World Neurosurg
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Patients with moderate traumatic brain injury (mTBI) are under the threat of intracranial hypertension (IHT). However, it is unclear which mTBI patient will develop IHT and should receive intracranial pressure (ICP)-lowering treatment or invasive ICP monitoring after admission. The purpose of the present study was to develop and validate a prediction model that estimates the risk of IHT in mTBI patients. ⋯ A prediction model based on baseline parameters was found to be highly sensitive in distinguishing mTBI patients with GCS score of 9-11 who would suffer IHT. The high discriminative ability of the prediction model supports its use in identifying mTBI patients with GCS score of 9-11 who need ICP-lowering therapy or invasive ICP monitoring.
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Chiari malformation type I (CM-1) is a complex disorder in which tonsillar herniation through the foramen magnum (FM) manifests with a spectrum of clinical symptoms. This work analyzes morphometric and volumetric characteristics of CM-1 patients. ⋯ Our findings suggest that the amount of tissue at the FM correlates with CM-1 patients who underwent decompressive surgery, more so than tonsillar length. Additionally, the combination of neural tissue at the FM, CBL, and fourth ventricular volumes led to a great degree of correlation with syrinx formation. Together, these findings suggest that a global compressive phenomenon within the posterior fossa leads to CM-1 symptomatology and syrinx formation.
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Historical Article
Mildred Codding (1902-1991): Neurosurgery Medical Illustrator at Harvard Medical School, Peter Bent Brigham Hospital, and Boston's Children Hospital.
This historical account reviews the life and times of Mildred Codding (1902-1991) in neurosurgery and medical illustration. ⋯ This article provides glimpses into the personality and marked influence of Mildred Codding on neurosurgery and medical education and adds to the growing literature on her person.
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Ankylosing spondylitis (AS) combined with severe kyphotic deformity can cause the trunk to collapse, pressing tightly against the front of the thighs and forming a "folded man" deformity. The purpose of this article is to evaluate the effectiveness and safety of a treatment strategy for correcting the "folded man" deformity. ⋯ The standardized treatment strategy involving staged correction of spinal kyphosis in a lateral position, followed by subsequent total hip arthroplasty, offers a safe and effective solution for managing AS with "folded man" deformity.
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Cauda equina syndrome (CES) is diagnosed both clinically and radiologically. However, it's unclear if a specific degree of cauda equina compression on imaging can confirm the diagnosis. This study aimed to identify an optimal percentage of prolapse to canal ratio (PCR) on magnetic resonance imaging that correlates with cauda equina compression, facilitating reliable decision-making for CES symptoms. ⋯ Simple radiological measurements of PCR can potentially triage CES patients and guide their management. Future studies should correlate PCR with clinical signs and symptoms for a comprehensive assessment.