Categorization of the cranial injury

BACKGROUND: Postoperative computed tomography scans allow for evaluation of the structural results of cranial vault reconstruction and potential surgical concerns. The authors evaluated the clinical utility of routine postoperative scans to identify relevant surgical findings in children treated for craniosynostosis. METHODS: The authors conducted a retrospective study of postoperative computed tomography reports for patients with craniosynostosis following cranial vault reconstruction during a 9-year period at their tertiary care pediatric hospital...

OBJECTIVE:  The aim of this study was to categorize the presentation, management, complications and long-term outcome of canine acetabular fractures, and to determine the factors affecting outcome. MATERIALS AND METHODS:  Case records and imaging for dogs with acetabular fractures were reviewed with long-term follow-up via canine brief pain inventory (CBPI) and owner questionnaires. RESULTS:  The majority of fractures were in the mid-third (36/52) and caudal-third (13/52) with few in the cranial-third of the acetabulum (3/52)...

BACKGROUND: Epidural hematoma (EDH) can result in a catastrophic outcome of traumatic brain injury. Current management guidelines do not consider the source of hemorrhage in decision making. The purpose of this study was to examine the relationship between EDH location and the source of hemorrhage. METHODS: We report retrospectively reviewed, prospectively obtained surgical data of patients with acute traumatic cranial EDH treated between 2007 and 2018. Computed tomography (CT) scans were used to categorize EDH location as lateral or medial...

PURPOSE: Low-velocity penetrating brain injury (LVPBI) caused by foreign bodies can pose life-threatening emergencies. Their complexity and lack of validated classification data have prevented standardization of clinical management. We aimed to compare the trans-base and trans-vault phenotypes of LVPBI to help provide guidance for clinical decision-making of such injury type. METHODS: A retrospective study on LVPBI patients managed at our institution from November 2013 to March 2020 was conducted...

Despite its high prevalence in children with sickle cell anemia (SCA), the pathophysiology of silent cerebral infarcts (SCIs) remains elusive. The main objective of this study was to explore the respective roles of major determinants of brain perfusion in SCA children with no past or current history of intracranial or extracranial vasculopathy. We used a multimodal approach based notably on perfusion imaging Arterial spin labelling (ASL) MRI and Near Infra-Red Spectroscopy (NIRS), as well as biomarkers reflecting blood rheology and endothelial activation...

Rheumatological diseases result in immune-mediated injury to not only connective tissue, but often components of the peripheral nervous system. These overlap conditions can be broadly categorized as peripheral neuropathies and overlap myositis. The peripheral neuropathies are distinctive as many have unusual presentations such as non-length-dependent, small fiber neuropathies and sensory neuronopathies (both due to dorsal root ganglia dysfunction), multiple mononeuropathies (e.g. vasculitic neuropathies), and even cranial neuropathies...

INTRODUCTION: Accelerative events commonly expose military pilots to potentially injurious + Gz (axial, caudal to cranial) accelerations. The Naval Biodynamics Laboratory exposed nonhuman primates (NHPs) to + Gz loading in two subject orientations (supine or upright) to assess the effect of orientation and accelerations associated with injury at accelerations unsafe for human participation. MATERIALS AND METHODS: Archived care records, run records, and necropsy and pathology reports were used to identify acceleration-related injuries...

BACKGROUND: There has been a dramatic change in the pattern of patients being seen in hospitals and surgeries performed during the ongoing COVID-19 pandemic. The objective of this study is to study the change in the volume and spectrum of surgeries performed during the ongoing COVID-19 pandemic compared to pre-COVID-19 era. METHODS: Details of all patients who were operated under department of neurosurgery at our institute since the onset of COVID-19 pandemic in India were collected and compared to the same time period last year...

PURPOSE: Current guideline recommends a uniform method of delineation of subclinical disease within the primary clinical target volume (CTVp) for all stages of nasopharyngeal carcinoma (NPC). We performed a prospective observational study to investigate the outcomes with a reduced CTVp and radiation dose for early-stage NPC. METHODS AND MATERIALS: Patients with newly diagnosed, biopsy-proven World Health Organization type II-III and American Joint Committee on Cancer/Union for International Cancer Control sixth edition stage T1-2N0-1 disease were enrolled...

In patients with facial trauma, multidetector computed tomography is the first-choice imaging test because it can detect and characterize even small fractures and their associated complications quickly and accurately. It has helped clinical management and surgical planning, so radiologists must communicate their findings to surgeons effectively. In Le Fort fractures, there is a breach between the pterygoid plates and the posterior maxilla. These fractures are classified in three basic patterns that can be combined and associated with various complications...

The British Association of Oral and Maxillofacial Surgeons (BAOMS) and Saving Faces undertook two national prospective surveys 11 years apart. They recorded the facial injuries treated in UK emergency departments and collected data on 14872 patients. In this paper, which aims to act as a feasibility study for a third national survey of facial injuries, we have reviewed hard-tissue injuries and specifically focused on temporal changes in their morphology. The two sets of directly comparable, categorical, unpaired, cross-sectional data were evaluated independently for statistical significance...

Background: Endoscopic endonasal transsphenoidal surgery (EES) is the gold standard for pituitary adenoma (PA) resection. The sphenoid sinus (SS), a highly variable anatomic structure, is located in the center of the cranial base. It has previously been reported that poor pneumatization of the lateral recess of the SS (LRSS) increases the difficulty level of the surgery and the risk of neural and vascular injury. However, to date no studies have evaluated the association between LRSS volume and PAs removal rate by EES...

BACKGROUND: Carotid body tumors (CBTs) are rare entities for which surgical resection remains the gold standard. Given their hypervascularity, preoperative embolization is often used; however, controversy exists over whether a benefit is associated. Proponents of embolization argue it minimizes blood loss and complications. Critics argue cost and stroke outweigh benefits. This study aimed to investigate the impact of embolization on outcomes after CBT resection. METHODS: Patients undergoing CBT resection were identified using the Healthcare Cost and Utilization Project State Inpatient Database for 5 states during the years 2006-2013...

Background: Olfactory fossa (OF) is a depression in anterior cranial cavity whose floor is formed by cribriform plate of ethmoid. Lateral lamella, which forms its lateral boundary, is a thin plate of bone and is at risk of injury during functional endoscopic sinus surgery, especially when fossa is deep/asymmetric. Aims: To measure the variations in the depth of OF and categorize Kerala population as per Keros classification using computed tomography (CT). Settings and Design: This study was conducted in our institution from January 2016 to August 2017...

Anterior skull base operations are complex surgical procedures that are performed to treat serious and complicated diseases. Despite significant advances in surgical techniques, complications are relatively frequent and can be serious. Endoscopic skull base surgery seems to be associated with less complications than open techniques. Different classifications aimed at categorizing these complications have been suggested, the use of which can be recommended when reporting complication rates. The most relevant and frequent complications of anterior skull base surgery are hemorrhage, cerebrospinal fluid (CSF) leak, meningitis, and cranial nerve injury...

OBJECTIVE: Classify rhythmic EEG patterns in extremely preterm infants and relate these to brain injury and outcome. METHODS: Retrospective analysis of 77 infants born <28 weeks gestational age (GA) who had a 2-channel EEG during the first 72 h after birth. Patterns detected by the BrainZ seizure detection algorithm were categorized: ictal discharges, periodic epileptiform discharges (PEDs) and other waveforms. Brain injury was assessed with sequential cranial ultrasound (cUS) and MRI at term-equivalent age...

Frontal sinus fractures account for 2% to 15% of maxillofacial injuries. Up to 66% to 87% of the patients with frontal sinus fractures experience associated facial fractures. The majority of classifications used today categorize frontal sinus fractures depending on the integrity of the anterior table, posterior table, and the nasofrontal outflow. A retrospective study was performed, which included 24 patients diagnosed with frontal sinus fractures. Treatment in all patients consisted of open reduction and bone fixation...

PURPOSE: Neurobrucellosis (NB) is a rare complication of brucellosis. NB presents with avariety of clinical manifestations, and the symptoms are always atypical. Our aim was to analyze the demographic characteristics, clinical manifestations, laboratory findings, imaging findings, treatments and outcomes of patients with NB. MATERIAL AND METHOD: We retrospectively reviewed the data from 17 patients with NB hospitalized at the Chinese People's Liberation Army General Hospital between 1 January 2005 and 31 October 2016...

OBJECTIVE: Prior studies have suggested a relationship between operative (Op) time and outcome after major vascular procedures. This study analyzed factors associated with Op time and outcome after carotid endarterectomy (CEA) in the Vascular Quality Initiative (VQI) registry. METHODS: Elective, primary CEAs without high anatomic risk or concomitant procedures from 2012 to 2015 in the VQI were analyzed (N = 26,327, performed by 1188 surgeons from 249 centers). Multivariable analysis was used to identify patient, procedure, and surgeon factors associated with Op time and major adverse events (MAEs), categorized as either technical (ipsilateral stroke, cranial nerve injury, reoperation) or cardiac (myocardial infarction, congestive heart failure, dysrhythmia requiring treatment, surgical site infection, and death)...

BACKGROUND: Carotid body tumors (CBTs) are rare entities for which surgical resection remains the gold standard. Given their hypervascularity, preoperative embolization is often used; however, controversy exists over whether a benefit is associated. Proponents of embolization argue that it minimizes blood loss and complications. Critics argue that cost and stroke outweigh benefits. This study aimed to investigate the impact of embolization on outcomes following CBT resection. METHODS: Patients undergoing CBT resection were identified using the Healthcare Cost and Utilization Project State Inpatient Database for 5 states between 2006 and 2013...