Pediatric Cervical Spine Trauma: A Narrative Review.

Study Design: Narrative review.

Objective: To provide an updated overview of pediatric cervical spine trauma.

Summary Of Background Data: Pediatric cervical spine trauma can cause debilitating morbidity and mortality and neurological impairment.

Case Series and Systematic Review of Electronic Scooter Crashes and Severe Traumatic Brain Injury.

Objective: Electric scooters (e-scooters) are an increasingly popular form of transportation, but their use has also resulted in increased incidence of traumatic brain injury (TBI). Previous reports have predominantly described mild TBI with limited attention to other injury patterns. Our objective was to evaluate the impact of e-scooter use on rates of severe TBI.

Superficial abdominal reflex in syringomyelia: Associations with Chiari I malformation.

An abnormal or absent superficial abdominal reflex (SAR) may be associated with an underlying spinal cord syrinx. The sensitivity of an abnormal or absent SAR and the relationship to Chiari malformation type I (CM-I) or syrinx morphology has not been studied. We aimed to describe the relationship between SAR abnormalities and syrinx size, location, and etiology.

Trans-lamina Terminalis Approach for Resection of Third Ventricular Tumor.

Granular cell tumors are rare vascular neoplastic lesions of the sellar and suprasellar region that usually arise from the pituitary stalk but can originate as low as the posterior pituitary or as high as the tuber cinereum. Complete resection, although ideal, can yield high rates of endocrine or visual morbidity. On headache workup, a 66-year-old woman was found to have a 1.

Longitudinal scoliosis behavior in Chiari malformation with and without syringomyelia.

Objective: The objective of this study was to understand the natural history of scoliosis in patients with Chiari malformation type I (CM-I) with and without syringomyelia.

Methods: A retrospective review of data was conducted. Patients with CM-I were identified from a cohort of 14,118 individuals age 18 years or younger who had undergone MRI over an 11-year period at the University of Michigan.

Emerging Utility of Applied Magnetic Resonance Imaging in the Management of Traumatic Brain Injury.

Traumatic brain injury (TBI) is a widespread and expensive problem globally. The standard diagnostic workup for new TBI includes obtaining a noncontrast computed tomography image of the head, which provides quick information on operative pathologies. However, given the limited sensitivity of computed tomography for identifying subtle but meaningful changes in the brain, magnetic resonance imaging (MRI) has shown better utility for ongoing management and prognostication after TBI.

Abdominal aortic aneurysm is associated with subarachnoid hemorrhage.

Background: Although intracranial aneurysms (IA) and abdominal aortic aneurysms (AAA) share similar risk factors, little is known about the relationship between them. Previous studies have shown an increased incidence of IA in patients with AAA, though the rate of subarachnoid hemorrhage (SAH) in patients with AAA has not been described.

Objective: To use claims data with longitudinal follow-up, to evaluate the incidence of aneurysmal SAH in patients diagnosed with AAA.

Management of Water and Sodium Disturbances after Transsphenoidal Resection of Pituitary Tumors.

Patients with pituitary masses who undergo transsphenoidal resection are at risk for a number of medical complications postoperatively. Among these are disturbances in fluid and sodium homeostasis, including diabetes insipidus (DI) and syndrome of inappropriate secretion of antidiuretic hormone (SIADH). It is believed that these pathologic states are a result of damage to the hypothalamic-pituitary axis from surgery, as are the downstream consequences, such as the triple phase response.

Effects of the presence and absence of amino acids on translation, signaling, and long-term depression in hippocampal slices from Fmr1 knockout mice.

Fragile X syndrome (FXS) is caused by silencing of the FMR1 gene and consequent absence of its protein product, fragile X mental retardation protein (FMRP). FMRP is an RNA-binding protein that can suppress translation. The absence of FMRP leads to symptoms of FXS including intellectual disability and has been proposed to lead to abnormalities in synaptic plasticity.

Obstetric Management and Maternal Outcomes of Childbirth Among Patients With Chiari Malformation Type I.

Background: A range of opinions exist in the literature regarding obstetric management of pregnant women with Chiari malformation type I (CM-I).

Objective: To examine obstetrical practices and outcomes with childbirth of women with CM-I.

Methods: We examined insurance claims data from a large, privately insured health care network and identified admissions for childbirth from 2004 to 2014.

Thirty-Day Hospital Readmission and Surgical Complication Rates for Shunting in Normal Pressure Hydrocephalus: A Large National Database Analysis.

Background: Research on age-related complications secondary to shunts in normal pressure hydrocephalus (NPH) is primarily limited to single-center studies and small cohorts.

Objective: To determine the rates of hospital readmission and surgical complications, and factors that predict them, following shunt surgery for NPH in a large healthcare network.

Methods: Surgical procedures, complications, and readmissions for adults undergoing ventricular shunting for NPH were determined using de-identified claims from a privately insured United States healthcare network in years 2007-2014.

Validation of the LACE Index (Length of Stay, Acuity of Admission, Comorbidities, Emergency Department Use) in the Adult Neurosurgical Patient Population.

Background: The LACE index (Length of stay, Acuity of admission, Comorbidities, Emergency department use) quantifies the risk of mortality or unplanned readmission within 30 d after hospital discharge. The index was validated originally in a large, general population and, subsequently, in several specialties, not including neurosurgery.

Objective: To determine if the LACE index accurately predicts mortality and unplanned readmission of neurosurgery patients within 30 d of discharge.

Recent trends in North American pediatric neurosurgical fellowship training.

Objective: The goal of this study was to evaluate trends in pediatric neurosurgical fellowship training in North America.

Methods: From a database maintained by the Accreditation Council for Pediatric Neurosurgery Fellowships (ACPNF), all graduates of ACPNF-accredited pediatric neurosurgery fellowships were identified, and an Internet search was conducted to determine sex, undergraduate and graduate degrees, location and dates of residency and fellowship training, current practice/employment environment, American Board of Neurological Surgery (ABNS) or Fellowship of the Royal College of Surgeons certification status, American Board of Pediatric Neurological Surgery (ABPNS) certification status, and extent of current pediatric-focused practice. The graduates were further studied to determine whether they had completed a neurosurgical residency at a program with an affiliated ACPNF-accredited pediatric neurosurgery fellowship program, and their residency training programs were further classified by whether the program was ranked in the top 50 by NIH funding awards.

Complications in Patients Undergoing Microsurgical Clipping of Intracranial Aneurysms with Pre-existing Ventriculoperitoneal Shunts Following a Cranial Procedure.

Introduction: Patients with ventriculoperitoneal/pleural (VP) shunts occasionally must undergo subsequent craniotomy, craniectomy, or cranioplasty. Due to changes in pressure dynamics following shunt placement, we hypothesized that such patients may have an increased risk of developing symptomatic collections of extra-axial blood, fluid, and/or air postoperatively, leading to longer stays and worse outcomes compared to those undergoing cranial operations without a VP shunt.

Methods: From a retrospective cohort of patients who underwent cranial operations for management of cerebral aneurysms in 2005-2014, we identified patients who previously had a VP shunt placed, determined the temporal relationship between shunt placement and cranial operation, and investigated outcomes in those with and without a shunt.

Incidence of the initiation of comfort care immediately following emergent neurosurgical and endovascular procedures.

Objective: It is unknown what proportion of patients who undergo emergent neurosurgical procedures initiate comfort care (CC) measures shortly after the operation. The purpose of the present study was to analyze the proportion and predictive factors of patients who initiated CC measures within the same hospital admission after undergoing emergent neurosurgery.

Methods: This retrospective cohort study included all adult patients who underwent emergent neurosurgical and endovascular procedures at a single center between 2009 and 2014.

Screening and surgery for foramen magnum stenosis in children with achondroplasia: a large, national database analysis.

OBJECTIVE The goal of this study was to determine the rates of screening and surgery for foramen magnum stenosis in children with achondroplasia in a large, privately insured healthcare network. METHODS Rates of screening and surgery for foramen magnum stenosis in children with achondroplasia were determined using de-identified insurance claims data from a large, privately insured healthcare network of over 58 million beneficiaries across the United States between 2001 and 2014. Cases of achondroplasia and screening and surgery claims were identified using a combination of International Classification of Diseases diagnosis codes and Current Procedural Terminology codes.

A Large Database Analysis of Rates of Aneurysm Screening, Elective Treatment, and Subarachnoid Hemorrhage in Patients With Polycystic Kidney Disease.

Background: Professional societies provide conflicting guidelines on aneurysm screening in patients with polycystic kidney disease (PKD), and the rate of subarachnoid hemorrhage (SAH) is poorly understood.

Objective: To evaluate screening, elective treatment, and the rate of SAH in patients with known PKD.

Methods: We examined longitudinally linked claims data from a large private insurer, identifying screening, elective treatment, aneurysmal subarachnoid hemorrhage (aSAH) and secured aneurysmal SAH (saSAH) in 2004 to 2014 amongst patients with known PKD.

Rates of cerebral protein synthesis in primary visual cortex during sleep-dependent memory consolidation, a study in human subjects.

If protein synthesis during sleep is required for sleep-dependent memory consolidation, we might expect rates of cerebral protein synthesis (rCPS) to increase during sleep in the local brain circuits that support performance on a particular task following training on that task. To measure circuit-specific brain protein synthesis during a daytime nap opportunity, we used the L-[1-(11)C]leucine positron emission tomography (PET) method with simultaneous polysomnography. We trained subjects on the visual texture discrimination task (TDT).

Incidence and risk factors for cognitive impairment in rural elderly populations in Costa Rica.

Risk factors for the onset of cognitive impairment in Costa Rica are not well understood, despite a substantial elderly population stemming from a higher than average life expectancy for the western hemisphere. To investigate the risk factors that predict the onset of cognitive impairment in the rural elderly of Costa Rica, a modified version of the Mini Mental State Exam-designed for illiterate populations-was administered to 90 elderly inhabitants of San Carlos, Alajuela, Costa Rica between April and May of 2011. Subsequently, each participant took a structured interview assessing viability of risk factors and behaviors potentially contributing to a diagnosis of cognitive impairment.

Identification of fragile X syndrome specific molecular markers in human fibroblasts: a useful model to test the efficacy of therapeutic drugs.

Fragile X syndrome (FXS) is the most frequent cause of inherited intellectual disability and autism. It is caused by the absence of the fragile X mental retardation 1 (FMR1) gene product, fragile X mental retardation protein (FMRP), an RNA-binding protein involved in the regulation of translation of a subset of brain mRNAs. In Fmr1 knockout mice, the absence of FMRP results in elevated protein synthesis in the brain as well as increased signaling of many translational regulators.

Sleep, plasticity and the pathophysiology of neurodevelopmental disorders: the potential roles of protein synthesis and other cellular processes.

Sleep is important for neural plasticity, and plasticity underlies sleep-dependent memory consolidation. It is widely appreciated that protein synthesis plays an essential role in neural plasticity. Studies of sleep-dependent memory and sleep-dependent plasticity have begun to examine alterations in these functions in populations with neurological and psychiatric disorders.