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W. Craig Clark, Michael Coscia, James D. Acker, Keith Wainscott and James T. Robertson

A tlantoaxial dislocations are usually categorized as congenital, traumatic, or acquired (“spontaneous”) in association with pharyngeal infection or inflammatory joint disease. 6, 13 The first case of spontaneous atlantoaxial dislocation was reported by Sir Charles Bell in 1830, and was associated with destruction of the transverse ligament by an eroding syphilitic ulcer of the posterior pharyngeal wall. 1, 20 Since that time more than 200 cases of spontaneous atlantoaxial dislocation have been reported. 5, 6, 22 The infection-related type has occurred

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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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Susan E. Wozniak, Eric M. Thompson and Nathan R. Selden

S ince 1997, vagal nerve stimulation has been widely used to treat medically intractable seizures. 3 Longterm VNS benefits may include reduction in seizure frequency, duration, and postictal period. 2 Most clinical side effects, including localized irritation, hoarseness, torticollis, and dysesthesias, may be tolerated and often disappear or improve with time. 10 The infection of VNS hardware, however, requires additional surgical intervention and may result in treatment failure. 9 As with many surgical device-related infections, standard treatment

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Tamara D. Simon, Matthew Hall, Jay Riva-Cambrin, J. Elaine Albert, Howard E. Jeffries, Bonnie LaFleur, J. Michael Dean, John R. W. Kestle and in collaboration with the Hydrocephalus Clinical Research Network

C erebrospinal fluid shunt placement is the mainstay of hydrocephalus treatment. 24 While allowing children with hydrocephalus to avoid further brain injury, CSF shunts can also be associated with new and chronic surgical and medical problems. 41 Malfunction is frequent, 4 , 6 , 7 , 23 and with each revision the cumulative risk of CSF shunt infection rises for the patient. 21 , 29 Infections are frequent complications of CSF shunt placement, and infection rates vary widely from study to study. Differences in reported rates are in part related to

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Ronald F. Young and Pablo M. Lawner

T he value of prophylactic antibiotics in the prevention of infections following neurosurgical operative procedures remains a subject of considerable interest. 9–11 Malis' report 15 of 1732 neurosurgical procedures without a single postoperative infection sparked renewed enthusiasm for the use of such prophylaxis. Recently, Geraghty and Feely 8 reported a statistically significant decrease in infections following neurosurgical operations with the use of perioperative prophylactic antibiotics. Tenney, et al. , 18 stressed the potential variability of

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

I ntrathecal baclofen (ITB) therapy has been used to treat spasticity in adults since the 1980s and in children since 1993, when Albright and colleagues 1 published their findings on the first series of 37 pediatric patients implanted with baclofen pumps. In that series, the authors found an overall infection rate of 19% without perioperative antibiotics and 5% with perioperative antibiotics. Subsequent studies have found infection rates in children with baclofen pumps that range from 3% to 40%, although most studies report an infection rate of

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Steven M. Kurtz, Edmund Lau, Kevin L. Ong, Leah Carreon, Heather Watson, Todd Albert and Steven Glassman

I nfection can be a devastating complication of instrumented spinal fusion because it may lead to excess morbidity and poor patient outcomes, including pseudarthrosis and osteomyelitis. 4 An SSI following instrumented spinal fusion can be differentiated by the following: depth of penetration; timing relative to index surgery; and treatment strategy. An SSI is classified as either superficial or deep wound infection, depending on whether the infection is subcutaneous or subfascial. Deep infections indicate that the peri-implant tissues have been

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Scott L. Parker, William N. Anderson, Sean Lilienfeld, J. Thomas Megerian and Matthew J. McGirt

C erebrospinal fluid shunts have been the primary surgical option in the treatment of hydrocephalus since their introduction in the 1950s. 11 While there has been a dramatic improvement over the past several decades in surgical technique, shunt technology, and surgical experience, shunt infection remains a serious complication. 10 , 25 , 26 , 31 In children it is associated with psychomotor retardation and reduced IQ, while in adults, it is associated with meningitis, endocarditis, and prolonged hospitalization. 27 , 36 , 37 As early as the mid-1970s

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Julia Champey, Clément Mourey, Gilles Francony, Patricia Pavese, Emmanuel Gay, Laurent Gergele, Romain Manet, Lionel Velly, Nicolas Bruder and Jean-François Payen

E xternal ventricular drains (EVDs) are commonly used to monitor intracranial pressure (ICP) via the gold-standard measurement of ventricular pressure. 4 Should ICP be raised, EVDs can also provide relief by draining off CSF and should be considered in the treatment of acute hydrocephalus after subarachnoid hemorrhage or posttraumatic brain edema. 9 , 27 However, EVD monitoring exposes the patient to complications, including infection, hemorrhage, and malfunction or obstruction of the drainage system. According to the literature, the incidence of EVD

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Venkatesh S. Madhugiri, Indira Devi Bhagavatula, Anita Mahadevan and Nagarathna Siddaiah

P haeohyphomycosis is the collective term for a heterogeneous group of mycotic infections that contain dematiaceous yeastlike cells, pseudohyphaelike elements, hyphae, or any combination of these forms in tissue. 7 , 8 Cerebral phaeohyphomycosis is a rare fungal infection of the brain typically caused by Cladophialophora bantiana, Exophiala dermatitidis , and Rhinocladiella mackenziei , all of which belong to the order Chaetothyriales . 2 The genus Fonsecaea is a rare cause of cerebral phaeohyphomycosis. There are sporadic reports of cerebral