Neurosurgery
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The cerebrovascular bed and cerebrospinal fluid circulation have been modeled extensively except for the cerebral venous outflow, which is the object of this study. ⋯ A new conceptual mathematical model can be used to explain the relationship between pressures and flow at the venous outflow from the cranium.
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Distal ventriculoperitoneal shunt failure has been associated with absorption failure secondary to previous peritonitis. This assumption has caused surgeons to seek alternate sites for distal catheter placement. We propose that the absorptive potential of the peritoneal cavity should be assessed before that site is discounted for catheter placement. ⋯ The peritoneal cavity remains the site of choice for distal shunt catheter placement. If failure of peritoneal cerebrospinal fluid absorption is suspected as a cause of shunt failure, then peritoneography with water-soluble contrast material may be safely used to demonstrate the adequacy of fluid absorption before a secondary site is chosen.
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To assess the safety, feasibility, and clinical outcome of percutaneous transpedicular polymethylmethacrylate vertebroplasty (PTPV) for the treatment of spinal compression fractures causing refractory pain. ⋯ PTPV provided significant relief in a high percentage of patients with refractory pain. PTPV is a safe and feasible treatment for patients with spinal compression fractures.