World Neurosurg
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Hydrocephalus is a common neurosurgical disorder that can lead to significant disability or death if not promptly identified and treated. Data on the burden of hydrocephalus in low-income countries are limited, given a lack of radiologic resources for the diagnosis of this condition. Here, we present an analysis of patterns of hydrocephalus from a large sample of computed tomography (CT) scans of the head performed at a public hospital in rural Haiti, a low-income country in the Caribbean. ⋯ In a large sample of CTs performed in a rural low-income setting, hydrocephalus was common, predominantly noncommunicating, and often associated with potentially operable intracranial lesions. Data of this nature can inform research, policy, and clinical collaborations that strengthen the neurosurgical capacity of low-income countries.
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Advanced magnetic resonance imaging (MRI) acquisition methods such as 4D phase contrast magnetic resonance imaging (4D pcMRI) have found widespread applications in assessing hemodynamics in cerebral aneurysms. One of the goals is the identification of a hemodynamic scenario predictive of aneurysm rupture. Because of the technical complexity the 4D pcMRI technology, challenges exist in extracting and communicating the wealth of information contained in the MRI image data, in particular, to a multidisciplinary team of health professionals and basic scientists. ⋯ Augmented reality may become an additional means for visualizing complex medical data, in particular complex flows as illustrated here.
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To explore the prevalence and distribution of abnormal vertebral pedicles in adolescent idiopathic scoliosis (AIS) in Chinese people. ⋯ There is a significantly high prevalence of abnormal pedicles in AIS in Chinese people, with a total prevalence of 65%. Female sex, proximal thoracic location, major curve greater than 70 degrees, and concave pedicle may be risk factors for type C and D pedicles.
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Case Reports
False Localization of a Ruptured Intracranial Dermoid Secondary to Subarachnoid Spread of Cyst Contents.
A 34-year-old right-handed female presented to the emergency department with a worsening headache, neck stiffness, intermittent abnormal sensation, and right arm weakness. Shortly after arrival, she had a generalized tonic-clonic seizure. A noncontrast head computed tomography scan revealed a right-sided, low-attenuating, lobulated mass ipsilateral to her arm symptoms. ⋯ During mass resection, sebum was visible throughout the subarachnoid space. The patient had an uneventful recovery from surgery and has been seizure free since the resection with steady improvement of symptoms. This case highlights the importance of avoiding cyst rupture of dermoid cysts.
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Examining spine surgery patterns over time is crucial to provide insights into variations and changes in clinical decision making. Changes in the number of surgeries, surgical methods, reoperation rates, and cost-effectiveness were analyzed for all patients who underwent surgery for lumbar spinal stenosis without spondylolisthesis in 2003 (2003 cohort) and 2008 (2008 cohort). ⋯ The increased numbers of spinal surgeries, fusion surgeries, and surgeries in older patients in a recent cohort were noteworthy. However, the increased surgical volume and fusion surgeries did not reduce the reoperation rate.