for SCST based on CT evaluation and morphology, adopted by AOSpine, in an attempt to improve the morphological classification ( Table 1 ). 3 , 10–16 TABLE 1. Morphological injury criteria of new AOSpine classification * Grade Definition Vertebral morphology A: Compression injuries A0 No/minor bony injury A1 Compression involving single endplate A2 Split vertebra A3 Burst involving single endplate A4 Burst involving both endplates B: Tension band injuries B1
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Otávio Turolo da Silva, Marcelo Ferreira Sabba, Henrique Igor Gomes Lira, Enrico Ghizoni, Helder Tedeschi, Alpesh A. Patel, and Andrei Fernandes Joaquim
Lori C. Jordan, George I. Jallo, and Philippe Gailloud
S pontaneous ICH is almost as prevalent as ischemic stroke in children. 9 Taken together, ischemic and hemorrhagic strokes are as common as brain tumors in the pediatric population. 12 Unfortunately, no clear guidelines exist to suggest the appropriate diagnostic evaluation of children with ICH. Adult guidelines may not be applicable given that the most frequent causes of adult ICH––that is, hypertension and amyloid angiopathy––are rare in children. 2 , 8 Based on case series data, the most common causes of ICH in children are AVMs, hematological
Karen Monuszko, Michael Malinzak, Lexie Zidanyue Yang, Donna Niedzwiecki, Herbert Fuchs, Carrie R. Muh, Krista Gingrich, Robert Lark, and Eric M. Thompson
a validated 5-point quality rating scale: 5 = optimal, 4 = good, 3 = still diagnostic, 2 = partial detection possible, and 1 = insufficient quality. 9 Images were evaluated in three categories: overall image quality, delineation of shunt, and contrast of shunt versus adjacent anatomy. The total score of each image was calculated as the sum of these three subscores. The phrase “contrast of shunt versus adjacent anatomy” was defined as the contrast of the shunt tubing to the anatomical structures such as the bones of the spine and ribs, the heart and lungs, and the
Hans Säveland, Bengt Sonesson, Bengt Ljunggren, Lennart Brandt, Tore Uski, Stefan Zygmunt, and Bengt Hindfelt
develop delayed ischemic cerebral complications. Over the last decade, computerized tomography (CT) has come into routine use in the acute evaluation of patients with SAH, 2, 7–11, 15, 19, 20, 25, 26, 28, 30, 31, 33, 34, 37, 41, 42 and evidence is emerging that the amount of extravasated blood within the intracranial compartment correlates positively with the subsequent development of vasospasm and ischemic deterioration. 11, 12, 28 The CT findings in the acute stage could therefore reasonably be integrated into any prognostic grading system in order to identify the
Xeroradiography in evaluation of cervical spine injuries
Technical note
Norman D. Peters and George Ehni
Xeroradiography is a simple means of evaluating the C6–7, T-1 level of patients in whom conventional filming fails to penetrate the thick shoulder and neck mass. The process, employing conventional x-ray generators (including portable apparatus) and a patented selenium plate, has two unique properties. It exaggerates density differences between soft tissue and bone, and exhibits the phenomenon of “edge enhancement” which sharpens the delineation of the interface between tissues of differing densities. This process allows excellent visualization of the cervical spine with a
Alan D. Waxman, Jan K. Siemsen, Ralph S. Wolfstein, and Theodore Kurze
G allium (Ga) scanning of the brain has been employed recently in the detection of brain tumors and in the differential diagnosis of cerebral lesions. 1, 3, 5 The most likely mechanism for gallium accumulation in brain lesions is a combination of blood-brain barrier breakdown and of active retention in highly cellular tissue. 5 Postcraniotomy patients may have positive technetium brain scans at the surgical site for long periods after the operation, making the detection of tumor recurrence notoriously difficult. 4 The purpose of this report is to evaluate a
John S. Meyer, Yasuhisa Kitagawa, Norio Tanahashi, Hisao Tachibana, Prasab Kandula, David A. Cech, Guy L. Clifton, and James E. Rose
, but surgical therapy was not advised at that time. His disease progressed until he was unable to walk, at which time the family requested a shunt procedure. He died while awaiting the CSF shunting procedure. At autopsy it was established that death resulted from pneumonia complicated by septicemia. The presence of communicating hydrocephalus without apparent cause was confirmed. Six patients (Cases 1, 4 to 7, and 9) had VP shunting and two (Cases 3 and 10) had LP shunting. Case 6 had originally been evaluated for NPH, including CBF studies, 4 years before and was
Joseph P. Broderick, Thomas G. Brott, Thomas Tomsick, William Barsan, and Judith Spilker
focal cerebral ischemia. One of the goals of this study is to identify appropriate stroke patients, evaluate them by means of computerized tomography (CT), and treat them within 90 minutes of stroke onset. Because the t-PA study investigators are called to evaluate a stroke patient before CT has been completed, they have the opportunity to evaluate patients with ICH soon after the onset of bleeding. From September 1, 1987, to August 1, 1988, eight patients who had a spontaneous ICH were evaluated by the study investigators. Each patient underwent CT within 2½ hours of
Zane Schnurman and Douglas Kondziolka
, including communications of personal experience or historical usage, in addition to clinical studies. Yet recently calls have intensified from payers, regulators, and many in the medical community to limit the definition of efficacy to high-level evidence, chiefly that from randomized controlled trials (RCTs). For better or worse, a major consequence of such adoption will be alterations in the way surgeons investigate new procedures. Effective reform requires critical evaluation of how innovations currently develop from conception to general acceptance. The goal of
Christopher P. Ames, Neil R. Crawford, Robert H. Chamberlain, Vivek Deshmukh, Belma Sadikovic, and Volker K. H. Sonntag
not characteristic of most instrumentation for spinal fixation, which usually produces much stronger and stiffer constructs compared with the intact condition. Perhaps, in cases of odontoid fracture fixation, the screw really functions more as a reduction mechanism, especially when combined with postoperative immobilization, making the ultimate material strength and stiffness less critical. Bioresorbable odontoid screws also are radiolucent on x-ray films, which is not the case with metallic screws. Thus, it is easier to evaluate the extent of reduction when the
