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Vacuum-assisted scalp repositioning: a novel temporizing approach to acute sinking skin flap syndrome. Illustrative cases

Evan Courville, Joshua Marquez, Michael Homma, Michael Conley, Georgios P Skandalakis, Peter Shin, James Botros, and Christian Ricks

. Outcome Shortly after the sunken flap was adjusted, the patient experienced a tonic-clonic seizure. The external cast and wound vacuum were promptly removed. Repeat head imaging revealed a new 3-mm acute subdural hematoma without mass effect, with near-complete resolution of the previously observed paradoxical brain herniation ( Fig. 3 ). The patient was intubated for airway protection and transferred to the intensive care unit (ICU) for monitoring, including long-term electroencephalography (EEG). FIG. 3 Case 2. Axial ( A ) and coronal ( B ) noncontrast CT

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Extended tulip cervical reduction screws to restore alignment in traumatic atlantoaxial dislocation after type 3 odontoid fracture: illustrative case

Christopher F. Dibble, Saad Javeed, Justin K. Zhang, Brenton Pennicooke, Wilson Z. Ray, and Camilo Molina

vehicle sustained 4 months prior, when she reportedly walked into traffic while intoxicated. Of note, she had a past medical history of polysubstance abuse, hepatitis C with cirrhosis, type 2 diabetes, and hypertension. At the time, she sustained numerous injuries, including a nondisplaced type III odontoid fracture ( Fig. 1A–C ), which was managed conservatively with a cervical collar, as well as separate three column/chance fractures at T3 and L4–5, which were managed with posterior percutaneous fixation. In addition, she had a small subdural hematoma managed