Measuring CSF shunt flow with MRI using flow enhancement of signal intensity (FENSI).

Purpose: To develop and validate a noninvasive imaging technique for accurately assessing very slow CSF flow within shunt tubes in pediatric patients with hydrocephalus, aiming to identify obstructions that might impede CSF drainage.

Theory And Methods: A simulation of shunt flow enhancement of signal intensity (shunt-FENSI) signal is used to establish the relationship between signal change and flow rate. The quantification of flow enhancement of signal intensity data involves normalization, curve fitting, and calibration to match simulated data.

Effects of alternating pressure patterns on sacral skin blood flow responses in people with spinal cord injury.

Alternating pressure support surface (APSS) is a common support surface for treating pressure injury in individuals with spinal cord injury (SCI). However, conflicting results on the effectiveness of APSS have been reported and may be associated with inappropriate configurations of APSS. The objectives of this study were to compare the different pressure amplitudes (75/5 mmHg [alternating between 75 and 5 mmHg] vs.

The neurosurgeon workforce: a geographical gender-focused analysis of the trends in representation of neurosurgeons and choices in training over 70 years.

Objective: Neurosurgeons frequently move throughout their careers, with moves driven by personal and professional factors. In this study, the authors analyzed these migration trends through a dynamic migratory map and statistical review, with a particular focus on differences in education and practice patterns between male and female neurosurgeons.

Methods: A list containing all board-certified and -affiliated US neurosurgeons practicing in 2019 was obtained from the American Association of Neurological Surgeons.

Factors influencing geographic gender disparity in neurosurgery: a nationwide geospatial clustering analysis.

Objective: Women neurosurgeons (WNs) continue to remain a minority in the specialty despite significant initiatives to increase their representation. One domain less explored is the regional distribution of WNs, facilitated by the hiring practices of neurosurgical departments across the US. In this analysis, the authors coupled the stated practice location of WNs with regional geospatial data to identify hot spots and cold spots of prevalence and examined regional predictors of increases and decreases in WNs over time.

Cephalohematomas, an occult nidus for infection and inflammation: A case report and review of the literature.

Background: Cephalohematomas (CH) are benign neonatal fluid collections that arise between the periosteum and skull due to birth trauma, and usually resolve spontaneously without intervention. CH may rarely become infected.

Case Description: The authors report a case of sterile CH requiring surgical evacuation in a persistently febrile neonate treated with intravenous (IV) antibiotics for urosepsis.

Kinematics of a cervical disc prosthesis implanted above or below one- and two-level fusions.

Background: The theoretical advantages of hybrid constructs over multi-level fusion have been illustrated in clinical and biomechanical studies. However, there is no biomechanical data on hybrid constructs using load control analyses. There is also no clear data on whether there is a biomechanical difference if the arthroplasty is below or above a 1- or 2-level fusion.

Hypertrophic cranial pachymeningitis and orbital apex syndrome secondary to infection of the eye: illustrative case.

Background: Hypertrophic cranial pachymeningitis is a rare inflammatory disorder characterized by thickening of the dura mater and multiple cranial neuropathies. Although an infectious etiology may be present, often no specific cause is discovered.

Observations: The authors described a 71-year-old man with progressive right eye vision loss, ptosis, and complete ophthalmoplegia with imaging findings suggestive of hypertrophic cranial pachymeningitis.

Gradient boosting for Parkinson's disease diagnosis from voice recordings.

Background: Parkinson's Disease (PD) is a clinically diagnosed neurodegenerative disorder that affects both motor and non-motor neural circuits. Speech deterioration (hypokinetic dysarthria) is a common symptom, which often presents early in the disease course. Machine learning can help movement disorders specialists improve their diagnostic accuracy using non-invasive and inexpensive voice recordings.

Effectiveness of cervical zero profile integrated cage with and without supplemental posterior Interfacet stabilization.

Background: Conditions requiring cervical decompression and stabilization are commonly treated using anterior cervical discectomy and fusion using an anterior cage-plate construct. Anterior zero profile integrated cages are an alternative to a cage-plate construct, but literature suggests they may result in less motion reduction. Interfacet cages may improve integrated cage stability.

Brain CT to Assess Intracranial Pressure in Patients with Traumatic Brain Injury.

Introduction: Morphologic features of computed tomography (CT) scans of the brain can be used to estimate intracranial pressure (ICP) via an image-processing algorithm. Clinically, such estimations can be used to prognosticate outcomes and avoid placement of invasive intracranial monitors in certain patients with severe traumatic brain injury. Features on a CT scan that may correlate with measurements of low ICP are sought.

A novel use of transfer function estimation for early assessment of brain injury outcome.

Normal blood flow in the brain as a response to pressure fluctuations is commonly referred to as cerebral autoregulation. Linear, nonparametric models of cerebral autoregulation were estimated for 77 human subjects afflicted with brain injury, with mean arterial pressure used as input, and invasively measured regional cerebral blood flow used as output. The data were continuously monitored from the beginning of subject hospital stay.

Role of microvascular shunts in the loss of cerebral blood flow autoregulation.

Historically, determination of the critical cerebral perfusion pressure (CPP) was done in animals by a progressive lowering of arterial pressure yielding a nominal critical CPP of 60 mmHg. Subsequently, it was shown that if the CPP was decreased by increasing intracranial pressure (ICP), critical CPP fell to 30 mmHg. This discrepancy was unexplained.

Microvascular shunts in the pathogenesis of high intracranial pressure.

Hyperemia in the infarcted brain has been -suggested for years by "red veins" reported by neurosurgeons, shunt peaks in radioactive blood flow clearance curves, and quantitative cerebral blood flow using stable xenon CT. Histological characterization of infarcted brain revealed capillary rarefaction with prominent microvascular shunts (MVS). Despite abundant histological evidence, the presence of cerebrovascular shunts have been largely ignored, perhaps because of a lack of physiological evidence demonstrating the transition from capillary flow to MVS flow.

Large cerebellar hemorrhage during trumpet playing: importance of blood pressure elevation during the valsalva maneuver: case report.

Objective: The authors report a case of a large intracerebellar hemorrhage that occurred in a professional musician while playing the trumpet. This is the first report of such a complication.

Clinical Presentation: A 60-year-old man presented with severe occipital headache accompanied by nausea, vomiting, and dizziness that occurred while he was practicing the trumpet.

Beyond fusiform and saccular: a novel quantitative tortuosity index may help classify aneurysm shape and predict aneurysm rupture potential.

While saccular abdominal aortic aneurysms (AAAs) are thought to be more prone to rupture than fusiform aneurysms, attempts to validate this observation have been limited by the inability to quantitatively define the three-dimensional shape of an aorta. A quantitative three-dimensional shape model may distinguish among shape classes and ultimately be useful in identifying aneurysms at risk for rupture. Three-dimensional luminal surface data of AAAs were generated from computed tomographic (CT) images of 15 patients with small aneurysms (< or =5.

Sestamibi scans are not all created equally.

Hypothesis: The sensitivity of sestamibi scanning techniques used for preoperative localization in primary hyperparathyroidism is a function of the parameters of image acquisition and processing.

Design: Criterion standard vs optimized technique.

Setting: Tertiary referral center.