Damforsyth2378

No statistically significant regional variation was found for length of stay, charges, or readmissions after adjustment for child demographics, admission type, disposition, primary diagnosis, ICU stay, and number of chronic conditions.

This study characterized the population of children with LTVD hospitalized in 2014. No regional variation was found for length of stay, charges, or readmissions.

Children with established LTVD make up a small subset of all children admitted to children's hospitals however, they require substantial, costly, multifaceted care as most have additional complex chronic conditions and require multiple medical devices.

Children with established LTVD make up a small subset of all children admitted to children's hospitals however, they require substantial, costly, multifaceted care as most have additional complex chronic conditions and require multiple medical devices.Patient MRI from DBS implantations in the subthalamic nucleus (STN) were reviewed and it was found that around 10% had Virchow-Robin spaces (VRS). Patient-specific models were developed to evaluate changes in the electric field (EF) around DBS leads. The patients (n = 7) were implanted bilaterally either with the standard voltage-controlled lead 3389 or with the directional current-controlled lead 6180. The EF distribution was evaluated by comparing simulations using patient-specific models with homogeneous models without VRS. The EF, depicted with an isocontour of 0.2 V/mm, showed a deformation in the presence of the VRS around the DBS lead. For patient-specific models, the radial extension of the EF isocontours was enlarged regardless of the operating mode or the DBS lead used. The location of the VRS in relation to the active contact and the stimulation amplitude, determined the changes in the shape and extension of the EF. It is concluded that it is important to take the patients' brain anatomy into account as the high conductivity in VRS will alter the electric field if close to the DBS lead. This can be a cause of unexpected side effects.

We aim to evaluate whether intraoperative cerebrospinal fluid (CSF) sampling during ventriculo-peritoneal (VP) shunt insertion can predict future VP shunt infection or guide its management.

83 paediatric patients undergoing VP shunt insertion between February 2013 and July 2019 were retrospectively identified. Patient demographics, presence of pre-operative extra ventricular drain (EVD), pre-operative CSF results, and intra-operative CSF results were identified from patient case notes and electronic clinical databases. All included patients were followed up for a minimum of 6 months for identification of shunt infection.

90 VP shunt insertions were performed in 83 patients. Age at time of shunt insertion ranged from 5 days to 15.8 years (mean 44.2 months). Tumours were the most common aetiology for hydrocephalus (n=24). 67 cases (74.4%) had intra-operative CSF samples, of which 2 revealed the presence of bacteria. Only 1 patient with intra-operative CSF sampling positive for growth developed shunt infecan chance as a diagnostic tool. Further larger studies are needed to substantiate this.

The main aim of this study was to compare optic nerve sheath diameter (ONSD) measured using ultrasonography (USG) and computed tomography (CT) almost simultaneously in the same patients with suspected elevated intracranial pressure. The other aim of this study was to evaluate the diagnostic ability for detecting elevated intracranial pressure using ONSD measured by USG (USG-ONSD) and by CT (CT-ONSD).

This prospective, observational study was undertaken from June to October 2020 in the emergency department (ED) of a tertiary medical center in Seoul. ONSD was measured by USG and CT at 3mm behind the posterior aspect of the globe.

A total of 199 patients were enrolled. The median USG-ONSD and CT-ONSD were significantly higher in patients with elevated intracranial pressure than in patients with normal intracranial pressure. The interclass correlation coefficient between USG-ONSD and CT-ONSD was 0.785 (95% CI 0.715-0.837). A Bland-Altman plot showed significant agreement between USG and CT measurements. The optimal cutoff for detecting elevated intracranial pressure was >5.3mm (sensitivity of 75.4% and specificity of 90.8%) for USG and >5.0mm (sensitivity of 68.4% and specificity of 85.2%) for CT.

The ONSD measured using USG and CT were increased in patients with elevated intracranial pressure. Measurement of ONSD by USG and CT showed very high agreement.

The ONSD measured using USG and CT were increased in patients with elevated intracranial pressure. Measurement of ONSD by USG and CT showed very high agreement.

Knowledge of free-hand screw technique remains critical to adequately train neurosurgical residents. The purpose of this study was to evaluate the accuracy of screw placement via the free-hand technique in lumbar, thoracic, and cervical spine by neurosurgical residents completing an enfolded spine fellowship.

Medical records of all patients who underwent free-hand screw placement at all spinal levels over a 6-month period by senior neurosurgical residents enrolled in an in-folded spine fellowship were retrospectively reviewed. StemRegenin 1 ic50 Postoperative CT images were assessed for presence and direction of cortical breach.

Twenty-six patients underwent 162 free-hand screw placements. The most commonly placed screws were cervical lateral mass screws (n = 69), thoracic (n = 41), and lumbar pedicle screws (n = 41). The most common indication for surgery was deformity (n = 22), followed by infection (n = 2) and trauma (n = 2). Fifty-five breaches were identified in 44 (27 %) screws placed in 21 patients (81 %). Anterior breach was identified in 22 cases (40.0 %), lateral in 12 (23.6 %), superior in 7 (12.7 %), and inferior in 7 (12.7 %), and medial in 6 (10.9 %). The most common level of breach was observed in cervical lateral mass screws (n = 19, 43 %) and least common in C2 pars screws (n = 1, 2%). With an average length of follow up of 12.1 ± 7.7 months of follow-up, no clinical sequalae of screw breach was observed.

Despite the high prevalence of screw breach using the free-hand technique by neurosurgical residents, the absence of clinical sequelae implies safety and emphasizes the importance of early exposure to this technique during neurosurgical residency training.

Despite the high prevalence of screw breach using the free-hand technique by neurosurgical residents, the absence of clinical sequelae implies safety and emphasizes the importance of early exposure to this technique during neurosurgical residency training.