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Heather S. Spader, Dean A. Hertzler, John R. W. Kestle and Jay Riva-Cambrin

occurs within the first 10–20 days after initial hemorrhage and is manifested clinically by increasing head circumference, diastasis of cranial sutures, and full, bulging fontanelles. This dilation often requires neurosurgical intervention with the placement of a ventricular access device (VAD) to allow serial drainage of CSF to control head growth and to treat the hydrocephalus. The VAD is used until the premature infant demonstrates a need for a permanent ventriculoperitoneal (VP) shunt and is large enough to tolerate the placement procedure. Infections of VADs are

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Prospective multicenter studies in pediatric hydrocephalus

JNSPG 75th Anniversary Invited Review Article

John R. W. Kestle and Jay Riva-Cambrin

previous hydrocephalus trials have focused on device or procedure failure rather than developmental assessment. As discussed by Dr. Matson 65 years ago, 26 growth and development of the child is the most important outcome. This requires prolonged follow-up of children treated in infancy, but is doable. 21 , 43 Conclusions Hydrocephalus is the most common condition that we treat and our efforts to minimize its impact on children and families through prospective multicenter clinical research should continue to be among our highest priorities. Disclosures The authors

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Heather S. Spader, Robert J. Bollo, Christian A. Bowers and Jay Riva-Cambrin

, 2010 3 Dickey MP , Rice M , Kinnett DG , Lambert R , Donauer S , Gerber MA , : Infectious complications of intrathecal baclofen pump devices in a pediatric population . Pediatr Infect Dis J 32 : 715 – 722 , 2013 4 Fjelstad AB , Hommelstad J , Sorteberg A : Infections related to intrathecal baclofen therapy in children and adults: frequency and risk factors . J Neurosurg Pediatr 4 : 487 – 493 , 2009 5 Gooch JL , Oberg WA , Grams B , Ward LA , Walker ML : Complications of intrathecal baclofen pumps in children

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Madeleine P. de Lotbiniere-Bassett, Jay Riva-Cambrin and Patrick J. McDonald

to declare them, making them known to editors, reviewers, and, perhaps most importantly, readers, thus allowing them to decide whether the COI potentially biases the study’s results. Poorly managed conflicts have the potential to erode both the profession’s and the public’s trust in the integrity of scientific research. 17 With the increase in industry-funded and concurrent decline in publicly funded research, funding from device manufacturers and pharmaceutical companies is now increasingly responsible for advancements in medical knowledge. 21 Therefore, over

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Marcus D. Mazur, Walavan Sivakumar, Jay Riva-Cambrin, Jaes Jones and Douglas L. Brockmeyer

records and radiographs of patients who underwent OC fusion were double-reviewed for data collection and accuracy. Clinical variables were recorded, including sex, cause of OC instability, age at surgery, operation performed, number of previous fusion operations, method of cervical fixation, OC rigid fixation device, bone graft material, use of bone morphogenetic protein (BMP) or other biological adjuncts, postoperative bracing, use of the O-arm surgical imaging system (Medtronic, Inc.), and surgical complications requiring reoperation. The causes of OC instability

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Hsin-Hung Chen, Jay Riva-Cambrin, Douglas L. Brockmeyer, Marion L. Walker and John R. W. Kestle

showing a catheter sitting in the posterior ventricle; the catheter was retrieved endoscopically. Methods After the initial cases were identified, the hospital (Primary Children's Medical Center) and the manufacturer (Medtronic) were notified. Medtronic issued a voluntary recall of all unused units of the snap shunt ventricular catheter with BioGlide (catalog Nos. 27782, 27708, and 27802) on February 11, 2009. A US FDA recall of the devices was announced on February 12, 2009. Patient data were retrospectively reviewed for all patients whose records indicated that

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Michael M. H. Yang, Walter Hader, Kelly Bullivant, Mary Brindle and Jay Riva-Cambrin

lumboperitoneal shunts. Patients who underwent a shunt procedure to treat a shunt infection after appropriate antibiotic treatment were also included. Children who underwent surgery for the insertion or revision of ventricular access devices or subgaleal shunts were excluded at the time of those procedures but were potentially eligible if they later underwent a permanent CSF shunt procedure. Shunt procedures were classified into 4 different categories: 1) primary shunt insertions (patients who underwent their first CSF shunt implantation), 2) shunt revision (surgery in which a

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Tamara D. Simon, Matthew Hall, J. Michael Dean, John R. W. Kestle and Jay Riva-Cambrin

Swayne R , Rampling A , Newsom SW : Intraventricular vancomycin for treatment of shunt-associated ventriculitis . J Antimicrob Chemother 19 : 249 – 253 , 1987 35 Venes JL : Infections of CSF shunt and intracranial pressure monitoring devices . Infect Dis Clin North Am 3 : 289 – 299 , 1989 36 Vinchon M , Dhellemmes P : Cerebrospinal fluid shunt infection: risk factors and long-term follow-up . Childs Nerv Syst 22 : 692 – 697 , 2006 37 Walters BC , Hoffman HJ , Hendrick EB , Humphreys RP : Cerebrospinal fluid shunt

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Jetan H. Badhiwala, Chris J. Hong, Farshad Nassiri, Brian Y. Hong, Jay Riva-Cambrin and Abhaya V. Kulkarni

treatment for hydrocephalus. 11 , 45 , 66 Treatment paradigms for PHVD/posthemorrhagic hydrocephalus (PHH) in premature infants have shifted time and time again, and have included diuretics, serial lumbar puncture, intraventricular fibrinolytics, ventricular access device (VAD), external ventricular drain (EVD), and ventriculosubgaleal shunt (VSGS). 59 To date, there remains little in the way of evidence to guide the pediatric neurosurgeon. A common approach used today is to treat PHVD/PHH with a temporizing device—most commonly, either a VAD or VSGS, and less

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Marcus D. Mazur, Vijay M. Ravindra, Meic H. Schmidt, Darrel S. Brodke, Brandon D. Lawrence, Jay Riva-Cambrin and Andrew T. Dailey

-iliac (S2AI) screws has several potential advantages over traditional iliac bolts, namely greater cortical purchase and lower profile. S2AI screws can also be aligned with rostral instrumentation without the use of bulky offset connector devices. 23 , 28 The purpose of this study was to investigate whether the use of S2AI screws is associated with lower rates of unplanned reoperation in patients undergoing pelvic fixation compared with those receiving iliac bolts. Knowledge of the risk factors and timing of unplanned reoperation will enable surgeons to counsel patients