation of patient care alters coding accuracy of Medicare Severity Diagnosis-Related Groups (MS-DRGs), expected mortality, and expected length of stay (LOS) which impact quality metrics. We aimed to determine if neurosurgical quality metrics could be improved by facilitating accurate documentation and subsequently developed a mobile application and educational video to target areas of opportunity.

Methods: Vizient software was used to analyze MS-DRGs and expected LOS for sample of patients requiring surgery for spinal pathology, brain tumors, and subarachnoid hemorrhage (SAH) between January 2019 and August 2021.

Duration of effectiveness of coblation for recurrent epistaxis in hereditary hemorrhagic telangiectasia.

Introduction: Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disease leading to recurrent epistaxis, telangiectasias, and/or visceral arteriovenous malformations. Multiple treatment methods, including both pharmacologic and surgical, are described to be effective in managing symptomatic HHT. Few report the duration of symptom improvement for each of these treatment methods.

Reversal of cognitive, behavioral, and language impairments after the left frontal arachnoid cyst fenestration in a pediatric patient.

Background: Arachnoid cysts (ACs) are cerebrospinal fluid-containing cysts located between the surface of the brain or spinal cord and arachnoid layer of the leptomeninges. ACs have been known to cause cognitive, language, and behavioral deficits and currently there is no standard treatment paradigm. Surgical indications include papilledema, increasing growth with mass effect causing neurological deficit, or rapid head growth, however, cognitive symptoms related to mass effect may not always be considered.

Pediatric middle meningeal artery embolization for chronic subdural hematoma: A case report.

Background: The most common neuroradiological finding in pediatric nonaccidental trauma (NAT) is subdural hematoma (SDH). Management options for pediatric SDH range from conservative clinical surveillance to craniotomy or decompressive craniectomy. The middle meningeal artery (MMA) indirectly feeds the hematoma; thus, MMA embolization is an alternative or adjunct to current surgical treatments in adults.

Low Rate of Intrathecal Baclofen Pump Catheter-Related Complications: Long-Term Study in Over 100 Adult Patients Associated With Reinforced Catheter.

Objectives: Intrathecal baclofen (ITB) is a cost-effective therapy for patients with severe spasticity. The most common complications are catheter-related complications (CRCs) including kinking/occlusion, blockage, migration, fracture, disconnection, and CSF leak. Our objective was to determine the CRC rate in a large cohort of adults with newly implanted ITB pump systems with polymer reinforced silicone catheters.

Classification of Comprehensive Neuro-Ophthalmologic Measures of Postacute Concussion.

Importance: Symptom-based methods of concussion diagnosis in contact sports result in underdiagnosis and repeated head injury exposure, increasing the risk of long-term disability. Measures of neuro-ophthalmologic (NO) function have the potential to serve as objective aids, but their diagnostic utility is unknown.

Objective: To identify NO measures that accurately differentiate athletes with and without concussion.

Chiari Malformation Type 1 and Syringomyelia in a Patient With Prior Surgically-Treated Sagittal Synostosis Effectively Treated With Posterior Cranial Vault Distraction Osteogenesis.

The presenting report describes the use of a posterior cranial vault distraction procedure in resolving a Chiari malformation with associated syringomyelia following a surgically-treated nonsyndromic craniosynostosis. Chiari malformations are typically treated with posterior fossa decompression with or without expansion duraplasty. The objective of this report is to describe the effectiveness in resolving both Chiari malformation and secondary syringomyelia with posterior cranial vault distraction osteogenesis.