Comparing fourth ventricle shunt survival after placement via stereotactic transtentorial and suboccipital approaches.

Object: Fourth ventricle hydrocephalus, or a "trapped" fourth ventricle, presents a treatment challenge in pediatric neurosurgery. Fourth ventricle hydrocephalus develops most commonly as a result of congenital anomalies, intraventricular hemorrhage, or infection. Standard management of loculated fourth ventricle hydrocephalus consists of fourth ventricle shunt placement via a suboccipital approach.

Radiation exposure to the spine surgeon in lumbar and thoracolumbar fusions with the use of an intraoperative computed tomographic 3-dimensional imaging system.

Study Design: A prospective clinical research article.

Objective: The primary goals were to determine (1) radiation exposure to the spine surgeon with the use of an intraoperative 3-dimensional imaging system and (2) to define the safe distance from the computed tomographic scanner.

Summary Of Background: Intraoperative radiation exposure to the spinal surgeon has been assessed during 2-dimensional fluoroscopy but has not been investigated during intraoperative 3-dimensional imaging.

The biomechanical contribution of varying posterior constructs following anterior thoracolumbar corpectomy and reconstruction.

Object: Thoracolumbar corpectomy is a procedure commonly required for the treatment of various pathologies involving the vertebral body. Although the biomechanical stability of anterior reconstruction with plating has been studied, the biomechanical contribution of posterior instrumentation to anterior constructs remains unknown. The purpose of this study was to evaluate biomechanical stability after anterior thoracolumbar corpectomy and reconstruction with varying posterior constructs by measuring bending stiffness for the axes of flexion/extension, lateral bending, and axial rotation.

Massive Charcot spinal disease deformity in a patient presenting with increasing abdominal girth and discomfort. Case report.

Charcot spinal disease is a destructive degenerative process involving the vertebrae and surrounding discs, resulting from repetitive microtrauma in patients who have decreased joint protective mechanisms due to loss of deep pain and proprioceptive sensation. The typical presentation of the disease is back pain and progressive spinal instability and deformity. The authors report an unusual case of massive Charcot spinal disease deformity in a patient presenting with increasing abdominal girth and discomfort.

Endovascular balloon angioplasty for treatment of posttraumatic venous sinus thrombosis. Case report.

In severe cases, posttraumatic cerebral sinus thrombosis can result in venous congestion and persistent intracranial hypertension refractory to both conventional medical therapy and surgical decompression. The authors report a unique case of a patient successfully treated with endovascular mechanical thrombolysis using balloon angioplasty for clinically significant posttraumatic venous sinus thrombosis and review the reported treatments for cerebral venous sinus occlusive disease. This 18-year-old man suffered severe closed head injury from a fall while skateboarding.

Surgical treatment of occipitocervical instability.

Objective: Instability of the occipitocervical junction can be a challenging surgical problem because of the unique anatomic and biomechanical characteristics of this region. We review the causes of instability and the development of surgical techniques to stabilize the occipitocervical junction.

Methods: Occipitocervical instrumentation has advanced significantly, and modern modular screw-based constructs allow for rigid short-segment fixation of unstable elements while providing the stability needed to achieve successful fusion in nearly 100% of patients.

Recurrent cerebellar hemangioblastoma with enhancing tumor in the cyst wall: case report.

Objective: Hemangioblastomas are the most common primary intra-axial tumors of the adult posterior fossa and the tumors most often associated with von Hippel-Lindau disease. Resection of cerebellar hemangioblastomas involves tumor excision and drainage of associated cysts. The cyst wall is considered devoid of tumor cells and is not excised.

Glutaric aciduria type 1 presenting as bilateral subdural hematomas mimicking nonaccidental trauma. Case report and review of the literature.

Glutaric aciduria type 1 (GA1) is a rare neurometabolic disorder with characteristic neuroimaging and clinicopathological features. The authors describe a case of GA1 in a 7-month-old girl presenting with macrocephaly and bilateral subdural hematomas (SDHs) who was initially evaluated for nonaccidental trauma (NAT). Bilateral subdural drains were placed because of significant mass effect from the chronic SDHs, with subsequent neurological and neuroimaging-documented improvement.