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class="user-summary-container"><div class="social-profile-avatar-container"><img class="profile-avatar u-positionAbsolute" alt="Marion L Walker" border="0" onerror="if (this.src != '//a.academia-assets.com/images/s200_no_pic.png') this.src = '//a.academia-assets.com/images/s200_no_pic.png';" width="200" height="200" src="https://0.academia-photos.com/33852416/48771866/36920280/s200_marion.walker.jpeg" /></div><div class="title-container"><h1 class="ds2-5-heading-sans-serif-sm">Marion L Walker</h1><div class="affiliations-container fake-truncate js-profile-affiliations"><div><a class="u-tcGrayDarker" href="https://utah.academia.edu/">University of Utah</a>, <a class="u-tcGrayDarker" href="https://utah.academia.edu/Departments/Neurosurgery/Documents">Neurosurgery</a>, <span class="u-tcGrayDarker">Emeritus</span></div></div></div></div><div class="sidebar-cta-container"><button class="ds2-5-button hidden profile-cta-button grow js-profile-follow-button" 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in spinal cord injury-induced spasticity</a></div><div class="wp-workCard_item"><span>Journal of neurosurgery. Pediatrics</span><span>, 2014</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Selective dorsal rhizotomy may have a role in the management of spinal cord injury (SCI)-induced ...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Selective dorsal rhizotomy may have a role in the management of spinal cord injury (SCI)-induced spasticity. Spasticity and spasms are common sequelae of SCI in children. Depending on the clinical scenario, treatments may include physical and occupational therapy, oral medications, chemodenervation, and neurosurgical interventions. Selective dorsal rhizotomy (SDR) is used in the management of spasticity in selected children with cerebral palsy, but, to the authors&#39; knowledge, its use has not been reported in children with SCI. The authors describe the cases of 3 pediatric patients with SCI and associated spasticity treated with SDR. Two of the 3 patients have had significant long-term improvement in their preoperative spasticity. Although the third patient also experienced initial relief, his spasticity quickly returned to its preoperative severity, necessitating additional therapies. 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="26980660"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/26980660/A_14_Year_Old_Female_with_Decreasing_Visual_Acuity_Severe_Headache_Nausea_and_Vomiting"><img alt="Research paper thumbnail of A 14-Year-Old Female with Decreasing Visual Acuity, Severe Headache, Nausea and Vomiting" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/26980660/A_14_Year_Old_Female_with_Decreasing_Visual_Acuity_Severe_Headache_Nausea_and_Vomiting">A 14-Year-Old Female with Decreasing Visual Acuity, Severe Headache, Nausea and Vomiting</a></div><div class="wp-workCard_item"><span>Pediatric Neurosurgery</span><span>, Feb 1, 2001</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="26980660"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="26980660"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 26980660; 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="26980659"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/26980659/Clinicopathological_review_tumefactive_demyelination_in_a_12_year_old_girl"><img alt="Research paper thumbnail of Clinicopathological review: tumefactive demyelination in a 12-year-old girl" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/26980659/Clinicopathological_review_tumefactive_demyelination_in_a_12_year_old_girl">Clinicopathological review: tumefactive demyelination in a 12-year-old girl</a></div><div class="wp-workCard_item"><span>Neurosurgery</span><span>, May 1, 2005</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Dr. Anderson: The patient is a 12 year-old, right-handed girl without significant past medical or...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Dr. Anderson: The patient is a 12 year-old, right-handed girl without significant past medical or surgical history who developed the acute onset of right foot weakness approximately 10 days before admission. After sitting on the couch watching television, she tried to stand and ...</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="26980659"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="26980659"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 26980659; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=26980659]").text(description); $(".js-view-count[data-work-id=26980659]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 26980659; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='26980659']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 26980659, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=26980659]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":26980659,"title":"Clinicopathological review: tumefactive demyelination in a 12-year-old girl","translated_title":"","metadata":{"abstract":"Dr. Anderson: The patient is a 12 year-old, right-handed girl without significant past medical or surgical history who developed the acute onset of right foot weakness approximately 10 days before admission. After sitting on the couch watching television, she tried to stand and ...","publication_date":{"day":1,"month":5,"year":2005,"errors":{}},"publication_name":"Neurosurgery"},"translated_abstract":"Dr. Anderson: The patient is a 12 year-old, right-handed girl without significant past medical or surgical history who developed the acute onset of right foot weakness approximately 10 days before admission. After sitting on the couch watching television, she tried to stand and ...","internal_url":"https://www.academia.edu/26980659/Clinicopathological_review_tumefactive_demyelination_in_a_12_year_old_girl","translated_internal_url":"","created_at":"2016-07-14T05:40:29.888-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":33852416,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[],"downloadable_attachments":[],"slug":"Clinicopathological_review_tumefactive_demyelination_in_a_12_year_old_girl","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"Dr. Anderson: The patient is a 12 year-old, right-handed girl without significant past medical or surgical history who developed the acute onset of right foot weakness approximately 10 days before admission. After sitting on the couch watching television, she tried to stand and ...","owner":{"id":33852416,"first_name":"Marion","middle_initials":"L","last_name":"Walker","page_name":"MarionWalker","domain_name":"utah","created_at":"2015-08-12T08:15:14.624-07:00","display_name":"Marion L Walker","url":"https://utah.academia.edu/MarionWalker"},"attachments":[],"research_interests":[{"id":650,"name":"Neurosurgery","url":"https://www.academia.edu/Documents/in/Neurosurgery"},{"id":6200,"name":"Magnetic Resonance Imaging","url":"https://www.academia.edu/Documents/in/Magnetic_Resonance_Imaging"},{"id":109739,"name":"Infection","url":"https://www.academia.edu/Documents/in/Infection"},{"id":244814,"name":"Clinical Sciences","url":"https://www.academia.edu/Documents/in/Clinical_Sciences"},{"id":1239755,"name":"Neurosciences","url":"https://www.academia.edu/Documents/in/Neurosciences"}],"urls":[{"id":7322027,"url":"http://www.ncbi.nlm.nih.gov/pubmed/15854254"}]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="26980658"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/26980658/A_new_Hydrocephalus_Clinical_Research_Network_protocol_to_reduce_cerebrospinal_fluid_shunt_infection"><img alt="Research paper thumbnail of A new Hydrocephalus Clinical Research Network protocol to reduce cerebrospinal fluid shunt infection" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/26980658/A_new_Hydrocephalus_Clinical_Research_Network_protocol_to_reduce_cerebrospinal_fluid_shunt_infection">A new Hydrocephalus Clinical Research Network protocol to reduce cerebrospinal fluid shunt infection</a></div><div class="wp-workCard_item"><span>Journal of neurosurgery. Pediatrics</span><span>, Jan 18, 2015</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">OBJECT In a previous report by the same research group (Kestle et al., 2011), compliance with an ...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">OBJECT In a previous report by the same research group (Kestle et al., 2011), compliance with an 11-step protocol was shown to reduce CSF shunt infection at Hydrocephalus Clinical Research Network (HCRN) centers (from 8.7% to 5.7%). Antibiotic-impregnated catheters (AICs) were not part of the protocol but were used off protocol by some surgeons. The authors therefore began using a new protocol that included AICs in an effort to reduce the infection rate further. METHODS The new protocol was implemented at HCRN centers on January 1, 2012, for all shunt procedures (excluding external ventricular drains [EVDs], ventricular reservoirs, and subgaleal shunts). Procedures performed up to September 30, 2013, were included (21 months). Compliance with the protocol and outcome events up to March 30, 2014, were recorded. The definition of infection was unchanged from the authors&#39; previous report. RESULTS A total of 1935 procedures were performed on 1670 patients at 8 HCRN centers. The over...</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="26980658"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="26980658"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 26980658; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=26980658]").text(description); $(".js-view-count[data-work-id=26980658]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 26980658; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='26980658']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 26980658, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=26980658]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":26980658,"title":"A new Hydrocephalus Clinical Research Network protocol to reduce cerebrospinal fluid shunt infection","translated_title":"","metadata":{"abstract":"OBJECT In a previous report by the same research group (Kestle et al., 2011), compliance with an 11-step protocol was shown to reduce CSF shunt infection at Hydrocephalus Clinical Research Network (HCRN) centers (from 8.7% to 5.7%). Antibiotic-impregnated catheters (AICs) were not part of the protocol but were used off protocol by some surgeons. The authors therefore began using a new protocol that included AICs in an effort to reduce the infection rate further. METHODS The new protocol was implemented at HCRN centers on January 1, 2012, for all shunt procedures (excluding external ventricular drains [EVDs], ventricular reservoirs, and subgaleal shunts). Procedures performed up to September 30, 2013, were included (21 months). Compliance with the protocol and outcome events up to March 30, 2014, were recorded. The definition of infection was unchanged from the authors\u0026#39; previous report. RESULTS A total of 1935 procedures were performed on 1670 patients at 8 HCRN centers. The over...","publication_date":{"day":18,"month":1,"year":2015,"errors":{}},"publication_name":"Journal of neurosurgery. Pediatrics"},"translated_abstract":"OBJECT In a previous report by the same research group (Kestle et al., 2011), compliance with an 11-step protocol was shown to reduce CSF shunt infection at Hydrocephalus Clinical Research Network (HCRN) centers (from 8.7% to 5.7%). Antibiotic-impregnated catheters (AICs) were not part of the protocol but were used off protocol by some surgeons. The authors therefore began using a new protocol that included AICs in an effort to reduce the infection rate further. METHODS The new protocol was implemented at HCRN centers on January 1, 2012, for all shunt procedures (excluding external ventricular drains [EVDs], ventricular reservoirs, and subgaleal shunts). Procedures performed up to September 30, 2013, were included (21 months). Compliance with the protocol and outcome events up to March 30, 2014, were recorded. The definition of infection was unchanged from the authors\u0026#39; previous report. RESULTS A total of 1935 procedures were performed on 1670 patients at 8 HCRN centers. The over...","internal_url":"https://www.academia.edu/26980658/A_new_Hydrocephalus_Clinical_Research_Network_protocol_to_reduce_cerebrospinal_fluid_shunt_infection","translated_internal_url":"","created_at":"2016-07-14T05:40:29.551-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":33852416,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[],"downloadable_attachments":[],"slug":"A_new_Hydrocephalus_Clinical_Research_Network_protocol_to_reduce_cerebrospinal_fluid_shunt_infection","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"OBJECT In a previous report by the same research group (Kestle et al., 2011), compliance with an 11-step protocol was shown to reduce CSF shunt infection at Hydrocephalus Clinical Research Network (HCRN) centers (from 8.7% to 5.7%). Antibiotic-impregnated catheters (AICs) were not part of the protocol but were used off protocol by some surgeons. The authors therefore began using a new protocol that included AICs in an effort to reduce the infection rate further. METHODS The new protocol was implemented at HCRN centers on January 1, 2012, for all shunt procedures (excluding external ventricular drains [EVDs], ventricular reservoirs, and subgaleal shunts). Procedures performed up to September 30, 2013, were included (21 months). Compliance with the protocol and outcome events up to March 30, 2014, were recorded. The definition of infection was unchanged from the authors\u0026#39; previous report. RESULTS A total of 1935 procedures were performed on 1670 patients at 8 HCRN centers. The over...","owner":{"id":33852416,"first_name":"Marion","middle_initials":"L","last_name":"Walker","page_name":"MarionWalker","domain_name":"utah","created_at":"2015-08-12T08:15:14.624-07:00","display_name":"Marion L Walker","url":"https://utah.academia.edu/MarionWalker"},"attachments":[],"research_interests":[],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="26980657"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/26980657/Pediatric_skull_base_surgery_2_Experience_and_outcomes_in_55_patients"><img alt="Research paper thumbnail of Pediatric skull base surgery: 2. Experience and outcomes in 55 patients" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/26980657/Pediatric_skull_base_surgery_2_Experience_and_outcomes_in_55_patients">Pediatric skull base surgery: 2. Experience and outcomes in 55 patients</a></div><div class="wp-workCard_item"><span>Pediatric Neurosurgery</span><span>, Feb 1, 2003</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">In the second of these two articles, we will discuss our clinical experience with skull base surg...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">In the second of these two articles, we will discuss our clinical experience with skull base surgery in the pediatric population. We present a retrospective analysis of 55 patients less than 16 years of age who underwent skull base surgical approaches at the Primary Children&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Medical Center or the University of Utah Medical Center between January 1992 and April 1999. There were 30 boys and 25 girls (mean age 9.8 years). Patient follow-up averaged 58 months. Most patients had pathology that required either an anterior or anterolateral approach; 6 patients underwent a far-lateral or a transpetrosal exposure. Thirty-five procedures were performed by a neurosurgeon, a pediatric otolaryngologist performed 11 procedures, and 10 procedures were performed by both services together. Ninety-six percent of patients (n = 53) had a Glasgow Outcome Score of 4 or 5. Complications included 4 sustained cranial nerve palsies and 2 hemipareses. There were no CSF leaks, infections or deaths. Patients with sellar region pathology had a disproportionately higher incidence of postoperative morbidity. We conclude that in selected pediatric cases, skull base surgical techniques can be performed effectively and safely with the use of multidisciplinary teams. To implement these techniques, knowledge of their limitations and of the anatomical differences between the adult and pediatric cranial base is essential.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="26980657"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="26980657"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 26980657; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=26980657]").text(description); $(".js-view-count[data-work-id=26980657]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 26980657; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='26980657']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 26980657, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=26980657]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":26980657,"title":"Pediatric skull base surgery: 2. Experience and outcomes in 55 patients","translated_title":"","metadata":{"abstract":"In the second of these two articles, we will discuss our clinical experience with skull base surgery in the pediatric population. We present a retrospective analysis of 55 patients less than 16 years of age who underwent skull base surgical approaches at the Primary Children\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Medical Center or the University of Utah Medical Center between January 1992 and April 1999. There were 30 boys and 25 girls (mean age 9.8 years). Patient follow-up averaged 58 months. Most patients had pathology that required either an anterior or anterolateral approach; 6 patients underwent a far-lateral or a transpetrosal exposure. Thirty-five procedures were performed by a neurosurgeon, a pediatric otolaryngologist performed 11 procedures, and 10 procedures were performed by both services together. Ninety-six percent of patients (n = 53) had a Glasgow Outcome Score of 4 or 5. Complications included 4 sustained cranial nerve palsies and 2 hemipareses. There were no CSF leaks, infections or deaths. Patients with sellar region pathology had a disproportionately higher incidence of postoperative morbidity. We conclude that in selected pediatric cases, skull base surgical techniques can be performed effectively and safely with the use of multidisciplinary teams. To implement these techniques, knowledge of their limitations and of the anatomical differences between the adult and pediatric cranial base is essential.","publication_date":{"day":1,"month":2,"year":2003,"errors":{}},"publication_name":"Pediatric Neurosurgery"},"translated_abstract":"In the second of these two articles, we will discuss our clinical experience with skull base surgery in the pediatric population. We present a retrospective analysis of 55 patients less than 16 years of age who underwent skull base surgical approaches at the Primary Children\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Medical Center or the University of Utah Medical Center between January 1992 and April 1999. There were 30 boys and 25 girls (mean age 9.8 years). Patient follow-up averaged 58 months. Most patients had pathology that required either an anterior or anterolateral approach; 6 patients underwent a far-lateral or a transpetrosal exposure. Thirty-five procedures were performed by a neurosurgeon, a pediatric otolaryngologist performed 11 procedures, and 10 procedures were performed by both services together. Ninety-six percent of patients (n = 53) had a Glasgow Outcome Score of 4 or 5. Complications included 4 sustained cranial nerve palsies and 2 hemipareses. There were no CSF leaks, infections or deaths. Patients with sellar region pathology had a disproportionately higher incidence of postoperative morbidity. We conclude that in selected pediatric cases, skull base surgical techniques can be performed effectively and safely with the use of multidisciplinary teams. To implement these techniques, knowledge of their limitations and of the anatomical differences between the adult and pediatric cranial base is essential.","internal_url":"https://www.academia.edu/26980657/Pediatric_skull_base_surgery_2_Experience_and_outcomes_in_55_patients","translated_internal_url":"","created_at":"2016-07-14T05:40:29.220-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":33852416,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[],"downloadable_attachments":[],"slug":"Pediatric_skull_base_surgery_2_Experience_and_outcomes_in_55_patients","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"In the second of these two articles, we will discuss our clinical experience with skull base surgery in the pediatric population. We present a retrospective analysis of 55 patients less than 16 years of age who underwent skull base surgical approaches at the Primary Children\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Medical Center or the University of Utah Medical Center between January 1992 and April 1999. There were 30 boys and 25 girls (mean age 9.8 years). Patient follow-up averaged 58 months. Most patients had pathology that required either an anterior or anterolateral approach; 6 patients underwent a far-lateral or a transpetrosal exposure. Thirty-five procedures were performed by a neurosurgeon, a pediatric otolaryngologist performed 11 procedures, and 10 procedures were performed by both services together. Ninety-six percent of patients (n = 53) had a Glasgow Outcome Score of 4 or 5. Complications included 4 sustained cranial nerve palsies and 2 hemipareses. There were no CSF leaks, infections or deaths. Patients with sellar region pathology had a disproportionately higher incidence of postoperative morbidity. We conclude that in selected pediatric cases, skull base surgical techniques can be performed effectively and safely with the use of multidisciplinary teams. To implement these techniques, knowledge of their limitations and of the anatomical differences between the adult and pediatric cranial base is essential.","owner":{"id":33852416,"first_name":"Marion","middle_initials":"L","last_name":"Walker","page_name":"MarionWalker","domain_name":"utah","created_at":"2015-08-12T08:15:14.624-07:00","display_name":"Marion L Walker","url":"https://utah.academia.edu/MarionWalker"},"attachments":[],"research_interests":[{"id":631,"name":"Pediatrics","url":"https://www.academia.edu/Documents/in/Pediatrics"},{"id":647,"name":"Surgery","url":"https://www.academia.edu/Documents/in/Surgery"},{"id":22506,"name":"Adolescent","url":"https://www.academia.edu/Documents/in/Adolescent"},{"id":28235,"name":"Multidisciplinary","url":"https://www.academia.edu/Documents/in/Multidisciplinary"},{"id":54589,"name":"Anatomy","url":"https://www.academia.edu/Documents/in/Anatomy"},{"id":64933,"name":"Child","url":"https://www.academia.edu/Documents/in/Child"},{"id":121939,"name":"Technique","url":"https://www.academia.edu/Documents/in/Technique"},{"id":124105,"name":"Pediatric Neurosurgery","url":"https://www.academia.edu/Documents/in/Pediatric_Neurosurgery"},{"id":134346,"name":"Infant","url":"https://www.academia.edu/Documents/in/Infant"},{"id":162404,"name":"Skull Base","url":"https://www.academia.edu/Documents/in/Skull_Base"},{"id":189576,"name":"Pediatric","url":"https://www.academia.edu/Documents/in/Pediatric"},{"id":469105,"name":"Retrospective Studies","url":"https://www.academia.edu/Documents/in/Retrospective_Studies"},{"id":546419,"name":"Age Factors","url":"https://www.academia.edu/Documents/in/Age_Factors"},{"id":1239755,"name":"Neurosciences","url":"https://www.academia.edu/Documents/in/Neurosciences"},{"id":1423078,"name":"Nervous System Diseases","url":"https://www.academia.edu/Documents/in/Nervous_System_Diseases"},{"id":1929419,"name":"Nino","url":"https://www.academia.edu/Documents/in/Nino"},{"id":2463621,"name":"Postoperative Complications","url":"https://www.academia.edu/Documents/in/Postoperative_Complications"},{"id":2489700,"name":"Child preschool","url":"https://www.academia.edu/Documents/in/Child_preschool"}],"urls":[{"id":7322026,"url":"http://cat.inist.fr/?aModele=afficheN\u0026cpsidt=14501037"}]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="26980656"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/26980656/Medical_Management_of_Head_Injuries_in_Neonates_and_Infants"><img alt="Research paper thumbnail of Medical Management of Head Injuries in Neonates and Infants" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/26980656/Medical_Management_of_Head_Injuries_in_Neonates_and_Infants">Medical Management of Head Injuries in Neonates and Infants</a></div><div class="wp-workCard_item"><span>Principles of Pediatric Neurosurgery</span><span>, 1986</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="26980656"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="26980656"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 26980656; 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="26980655"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/26980655/Its_everything_else_you_do_Alumni_views_on_extracurricular_activities_and_employability"><img alt="Research paper thumbnail of It's everything else you do...': Alumni views on extracurricular activities and employability" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/26980655/Its_everything_else_you_do_Alumni_views_on_extracurricular_activities_and_employability">It's everything else you do...': Alumni views on extracurricular activities and employability</a></div><div class="wp-workCard_item"><span>Active Learning in Higher Education</span><span>, 2015</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">ABSTRACT This article explores students’ extracurricular activities and, uniquely, their short- a...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">ABSTRACT This article explores students’ extracurricular activities and, uniquely, their short- and long-term effects on employability. Drawing on the literature, six research questions are identified. A questionnaire and interviews with alumni provide the quantitative and qualitative information needed. The effects of different extracurricular activities and the skills and qualities they promote are demonstrated for early- and later-career jobs, as are the complementary effects for employability of degree schemes and extracurricular activities. Alumni who are now recruiters of staff use their double perspective to explain the role extracurricular activities have played in their lives and now as professional recruiters. The paper shows how the alumni of any university could share these insights with undergraduates.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="26980655"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="26980655"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 26980655; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=26980655]").text(description); $(".js-view-count[data-work-id=26980655]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 26980655; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='26980655']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 26980655, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=26980655]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":26980655,"title":"It's everything else you do...': Alumni views on extracurricular activities and employability","translated_title":"","metadata":{"abstract":"ABSTRACT This article explores students’ extracurricular activities and, uniquely, their short- and long-term effects on employability. Drawing on the literature, six research questions are identified. A questionnaire and interviews with alumni provide the quantitative and qualitative information needed. The effects of different extracurricular activities and the skills and qualities they promote are demonstrated for early- and later-career jobs, as are the complementary effects for employability of degree schemes and extracurricular activities. Alumni who are now recruiters of staff use their double perspective to explain the role extracurricular activities have played in their lives and now as professional recruiters. The paper shows how the alumni of any university could share these insights with undergraduates.","publication_date":{"day":null,"month":null,"year":2015,"errors":{}},"publication_name":"Active Learning in Higher Education"},"translated_abstract":"ABSTRACT This article explores students’ extracurricular activities and, uniquely, their short- and long-term effects on employability. Drawing on the literature, six research questions are identified. A questionnaire and interviews with alumni provide the quantitative and qualitative information needed. The effects of different extracurricular activities and the skills and qualities they promote are demonstrated for early- and later-career jobs, as are the complementary effects for employability of degree schemes and extracurricular activities. Alumni who are now recruiters of staff use their double perspective to explain the role extracurricular activities have played in their lives and now as professional recruiters. The paper shows how the alumni of any university could share these insights with undergraduates.","internal_url":"https://www.academia.edu/26980655/Its_everything_else_you_do_Alumni_views_on_extracurricular_activities_and_employability","translated_internal_url":"","created_at":"2016-07-14T05:40:28.848-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":33852416,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[],"downloadable_attachments":[],"slug":"Its_everything_else_you_do_Alumni_views_on_extracurricular_activities_and_employability","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"ABSTRACT This article explores students’ extracurricular activities and, uniquely, their short- and long-term effects on employability. Drawing on the literature, six research questions are identified. A questionnaire and interviews with alumni provide the quantitative and qualitative information needed. The effects of different extracurricular activities and the skills and qualities they promote are demonstrated for early- and later-career jobs, as are the complementary effects for employability of degree schemes and extracurricular activities. Alumni who are now recruiters of staff use their double perspective to explain the role extracurricular activities have played in their lives and now as professional recruiters. The paper shows how the alumni of any university could share these insights with undergraduates.","owner":{"id":33852416,"first_name":"Marion","middle_initials":"L","last_name":"Walker","page_name":"MarionWalker","domain_name":"utah","created_at":"2015-08-12T08:15:14.624-07:00","display_name":"Marion L Walker","url":"https://utah.academia.edu/MarionWalker"},"attachments":[],"research_interests":[{"id":124971,"name":"Education Systems","url":"https://www.academia.edu/Documents/in/Education_Systems"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="26980654"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/26980654/Poster_532_Validation_of_a_Long_Term_Post_Stroke_Checklist"><img alt="Research paper thumbnail of Poster 532 Validation of a Long-Term Post-Stroke Checklist" class="work-thumbnail" src="https://attachments.academia-assets.com/47243006/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/26980654/Poster_532_Validation_of_a_Long_Term_Post_Stroke_Checklist">Poster 532 Validation of a Long-Term Post-Stroke Checklist</a></div><div class="wp-workCard_item"><span>PM&R</span><span>, 2012</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">and aphasia. Computed tomography of the brain showed left M2 middle cerebral artery (MCA) branch ...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">and aphasia. Computed tomography of the brain showed left M2 middle cerebral artery (MCA) branch occlusion. He met criteria for and received tissue plasminogen activator. Within 3 hours of admission, patient developed rigors, hypotension, fever and lethargy. Pressors and broad-spectrum antibiotics were started. Echocardiogram showed perivalvular leak of the aortic valve prosthesis and no vegetations. Acute infectious endocarditis workup was initially negative. He was transferred to acute rehabilitation unit. Setting: Tertiary care hospital. Results or Clinical Course: Q fever titers returned positive with phase I and phase II IgG Ͼ1:8192, consistent with acute infection. Patient was started on hydroxyquinolone and doxycycline for at least 18 months. He was likely infected with Q fever via contact with infected horse placenta. Initially at the rehabilitation unit, patient had mild cognitive impairments and moderate expressive and receptive aphasia. These deficits gradually improved as did his right hemiparesis, apraxia, and ataxia. Several weeks after discharge from rehab, he underwent aortic valve replacement surgery. On follow up, he had notable cognitive, speech, and motor improvement with some mild residual deficits. Discussion: This is a rare case of Q fever endocarditis in a patient with a bioprosthetic heart valve and a perivalvular leak on transthoracic echocardiogram who presented with a left MCA embolic stroke. Conclusions: Mortality rate for untreated Q fever endocarditis remains high. Therefore, Q fever should continue to be part of the differential diagnosis in patients who present with acute ischemic stroke in a setting of fever and perivalvular leak.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="a891b741b1cfa2ac1accaf391ee89db8" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":47243006,"asset_id":26980654,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/47243006/download_file?st=MTczMzkxNzc3NCw4LjIyMi4yMDguMTQ2&s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="26980654"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="26980654"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 26980654; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=26980654]").text(description); $(".js-view-count[data-work-id=26980654]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 26980654; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='26980654']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 26980654, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "a891b741b1cfa2ac1accaf391ee89db8" } } $('.js-work-strip[data-work-id=26980654]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":26980654,"title":"Poster 532 Validation of a Long-Term Post-Stroke Checklist","translated_title":"","metadata":{"ai_title_tag":"Long-Term Checklist Validation Post-Stroke and Q Fever Insights","grobid_abstract":"and aphasia. Computed tomography of the brain showed left M2 middle cerebral artery (MCA) branch occlusion. He met criteria for and received tissue plasminogen activator. Within 3 hours of admission, patient developed rigors, hypotension, fever and lethargy. Pressors and broad-spectrum antibiotics were started. Echocardiogram showed perivalvular leak of the aortic valve prosthesis and no vegetations. Acute infectious endocarditis workup was initially negative. He was transferred to acute rehabilitation unit. Setting: Tertiary care hospital. Results or Clinical Course: Q fever titers returned positive with phase I and phase II IgG Ͼ1:8192, consistent with acute infection. Patient was started on hydroxyquinolone and doxycycline for at least 18 months. He was likely infected with Q fever via contact with infected horse placenta. Initially at the rehabilitation unit, patient had mild cognitive impairments and moderate expressive and receptive aphasia. These deficits gradually improved as did his right hemiparesis, apraxia, and ataxia. Several weeks after discharge from rehab, he underwent aortic valve replacement surgery. On follow up, he had notable cognitive, speech, and motor improvement with some mild residual deficits. Discussion: This is a rare case of Q fever endocarditis in a patient with a bioprosthetic heart valve and a perivalvular leak on transthoracic echocardiogram who presented with a left MCA embolic stroke. Conclusions: Mortality rate for untreated Q fever endocarditis remains high. Therefore, Q fever should continue to be part of the differential diagnosis in patients who present with acute ischemic stroke in a setting of fever and perivalvular leak.","publication_date":{"day":null,"month":null,"year":2012,"errors":{}},"publication_name":"PM\u0026R","grobid_abstract_attachment_id":47243006},"translated_abstract":null,"internal_url":"https://www.academia.edu/26980654/Poster_532_Validation_of_a_Long_Term_Post_Stroke_Checklist","translated_internal_url":"","created_at":"2016-07-14T05:40:28.642-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":33852416,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[],"downloadable_attachments":[{"id":47243006,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/47243006/thumbnails/1.jpg","file_name":"j.pmrj.2012.09.113320160714-7071-1ynwg32.pdf","download_url":"https://www.academia.edu/attachments/47243006/download_file?st=MTczMzkxNzc3NCw4LjIyMi4yMDguMTQ2&","bulk_download_file_name":"Poster_532_Validation_of_a_Long_Term_Pos.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/47243006/j.pmrj.2012.09.113320160714-7071-1ynwg32-libre.pdf?1468500384=\u0026response-content-disposition=attachment%3B+filename%3DPoster_532_Validation_of_a_Long_Term_Pos.pdf\u0026Expires=1733921374\u0026Signature=cZ0zR8IjECg8c4afXqLqPfKP3C57nn3xA6k2EfrP33mfT7S7IqvT9LyOZWPQqEaxRvg7D0mDE3KSaeHvBOhjbHnDTuwrAiC97VOpEvAgiAcAwwxR7l~tLOe8Aiv6ieyvwv-MEyyJIIydHVquiewfEwq7ItbhOLFoFTKWVtmasS3IHxqcfMGDDGIY3aN5Wz-UDK10gMKUr9L9drk6kdcX0K16cQF0hu4ckx22ba9AW5kzlV0996CBY68ParDh-MW5NnvTqPSv-ewDq7mQW6K7a18u24uHi54aziLgxFjHy3s43Ghif8KKovNvZ6z6ikDKo4aBlR-rCU5b-0MQ8FgazQ__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"slug":"Poster_532_Validation_of_a_Long_Term_Post_Stroke_Checklist","translated_slug":"","page_count":1,"language":"en","content_type":"Work","summary":"and aphasia. Computed tomography of the brain showed left M2 middle cerebral artery (MCA) branch occlusion. He met criteria for and received tissue plasminogen activator. Within 3 hours of admission, patient developed rigors, hypotension, fever and lethargy. Pressors and broad-spectrum antibiotics were started. Echocardiogram showed perivalvular leak of the aortic valve prosthesis and no vegetations. Acute infectious endocarditis workup was initially negative. He was transferred to acute rehabilitation unit. Setting: Tertiary care hospital. Results or Clinical Course: Q fever titers returned positive with phase I and phase II IgG Ͼ1:8192, consistent with acute infection. Patient was started on hydroxyquinolone and doxycycline for at least 18 months. He was likely infected with Q fever via contact with infected horse placenta. Initially at the rehabilitation unit, patient had mild cognitive impairments and moderate expressive and receptive aphasia. These deficits gradually improved as did his right hemiparesis, apraxia, and ataxia. Several weeks after discharge from rehab, he underwent aortic valve replacement surgery. On follow up, he had notable cognitive, speech, and motor improvement with some mild residual deficits. Discussion: This is a rare case of Q fever endocarditis in a patient with a bioprosthetic heart valve and a perivalvular leak on transthoracic echocardiogram who presented with a left MCA embolic stroke. Conclusions: Mortality rate for untreated Q fever endocarditis remains high. Therefore, Q fever should continue to be part of the differential diagnosis in patients who present with acute ischemic stroke in a setting of fever and perivalvular leak.","owner":{"id":33852416,"first_name":"Marion","middle_initials":"L","last_name":"Walker","page_name":"MarionWalker","domain_name":"utah","created_at":"2015-08-12T08:15:14.624-07:00","display_name":"Marion L Walker","url":"https://utah.academia.edu/MarionWalker"},"attachments":[{"id":47243006,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/47243006/thumbnails/1.jpg","file_name":"j.pmrj.2012.09.113320160714-7071-1ynwg32.pdf","download_url":"https://www.academia.edu/attachments/47243006/download_file?st=MTczMzkxNzc3NCw4LjIyMi4yMDguMTQ2&","bulk_download_file_name":"Poster_532_Validation_of_a_Long_Term_Pos.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/47243006/j.pmrj.2012.09.113320160714-7071-1ynwg32-libre.pdf?1468500384=\u0026response-content-disposition=attachment%3B+filename%3DPoster_532_Validation_of_a_Long_Term_Pos.pdf\u0026Expires=1733921374\u0026Signature=cZ0zR8IjECg8c4afXqLqPfKP3C57nn3xA6k2EfrP33mfT7S7IqvT9LyOZWPQqEaxRvg7D0mDE3KSaeHvBOhjbHnDTuwrAiC97VOpEvAgiAcAwwxR7l~tLOe8Aiv6ieyvwv-MEyyJIIydHVquiewfEwq7ItbhOLFoFTKWVtmasS3IHxqcfMGDDGIY3aN5Wz-UDK10gMKUr9L9drk6kdcX0K16cQF0hu4ckx22ba9AW5kzlV0996CBY68ParDh-MW5NnvTqPSv-ewDq7mQW6K7a18u24uHi54aziLgxFjHy3s43Ghif8KKovNvZ6z6ikDKo4aBlR-rCU5b-0MQ8FgazQ__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"research_interests":[{"id":244814,"name":"Clinical Sciences","url":"https://www.academia.edu/Documents/in/Clinical_Sciences"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="21730917"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/21730917/Stereotactic_endoscopic_placement_of_third_ventricle_catheter_for_long_term_infusion_of_baclofen_in_patients_with_secondary_generalized_dystonia"><img alt="Research paper thumbnail of Stereotactic endoscopic placement of third ventricle catheter for long-term infusion of baclofen in patients with secondary generalized dystonia" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/21730917/Stereotactic_endoscopic_placement_of_third_ventricle_catheter_for_long_term_infusion_of_baclofen_in_patients_with_secondary_generalized_dystonia">Stereotactic endoscopic placement of third ventricle catheter for long-term infusion of baclofen in patients with secondary generalized dystonia</a></div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/GoochJudith">Judith Gooch</a> and <a class="" data-click-track="profile-work-strip-authors" href="https://utah.academia.edu/MarionWalker">Marion L Walker</a></span></div><div class="wp-workCard_item"><span>Journal of neurosurgery. Pediatrics</span><span>, 2012</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Continuous infusion of baclofen is a treatment option for severe generalized dystonia. Catheter i...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Continuous infusion of baclofen is a treatment option for severe generalized dystonia. Catheter insertion within the third ventricle has been described as an alternative to standard intrathecal placement to maximize intracranial concentrations of baclofen. The authors describe their experience with a novel technique for stereotactic endoscopic insertion of baclofen infusion catheters in the third ventricle in 3 patients with severe secondary generalized dystonia. Insertion was successful in all 3 patients, and all of them experienced significant improvement in dystonia scores on the Barry-Albright Dystonia Scale. Follow-up ranged from 5.5 to 7 months (mean 6 months), and no mechanical complications or CSF leaks were observed. The stereotactic endoscopic insertion of a baclofen infusion catheter into the third ventricle appears to be a safe method for continuous intraventricular baclofen infusion in patients with generalized secondary dystonia.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="21730917"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="21730917"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 21730917; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=21730917]").text(description); $(".js-view-count[data-work-id=21730917]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 21730917; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='21730917']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 21730917, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=21730917]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":21730917,"title":"Stereotactic endoscopic placement of third ventricle catheter for long-term infusion of baclofen in patients with secondary generalized dystonia","translated_title":"","metadata":{"abstract":"Continuous infusion of baclofen is a treatment option for severe generalized dystonia. Catheter insertion within the third ventricle has been described as an alternative to standard intrathecal placement to maximize intracranial concentrations of baclofen. The authors describe their experience with a novel technique for stereotactic endoscopic insertion of baclofen infusion catheters in the third ventricle in 3 patients with severe secondary generalized dystonia. Insertion was successful in all 3 patients, and all of them experienced significant improvement in dystonia scores on the Barry-Albright Dystonia Scale. Follow-up ranged from 5.5 to 7 months (mean 6 months), and no mechanical complications or CSF leaks were observed. The stereotactic endoscopic insertion of a baclofen infusion catheter into the third ventricle appears to be a safe method for continuous intraventricular baclofen infusion in patients with generalized secondary dystonia.","publication_date":{"day":null,"month":null,"year":2012,"errors":{}},"publication_name":"Journal of neurosurgery. Pediatrics"},"translated_abstract":"Continuous infusion of baclofen is a treatment option for severe generalized dystonia. Catheter insertion within the third ventricle has been described as an alternative to standard intrathecal placement to maximize intracranial concentrations of baclofen. The authors describe their experience with a novel technique for stereotactic endoscopic insertion of baclofen infusion catheters in the third ventricle in 3 patients with severe secondary generalized dystonia. Insertion was successful in all 3 patients, and all of them experienced significant improvement in dystonia scores on the Barry-Albright Dystonia Scale. Follow-up ranged from 5.5 to 7 months (mean 6 months), and no mechanical complications or CSF leaks were observed. The stereotactic endoscopic insertion of a baclofen infusion catheter into the third ventricle appears to be a safe method for continuous intraventricular baclofen infusion in patients with generalized secondary dystonia.","internal_url":"https://www.academia.edu/21730917/Stereotactic_endoscopic_placement_of_third_ventricle_catheter_for_long_term_infusion_of_baclofen_in_patients_with_secondary_generalized_dystonia","translated_internal_url":"","created_at":"2016-02-09T06:53:12.841-08:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":42923259,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":15027093,"work_id":21730917,"tagging_user_id":42923259,"tagged_user_id":33852416,"co_author_invite_id":null,"email":"m***r@hsc.utah.edu","affiliation":"University of Utah","display_order":0,"name":"Marion L Walker","title":"Stereotactic endoscopic placement of third ventricle catheter for long-term infusion of baclofen in patients with secondary generalized dystonia"},{"id":22578499,"work_id":21730917,"tagging_user_id":33852416,"tagged_user_id":null,"co_author_invite_id":503368,"email":"r***o@hsc.utah.edu","display_order":4194304,"name":"Robert Bollo","title":"Stereotactic endoscopic placement of third ventricle catheter for long-term infusion of baclofen in patients with secondary generalized dystonia"}],"downloadable_attachments":[],"slug":"Stereotactic_endoscopic_placement_of_third_ventricle_catheter_for_long_term_infusion_of_baclofen_in_patients_with_secondary_generalized_dystonia","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"Continuous infusion of baclofen is a treatment option for severe generalized dystonia. Catheter insertion within the third ventricle has been described as an alternative to standard intrathecal placement to maximize intracranial concentrations of baclofen. The authors describe their experience with a novel technique for stereotactic endoscopic insertion of baclofen infusion catheters in the third ventricle in 3 patients with severe secondary generalized dystonia. Insertion was successful in all 3 patients, and all of them experienced significant improvement in dystonia scores on the Barry-Albright Dystonia Scale. Follow-up ranged from 5.5 to 7 months (mean 6 months), and no mechanical complications or CSF leaks were observed. The stereotactic endoscopic insertion of a baclofen infusion catheter into the third ventricle appears to be a safe method for continuous intraventricular baclofen infusion in patients with generalized secondary dystonia.","owner":{"id":42923259,"first_name":"Judith","middle_initials":null,"last_name":"Gooch","page_name":"GoochJudith","domain_name":"independent","created_at":"2016-02-09T06:52:47.536-08:00","display_name":"Judith Gooch","url":"https://independent.academia.edu/GoochJudith"},"attachments":[],"research_interests":[{"id":22506,"name":"Adolescent","url":"https://www.academia.edu/Documents/in/Adolescent"},{"id":64933,"name":"Child","url":"https://www.academia.edu/Documents/in/Child"},{"id":298288,"name":"Baclofen","url":"https://www.academia.edu/Documents/in/Baclofen"},{"id":451510,"name":"Neuroendoscopy","url":"https://www.academia.edu/Documents/in/Neuroendoscopy"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="26980653"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/26980653/Shunt_failure_due_to_intracranial_migration_of_BioGlide_ventricular_catheters"><img alt="Research paper thumbnail of Shunt failure due to intracranial migration of BioGlide ventricular catheters" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/26980653/Shunt_failure_due_to_intracranial_migration_of_BioGlide_ventricular_catheters">Shunt failure due to intracranial migration of BioGlide ventricular catheters</a></div><div class="wp-workCard_item"><span>Journal of neurosurgery. Pediatrics</span><span>, 2011</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">In late 2008, the authors recognized a new type of ventriculoperitoneal shunt failure specific to...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">In late 2008, the authors recognized a new type of ventriculoperitoneal shunt failure specific to the Bio-Glide Snap Shunt ventricular catheters. This prompted a retrospective review of the patient cohort and resulted in a recall by the FDA in the US. After the index cases were identified, the FDA was notified by the hospital, leading to a recall of the product. Hospital operative logs were used to identify patients in whom the affected products were used. A letter describing the risk was sent to all patients offering a free screening CT scan to look for disconnection. A call center was established to respond to patient questions, and an informational video was made available on the hospital website. The authors reviewed the records of the index cases and other cases subsequently identified. Seven index cases and an additional 16 cases of disconnection were identified in the 466 patients in whom a BioGlide Snap Shunt ventricular catheter had been implanted. Mean time to disconnectio...</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="26980653"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="26980653"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 26980653; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=26980653]").text(description); $(".js-view-count[data-work-id=26980653]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 26980653; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='26980653']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 26980653, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=26980653]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":26980653,"title":"Shunt failure due to intracranial migration of BioGlide ventricular catheters","translated_title":"","metadata":{"abstract":"In late 2008, the authors recognized a new type of ventriculoperitoneal shunt failure specific to the Bio-Glide Snap Shunt ventricular catheters. This prompted a retrospective review of the patient cohort and resulted in a recall by the FDA in the US. After the index cases were identified, the FDA was notified by the hospital, leading to a recall of the product. Hospital operative logs were used to identify patients in whom the affected products were used. A letter describing the risk was sent to all patients offering a free screening CT scan to look for disconnection. A call center was established to respond to patient questions, and an informational video was made available on the hospital website. The authors reviewed the records of the index cases and other cases subsequently identified. Seven index cases and an additional 16 cases of disconnection were identified in the 466 patients in whom a BioGlide Snap Shunt ventricular catheter had been implanted. Mean time to disconnectio...","publication_date":{"day":null,"month":null,"year":2011,"errors":{}},"publication_name":"Journal of neurosurgery. Pediatrics"},"translated_abstract":"In late 2008, the authors recognized a new type of ventriculoperitoneal shunt failure specific to the Bio-Glide Snap Shunt ventricular catheters. This prompted a retrospective review of the patient cohort and resulted in a recall by the FDA in the US. After the index cases were identified, the FDA was notified by the hospital, leading to a recall of the product. Hospital operative logs were used to identify patients in whom the affected products were used. A letter describing the risk was sent to all patients offering a free screening CT scan to look for disconnection. A call center was established to respond to patient questions, and an informational video was made available on the hospital website. The authors reviewed the records of the index cases and other cases subsequently identified. Seven index cases and an additional 16 cases of disconnection were identified in the 466 patients in whom a BioGlide Snap Shunt ventricular catheter had been implanted. Mean time to disconnectio...","internal_url":"https://www.academia.edu/26980653/Shunt_failure_due_to_intracranial_migration_of_BioGlide_ventricular_catheters","translated_internal_url":"","created_at":"2016-07-14T05:40:27.969-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":33852416,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[],"downloadable_attachments":[],"slug":"Shunt_failure_due_to_intracranial_migration_of_BioGlide_ventricular_catheters","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"In late 2008, the authors recognized a new type of ventriculoperitoneal shunt failure specific to the Bio-Glide Snap Shunt ventricular catheters. This prompted a retrospective review of the patient cohort and resulted in a recall by the FDA in the US. After the index cases were identified, the FDA was notified by the hospital, leading to a recall of the product. Hospital operative logs were used to identify patients in whom the affected products were used. A letter describing the risk was sent to all patients offering a free screening CT scan to look for disconnection. A call center was established to respond to patient questions, and an informational video was made available on the hospital website. The authors reviewed the records of the index cases and other cases subsequently identified. Seven index cases and an additional 16 cases of disconnection were identified in the 466 patients in whom a BioGlide Snap Shunt ventricular catheter had been implanted. Mean time to disconnectio...","owner":{"id":33852416,"first_name":"Marion","middle_initials":"L","last_name":"Walker","page_name":"MarionWalker","domain_name":"utah","created_at":"2015-08-12T08:15:14.624-07:00","display_name":"Marion L Walker","url":"https://utah.academia.edu/MarionWalker"},"attachments":[],"research_interests":[{"id":8207,"name":"Risk","url":"https://www.academia.edu/Documents/in/Risk"},{"id":134346,"name":"Infant","url":"https://www.academia.edu/Documents/in/Infant"},{"id":745088,"name":"FOREIGN BODY MIGRATION","url":"https://www.academia.edu/Documents/in/FOREIGN_BODY_MIGRATION"},{"id":773847,"name":"Catheters","url":"https://www.academia.edu/Documents/in/Catheters"},{"id":959921,"name":"X ray Computed Tomography","url":"https://www.academia.edu/Documents/in/X_ray_Computed_Tomography"},{"id":1423078,"name":"Nervous System Diseases","url":"https://www.academia.edu/Documents/in/Nervous_System_Diseases"},{"id":2482067,"name":"Reoperation","url":"https://www.academia.edu/Documents/in/Reoperation"},{"id":2489700,"name":"Child preschool","url":"https://www.academia.edu/Documents/in/Child_preschool"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="26980652"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/26980652/The_posterior_petrosal_approach_technique_and_applications_in_pediatric_neurosurgery"><img alt="Research paper thumbnail of The posterior petrosal approach: technique and applications in pediatric neurosurgery" class="work-thumbnail" src="https://attachments.academia-assets.com/47243005/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/26980652/The_posterior_petrosal_approach_technique_and_applications_in_pediatric_neurosurgery">The posterior petrosal approach: technique and applications in pediatric neurosurgery</a></div><div class="wp-workCard_item"><span>Journal of neurosurgery. Pediatrics</span><span>, 2009</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Various lesions occur in deep locations or at the skull base in pediatric patients and require sk...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Various lesions occur in deep locations or at the skull base in pediatric patients and require skull base approaches for resection. Skull base surgery confers the advantages of improved line of sight, a wider operative corridor, and reduced brain retraction. The posterior petrosal approach provides simultaneous access to lesions in the posterior middle fossa and posterior fossa from the top of the clivus to the level of the jugular foramen. It allows visualization of the ventrolateral brainstem and may be combined with various other supra- and infratentorial approaches, thus giving the surgeon a wide array of access routes to the lesion. The authors conducted a retrospective review of all cases involving pediatric patients undergoing a posterior petrosal approach, either alone or in combination with other cranial approaches. Preoperative and postoperative data were collected, including presentation, neurological examination, imaging findings, pathological condition, operative detail...</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="8aaa456843e78db127c991901c4f631e" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":47243005,"asset_id":26980652,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/47243005/download_file?st=MTczMzkxNzc3NCw4LjIyMi4yMDguMTQ2&s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="26980652"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="26980652"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 26980652; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=26980652]").text(description); $(".js-view-count[data-work-id=26980652]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 26980652; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='26980652']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 26980652, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "8aaa456843e78db127c991901c4f631e" } } $('.js-work-strip[data-work-id=26980652]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":26980652,"title":"The posterior petrosal approach: technique and applications in pediatric neurosurgery","translated_title":"","metadata":{"abstract":"Various lesions occur in deep locations or at the skull base in pediatric patients and require skull base approaches for resection. Skull base surgery confers the advantages of improved line of sight, a wider operative corridor, and reduced brain retraction. The posterior petrosal approach provides simultaneous access to lesions in the posterior middle fossa and posterior fossa from the top of the clivus to the level of the jugular foramen. It allows visualization of the ventrolateral brainstem and may be combined with various other supra- and infratentorial approaches, thus giving the surgeon a wide array of access routes to the lesion. The authors conducted a retrospective review of all cases involving pediatric patients undergoing a posterior petrosal approach, either alone or in combination with other cranial approaches. Preoperative and postoperative data were collected, including presentation, neurological examination, imaging findings, pathological condition, operative detail...","publication_date":{"day":null,"month":null,"year":2009,"errors":{}},"publication_name":"Journal of neurosurgery. Pediatrics"},"translated_abstract":"Various lesions occur in deep locations or at the skull base in pediatric patients and require skull base approaches for resection. Skull base surgery confers the advantages of improved line of sight, a wider operative corridor, and reduced brain retraction. The posterior petrosal approach provides simultaneous access to lesions in the posterior middle fossa and posterior fossa from the top of the clivus to the level of the jugular foramen. It allows visualization of the ventrolateral brainstem and may be combined with various other supra- and infratentorial approaches, thus giving the surgeon a wide array of access routes to the lesion. The authors conducted a retrospective review of all cases involving pediatric patients undergoing a posterior petrosal approach, either alone or in combination with other cranial approaches. Preoperative and postoperative data were collected, including presentation, neurological examination, imaging findings, pathological condition, operative detail...","internal_url":"https://www.academia.edu/26980652/The_posterior_petrosal_approach_technique_and_applications_in_pediatric_neurosurgery","translated_internal_url":"","created_at":"2016-07-14T05:40:27.718-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":33852416,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[],"downloadable_attachments":[{"id":47243005,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/47243005/thumbnails/1.jpg","file_name":"The_posterior_petrosal_approach_Techniqu20160714-1086-1ludnaz.pdf","download_url":"https://www.academia.edu/attachments/47243005/download_file?st=MTczMzkxNzc3NCw4LjIyMi4yMDguMTQ2&","bulk_download_file_name":"The_posterior_petrosal_approach_techniqu.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/47243005/The_posterior_petrosal_approach_Techniqu20160714-1086-1ludnaz-libre.pdf?1468500401=\u0026response-content-disposition=attachment%3B+filename%3DThe_posterior_petrosal_approach_techniqu.pdf\u0026Expires=1733921374\u0026Signature=B2U8EBr7I6gpyHUYmFaKoMH0p6M7U-BU2mAcUihzGumE~baxMKz~R1O9ROUzTQN4-dzp5Id5SvCITnnphFbTnuWSq531ACIOMz9Kk70W~1l19RXpmTQDsBPpKo7G5Zr-hi7u5l7U44QcSWQXW3cQXRCdnVW41fxbJanLYuDBnGHVU9Hrf3UeilKQlDKWiXVPchIPgytkJ04ZwueiKTaKUuHWvwbTWFKNxkuhAxAnUbn7D9hKrzzF2AaKSnubK298hF7XOuCN6G7nROUp4k3NAjUqQAZZWZlW7fCgTcNplyDWff5rwVO7cAkwwpokr6KAfkUDlFi5M3fokt31-58V8Q__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"slug":"The_posterior_petrosal_approach_technique_and_applications_in_pediatric_neurosurgery","translated_slug":"","page_count":5,"language":"en","content_type":"Work","summary":"Various lesions occur in deep locations or at the skull base in pediatric patients and require skull base approaches for resection. Skull base surgery confers the advantages of improved line of sight, a wider operative corridor, and reduced brain retraction. The posterior petrosal approach provides simultaneous access to lesions in the posterior middle fossa and posterior fossa from the top of the clivus to the level of the jugular foramen. It allows visualization of the ventrolateral brainstem and may be combined with various other supra- and infratentorial approaches, thus giving the surgeon a wide array of access routes to the lesion. The authors conducted a retrospective review of all cases involving pediatric patients undergoing a posterior petrosal approach, either alone or in combination with other cranial approaches. 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="26980651"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/26980651/Risk_factors_and_rates_of_bone_flap_resorption_in_pediatric_patients_after_decompressive_craniectomy_for_traumatic_brain_injury"><img alt="Research paper thumbnail of Risk factors and rates of bone flap resorption in pediatric patients after decompressive craniectomy for traumatic brain injury" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/26980651/Risk_factors_and_rates_of_bone_flap_resorption_in_pediatric_patients_after_decompressive_craniectomy_for_traumatic_brain_injury">Risk factors and rates of bone flap resorption in pediatric patients after decompressive craniectomy for traumatic brain injury</a></div><div class="wp-workCard_item"><span>Journal of Neurosurgery: Pediatrics</span><span>, 2013</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Decompressive craniectomy with subsequent autologous cranioplasty, or the replacement of the nati...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Decompressive craniectomy with subsequent autologous cranioplasty, or the replacement of the native bone flap, is often used for pediatric patients with traumatic brain injury (TBI) who have a mass lesion and intractable intracranial hypertension. Bone flap resorption is common after bone flap replacement, necessitating additional surgery. The authors reviewed their large database of pediatric patients with TBI who underwent decompressive craniectomy followed by bone flap replacement to determine the rate of bone flap resorption and identify associated risk factors. A retrospective cohort chart review was performed to identify long-term survivors who underwent decompressive craniectomy for severe TBI with bone flap replacement from January 1, 1996, to December 31, 2011. The risk factors investigated in a univariate statistical analysis were age, sex, underlying parenchymal contusion, Glasgow Coma Scale score on arrival, comminuted skull fracture, posttraumatic hydrocephalus, bone flap wound infection, and freezer time (the amount of time the bone flap was stored in the freezer before replacement). A multivariate logistic regression model was then used to determine which of these were independent risk factors for bone flap resorption. Bone flap replacement was performed at an average of 2.1 months after decompressive craniectomy. Of the 54 patients identified (35 boys, 19 girls; mean age 6.2 years), 27 (50.0%) experienced bone flap resorption after an average of 4.8 months. Underlying parenchymal contusion, comminuted skull fracture, age ≤ 2.5 years, and posttraumatic hydrocephalus were significant, or nearly significant, on univariate analysis. Multivariate analysis identified underlying contusion (p = 0.004, OR 34.4, 95% CI 3.0-392.7), comminuted skull fractures (p = 0.046, OR 8.5, 95% CI 1.0-69.6), posttraumatic hydrocephalus (p = 0.005, OR 35.9, 95% CI 2.9-436.6), and age ≤ 2.5 years old (p = 0.01, OR 23.1, 95% CI 2.1-257.7) as independent risk factors for bone flap resorption. After decompressive craniectomy for pediatric TBI, half of the patients (50%) who underwent bone flap replacement experienced resorption. Multivariate analysis indicated young age (≤ 2.5 years), hydrocephalus, underlying contusion as opposed to a hemispheric acute subdural hematoma, and a comminuted skull fracture were all independent risk factors for bone flap resorption. Freezer time was not found to be associated with bone flap resorption.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="26980651"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="26980651"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 26980651; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=26980651]").text(description); $(".js-view-count[data-work-id=26980651]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 26980651; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='26980651']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 26980651, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=26980651]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":26980651,"title":"Risk factors and rates of bone flap resorption in pediatric patients after decompressive craniectomy for traumatic brain injury","translated_title":"","metadata":{"abstract":"Decompressive craniectomy with subsequent autologous cranioplasty, or the replacement of the native bone flap, is often used for pediatric patients with traumatic brain injury (TBI) who have a mass lesion and intractable intracranial hypertension. Bone flap resorption is common after bone flap replacement, necessitating additional surgery. The authors reviewed their large database of pediatric patients with TBI who underwent decompressive craniectomy followed by bone flap replacement to determine the rate of bone flap resorption and identify associated risk factors. A retrospective cohort chart review was performed to identify long-term survivors who underwent decompressive craniectomy for severe TBI with bone flap replacement from January 1, 1996, to December 31, 2011. The risk factors investigated in a univariate statistical analysis were age, sex, underlying parenchymal contusion, Glasgow Coma Scale score on arrival, comminuted skull fracture, posttraumatic hydrocephalus, bone flap wound infection, and freezer time (the amount of time the bone flap was stored in the freezer before replacement). A multivariate logistic regression model was then used to determine which of these were independent risk factors for bone flap resorption. Bone flap replacement was performed at an average of 2.1 months after decompressive craniectomy. Of the 54 patients identified (35 boys, 19 girls; mean age 6.2 years), 27 (50.0%) experienced bone flap resorption after an average of 4.8 months. Underlying parenchymal contusion, comminuted skull fracture, age ≤ 2.5 years, and posttraumatic hydrocephalus were significant, or nearly significant, on univariate analysis. Multivariate analysis identified underlying contusion (p = 0.004, OR 34.4, 95% CI 3.0-392.7), comminuted skull fractures (p = 0.046, OR 8.5, 95% CI 1.0-69.6), posttraumatic hydrocephalus (p = 0.005, OR 35.9, 95% CI 2.9-436.6), and age ≤ 2.5 years old (p = 0.01, OR 23.1, 95% CI 2.1-257.7) as independent risk factors for bone flap resorption. After decompressive craniectomy for pediatric TBI, half of the patients (50%) who underwent bone flap replacement experienced resorption. Multivariate analysis indicated young age (≤ 2.5 years), hydrocephalus, underlying contusion as opposed to a hemispheric acute subdural hematoma, and a comminuted skull fracture were all independent risk factors for bone flap resorption. Freezer time was not found to be associated with bone flap resorption.","publication_date":{"day":null,"month":null,"year":2013,"errors":{}},"publication_name":"Journal of Neurosurgery: Pediatrics"},"translated_abstract":"Decompressive craniectomy with subsequent autologous cranioplasty, or the replacement of the native bone flap, is often used for pediatric patients with traumatic brain injury (TBI) who have a mass lesion and intractable intracranial hypertension. Bone flap resorption is common after bone flap replacement, necessitating additional surgery. The authors reviewed their large database of pediatric patients with TBI who underwent decompressive craniectomy followed by bone flap replacement to determine the rate of bone flap resorption and identify associated risk factors. A retrospective cohort chart review was performed to identify long-term survivors who underwent decompressive craniectomy for severe TBI with bone flap replacement from January 1, 1996, to December 31, 2011. The risk factors investigated in a univariate statistical analysis were age, sex, underlying parenchymal contusion, Glasgow Coma Scale score on arrival, comminuted skull fracture, posttraumatic hydrocephalus, bone flap wound infection, and freezer time (the amount of time the bone flap was stored in the freezer before replacement). A multivariate logistic regression model was then used to determine which of these were independent risk factors for bone flap resorption. Bone flap replacement was performed at an average of 2.1 months after decompressive craniectomy. Of the 54 patients identified (35 boys, 19 girls; mean age 6.2 years), 27 (50.0%) experienced bone flap resorption after an average of 4.8 months. Underlying parenchymal contusion, comminuted skull fracture, age ≤ 2.5 years, and posttraumatic hydrocephalus were significant, or nearly significant, on univariate analysis. Multivariate analysis identified underlying contusion (p = 0.004, OR 34.4, 95% CI 3.0-392.7), comminuted skull fractures (p = 0.046, OR 8.5, 95% CI 1.0-69.6), posttraumatic hydrocephalus (p = 0.005, OR 35.9, 95% CI 2.9-436.6), and age ≤ 2.5 years old (p = 0.01, OR 23.1, 95% CI 2.1-257.7) as independent risk factors for bone flap resorption. After decompressive craniectomy for pediatric TBI, half of the patients (50%) who underwent bone flap replacement experienced resorption. Multivariate analysis indicated young age (≤ 2.5 years), hydrocephalus, underlying contusion as opposed to a hemispheric acute subdural hematoma, and a comminuted skull fracture were all independent risk factors for bone flap resorption. Freezer time was not found to be associated with bone flap resorption.","internal_url":"https://www.academia.edu/26980651/Risk_factors_and_rates_of_bone_flap_resorption_in_pediatric_patients_after_decompressive_craniectomy_for_traumatic_brain_injury","translated_internal_url":"","created_at":"2016-07-14T05:40:27.544-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":33852416,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[],"downloadable_attachments":[],"slug":"Risk_factors_and_rates_of_bone_flap_resorption_in_pediatric_patients_after_decompressive_craniectomy_for_traumatic_brain_injury","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"Decompressive craniectomy with subsequent autologous cranioplasty, or the replacement of the native bone flap, is often used for pediatric patients with traumatic brain injury (TBI) who have a mass lesion and intractable intracranial hypertension. Bone flap resorption is common after bone flap replacement, necessitating additional surgery. The authors reviewed their large database of pediatric patients with TBI who underwent decompressive craniectomy followed by bone flap replacement to determine the rate of bone flap resorption and identify associated risk factors. A retrospective cohort chart review was performed to identify long-term survivors who underwent decompressive craniectomy for severe TBI with bone flap replacement from January 1, 1996, to December 31, 2011. The risk factors investigated in a univariate statistical analysis were age, sex, underlying parenchymal contusion, Glasgow Coma Scale score on arrival, comminuted skull fracture, posttraumatic hydrocephalus, bone flap wound infection, and freezer time (the amount of time the bone flap was stored in the freezer before replacement). A multivariate logistic regression model was then used to determine which of these were independent risk factors for bone flap resorption. Bone flap replacement was performed at an average of 2.1 months after decompressive craniectomy. Of the 54 patients identified (35 boys, 19 girls; mean age 6.2 years), 27 (50.0%) experienced bone flap resorption after an average of 4.8 months. Underlying parenchymal contusion, comminuted skull fracture, age ≤ 2.5 years, and posttraumatic hydrocephalus were significant, or nearly significant, on univariate analysis. Multivariate analysis identified underlying contusion (p = 0.004, OR 34.4, 95% CI 3.0-392.7), comminuted skull fractures (p = 0.046, OR 8.5, 95% CI 1.0-69.6), posttraumatic hydrocephalus (p = 0.005, OR 35.9, 95% CI 2.9-436.6), and age ≤ 2.5 years old (p = 0.01, OR 23.1, 95% CI 2.1-257.7) as independent risk factors for bone flap resorption. After decompressive craniectomy for pediatric TBI, half of the patients (50%) who underwent bone flap replacement experienced resorption. Multivariate analysis indicated young age (≤ 2.5 years), hydrocephalus, underlying contusion as opposed to a hemispheric acute subdural hematoma, and a comminuted skull fracture were all independent risk factors for bone flap resorption. Freezer time was not found to be associated with bone flap resorption.","owner":{"id":33852416,"first_name":"Marion","middle_initials":"L","last_name":"Walker","page_name":"MarionWalker","domain_name":"utah","created_at":"2015-08-12T08:15:14.624-07:00","display_name":"Marion L Walker","url":"https://utah.academia.edu/MarionWalker"},"attachments":[],"research_interests":[{"id":12426,"name":"Treatment Outcome","url":"https://www.academia.edu/Documents/in/Treatment_Outcome"},{"id":19295,"name":"Cryopreservation","url":"https://www.academia.edu/Documents/in/Cryopreservation"},{"id":60974,"name":"Hydrocephalus","url":"https://www.academia.edu/Documents/in/Hydrocephalus"},{"id":64933,"name":"Child","url":"https://www.academia.edu/Documents/in/Child"},{"id":132366,"name":"Glasgow Coma Scale","url":"https://www.academia.edu/Documents/in/Glasgow_Coma_Scale"},{"id":192721,"name":"Risk factors","url":"https://www.academia.edu/Documents/in/Risk_factors"},{"id":196189,"name":"Sample Size","url":"https://www.academia.edu/Documents/in/Sample_Size"},{"id":413192,"name":"Sex Factors","url":"https://www.academia.edu/Documents/in/Sex_Factors"},{"id":413194,"name":"Analysis of Variance","url":"https://www.academia.edu/Documents/in/Analysis_of_Variance"},{"id":413195,"name":"Time Factors","url":"https://www.academia.edu/Documents/in/Time_Factors"},{"id":469105,"name":"Retrospective Studies","url":"https://www.academia.edu/Documents/in/Retrospective_Studies"},{"id":546419,"name":"Age Factors","url":"https://www.academia.edu/Documents/in/Age_Factors"},{"id":620049,"name":"Risk Factors","url":"https://www.academia.edu/Documents/in/Risk_Factors-1"},{"id":874382,"name":"Medical Records","url":"https://www.academia.edu/Documents/in/Medical_Records"},{"id":959921,"name":"X ray Computed Tomography","url":"https://www.academia.edu/Documents/in/X_ray_Computed_Tomography"},{"id":1294607,"name":"Logistic Models","url":"https://www.academia.edu/Documents/in/Logistic_Models"},{"id":1399820,"name":"Bone Resorption","url":"https://www.academia.edu/Documents/in/Bone_Resorption"},{"id":1515979,"name":"Decompressive Craniectomy","url":"https://www.academia.edu/Documents/in/Decompressive_Craniectomy"},{"id":2450733,"name":"Brain injuries","url":"https://www.academia.edu/Documents/in/Brain_injuries"},{"id":2482067,"name":"Reoperation","url":"https://www.academia.edu/Documents/in/Reoperation"},{"id":2489700,"name":"Child preschool","url":"https://www.academia.edu/Documents/in/Child_preschool"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="26980650"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/26980650/Spinal_arteriovenous_fistulas_in_children_with_hereditary_hemorrhagic_telangiectasia"><img alt="Research paper thumbnail of Spinal arteriovenous fistulas in children with hereditary hemorrhagic telangiectasia" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/26980650/Spinal_arteriovenous_fistulas_in_children_with_hereditary_hemorrhagic_telangiectasia">Spinal arteriovenous fistulas in children with hereditary hemorrhagic telangiectasia</a></div><div class="wp-workCard_item"><span>Journal of Neurosurgery: Pediatrics</span><span>, 2012</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant angiodysplasia with high pen...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant angiodysplasia with high penetrance and variable expression. The manifestations of HHT are often age related, and spinal arteriovenous fistula (AVF) may be the initial presentation of HHT in young children. Because spinal AVFs are rarely reported, however, screening is not incorporated into current clinical recommendations for the treatment of patients with HHT. The authors describe 2 cases of children younger than 2 years of age with acute neurological deterioration in the context of a spinal AVF and in whom HHT was subsequently diagnosed. One patient presented with intraventricular and subarachnoid hemorrhage and the other with acute thrombosis of an intramedullary varix. These cases highlight the potential for significant neurological morbidity from a symptomatic AVF in very young children with HHT. Given the lack of data regarding the true incidence and natural history of these lesions, these cases raise the question of whether spinal cord imaging should be incorporated into screening recommendations for patients with HHT.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="26980650"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="26980650"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 26980650; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=26980650]").text(description); $(".js-view-count[data-work-id=26980650]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 26980650; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='26980650']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 26980650, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=26980650]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":26980650,"title":"Spinal arteriovenous fistulas in children with hereditary hemorrhagic telangiectasia","translated_title":"","metadata":{"abstract":"Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant angiodysplasia with high penetrance and variable expression. The manifestations of HHT are often age related, and spinal arteriovenous fistula (AVF) may be the initial presentation of HHT in young children. Because spinal AVFs are rarely reported, however, screening is not incorporated into current clinical recommendations for the treatment of patients with HHT. The authors describe 2 cases of children younger than 2 years of age with acute neurological deterioration in the context of a spinal AVF and in whom HHT was subsequently diagnosed. One patient presented with intraventricular and subarachnoid hemorrhage and the other with acute thrombosis of an intramedullary varix. These cases highlight the potential for significant neurological morbidity from a symptomatic AVF in very young children with HHT. Given the lack of data regarding the true incidence and natural history of these lesions, these cases raise the question of whether spinal cord imaging should be incorporated into screening recommendations for patients with HHT.","publication_date":{"day":null,"month":null,"year":2012,"errors":{}},"publication_name":"Journal of Neurosurgery: Pediatrics"},"translated_abstract":"Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant angiodysplasia with high penetrance and variable expression. The manifestations of HHT are often age related, and spinal arteriovenous fistula (AVF) may be the initial presentation of HHT in young children. Because spinal AVFs are rarely reported, however, screening is not incorporated into current clinical recommendations for the treatment of patients with HHT. The authors describe 2 cases of children younger than 2 years of age with acute neurological deterioration in the context of a spinal AVF and in whom HHT was subsequently diagnosed. One patient presented with intraventricular and subarachnoid hemorrhage and the other with acute thrombosis of an intramedullary varix. These cases highlight the potential for significant neurological morbidity from a symptomatic AVF in very young children with HHT. Given the lack of data regarding the true incidence and natural history of these lesions, these cases raise the question of whether spinal cord imaging should be incorporated into screening recommendations for patients with HHT.","internal_url":"https://www.academia.edu/26980650/Spinal_arteriovenous_fistulas_in_children_with_hereditary_hemorrhagic_telangiectasia","translated_internal_url":"","created_at":"2016-07-14T05:40:27.379-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":33852416,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[],"downloadable_attachments":[],"slug":"Spinal_arteriovenous_fistulas_in_children_with_hereditary_hemorrhagic_telangiectasia","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant angiodysplasia with high penetrance and variable expression. The manifestations of HHT are often age related, and spinal arteriovenous fistula (AVF) may be the initial presentation of HHT in young children. Because spinal AVFs are rarely reported, however, screening is not incorporated into current clinical recommendations for the treatment of patients with HHT. The authors describe 2 cases of children younger than 2 years of age with acute neurological deterioration in the context of a spinal AVF and in whom HHT was subsequently diagnosed. One patient presented with intraventricular and subarachnoid hemorrhage and the other with acute thrombosis of an intramedullary varix. These cases highlight the potential for significant neurological morbidity from a symptomatic AVF in very young children with HHT. Given the lack of data regarding the true incidence and natural history of these lesions, these cases raise the question of whether spinal cord imaging should be incorporated into screening recommendations for patients with HHT.","owner":{"id":33852416,"first_name":"Marion","middle_initials":"L","last_name":"Walker","page_name":"MarionWalker","domain_name":"utah","created_at":"2015-08-12T08:15:14.624-07:00","display_name":"Marion L Walker","url":"https://utah.academia.edu/MarionWalker"},"attachments":[],"research_interests":[{"id":6200,"name":"Magnetic Resonance Imaging","url":"https://www.academia.edu/Documents/in/Magnetic_Resonance_Imaging"},{"id":99421,"name":"Spinal Cord","url":"https://www.academia.edu/Documents/in/Spinal_Cord"},{"id":154732,"name":"Hereditary Hemorrhagic Telangiectasia (HHT)","url":"https://www.academia.edu/Documents/in/Hereditary_Hemorrhagic_Telangiectasia_HHT_"},{"id":247701,"name":"Angiography","url":"https://www.academia.edu/Documents/in/Angiography"},{"id":253560,"name":"Newborn Infant","url":"https://www.academia.edu/Documents/in/Newborn_Infant"},{"id":959921,"name":"X ray Computed Tomography","url":"https://www.academia.edu/Documents/in/X_ray_Computed_Tomography"},{"id":2489700,"name":"Child preschool","url":"https://www.academia.edu/Documents/in/Child_preschool"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="26980649"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/26980649/Factors_associated_with_ventricular_catheter_movement_and_inaccurate_catheter_location_post_hoc_analysis_of_the_Hydrocephalus_Clinical_Research_Network_Ultrasound_Guided_Shunt_Placement_study"><img alt="Research paper thumbnail of Factors associated with ventricular catheter movement and inaccurate catheter location: post hoc analysis of the Hydrocephalus Clinical Research Network Ultrasound-Guided Shunt Placement study" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/26980649/Factors_associated_with_ventricular_catheter_movement_and_inaccurate_catheter_location_post_hoc_analysis_of_the_Hydrocephalus_Clinical_Research_Network_Ultrasound_Guided_Shunt_Placement_study">Factors associated with ventricular catheter movement and inaccurate catheter location: post hoc analysis of the Hydrocephalus Clinical Research Network Ultrasound-Guided Shunt Placement study</a></div><div class="wp-workCard_item"><span>Journal of Neurosurgery: Pediatrics</span><span>, 2014</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Shunt survival may improve when ventricular catheters are placed into the frontal horn or trigone...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Shunt survival may improve when ventricular catheters are placed into the frontal horn or trigone of the lateral ventricle. However, techniques for accurate catheter placement have not been developed. The authors recently reported a prospective study designed to test the accuracy of catheter placement with the assistance of intraoperative ultrasound, but the results were poor (accurate placement in 59%). A major reason for the poor accurate placement rate was catheter movement that occurred between the time of the intraoperative ultrasound image and the first postoperative scan (33% of cases). The control group of non-ultrasound using surgeons also had a low rate of accurate placement (accurate placement in 49%). The authors conducted an exploratory post hoc analysis of patients in their ultrasound study to identify factors associated with either catheter movement or poor catheter placement so that improved surgical techniques for catheter insertion could be developed. The authors investigated the following risk factors for catheter movement and poor catheter placement: age, ventricular size, cortical mantle thickness, surgeon experience, surgeon experience with ultrasound prior to trial, shunt entry site, shunt hardware at entry site, ventricular catheter length, and use of an ultrasound probe guide for catheter insertion. Univariate analysis followed by multivariate logistic regression models were used to determine which factors were independent risk factors for either catheter movement or inaccurate catheter location. In the univariate analyses, only age &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 6 months was associated with catheter movement (p = 0.021); cortical mantle thickness &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 1 cm was near-significant (p = 0.066). In a multivariate model, age remained significant after adjusting for cortical mantle thickness (OR 8.35, exact 95% CI 1.20-infinity). Univariate analyses of factors associated with inaccurate catheter placement showed that age &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 6 months (p = 0.001) and a posterior shunt entry site (p = 0.021) were both associated with poor catheter placement. In a multivariate model, both age &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 6 months and a posterior shunt entry site were independent risk factors for…</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="26980649"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="26980649"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 26980649; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=26980649]").text(description); $(".js-view-count[data-work-id=26980649]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 26980649; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='26980649']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 26980649, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=26980649]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":26980649,"title":"Factors associated with ventricular catheter movement and inaccurate catheter location: post hoc analysis of the Hydrocephalus Clinical Research Network Ultrasound-Guided Shunt Placement study","translated_title":"","metadata":{"abstract":"Shunt survival may improve when ventricular catheters are placed into the frontal horn or trigone of the lateral ventricle. However, techniques for accurate catheter placement have not been developed. The authors recently reported a prospective study designed to test the accuracy of catheter placement with the assistance of intraoperative ultrasound, but the results were poor (accurate placement in 59%). A major reason for the poor accurate placement rate was catheter movement that occurred between the time of the intraoperative ultrasound image and the first postoperative scan (33% of cases). The control group of non-ultrasound using surgeons also had a low rate of accurate placement (accurate placement in 49%). The authors conducted an exploratory post hoc analysis of patients in their ultrasound study to identify factors associated with either catheter movement or poor catheter placement so that improved surgical techniques for catheter insertion could be developed. The authors investigated the following risk factors for catheter movement and poor catheter placement: age, ventricular size, cortical mantle thickness, surgeon experience, surgeon experience with ultrasound prior to trial, shunt entry site, shunt hardware at entry site, ventricular catheter length, and use of an ultrasound probe guide for catheter insertion. Univariate analysis followed by multivariate logistic regression models were used to determine which factors were independent risk factors for either catheter movement or inaccurate catheter location. In the univariate analyses, only age \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 6 months was associated with catheter movement (p = 0.021); cortical mantle thickness \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 1 cm was near-significant (p = 0.066). In a multivariate model, age remained significant after adjusting for cortical mantle thickness (OR 8.35, exact 95% CI 1.20-infinity). Univariate analyses of factors associated with inaccurate catheter placement showed that age \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 6 months (p = 0.001) and a posterior shunt entry site (p = 0.021) were both associated with poor catheter placement. In a multivariate model, both age \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 6 months and a posterior shunt entry site were independent risk factors for…","publication_date":{"day":null,"month":null,"year":2014,"errors":{}},"publication_name":"Journal of Neurosurgery: Pediatrics"},"translated_abstract":"Shunt survival may improve when ventricular catheters are placed into the frontal horn or trigone of the lateral ventricle. However, techniques for accurate catheter placement have not been developed. The authors recently reported a prospective study designed to test the accuracy of catheter placement with the assistance of intraoperative ultrasound, but the results were poor (accurate placement in 59%). A major reason for the poor accurate placement rate was catheter movement that occurred between the time of the intraoperative ultrasound image and the first postoperative scan (33% of cases). The control group of non-ultrasound using surgeons also had a low rate of accurate placement (accurate placement in 49%). The authors conducted an exploratory post hoc analysis of patients in their ultrasound study to identify factors associated with either catheter movement or poor catheter placement so that improved surgical techniques for catheter insertion could be developed. The authors investigated the following risk factors for catheter movement and poor catheter placement: age, ventricular size, cortical mantle thickness, surgeon experience, surgeon experience with ultrasound prior to trial, shunt entry site, shunt hardware at entry site, ventricular catheter length, and use of an ultrasound probe guide for catheter insertion. Univariate analysis followed by multivariate logistic regression models were used to determine which factors were independent risk factors for either catheter movement or inaccurate catheter location. In the univariate analyses, only age \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 6 months was associated with catheter movement (p = 0.021); cortical mantle thickness \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 1 cm was near-significant (p = 0.066). In a multivariate model, age remained significant after adjusting for cortical mantle thickness (OR 8.35, exact 95% CI 1.20-infinity). Univariate analyses of factors associated with inaccurate catheter placement showed that age \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 6 months (p = 0.001) and a posterior shunt entry site (p = 0.021) were both associated with poor catheter placement. In a multivariate model, both age \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 6 months and a posterior shunt entry site were independent risk factors for…","internal_url":"https://www.academia.edu/26980649/Factors_associated_with_ventricular_catheter_movement_and_inaccurate_catheter_location_post_hoc_analysis_of_the_Hydrocephalus_Clinical_Research_Network_Ultrasound_Guided_Shunt_Placement_study","translated_internal_url":"","created_at":"2016-07-14T05:40:27.224-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":33852416,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[],"downloadable_attachments":[],"slug":"Factors_associated_with_ventricular_catheter_movement_and_inaccurate_catheter_location_post_hoc_analysis_of_the_Hydrocephalus_Clinical_Research_Network_Ultrasound_Guided_Shunt_Placement_study","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"Shunt survival may improve when ventricular catheters are placed into the frontal horn or trigone of the lateral ventricle. However, techniques for accurate catheter placement have not been developed. The authors recently reported a prospective study designed to test the accuracy of catheter placement with the assistance of intraoperative ultrasound, but the results were poor (accurate placement in 59%). A major reason for the poor accurate placement rate was catheter movement that occurred between the time of the intraoperative ultrasound image and the first postoperative scan (33% of cases). The control group of non-ultrasound using surgeons also had a low rate of accurate placement (accurate placement in 49%). The authors conducted an exploratory post hoc analysis of patients in their ultrasound study to identify factors associated with either catheter movement or poor catheter placement so that improved surgical techniques for catheter insertion could be developed. The authors investigated the following risk factors for catheter movement and poor catheter placement: age, ventricular size, cortical mantle thickness, surgeon experience, surgeon experience with ultrasound prior to trial, shunt entry site, shunt hardware at entry site, ventricular catheter length, and use of an ultrasound probe guide for catheter insertion. Univariate analysis followed by multivariate logistic regression models were used to determine which factors were independent risk factors for either catheter movement or inaccurate catheter location. In the univariate analyses, only age \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 6 months was associated with catheter movement (p = 0.021); cortical mantle thickness \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 1 cm was near-significant (p = 0.066). In a multivariate model, age remained significant after adjusting for cortical mantle thickness (OR 8.35, exact 95% CI 1.20-infinity). Univariate analyses of factors associated with inaccurate catheter placement showed that age \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 6 months (p = 0.001) and a posterior shunt entry site (p = 0.021) were both associated with poor catheter placement. In a multivariate model, both age \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 6 months and a posterior shunt entry site were independent risk factors for…","owner":{"id":33852416,"first_name":"Marion","middle_initials":"L","last_name":"Walker","page_name":"MarionWalker","domain_name":"utah","created_at":"2015-08-12T08:15:14.624-07:00","display_name":"Marion L Walker","url":"https://utah.academia.edu/MarionWalker"},"attachments":[],"research_interests":[{"id":60974,"name":"Hydrocephalus","url":"https://www.academia.edu/Documents/in/Hydrocephalus"},{"id":62112,"name":"Prospective studies","url":"https://www.academia.edu/Documents/in/Prospective_studies"},{"id":78467,"name":"Cerebral Cortex","url":"https://www.academia.edu/Documents/in/Cerebral_Cortex"},{"id":90702,"name":"Ultrasonography","url":"https://www.academia.edu/Documents/in/Ultrasonography"},{"id":134346,"name":"Infant","url":"https://www.academia.edu/Documents/in/Infant"},{"id":192721,"name":"Risk factors","url":"https://www.academia.edu/Documents/in/Risk_factors"},{"id":546419,"name":"Age Factors","url":"https://www.academia.edu/Documents/in/Age_Factors"},{"id":620049,"name":"Risk Factors","url":"https://www.academia.edu/Documents/in/Risk_Factors-1"},{"id":745088,"name":"FOREIGN BODY MIGRATION","url":"https://www.academia.edu/Documents/in/FOREIGN_BODY_MIGRATION"},{"id":773847,"name":"Catheters","url":"https://www.academia.edu/Documents/in/Catheters"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="21730914"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/21730914/Selective_dorsal_rhizotomy_in_children_with_spastic_hemiparesis"><img alt="Research paper thumbnail of Selective dorsal rhizotomy in children with spastic hemiparesis" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/21730914/Selective_dorsal_rhizotomy_in_children_with_spastic_hemiparesis">Selective dorsal rhizotomy in children with spastic hemiparesis</a></div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/GoochJudith">Judith Gooch</a>, <a class="" data-click-track="profile-work-strip-authors" href="https://utah.academia.edu/MarionWalker">Marion L Walker</a>, and <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/AllisonOki">Allison Oki</a></span></div><div class="wp-workCard_item"><span>Journal of Neurosurgery: Pediatrics</span><span>, 2010</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Neurological conditions including cerebral palsy, brain injury, and stroke often result in severe...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Neurological conditions including cerebral palsy, brain injury, and stroke often result in severe spasticity, which can lead to significant deformity and interfere with function. Treatments for spasticity include oral medications, intramuscular botulinum toxin type A injections, orthopedic surgeries, intrathecal baclofen pump implantation, and selective dorsal rhizotomy (SDR). Selective dorsal rhizotomy, which has been well studied in children with spastic diplegia, results in significant reduction in spasticity and improved function in children. To the authors&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; knowledge, there are no published outcome data for SDR in patients with spastic hemiparesis. The object of this study was to examine the effects of SDR on spastic hemiparesis. A 2-year study was undertaken including all children with spastic hemiparesis who underwent SDR at the authors&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; institution. The degree of spasticity, as measured by the Modified Ashworth Scale or quality of gait rated using the visual gait assessment scale, the gait parameters, and velocity were compared in patients before and after undergoing SDR. Thirteen children (mean age 6 years 7 months) with spastic hemiparesis underwent SDR performed by the same surgeon during a 2-year period. All of the patients had a decrease in tone in the affected lower extremity after the procedure. The mean reduction in tone in 4 muscle groups (hip adductors, knee flexors, knee extensors, and ankle plantar flexors) according to the modified Ashworth scale score was 2.6 ± 1.26 (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001). The quality of gait was assessed in 7 patients by using the visual gait assessment scale. This score improved in 6 patients and remained the same in 1. Stride length and gait velocity were measured in 4 children. Velocity increased in 3 patients and decreased in a 3-year-old child. Parents and clinicians reported an improvement in quality of gait after the procedure. Stride length increased bilaterally in 3 patients and increased on one side and decreased on the other in the other patient. Selective dorsal rhizotomy showed efficacy in the treatment of spastic hemiparesis in children. All of the patients had decreased tone after SDR as measured by the modified Ashworth scale. The majority of patients had qualitative and quantitative improvements in gait.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="21730914"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="21730914"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 21730914; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=21730914]").text(description); $(".js-view-count[data-work-id=21730914]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 21730914; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='21730914']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 21730914, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=21730914]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":21730914,"title":"Selective dorsal rhizotomy in children with spastic hemiparesis","translated_title":"","metadata":{"abstract":"Neurological conditions including cerebral palsy, brain injury, and stroke often result in severe spasticity, which can lead to significant deformity and interfere with function. Treatments for spasticity include oral medications, intramuscular botulinum toxin type A injections, orthopedic surgeries, intrathecal baclofen pump implantation, and selective dorsal rhizotomy (SDR). Selective dorsal rhizotomy, which has been well studied in children with spastic diplegia, results in significant reduction in spasticity and improved function in children. To the authors\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; knowledge, there are no published outcome data for SDR in patients with spastic hemiparesis. The object of this study was to examine the effects of SDR on spastic hemiparesis. A 2-year study was undertaken including all children with spastic hemiparesis who underwent SDR at the authors\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; institution. The degree of spasticity, as measured by the Modified Ashworth Scale or quality of gait rated using the visual gait assessment scale, the gait parameters, and velocity were compared in patients before and after undergoing SDR. Thirteen children (mean age 6 years 7 months) with spastic hemiparesis underwent SDR performed by the same surgeon during a 2-year period. All of the patients had a decrease in tone in the affected lower extremity after the procedure. The mean reduction in tone in 4 muscle groups (hip adductors, knee flexors, knee extensors, and ankle plantar flexors) according to the modified Ashworth scale score was 2.6 ± 1.26 (p \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001). The quality of gait was assessed in 7 patients by using the visual gait assessment scale. This score improved in 6 patients and remained the same in 1. Stride length and gait velocity were measured in 4 children. Velocity increased in 3 patients and decreased in a 3-year-old child. Parents and clinicians reported an improvement in quality of gait after the procedure. Stride length increased bilaterally in 3 patients and increased on one side and decreased on the other in the other patient. Selective dorsal rhizotomy showed efficacy in the treatment of spastic hemiparesis in children. All of the patients had decreased tone after SDR as measured by the modified Ashworth scale. The majority of patients had qualitative and quantitative improvements in gait.","publication_date":{"day":null,"month":null,"year":2010,"errors":{}},"publication_name":"Journal of Neurosurgery: Pediatrics"},"translated_abstract":"Neurological conditions including cerebral palsy, brain injury, and stroke often result in severe spasticity, which can lead to significant deformity and interfere with function. Treatments for spasticity include oral medications, intramuscular botulinum toxin type A injections, orthopedic surgeries, intrathecal baclofen pump implantation, and selective dorsal rhizotomy (SDR). Selective dorsal rhizotomy, which has been well studied in children with spastic diplegia, results in significant reduction in spasticity and improved function in children. To the authors\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; knowledge, there are no published outcome data for SDR in patients with spastic hemiparesis. The object of this study was to examine the effects of SDR on spastic hemiparesis. A 2-year study was undertaken including all children with spastic hemiparesis who underwent SDR at the authors\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; institution. The degree of spasticity, as measured by the Modified Ashworth Scale or quality of gait rated using the visual gait assessment scale, the gait parameters, and velocity were compared in patients before and after undergoing SDR. Thirteen children (mean age 6 years 7 months) with spastic hemiparesis underwent SDR performed by the same surgeon during a 2-year period. All of the patients had a decrease in tone in the affected lower extremity after the procedure. The mean reduction in tone in 4 muscle groups (hip adductors, knee flexors, knee extensors, and ankle plantar flexors) according to the modified Ashworth scale score was 2.6 ± 1.26 (p \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001). The quality of gait was assessed in 7 patients by using the visual gait assessment scale. This score improved in 6 patients and remained the same in 1. Stride length and gait velocity were measured in 4 children. Velocity increased in 3 patients and decreased in a 3-year-old child. Parents and clinicians reported an improvement in quality of gait after the procedure. Stride length increased bilaterally in 3 patients and increased on one side and decreased on the other in the other patient. Selective dorsal rhizotomy showed efficacy in the treatment of spastic hemiparesis in children. All of the patients had decreased tone after SDR as measured by the modified Ashworth scale. The majority of patients had qualitative and quantitative improvements in gait.","internal_url":"https://www.academia.edu/21730914/Selective_dorsal_rhizotomy_in_children_with_spastic_hemiparesis","translated_internal_url":"","created_at":"2016-02-09T06:53:12.258-08:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":42923259,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":15027090,"work_id":21730914,"tagging_user_id":42923259,"tagged_user_id":33852416,"co_author_invite_id":null,"email":"m***r@hsc.utah.edu","affiliation":"University of Utah","display_order":0,"name":"Marion L Walker","title":"Selective dorsal rhizotomy in children with spastic hemiparesis"},{"id":22578498,"work_id":21730914,"tagging_user_id":33852416,"tagged_user_id":51198650,"co_author_invite_id":5039624,"email":"a***i@hsc.utah.edu","display_order":4194304,"name":"Allison Oki","title":"Selective dorsal rhizotomy in children with spastic hemiparesis"}],"downloadable_attachments":[],"slug":"Selective_dorsal_rhizotomy_in_children_with_spastic_hemiparesis","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"Neurological conditions including cerebral palsy, brain injury, and stroke often result in severe spasticity, which can lead to significant deformity and interfere with function. Treatments for spasticity include oral medications, intramuscular botulinum toxin type A injections, orthopedic surgeries, intrathecal baclofen pump implantation, and selective dorsal rhizotomy (SDR). Selective dorsal rhizotomy, which has been well studied in children with spastic diplegia, results in significant reduction in spasticity and improved function in children. To the authors\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; knowledge, there are no published outcome data for SDR in patients with spastic hemiparesis. The object of this study was to examine the effects of SDR on spastic hemiparesis. A 2-year study was undertaken including all children with spastic hemiparesis who underwent SDR at the authors\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; institution. The degree of spasticity, as measured by the Modified Ashworth Scale or quality of gait rated using the visual gait assessment scale, the gait parameters, and velocity were compared in patients before and after undergoing SDR. Thirteen children (mean age 6 years 7 months) with spastic hemiparesis underwent SDR performed by the same surgeon during a 2-year period. All of the patients had a decrease in tone in the affected lower extremity after the procedure. The mean reduction in tone in 4 muscle groups (hip adductors, knee flexors, knee extensors, and ankle plantar flexors) according to the modified Ashworth scale score was 2.6 ± 1.26 (p \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001). The quality of gait was assessed in 7 patients by using the visual gait assessment scale. This score improved in 6 patients and remained the same in 1. Stride length and gait velocity were measured in 4 children. Velocity increased in 3 patients and decreased in a 3-year-old child. Parents and clinicians reported an improvement in quality of gait after the procedure. Stride length increased bilaterally in 3 patients and increased on one side and decreased on the other in the other patient. Selective dorsal rhizotomy showed efficacy in the treatment of spastic hemiparesis in children. All of the patients had decreased tone after SDR as measured by the modified Ashworth scale. The majority of patients had qualitative and quantitative improvements in gait.","owner":{"id":42923259,"first_name":"Judith","middle_initials":null,"last_name":"Gooch","page_name":"GoochJudith","domain_name":"independent","created_at":"2016-02-09T06:52:47.536-08:00","display_name":"Judith Gooch","url":"https://independent.academia.edu/GoochJudith"},"attachments":[],"research_interests":[{"id":12426,"name":"Treatment Outcome","url":"https://www.academia.edu/Documents/in/Treatment_Outcome"},{"id":17845,"name":"Cerebral Palsy","url":"https://www.academia.edu/Documents/in/Cerebral_Palsy"},{"id":60256,"name":"Gait","url":"https://www.academia.edu/Documents/in/Gait"},{"id":64933,"name":"Child","url":"https://www.academia.edu/Documents/in/Child"},{"id":137516,"name":"Follow-up studies","url":"https://www.academia.edu/Documents/in/Follow-up_studies"},{"id":145032,"name":"Rhizotomy","url":"https://www.academia.edu/Documents/in/Rhizotomy"},{"id":263281,"name":"Postoperative pain","url":"https://www.academia.edu/Documents/in/Postoperative_pain"},{"id":469105,"name":"Retrospective Studies","url":"https://www.academia.edu/Documents/in/Retrospective_Studies"},{"id":1929419,"name":"Nino","url":"https://www.academia.edu/Documents/in/Nino"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="26980648"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/26980648/A_standardized_protocol_to_reduce_cerebrospinal_fluid_shunt_infection_The_Hydrocephalus_Clinical_Research_Network_Quality_Improvement_Initiative"><img alt="Research paper thumbnail of A standardized protocol to reduce cerebrospinal fluid shunt infection: The Hydrocephalus Clinical Research Network Quality Improvement Initiative" class="work-thumbnail" src="https://attachments.academia-assets.com/47243008/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/26980648/A_standardized_protocol_to_reduce_cerebrospinal_fluid_shunt_infection_The_Hydrocephalus_Clinical_Research_Network_Quality_Improvement_Initiative">A standardized protocol to reduce cerebrospinal fluid shunt infection: The Hydrocephalus Clinical Research Network Quality Improvement Initiative</a></div><div class="wp-workCard_item"><span>Journal of Neurosurgery: Pediatrics</span><span>, 2011</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Object-Quality improvement techniques are being implemented in many areas of medicine. In an effo...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Object-Quality improvement techniques are being implemented in many areas of medicine. In an effort to reduce the ventriculoperitoneal shunt infection rate, a standardized protocol was developed and implemented at 4 centers of the Hydrocephalus Clinical Research Network (HCRN).</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="453cefb205570d25cfc15ced038d84e3" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":47243008,"asset_id":26980648,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/47243008/download_file?st=MTczMzkxNzc3NCw4LjIyMi4yMDguMTQ2&s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="26980648"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="26980648"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 26980648; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=26980648]").text(description); $(".js-view-count[data-work-id=26980648]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 26980648; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='26980648']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 26980648, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "453cefb205570d25cfc15ced038d84e3" } } $('.js-work-strip[data-work-id=26980648]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":26980648,"title":"A standardized protocol to reduce cerebrospinal fluid shunt infection: The Hydrocephalus Clinical Research Network Quality Improvement Initiative","translated_title":"","metadata":{"ai_title_tag":"Standardized Protocol to Lower Shunt Infection Rates","grobid_abstract":"Object-Quality improvement techniques are being implemented in many areas of medicine. 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Developing surgical techniques for accurate catheter insertion could, therefore, be beneficial to patients. This study was conducted to determine if the rate of accurate catheter location with intraoperative ultrasound guidance could exceed 80%. The authors conducted a prospective, multicenter study of children (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 18 years) requiring first-time treatment for hydrocephalus with a ventriculoperitoneal shunt. Using intraoperative ultrasound, surgeons were required to target the frontal horn or trigone for catheter tip placement. An intraoperative ultrasound image was obtained at the time of catheter insertion. Ventricular catheter location, the primary outcome measure, was determined from the first postoperative image. A control group of patients treated by nonultrasound surgeons (conventional surgeons) were enrolled using the same study criteria. Conventional shunt surgeons also agreed to target the frontal horn or trigone for all catheter insertions. Patients were triaged to participating surgeons based on call schedules at each center. A pediatric neuroradiologist blinded to method of insertion, center, and surgeon determined ventricular catheter tip location. Eleven surgeons enrolled as ultrasound surgeons and 6 as conventional surgeons. Between February 2009 and February 2010, 121 patients were enrolled at 4 Hydrocephalus Clinical Research Network centers. Experienced ultrasound surgeons (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 15 cases prior to study) operated on 67 patients; conventional surgeons operated on 52 patients. Experienced ultrasound surgeons achieved accurate catheter location in 39 (59%) of 66 patients, 95% CI (46%-71%). Intraoperative ultrasound images were compared with postoperative scans. In 32.7% of cases, the catheter tip moved from an accurate location on the intraoperative ultrasound image to an inaccurate location on the postoperative study. This was the most significant factor affecting accuracy. In comparison, conventional surgeons achieved accurate location in 24 (49.0%) of 49 cases (95% CI [34%-64%]). The shunt survival rate at 1 year was 70.8% in the experienced ultrasound group and 66.9% in the conventional group (p = 0.66). Ultrasound surgeons had more catheters surrounded by CSF (30.8% vs 6.1%, p = 0.0012) and away from the choroid plexus (72.3% vs 58.3%, p = 0.12), and fewer catheters in the brain (3% vs 22.4%, p = 0.0011) and crossing the midline (4.5% vs 34.7%, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), but they had a higher proportion of postoperative pseudomeningocele (10.1% vs 3.8%, p = 0.30), wound dehiscence (5.8% vs 0%, p = 0.13), CSF leak (10.1% vs 1.9%, p = 0.14), and shunt infection (11.6% vs 5.8%, p = 0.35). Ultrasound-guided shunt insertion as performed in this study was unable to consistently place catheters into the frontal horn or trigone. The technique is safe and achieves outcomes similar to other conventional shunt insertion techniques. Further efforts to improve accurate catheter location should focus on prevention of catheter migration that occurs between intraoperative placement and postoperative imaging. Clinical trial registration no.: NCT01007786 ( ClinicalTrials.gov ).</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="26980647"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="26980647"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 26980647; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=26980647]").text(description); $(".js-view-count[data-work-id=26980647]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 26980647; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='26980647']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 26980647, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=26980647]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":26980647,"title":"No significant improvement in the rate of accurate ventricular catheter location using ultrasound-guided CSF shunt insertion: a prospective, controlled study by the Hydrocephalus Clinical Research Network","translated_title":"","metadata":{"abstract":"Cerebrospinal fluid shunt ventricular catheters inserted into the frontal horn or trigone are associated with prolonged shunt survival. Developing surgical techniques for accurate catheter insertion could, therefore, be beneficial to patients. This study was conducted to determine if the rate of accurate catheter location with intraoperative ultrasound guidance could exceed 80%. The authors conducted a prospective, multicenter study of children (\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 18 years) requiring first-time treatment for hydrocephalus with a ventriculoperitoneal shunt. Using intraoperative ultrasound, surgeons were required to target the frontal horn or trigone for catheter tip placement. An intraoperative ultrasound image was obtained at the time of catheter insertion. Ventricular catheter location, the primary outcome measure, was determined from the first postoperative image. A control group of patients treated by nonultrasound surgeons (conventional surgeons) were enrolled using the same study criteria. Conventional shunt surgeons also agreed to target the frontal horn or trigone for all catheter insertions. Patients were triaged to participating surgeons based on call schedules at each center. A pediatric neuroradiologist blinded to method of insertion, center, and surgeon determined ventricular catheter tip location. Eleven surgeons enrolled as ultrasound surgeons and 6 as conventional surgeons. Between February 2009 and February 2010, 121 patients were enrolled at 4 Hydrocephalus Clinical Research Network centers. Experienced ultrasound surgeons (\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 15 cases prior to study) operated on 67 patients; conventional surgeons operated on 52 patients. Experienced ultrasound surgeons achieved accurate catheter location in 39 (59%) of 66 patients, 95% CI (46%-71%). Intraoperative ultrasound images were compared with postoperative scans. In 32.7% of cases, the catheter tip moved from an accurate location on the intraoperative ultrasound image to an inaccurate location on the postoperative study. This was the most significant factor affecting accuracy. In comparison, conventional surgeons achieved accurate location in 24 (49.0%) of 49 cases (95% CI [34%-64%]). The shunt survival rate at 1 year was 70.8% in the experienced ultrasound group and 66.9% in the conventional group (p = 0.66). Ultrasound surgeons had more catheters surrounded by CSF (30.8% vs 6.1%, p = 0.0012) and away from the choroid plexus (72.3% vs 58.3%, p = 0.12), and fewer catheters in the brain (3% vs 22.4%, p = 0.0011) and crossing the midline (4.5% vs 34.7%, p \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), but they had a higher proportion of postoperative pseudomeningocele (10.1% vs 3.8%, p = 0.30), wound dehiscence (5.8% vs 0%, p = 0.13), CSF leak (10.1% vs 1.9%, p = 0.14), and shunt infection (11.6% vs 5.8%, p = 0.35). Ultrasound-guided shunt insertion as performed in this study was unable to consistently place catheters into the frontal horn or trigone. The technique is safe and achieves outcomes similar to other conventional shunt insertion techniques. Further efforts to improve accurate catheter location should focus on prevention of catheter migration that occurs between intraoperative placement and postoperative imaging. Clinical trial registration no.: NCT01007786 ( ClinicalTrials.gov ).","publication_date":{"day":null,"month":null,"year":2013,"errors":{}},"publication_name":"Journal of Neurosurgery: Pediatrics"},"translated_abstract":"Cerebrospinal fluid shunt ventricular catheters inserted into the frontal horn or trigone are associated with prolonged shunt survival. Developing surgical techniques for accurate catheter insertion could, therefore, be beneficial to patients. This study was conducted to determine if the rate of accurate catheter location with intraoperative ultrasound guidance could exceed 80%. The authors conducted a prospective, multicenter study of children (\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 18 years) requiring first-time treatment for hydrocephalus with a ventriculoperitoneal shunt. Using intraoperative ultrasound, surgeons were required to target the frontal horn or trigone for catheter tip placement. An intraoperative ultrasound image was obtained at the time of catheter insertion. Ventricular catheter location, the primary outcome measure, was determined from the first postoperative image. A control group of patients treated by nonultrasound surgeons (conventional surgeons) were enrolled using the same study criteria. Conventional shunt surgeons also agreed to target the frontal horn or trigone for all catheter insertions. Patients were triaged to participating surgeons based on call schedules at each center. A pediatric neuroradiologist blinded to method of insertion, center, and surgeon determined ventricular catheter tip location. Eleven surgeons enrolled as ultrasound surgeons and 6 as conventional surgeons. Between February 2009 and February 2010, 121 patients were enrolled at 4 Hydrocephalus Clinical Research Network centers. Experienced ultrasound surgeons (\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 15 cases prior to study) operated on 67 patients; conventional surgeons operated on 52 patients. Experienced ultrasound surgeons achieved accurate catheter location in 39 (59%) of 66 patients, 95% CI (46%-71%). Intraoperative ultrasound images were compared with postoperative scans. In 32.7% of cases, the catheter tip moved from an accurate location on the intraoperative ultrasound image to an inaccurate location on the postoperative study. This was the most significant factor affecting accuracy. In comparison, conventional surgeons achieved accurate location in 24 (49.0%) of 49 cases (95% CI [34%-64%]). The shunt survival rate at 1 year was 70.8% in the experienced ultrasound group and 66.9% in the conventional group (p = 0.66). Ultrasound surgeons had more catheters surrounded by CSF (30.8% vs 6.1%, p = 0.0012) and away from the choroid plexus (72.3% vs 58.3%, p = 0.12), and fewer catheters in the brain (3% vs 22.4%, p = 0.0011) and crossing the midline (4.5% vs 34.7%, p \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), but they had a higher proportion of postoperative pseudomeningocele (10.1% vs 3.8%, p = 0.30), wound dehiscence (5.8% vs 0%, p = 0.13), CSF leak (10.1% vs 1.9%, p = 0.14), and shunt infection (11.6% vs 5.8%, p = 0.35). Ultrasound-guided shunt insertion as performed in this study was unable to consistently place catheters into the frontal horn or trigone. The technique is safe and achieves outcomes similar to other conventional shunt insertion techniques. Further efforts to improve accurate catheter location should focus on prevention of catheter migration that occurs between intraoperative placement and postoperative imaging. Clinical trial registration no.: NCT01007786 ( ClinicalTrials.gov ).","internal_url":"https://www.academia.edu/26980647/No_significant_improvement_in_the_rate_of_accurate_ventricular_catheter_location_using_ultrasound_guided_CSF_shunt_insertion_a_prospective_controlled_study_by_the_Hydrocephalus_Clinical_Research_Network","translated_internal_url":"","created_at":"2016-07-14T05:40:26.626-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":33852416,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[],"downloadable_attachments":[],"slug":"No_significant_improvement_in_the_rate_of_accurate_ventricular_catheter_location_using_ultrasound_guided_CSF_shunt_insertion_a_prospective_controlled_study_by_the_Hydrocephalus_Clinical_Research_Network","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"Cerebrospinal fluid shunt ventricular catheters inserted into the frontal horn or trigone are associated with prolonged shunt survival. Developing surgical techniques for accurate catheter insertion could, therefore, be beneficial to patients. This study was conducted to determine if the rate of accurate catheter location with intraoperative ultrasound guidance could exceed 80%. The authors conducted a prospective, multicenter study of children (\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 18 years) requiring first-time treatment for hydrocephalus with a ventriculoperitoneal shunt. Using intraoperative ultrasound, surgeons were required to target the frontal horn or trigone for catheter tip placement. An intraoperative ultrasound image was obtained at the time of catheter insertion. Ventricular catheter location, the primary outcome measure, was determined from the first postoperative image. A control group of patients treated by nonultrasound surgeons (conventional surgeons) were enrolled using the same study criteria. Conventional shunt surgeons also agreed to target the frontal horn or trigone for all catheter insertions. Patients were triaged to participating surgeons based on call schedules at each center. A pediatric neuroradiologist blinded to method of insertion, center, and surgeon determined ventricular catheter tip location. Eleven surgeons enrolled as ultrasound surgeons and 6 as conventional surgeons. Between February 2009 and February 2010, 121 patients were enrolled at 4 Hydrocephalus Clinical Research Network centers. Experienced ultrasound surgeons (\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 15 cases prior to study) operated on 67 patients; conventional surgeons operated on 52 patients. Experienced ultrasound surgeons achieved accurate catheter location in 39 (59%) of 66 patients, 95% CI (46%-71%). Intraoperative ultrasound images were compared with postoperative scans. In 32.7% of cases, the catheter tip moved from an accurate location on the intraoperative ultrasound image to an inaccurate location on the postoperative study. This was the most significant factor affecting accuracy. In comparison, conventional surgeons achieved accurate location in 24 (49.0%) of 49 cases (95% CI [34%-64%]). The shunt survival rate at 1 year was 70.8% in the experienced ultrasound group and 66.9% in the conventional group (p = 0.66). Ultrasound surgeons had more catheters surrounded by CSF (30.8% vs 6.1%, p = 0.0012) and away from the choroid plexus (72.3% vs 58.3%, p = 0.12), and fewer catheters in the brain (3% vs 22.4%, p = 0.0011) and crossing the midline (4.5% vs 34.7%, p \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), but they had a higher proportion of postoperative pseudomeningocele (10.1% vs 3.8%, p = 0.30), wound dehiscence (5.8% vs 0%, p = 0.13), CSF leak (10.1% vs 1.9%, p = 0.14), and shunt infection (11.6% vs 5.8%, p = 0.35). Ultrasound-guided shunt insertion as performed in this study was unable to consistently place catheters into the frontal horn or trigone. The technique is safe and achieves outcomes similar to other conventional shunt insertion techniques. Further efforts to improve accurate catheter location should focus on prevention of catheter migration that occurs between intraoperative placement and postoperative imaging. Clinical trial registration no.: NCT01007786 ( ClinicalTrials.gov ).","owner":{"id":33852416,"first_name":"Marion","middle_initials":"L","last_name":"Walker","page_name":"MarionWalker","domain_name":"utah","created_at":"2015-08-12T08:15:14.624-07:00","display_name":"Marion L Walker","url":"https://utah.academia.edu/MarionWalker"},"attachments":[],"research_interests":[{"id":12426,"name":"Treatment Outcome","url":"https://www.academia.edu/Documents/in/Treatment_Outcome"},{"id":15639,"name":"Ultrasound","url":"https://www.academia.edu/Documents/in/Ultrasound"},{"id":22506,"name":"Adolescent","url":"https://www.academia.edu/Documents/in/Adolescent"},{"id":60974,"name":"Hydrocephalus","url":"https://www.academia.edu/Documents/in/Hydrocephalus"},{"id":62112,"name":"Prospective studies","url":"https://www.academia.edu/Documents/in/Prospective_studies"},{"id":64933,"name":"Child","url":"https://www.academia.edu/Documents/in/Child"},{"id":134346,"name":"Infant","url":"https://www.academia.edu/Documents/in/Infant"},{"id":196189,"name":"Sample Size","url":"https://www.academia.edu/Documents/in/Sample_Size"},{"id":253560,"name":"Newborn Infant","url":"https://www.academia.edu/Documents/in/Newborn_Infant"},{"id":413195,"name":"Time Factors","url":"https://www.academia.edu/Documents/in/Time_Factors"},{"id":704648,"name":"Clinical Competence","url":"https://www.academia.edu/Documents/in/Clinical_Competence"},{"id":745088,"name":"FOREIGN BODY MIGRATION","url":"https://www.academia.edu/Documents/in/FOREIGN_BODY_MIGRATION"},{"id":2489700,"name":"Child preschool","url":"https://www.academia.edu/Documents/in/Child_preschool"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="26980646"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/26980646/Adjustment_and_malfunction_of_a_programmable_valve_after_exposure_to_toy_magnets_Case_report"><img alt="Research paper thumbnail of Adjustment and malfunction of a programmable valve after exposure to toy magnets. Case report" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/26980646/Adjustment_and_malfunction_of_a_programmable_valve_after_exposure_to_toy_magnets_Case_report">Adjustment and malfunction of a programmable valve after exposure to toy magnets. Case report</a></div><div class="wp-workCard_item"><span>Journal of neurosurgery</span><span>, 2004</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Inadvertent adjustments and malfunctions of programmable valves have been reported in cases in wh...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Inadvertent adjustments and malfunctions of programmable valves have been reported in cases in which patients have encountered powerful electromagnetic fields such as those involved in magnetic resonance imaging, but the effects of small magnetic fields are not well known. The authors present a case in which a child playing with a collection of commercially available toy magnets altered the pressure setting of an implanted valve and may have caused its permanent malfunction.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="26980646"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="26980646"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 26980646; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=26980646]").text(description); $(".js-view-count[data-work-id=26980646]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 26980646; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='26980646']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 26980646, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=26980646]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":26980646,"title":"Adjustment and malfunction of a programmable valve after exposure to toy magnets. Case report","translated_title":"","metadata":{"abstract":"Inadvertent adjustments and malfunctions of programmable valves have been reported in cases in which patients have encountered powerful electromagnetic fields such as those involved in magnetic resonance imaging, but the effects of small magnetic fields are not well known. The authors present a case in which a child playing with a collection of commercially available toy magnets altered the pressure setting of an implanted valve and may have caused its permanent malfunction.","publication_date":{"day":null,"month":null,"year":2004,"errors":{}},"publication_name":"Journal of neurosurgery"},"translated_abstract":"Inadvertent adjustments and malfunctions of programmable valves have been reported in cases in which patients have encountered powerful electromagnetic fields such as those involved in magnetic resonance imaging, but the effects of small magnetic fields are not well known. The authors present a case in which a child playing with a collection of commercially available toy magnets altered the pressure setting of an implanted valve and may have caused its permanent malfunction.","internal_url":"https://www.academia.edu/26980646/Adjustment_and_malfunction_of_a_programmable_valve_after_exposure_to_toy_magnets_Case_report","translated_internal_url":"","created_at":"2016-07-14T05:40:26.432-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":33852416,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[],"downloadable_attachments":[],"slug":"Adjustment_and_malfunction_of_a_programmable_valve_after_exposure_to_toy_magnets_Case_report","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"Inadvertent adjustments and malfunctions of programmable valves have been reported in cases in which patients have encountered powerful electromagnetic fields such as those involved in magnetic resonance imaging, but the effects of small magnetic fields are not well known. The authors present a case in which a child playing with a collection of commercially available toy magnets altered the pressure setting of an implanted valve and may have caused its permanent malfunction.","owner":{"id":33852416,"first_name":"Marion","middle_initials":"L","last_name":"Walker","page_name":"MarionWalker","domain_name":"utah","created_at":"2015-08-12T08:15:14.624-07:00","display_name":"Marion L Walker","url":"https://utah.academia.edu/MarionWalker"},"attachments":[],"research_interests":[{"id":650,"name":"Neurosurgery","url":"https://www.academia.edu/Documents/in/Neurosurgery"},{"id":60974,"name":"Hydrocephalus","url":"https://www.academia.edu/Documents/in/Hydrocephalus"},{"id":131236,"name":"Electromagnetic Fields","url":"https://www.academia.edu/Documents/in/Electromagnetic_Fields"},{"id":211387,"name":"Electromagnetic Field","url":"https://www.academia.edu/Documents/in/Electromagnetic_Field"},{"id":244814,"name":"Clinical Sciences","url":"https://www.academia.edu/Documents/in/Clinical_Sciences"},{"id":1239755,"name":"Neurosciences","url":"https://www.academia.edu/Documents/in/Neurosciences"},{"id":2489700,"name":"Child preschool","url":"https://www.academia.edu/Documents/in/Child_preschool"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="26980645"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/26980645/Complications_of_intracranial_pressure_monitoring_in_children_with_head_trauma"><img alt="Research paper thumbnail of Complications of intracranial pressure monitoring in children with head trauma" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/26980645/Complications_of_intracranial_pressure_monitoring_in_children_with_head_trauma">Complications of intracranial pressure monitoring in children with head trauma</a></div><div class="wp-workCard_item"><span>Journal of neurosurgery</span><span>, 2004</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Intracranial pressure (ICP) monitoring has become routine in the management of patients with trau...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Intracranial pressure (ICP) monitoring has become routine in the management of patients with traumatic brain injury (TBI). Many surgeons prefer to use external ventricular drains (EVDs) over fiberoptic monitors to measure ICP because of the added benefit of cerebrospinal fluid drainage. The purpose of this study was to examine a consecutive series of children with TBI and compare the incidence of complications after placement of an EVD, a fiberoptic intraparencyhmal monitor, or both. A retrospective chart review was conducted to identify children with TBI who met the criteria for insertion of an ICP monitor. All patients underwent head CT scanning on admission and after placement of an ICP monitor. During a 5-year period 80 children met the criteria for inclusion in the study. Eighteen children (22.5%) underwent EVD placement only, 18 (22.5%) underwent placement of a fiberoptic device only, and 44 (55%) received both. A total of 62 fiberoptic devices (48%) were inserted, and 68 EVDs...</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="26980645"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="26980645"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 26980645; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=26980645]").text(description); $(".js-view-count[data-work-id=26980645]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 26980645; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='26980645']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 26980645, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=26980645]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":26980645,"title":"Complications of intracranial pressure monitoring in children with head trauma","translated_title":"","metadata":{"abstract":"Intracranial pressure (ICP) monitoring has become routine in the management of patients with traumatic brain injury (TBI). Many surgeons prefer to use external ventricular drains (EVDs) over fiberoptic monitors to measure ICP because of the added benefit of cerebrospinal fluid drainage. The purpose of this study was to examine a consecutive series of children with TBI and compare the incidence of complications after placement of an EVD, a fiberoptic intraparencyhmal monitor, or both. A retrospective chart review was conducted to identify children with TBI who met the criteria for insertion of an ICP monitor. All patients underwent head CT scanning on admission and after placement of an ICP monitor. During a 5-year period 80 children met the criteria for inclusion in the study. Eighteen children (22.5%) underwent EVD placement only, 18 (22.5%) underwent placement of a fiberoptic device only, and 44 (55%) received both. A total of 62 fiberoptic devices (48%) were inserted, and 68 EVDs...","publication_date":{"day":null,"month":null,"year":2004,"errors":{}},"publication_name":"Journal of neurosurgery"},"translated_abstract":"Intracranial pressure (ICP) monitoring has become routine in the management of patients with traumatic brain injury (TBI). Many surgeons prefer to use external ventricular drains (EVDs) over fiberoptic monitors to measure ICP because of the added benefit of cerebrospinal fluid drainage. The purpose of this study was to examine a consecutive series of children with TBI and compare the incidence of complications after placement of an EVD, a fiberoptic intraparencyhmal monitor, or both. A retrospective chart review was conducted to identify children with TBI who met the criteria for insertion of an ICP monitor. All patients underwent head CT scanning on admission and after placement of an ICP monitor. During a 5-year period 80 children met the criteria for inclusion in the study. Eighteen children (22.5%) underwent EVD placement only, 18 (22.5%) underwent placement of a fiberoptic device only, and 44 (55%) received both. A total of 62 fiberoptic devices (48%) were inserted, and 68 EVDs...","internal_url":"https://www.academia.edu/26980645/Complications_of_intracranial_pressure_monitoring_in_children_with_head_trauma","translated_internal_url":"","created_at":"2016-07-14T05:40:26.256-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":33852416,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[],"downloadable_attachments":[],"slug":"Complications_of_intracranial_pressure_monitoring_in_children_with_head_trauma","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"Intracranial pressure (ICP) monitoring has become routine in the management of patients with traumatic brain injury (TBI). Many surgeons prefer to use external ventricular drains (EVDs) over fiberoptic monitors to measure ICP because of the added benefit of cerebrospinal fluid drainage. The purpose of this study was to examine a consecutive series of children with TBI and compare the incidence of complications after placement of an EVD, a fiberoptic intraparencyhmal monitor, or both. A retrospective chart review was conducted to identify children with TBI who met the criteria for insertion of an ICP monitor. All patients underwent head CT scanning on admission and after placement of an ICP monitor. During a 5-year period 80 children met the criteria for inclusion in the study. Eighteen children (22.5%) underwent EVD placement only, 18 (22.5%) underwent placement of a fiberoptic device only, and 44 (55%) received both. 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="26980722"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/26980722/Role_of_dorsal_rhizotomy_in_spinal_cord_injury_induced_spasticity"><img alt="Research paper thumbnail of Role of dorsal rhizotomy in spinal cord injury-induced spasticity" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/26980722/Role_of_dorsal_rhizotomy_in_spinal_cord_injury_induced_spasticity">Role of dorsal rhizotomy in spinal cord injury-induced spasticity</a></div><div class="wp-workCard_item"><span>Journal of neurosurgery. Pediatrics</span><span>, 2014</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Selective dorsal rhizotomy may have a role in the management of spinal cord injury (SCI)-induced ...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Selective dorsal rhizotomy may have a role in the management of spinal cord injury (SCI)-induced spasticity. Spasticity and spasms are common sequelae of SCI in children. Depending on the clinical scenario, treatments may include physical and occupational therapy, oral medications, chemodenervation, and neurosurgical interventions. Selective dorsal rhizotomy (SDR) is used in the management of spasticity in selected children with cerebral palsy, but, to the authors&#39; knowledge, its use has not been reported in children with SCI. The authors describe the cases of 3 pediatric patients with SCI and associated spasticity treated with SDR. Two of the 3 patients have had significant long-term improvement in their preoperative spasticity. Although the third patient also experienced initial relief, his spasticity quickly returned to its preoperative severity, necessitating additional therapies. Selective dorsal rhizotomy may have a place in the treatment of selected children with spastici...</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="26980722"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="26980722"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 26980722; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=26980722]").text(description); $(".js-view-count[data-work-id=26980722]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 26980722; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='26980722']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 26980722, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=26980722]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":26980722,"title":"Role of dorsal rhizotomy in spinal cord injury-induced spasticity","translated_title":"","metadata":{"abstract":"Selective dorsal rhizotomy may have a role in the management of spinal cord injury (SCI)-induced spasticity. Spasticity and spasms are common sequelae of SCI in children. Depending on the clinical scenario, treatments may include physical and occupational therapy, oral medications, chemodenervation, and neurosurgical interventions. Selective dorsal rhizotomy (SDR) is used in the management of spasticity in selected children with cerebral palsy, but, to the authors\u0026#39; knowledge, its use has not been reported in children with SCI. The authors describe the cases of 3 pediatric patients with SCI and associated spasticity treated with SDR. Two of the 3 patients have had significant long-term improvement in their preoperative spasticity. Although the third patient also experienced initial relief, his spasticity quickly returned to its preoperative severity, necessitating additional therapies. Selective dorsal rhizotomy may have a place in the treatment of selected children with spastici...","publication_date":{"day":null,"month":null,"year":2014,"errors":{}},"publication_name":"Journal of neurosurgery. Pediatrics"},"translated_abstract":"Selective dorsal rhizotomy may have a role in the management of spinal cord injury (SCI)-induced spasticity. Spasticity and spasms are common sequelae of SCI in children. Depending on the clinical scenario, treatments may include physical and occupational therapy, oral medications, chemodenervation, and neurosurgical interventions. Selective dorsal rhizotomy (SDR) is used in the management of spasticity in selected children with cerebral palsy, but, to the authors\u0026#39; knowledge, its use has not been reported in children with SCI. The authors describe the cases of 3 pediatric patients with SCI and associated spasticity treated with SDR. Two of the 3 patients have had significant long-term improvement in their preoperative spasticity. Although the third patient also experienced initial relief, his spasticity quickly returned to its preoperative severity, necessitating additional therapies. Selective dorsal rhizotomy may have a place in the treatment of selected children with spastici...","internal_url":"https://www.academia.edu/26980722/Role_of_dorsal_rhizotomy_in_spinal_cord_injury_induced_spasticity","translated_internal_url":"","created_at":"2016-07-14T05:45:03.322-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":33852416,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[],"downloadable_attachments":[],"slug":"Role_of_dorsal_rhizotomy_in_spinal_cord_injury_induced_spasticity","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"Selective dorsal rhizotomy may have a role in the management of spinal cord injury (SCI)-induced spasticity. Spasticity and spasms are common sequelae of SCI in children. 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Selective dorsal rhizotomy may have a place in the treatment of selected children with spastici...","owner":{"id":33852416,"first_name":"Marion","middle_initials":"L","last_name":"Walker","page_name":"MarionWalker","domain_name":"utah","created_at":"2015-08-12T08:15:14.624-07:00","display_name":"Marion L Walker","url":"https://utah.academia.edu/MarionWalker"},"attachments":[],"research_interests":[{"id":12426,"name":"Treatment Outcome","url":"https://www.academia.edu/Documents/in/Treatment_Outcome"},{"id":22506,"name":"Adolescent","url":"https://www.academia.edu/Documents/in/Adolescent"},{"id":64933,"name":"Child","url":"https://www.academia.edu/Documents/in/Child"},{"id":145032,"name":"Rhizotomy","url":"https://www.academia.edu/Documents/in/Rhizotomy"},{"id":186079,"name":"Cervical Vertebrae","url":"https://www.academia.edu/Documents/in/Cervical_Vertebrae"},{"id":291259,"name":"Quadriplegia","url":"https://www.academia.edu/Documents/in/Quadriplegia"},{"id":298288,"name":"Baclofen","url":"https://www.academia.edu/Documents/in/Baclofen"},{"id":963201,"name":"Thoracic Vertebrae","url":"https://www.academia.edu/Documents/in/Thoracic_Vertebrae"},{"id":1011135,"name":"Spinal Cord Injuries","url":"https://www.academia.edu/Documents/in/Spinal_Cord_Injuries"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="26980660"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/26980660/A_14_Year_Old_Female_with_Decreasing_Visual_Acuity_Severe_Headache_Nausea_and_Vomiting"><img alt="Research paper thumbnail of A 14-Year-Old Female with Decreasing Visual Acuity, Severe Headache, Nausea and Vomiting" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/26980660/A_14_Year_Old_Female_with_Decreasing_Visual_Acuity_Severe_Headache_Nausea_and_Vomiting">A 14-Year-Old Female with Decreasing Visual Acuity, Severe Headache, Nausea and Vomiting</a></div><div class="wp-workCard_item"><span>Pediatric Neurosurgery</span><span>, Feb 1, 2001</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="26980660"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="26980660"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 26980660; 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="26980659"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/26980659/Clinicopathological_review_tumefactive_demyelination_in_a_12_year_old_girl"><img alt="Research paper thumbnail of Clinicopathological review: tumefactive demyelination in a 12-year-old girl" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/26980659/Clinicopathological_review_tumefactive_demyelination_in_a_12_year_old_girl">Clinicopathological review: tumefactive demyelination in a 12-year-old girl</a></div><div class="wp-workCard_item"><span>Neurosurgery</span><span>, May 1, 2005</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Dr. Anderson: The patient is a 12 year-old, right-handed girl without significant past medical or...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Dr. Anderson: The patient is a 12 year-old, right-handed girl without significant past medical or surgical history who developed the acute onset of right foot weakness approximately 10 days before admission. After sitting on the couch watching television, she tried to stand and ...</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="26980659"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="26980659"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 26980659; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=26980659]").text(description); $(".js-view-count[data-work-id=26980659]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 26980659; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='26980659']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 26980659, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=26980659]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":26980659,"title":"Clinicopathological review: tumefactive demyelination in a 12-year-old girl","translated_title":"","metadata":{"abstract":"Dr. Anderson: The patient is a 12 year-old, right-handed girl without significant past medical or surgical history who developed the acute onset of right foot weakness approximately 10 days before admission. After sitting on the couch watching television, she tried to stand and ...","publication_date":{"day":1,"month":5,"year":2005,"errors":{}},"publication_name":"Neurosurgery"},"translated_abstract":"Dr. Anderson: The patient is a 12 year-old, right-handed girl without significant past medical or surgical history who developed the acute onset of right foot weakness approximately 10 days before admission. After sitting on the couch watching television, she tried to stand and ...","internal_url":"https://www.academia.edu/26980659/Clinicopathological_review_tumefactive_demyelination_in_a_12_year_old_girl","translated_internal_url":"","created_at":"2016-07-14T05:40:29.888-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":33852416,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[],"downloadable_attachments":[],"slug":"Clinicopathological_review_tumefactive_demyelination_in_a_12_year_old_girl","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"Dr. Anderson: The patient is a 12 year-old, right-handed girl without significant past medical or surgical history who developed the acute onset of right foot weakness approximately 10 days before admission. After sitting on the couch watching television, she tried to stand and ...","owner":{"id":33852416,"first_name":"Marion","middle_initials":"L","last_name":"Walker","page_name":"MarionWalker","domain_name":"utah","created_at":"2015-08-12T08:15:14.624-07:00","display_name":"Marion L Walker","url":"https://utah.academia.edu/MarionWalker"},"attachments":[],"research_interests":[{"id":650,"name":"Neurosurgery","url":"https://www.academia.edu/Documents/in/Neurosurgery"},{"id":6200,"name":"Magnetic Resonance Imaging","url":"https://www.academia.edu/Documents/in/Magnetic_Resonance_Imaging"},{"id":109739,"name":"Infection","url":"https://www.academia.edu/Documents/in/Infection"},{"id":244814,"name":"Clinical Sciences","url":"https://www.academia.edu/Documents/in/Clinical_Sciences"},{"id":1239755,"name":"Neurosciences","url":"https://www.academia.edu/Documents/in/Neurosciences"}],"urls":[{"id":7322027,"url":"http://www.ncbi.nlm.nih.gov/pubmed/15854254"}]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="26980658"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/26980658/A_new_Hydrocephalus_Clinical_Research_Network_protocol_to_reduce_cerebrospinal_fluid_shunt_infection"><img alt="Research paper thumbnail of A new Hydrocephalus Clinical Research Network protocol to reduce cerebrospinal fluid shunt infection" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/26980658/A_new_Hydrocephalus_Clinical_Research_Network_protocol_to_reduce_cerebrospinal_fluid_shunt_infection">A new Hydrocephalus Clinical Research Network protocol to reduce cerebrospinal fluid shunt infection</a></div><div class="wp-workCard_item"><span>Journal of neurosurgery. Pediatrics</span><span>, Jan 18, 2015</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">OBJECT In a previous report by the same research group (Kestle et al., 2011), compliance with an ...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">OBJECT In a previous report by the same research group (Kestle et al., 2011), compliance with an 11-step protocol was shown to reduce CSF shunt infection at Hydrocephalus Clinical Research Network (HCRN) centers (from 8.7% to 5.7%). Antibiotic-impregnated catheters (AICs) were not part of the protocol but were used off protocol by some surgeons. The authors therefore began using a new protocol that included AICs in an effort to reduce the infection rate further. METHODS The new protocol was implemented at HCRN centers on January 1, 2012, for all shunt procedures (excluding external ventricular drains [EVDs], ventricular reservoirs, and subgaleal shunts). Procedures performed up to September 30, 2013, were included (21 months). Compliance with the protocol and outcome events up to March 30, 2014, were recorded. The definition of infection was unchanged from the authors&#39; previous report. RESULTS A total of 1935 procedures were performed on 1670 patients at 8 HCRN centers. The over...</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="26980658"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="26980658"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 26980658; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=26980658]").text(description); $(".js-view-count[data-work-id=26980658]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 26980658; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='26980658']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 26980658, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=26980658]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":26980658,"title":"A new Hydrocephalus Clinical Research Network protocol to reduce cerebrospinal fluid shunt infection","translated_title":"","metadata":{"abstract":"OBJECT In a previous report by the same research group (Kestle et al., 2011), compliance with an 11-step protocol was shown to reduce CSF shunt infection at Hydrocephalus Clinical Research Network (HCRN) centers (from 8.7% to 5.7%). Antibiotic-impregnated catheters (AICs) were not part of the protocol but were used off protocol by some surgeons. The authors therefore began using a new protocol that included AICs in an effort to reduce the infection rate further. METHODS The new protocol was implemented at HCRN centers on January 1, 2012, for all shunt procedures (excluding external ventricular drains [EVDs], ventricular reservoirs, and subgaleal shunts). Procedures performed up to September 30, 2013, were included (21 months). Compliance with the protocol and outcome events up to March 30, 2014, were recorded. The definition of infection was unchanged from the authors\u0026#39; previous report. RESULTS A total of 1935 procedures were performed on 1670 patients at 8 HCRN centers. The over...","publication_date":{"day":18,"month":1,"year":2015,"errors":{}},"publication_name":"Journal of neurosurgery. Pediatrics"},"translated_abstract":"OBJECT In a previous report by the same research group (Kestle et al., 2011), compliance with an 11-step protocol was shown to reduce CSF shunt infection at Hydrocephalus Clinical Research Network (HCRN) centers (from 8.7% to 5.7%). Antibiotic-impregnated catheters (AICs) were not part of the protocol but were used off protocol by some surgeons. The authors therefore began using a new protocol that included AICs in an effort to reduce the infection rate further. METHODS The new protocol was implemented at HCRN centers on January 1, 2012, for all shunt procedures (excluding external ventricular drains [EVDs], ventricular reservoirs, and subgaleal shunts). Procedures performed up to September 30, 2013, were included (21 months). Compliance with the protocol and outcome events up to March 30, 2014, were recorded. The definition of infection was unchanged from the authors\u0026#39; previous report. RESULTS A total of 1935 procedures were performed on 1670 patients at 8 HCRN centers. The over...","internal_url":"https://www.academia.edu/26980658/A_new_Hydrocephalus_Clinical_Research_Network_protocol_to_reduce_cerebrospinal_fluid_shunt_infection","translated_internal_url":"","created_at":"2016-07-14T05:40:29.551-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":33852416,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[],"downloadable_attachments":[],"slug":"A_new_Hydrocephalus_Clinical_Research_Network_protocol_to_reduce_cerebrospinal_fluid_shunt_infection","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"OBJECT In a previous report by the same research group (Kestle et al., 2011), compliance with an 11-step protocol was shown to reduce CSF shunt infection at Hydrocephalus Clinical Research Network (HCRN) centers (from 8.7% to 5.7%). Antibiotic-impregnated catheters (AICs) were not part of the protocol but were used off protocol by some surgeons. The authors therefore began using a new protocol that included AICs in an effort to reduce the infection rate further. METHODS The new protocol was implemented at HCRN centers on January 1, 2012, for all shunt procedures (excluding external ventricular drains [EVDs], ventricular reservoirs, and subgaleal shunts). Procedures performed up to September 30, 2013, were included (21 months). Compliance with the protocol and outcome events up to March 30, 2014, were recorded. The definition of infection was unchanged from the authors\u0026#39; previous report. RESULTS A total of 1935 procedures were performed on 1670 patients at 8 HCRN centers. The over...","owner":{"id":33852416,"first_name":"Marion","middle_initials":"L","last_name":"Walker","page_name":"MarionWalker","domain_name":"utah","created_at":"2015-08-12T08:15:14.624-07:00","display_name":"Marion L Walker","url":"https://utah.academia.edu/MarionWalker"},"attachments":[],"research_interests":[],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="26980657"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/26980657/Pediatric_skull_base_surgery_2_Experience_and_outcomes_in_55_patients"><img alt="Research paper thumbnail of Pediatric skull base surgery: 2. Experience and outcomes in 55 patients" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/26980657/Pediatric_skull_base_surgery_2_Experience_and_outcomes_in_55_patients">Pediatric skull base surgery: 2. Experience and outcomes in 55 patients</a></div><div class="wp-workCard_item"><span>Pediatric Neurosurgery</span><span>, Feb 1, 2003</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">In the second of these two articles, we will discuss our clinical experience with skull base surg...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">In the second of these two articles, we will discuss our clinical experience with skull base surgery in the pediatric population. We present a retrospective analysis of 55 patients less than 16 years of age who underwent skull base surgical approaches at the Primary Children&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Medical Center or the University of Utah Medical Center between January 1992 and April 1999. There were 30 boys and 25 girls (mean age 9.8 years). Patient follow-up averaged 58 months. Most patients had pathology that required either an anterior or anterolateral approach; 6 patients underwent a far-lateral or a transpetrosal exposure. Thirty-five procedures were performed by a neurosurgeon, a pediatric otolaryngologist performed 11 procedures, and 10 procedures were performed by both services together. Ninety-six percent of patients (n = 53) had a Glasgow Outcome Score of 4 or 5. Complications included 4 sustained cranial nerve palsies and 2 hemipareses. There were no CSF leaks, infections or deaths. Patients with sellar region pathology had a disproportionately higher incidence of postoperative morbidity. We conclude that in selected pediatric cases, skull base surgical techniques can be performed effectively and safely with the use of multidisciplinary teams. To implement these techniques, knowledge of their limitations and of the anatomical differences between the adult and pediatric cranial base is essential.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="26980657"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="26980657"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 26980657; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=26980657]").text(description); $(".js-view-count[data-work-id=26980657]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 26980657; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='26980657']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 26980657, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=26980657]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":26980657,"title":"Pediatric skull base surgery: 2. Experience and outcomes in 55 patients","translated_title":"","metadata":{"abstract":"In the second of these two articles, we will discuss our clinical experience with skull base surgery in the pediatric population. We present a retrospective analysis of 55 patients less than 16 years of age who underwent skull base surgical approaches at the Primary Children\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Medical Center or the University of Utah Medical Center between January 1992 and April 1999. There were 30 boys and 25 girls (mean age 9.8 years). Patient follow-up averaged 58 months. Most patients had pathology that required either an anterior or anterolateral approach; 6 patients underwent a far-lateral or a transpetrosal exposure. Thirty-five procedures were performed by a neurosurgeon, a pediatric otolaryngologist performed 11 procedures, and 10 procedures were performed by both services together. Ninety-six percent of patients (n = 53) had a Glasgow Outcome Score of 4 or 5. Complications included 4 sustained cranial nerve palsies and 2 hemipareses. There were no CSF leaks, infections or deaths. Patients with sellar region pathology had a disproportionately higher incidence of postoperative morbidity. We conclude that in selected pediatric cases, skull base surgical techniques can be performed effectively and safely with the use of multidisciplinary teams. To implement these techniques, knowledge of their limitations and of the anatomical differences between the adult and pediatric cranial base is essential.","publication_date":{"day":1,"month":2,"year":2003,"errors":{}},"publication_name":"Pediatric Neurosurgery"},"translated_abstract":"In the second of these two articles, we will discuss our clinical experience with skull base surgery in the pediatric population. We present a retrospective analysis of 55 patients less than 16 years of age who underwent skull base surgical approaches at the Primary Children\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Medical Center or the University of Utah Medical Center between January 1992 and April 1999. There were 30 boys and 25 girls (mean age 9.8 years). Patient follow-up averaged 58 months. Most patients had pathology that required either an anterior or anterolateral approach; 6 patients underwent a far-lateral or a transpetrosal exposure. Thirty-five procedures were performed by a neurosurgeon, a pediatric otolaryngologist performed 11 procedures, and 10 procedures were performed by both services together. Ninety-six percent of patients (n = 53) had a Glasgow Outcome Score of 4 or 5. Complications included 4 sustained cranial nerve palsies and 2 hemipareses. There were no CSF leaks, infections or deaths. Patients with sellar region pathology had a disproportionately higher incidence of postoperative morbidity. We conclude that in selected pediatric cases, skull base surgical techniques can be performed effectively and safely with the use of multidisciplinary teams. To implement these techniques, knowledge of their limitations and of the anatomical differences between the adult and pediatric cranial base is essential.","internal_url":"https://www.academia.edu/26980657/Pediatric_skull_base_surgery_2_Experience_and_outcomes_in_55_patients","translated_internal_url":"","created_at":"2016-07-14T05:40:29.220-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":33852416,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[],"downloadable_attachments":[],"slug":"Pediatric_skull_base_surgery_2_Experience_and_outcomes_in_55_patients","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"In the second of these two articles, we will discuss our clinical experience with skull base surgery in the pediatric population. We present a retrospective analysis of 55 patients less than 16 years of age who underwent skull base surgical approaches at the Primary Children\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Medical Center or the University of Utah Medical Center between January 1992 and April 1999. There were 30 boys and 25 girls (mean age 9.8 years). Patient follow-up averaged 58 months. Most patients had pathology that required either an anterior or anterolateral approach; 6 patients underwent a far-lateral or a transpetrosal exposure. Thirty-five procedures were performed by a neurosurgeon, a pediatric otolaryngologist performed 11 procedures, and 10 procedures were performed by both services together. Ninety-six percent of patients (n = 53) had a Glasgow Outcome Score of 4 or 5. Complications included 4 sustained cranial nerve palsies and 2 hemipareses. There were no CSF leaks, infections or deaths. Patients with sellar region pathology had a disproportionately higher incidence of postoperative morbidity. We conclude that in selected pediatric cases, skull base surgical techniques can be performed effectively and safely with the use of multidisciplinary teams. To implement these techniques, knowledge of their limitations and of the anatomical differences between the adult and pediatric cranial base is essential.","owner":{"id":33852416,"first_name":"Marion","middle_initials":"L","last_name":"Walker","page_name":"MarionWalker","domain_name":"utah","created_at":"2015-08-12T08:15:14.624-07:00","display_name":"Marion L Walker","url":"https://utah.academia.edu/MarionWalker"},"attachments":[],"research_interests":[{"id":631,"name":"Pediatrics","url":"https://www.academia.edu/Documents/in/Pediatrics"},{"id":647,"name":"Surgery","url":"https://www.academia.edu/Documents/in/Surgery"},{"id":22506,"name":"Adolescent","url":"https://www.academia.edu/Documents/in/Adolescent"},{"id":28235,"name":"Multidisciplinary","url":"https://www.academia.edu/Documents/in/Multidisciplinary"},{"id":54589,"name":"Anatomy","url":"https://www.academia.edu/Documents/in/Anatomy"},{"id":64933,"name":"Child","url":"https://www.academia.edu/Documents/in/Child"},{"id":121939,"name":"Technique","url":"https://www.academia.edu/Documents/in/Technique"},{"id":124105,"name":"Pediatric Neurosurgery","url":"https://www.academia.edu/Documents/in/Pediatric_Neurosurgery"},{"id":134346,"name":"Infant","url":"https://www.academia.edu/Documents/in/Infant"},{"id":162404,"name":"Skull Base","url":"https://www.academia.edu/Documents/in/Skull_Base"},{"id":189576,"name":"Pediatric","url":"https://www.academia.edu/Documents/in/Pediatric"},{"id":469105,"name":"Retrospective Studies","url":"https://www.academia.edu/Documents/in/Retrospective_Studies"},{"id":546419,"name":"Age Factors","url":"https://www.academia.edu/Documents/in/Age_Factors"},{"id":1239755,"name":"Neurosciences","url":"https://www.academia.edu/Documents/in/Neurosciences"},{"id":1423078,"name":"Nervous System Diseases","url":"https://www.academia.edu/Documents/in/Nervous_System_Diseases"},{"id":1929419,"name":"Nino","url":"https://www.academia.edu/Documents/in/Nino"},{"id":2463621,"name":"Postoperative Complications","url":"https://www.academia.edu/Documents/in/Postoperative_Complications"},{"id":2489700,"name":"Child preschool","url":"https://www.academia.edu/Documents/in/Child_preschool"}],"urls":[{"id":7322026,"url":"http://cat.inist.fr/?aModele=afficheN\u0026cpsidt=14501037"}]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="26980656"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/26980656/Medical_Management_of_Head_Injuries_in_Neonates_and_Infants"><img alt="Research paper thumbnail of Medical Management of Head Injuries in Neonates and Infants" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/26980656/Medical_Management_of_Head_Injuries_in_Neonates_and_Infants">Medical Management of Head Injuries in Neonates and Infants</a></div><div class="wp-workCard_item"><span>Principles of Pediatric Neurosurgery</span><span>, 1986</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="26980656"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="26980656"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 26980656; 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="26980655"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/26980655/Its_everything_else_you_do_Alumni_views_on_extracurricular_activities_and_employability"><img alt="Research paper thumbnail of It's everything else you do...': Alumni views on extracurricular activities and employability" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/26980655/Its_everything_else_you_do_Alumni_views_on_extracurricular_activities_and_employability">It's everything else you do...': Alumni views on extracurricular activities and employability</a></div><div class="wp-workCard_item"><span>Active Learning in Higher Education</span><span>, 2015</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">ABSTRACT This article explores students’ extracurricular activities and, uniquely, their short- a...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">ABSTRACT This article explores students’ extracurricular activities and, uniquely, their short- and long-term effects on employability. Drawing on the literature, six research questions are identified. A questionnaire and interviews with alumni provide the quantitative and qualitative information needed. The effects of different extracurricular activities and the skills and qualities they promote are demonstrated for early- and later-career jobs, as are the complementary effects for employability of degree schemes and extracurricular activities. Alumni who are now recruiters of staff use their double perspective to explain the role extracurricular activities have played in their lives and now as professional recruiters. The paper shows how the alumni of any university could share these insights with undergraduates.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="26980655"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="26980655"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 26980655; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=26980655]").text(description); $(".js-view-count[data-work-id=26980655]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 26980655; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='26980655']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 26980655, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=26980655]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":26980655,"title":"It's everything else you do...': Alumni views on extracurricular activities and employability","translated_title":"","metadata":{"abstract":"ABSTRACT This article explores students’ extracurricular activities and, uniquely, their short- and long-term effects on employability. Drawing on the literature, six research questions are identified. A questionnaire and interviews with alumni provide the quantitative and qualitative information needed. The effects of different extracurricular activities and the skills and qualities they promote are demonstrated for early- and later-career jobs, as are the complementary effects for employability of degree schemes and extracurricular activities. Alumni who are now recruiters of staff use their double perspective to explain the role extracurricular activities have played in their lives and now as professional recruiters. The paper shows how the alumni of any university could share these insights with undergraduates.","publication_date":{"day":null,"month":null,"year":2015,"errors":{}},"publication_name":"Active Learning in Higher Education"},"translated_abstract":"ABSTRACT This article explores students’ extracurricular activities and, uniquely, their short- and long-term effects on employability. Drawing on the literature, six research questions are identified. A questionnaire and interviews with alumni provide the quantitative and qualitative information needed. The effects of different extracurricular activities and the skills and qualities they promote are demonstrated for early- and later-career jobs, as are the complementary effects for employability of degree schemes and extracurricular activities. Alumni who are now recruiters of staff use their double perspective to explain the role extracurricular activities have played in their lives and now as professional recruiters. The paper shows how the alumni of any university could share these insights with undergraduates.","internal_url":"https://www.academia.edu/26980655/Its_everything_else_you_do_Alumni_views_on_extracurricular_activities_and_employability","translated_internal_url":"","created_at":"2016-07-14T05:40:28.848-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":33852416,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[],"downloadable_attachments":[],"slug":"Its_everything_else_you_do_Alumni_views_on_extracurricular_activities_and_employability","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"ABSTRACT This article explores students’ extracurricular activities and, uniquely, their short- and long-term effects on employability. Drawing on the literature, six research questions are identified. A questionnaire and interviews with alumni provide the quantitative and qualitative information needed. The effects of different extracurricular activities and the skills and qualities they promote are demonstrated for early- and later-career jobs, as are the complementary effects for employability of degree schemes and extracurricular activities. Alumni who are now recruiters of staff use their double perspective to explain the role extracurricular activities have played in their lives and now as professional recruiters. The paper shows how the alumni of any university could share these insights with undergraduates.","owner":{"id":33852416,"first_name":"Marion","middle_initials":"L","last_name":"Walker","page_name":"MarionWalker","domain_name":"utah","created_at":"2015-08-12T08:15:14.624-07:00","display_name":"Marion L Walker","url":"https://utah.academia.edu/MarionWalker"},"attachments":[],"research_interests":[{"id":124971,"name":"Education Systems","url":"https://www.academia.edu/Documents/in/Education_Systems"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="26980654"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/26980654/Poster_532_Validation_of_a_Long_Term_Post_Stroke_Checklist"><img alt="Research paper thumbnail of Poster 532 Validation of a Long-Term Post-Stroke Checklist" class="work-thumbnail" src="https://attachments.academia-assets.com/47243006/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/26980654/Poster_532_Validation_of_a_Long_Term_Post_Stroke_Checklist">Poster 532 Validation of a Long-Term Post-Stroke Checklist</a></div><div class="wp-workCard_item"><span>PM&R</span><span>, 2012</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">and aphasia. Computed tomography of the brain showed left M2 middle cerebral artery (MCA) branch ...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">and aphasia. Computed tomography of the brain showed left M2 middle cerebral artery (MCA) branch occlusion. He met criteria for and received tissue plasminogen activator. Within 3 hours of admission, patient developed rigors, hypotension, fever and lethargy. Pressors and broad-spectrum antibiotics were started. Echocardiogram showed perivalvular leak of the aortic valve prosthesis and no vegetations. Acute infectious endocarditis workup was initially negative. He was transferred to acute rehabilitation unit. Setting: Tertiary care hospital. Results or Clinical Course: Q fever titers returned positive with phase I and phase II IgG Ͼ1:8192, consistent with acute infection. Patient was started on hydroxyquinolone and doxycycline for at least 18 months. He was likely infected with Q fever via contact with infected horse placenta. Initially at the rehabilitation unit, patient had mild cognitive impairments and moderate expressive and receptive aphasia. These deficits gradually improved as did his right hemiparesis, apraxia, and ataxia. Several weeks after discharge from rehab, he underwent aortic valve replacement surgery. On follow up, he had notable cognitive, speech, and motor improvement with some mild residual deficits. Discussion: This is a rare case of Q fever endocarditis in a patient with a bioprosthetic heart valve and a perivalvular leak on transthoracic echocardiogram who presented with a left MCA embolic stroke. Conclusions: Mortality rate for untreated Q fever endocarditis remains high. Therefore, Q fever should continue to be part of the differential diagnosis in patients who present with acute ischemic stroke in a setting of fever and perivalvular leak.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="a891b741b1cfa2ac1accaf391ee89db8" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":47243006,"asset_id":26980654,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/47243006/download_file?st=MTczMzkxNzc3NCw4LjIyMi4yMDguMTQ2&st=MTczMzkxNzc3NCw4LjIyMi4yMDguMTQ2&s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="26980654"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="26980654"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 26980654; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=26980654]").text(description); $(".js-view-count[data-work-id=26980654]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 26980654; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='26980654']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 26980654, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "a891b741b1cfa2ac1accaf391ee89db8" } } $('.js-work-strip[data-work-id=26980654]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":26980654,"title":"Poster 532 Validation of a Long-Term Post-Stroke Checklist","translated_title":"","metadata":{"ai_title_tag":"Long-Term Checklist Validation Post-Stroke and Q Fever Insights","grobid_abstract":"and aphasia. Computed tomography of the brain showed left M2 middle cerebral artery (MCA) branch occlusion. He met criteria for and received tissue plasminogen activator. Within 3 hours of admission, patient developed rigors, hypotension, fever and lethargy. Pressors and broad-spectrum antibiotics were started. Echocardiogram showed perivalvular leak of the aortic valve prosthesis and no vegetations. Acute infectious endocarditis workup was initially negative. He was transferred to acute rehabilitation unit. Setting: Tertiary care hospital. Results or Clinical Course: Q fever titers returned positive with phase I and phase II IgG Ͼ1:8192, consistent with acute infection. Patient was started on hydroxyquinolone and doxycycline for at least 18 months. He was likely infected with Q fever via contact with infected horse placenta. Initially at the rehabilitation unit, patient had mild cognitive impairments and moderate expressive and receptive aphasia. These deficits gradually improved as did his right hemiparesis, apraxia, and ataxia. Several weeks after discharge from rehab, he underwent aortic valve replacement surgery. On follow up, he had notable cognitive, speech, and motor improvement with some mild residual deficits. Discussion: This is a rare case of Q fever endocarditis in a patient with a bioprosthetic heart valve and a perivalvular leak on transthoracic echocardiogram who presented with a left MCA embolic stroke. Conclusions: Mortality rate for untreated Q fever endocarditis remains high. Therefore, Q fever should continue to be part of the differential diagnosis in patients who present with acute ischemic stroke in a setting of fever and perivalvular leak.","publication_date":{"day":null,"month":null,"year":2012,"errors":{}},"publication_name":"PM\u0026R","grobid_abstract_attachment_id":47243006},"translated_abstract":null,"internal_url":"https://www.academia.edu/26980654/Poster_532_Validation_of_a_Long_Term_Post_Stroke_Checklist","translated_internal_url":"","created_at":"2016-07-14T05:40:28.642-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":33852416,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[],"downloadable_attachments":[{"id":47243006,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/47243006/thumbnails/1.jpg","file_name":"j.pmrj.2012.09.113320160714-7071-1ynwg32.pdf","download_url":"https://www.academia.edu/attachments/47243006/download_file?st=MTczMzkxNzc3NCw4LjIyMi4yMDguMTQ2&st=MTczMzkxNzc3NCw4LjIyMi4yMDguMTQ2&","bulk_download_file_name":"Poster_532_Validation_of_a_Long_Term_Pos.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/47243006/j.pmrj.2012.09.113320160714-7071-1ynwg32-libre.pdf?1468500384=\u0026response-content-disposition=attachment%3B+filename%3DPoster_532_Validation_of_a_Long_Term_Pos.pdf\u0026Expires=1733921374\u0026Signature=cZ0zR8IjECg8c4afXqLqPfKP3C57nn3xA6k2EfrP33mfT7S7IqvT9LyOZWPQqEaxRvg7D0mDE3KSaeHvBOhjbHnDTuwrAiC97VOpEvAgiAcAwwxR7l~tLOe8Aiv6ieyvwv-MEyyJIIydHVquiewfEwq7ItbhOLFoFTKWVtmasS3IHxqcfMGDDGIY3aN5Wz-UDK10gMKUr9L9drk6kdcX0K16cQF0hu4ckx22ba9AW5kzlV0996CBY68ParDh-MW5NnvTqPSv-ewDq7mQW6K7a18u24uHi54aziLgxFjHy3s43Ghif8KKovNvZ6z6ikDKo4aBlR-rCU5b-0MQ8FgazQ__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"slug":"Poster_532_Validation_of_a_Long_Term_Post_Stroke_Checklist","translated_slug":"","page_count":1,"language":"en","content_type":"Work","summary":"and aphasia. Computed tomography of the brain showed left M2 middle cerebral artery (MCA) branch occlusion. He met criteria for and received tissue plasminogen activator. Within 3 hours of admission, patient developed rigors, hypotension, fever and lethargy. Pressors and broad-spectrum antibiotics were started. Echocardiogram showed perivalvular leak of the aortic valve prosthesis and no vegetations. Acute infectious endocarditis workup was initially negative. He was transferred to acute rehabilitation unit. Setting: Tertiary care hospital. Results or Clinical Course: Q fever titers returned positive with phase I and phase II IgG Ͼ1:8192, consistent with acute infection. Patient was started on hydroxyquinolone and doxycycline for at least 18 months. He was likely infected with Q fever via contact with infected horse placenta. Initially at the rehabilitation unit, patient had mild cognitive impairments and moderate expressive and receptive aphasia. These deficits gradually improved as did his right hemiparesis, apraxia, and ataxia. Several weeks after discharge from rehab, he underwent aortic valve replacement surgery. On follow up, he had notable cognitive, speech, and motor improvement with some mild residual deficits. Discussion: This is a rare case of Q fever endocarditis in a patient with a bioprosthetic heart valve and a perivalvular leak on transthoracic echocardiogram who presented with a left MCA embolic stroke. Conclusions: Mortality rate for untreated Q fever endocarditis remains high. Therefore, Q fever should continue to be part of the differential diagnosis in patients who present with acute ischemic stroke in a setting of fever and perivalvular leak.","owner":{"id":33852416,"first_name":"Marion","middle_initials":"L","last_name":"Walker","page_name":"MarionWalker","domain_name":"utah","created_at":"2015-08-12T08:15:14.624-07:00","display_name":"Marion L Walker","url":"https://utah.academia.edu/MarionWalker"},"attachments":[{"id":47243006,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/47243006/thumbnails/1.jpg","file_name":"j.pmrj.2012.09.113320160714-7071-1ynwg32.pdf","download_url":"https://www.academia.edu/attachments/47243006/download_file?st=MTczMzkxNzc3NCw4LjIyMi4yMDguMTQ2&st=MTczMzkxNzc3NCw4LjIyMi4yMDguMTQ2&","bulk_download_file_name":"Poster_532_Validation_of_a_Long_Term_Pos.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/47243006/j.pmrj.2012.09.113320160714-7071-1ynwg32-libre.pdf?1468500384=\u0026response-content-disposition=attachment%3B+filename%3DPoster_532_Validation_of_a_Long_Term_Pos.pdf\u0026Expires=1733921374\u0026Signature=cZ0zR8IjECg8c4afXqLqPfKP3C57nn3xA6k2EfrP33mfT7S7IqvT9LyOZWPQqEaxRvg7D0mDE3KSaeHvBOhjbHnDTuwrAiC97VOpEvAgiAcAwwxR7l~tLOe8Aiv6ieyvwv-MEyyJIIydHVquiewfEwq7ItbhOLFoFTKWVtmasS3IHxqcfMGDDGIY3aN5Wz-UDK10gMKUr9L9drk6kdcX0K16cQF0hu4ckx22ba9AW5kzlV0996CBY68ParDh-MW5NnvTqPSv-ewDq7mQW6K7a18u24uHi54aziLgxFjHy3s43Ghif8KKovNvZ6z6ikDKo4aBlR-rCU5b-0MQ8FgazQ__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"research_interests":[{"id":244814,"name":"Clinical Sciences","url":"https://www.academia.edu/Documents/in/Clinical_Sciences"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="21730917"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/21730917/Stereotactic_endoscopic_placement_of_third_ventricle_catheter_for_long_term_infusion_of_baclofen_in_patients_with_secondary_generalized_dystonia"><img alt="Research paper thumbnail of Stereotactic endoscopic placement of third ventricle catheter for long-term infusion of baclofen in patients with secondary generalized dystonia" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/21730917/Stereotactic_endoscopic_placement_of_third_ventricle_catheter_for_long_term_infusion_of_baclofen_in_patients_with_secondary_generalized_dystonia">Stereotactic endoscopic placement of third ventricle catheter for long-term infusion of baclofen in patients with secondary generalized dystonia</a></div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/GoochJudith">Judith Gooch</a> and <a class="" data-click-track="profile-work-strip-authors" href="https://utah.academia.edu/MarionWalker">Marion L Walker</a></span></div><div class="wp-workCard_item"><span>Journal of neurosurgery. Pediatrics</span><span>, 2012</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Continuous infusion of baclofen is a treatment option for severe generalized dystonia. Catheter i...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Continuous infusion of baclofen is a treatment option for severe generalized dystonia. Catheter insertion within the third ventricle has been described as an alternative to standard intrathecal placement to maximize intracranial concentrations of baclofen. The authors describe their experience with a novel technique for stereotactic endoscopic insertion of baclofen infusion catheters in the third ventricle in 3 patients with severe secondary generalized dystonia. Insertion was successful in all 3 patients, and all of them experienced significant improvement in dystonia scores on the Barry-Albright Dystonia Scale. Follow-up ranged from 5.5 to 7 months (mean 6 months), and no mechanical complications or CSF leaks were observed. The stereotactic endoscopic insertion of a baclofen infusion catheter into the third ventricle appears to be a safe method for continuous intraventricular baclofen infusion in patients with generalized secondary dystonia.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="21730917"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="21730917"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 21730917; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=21730917]").text(description); $(".js-view-count[data-work-id=21730917]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 21730917; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='21730917']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 21730917, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=21730917]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":21730917,"title":"Stereotactic endoscopic placement of third ventricle catheter for long-term infusion of baclofen in patients with secondary generalized dystonia","translated_title":"","metadata":{"abstract":"Continuous infusion of baclofen is a treatment option for severe generalized dystonia. Catheter insertion within the third ventricle has been described as an alternative to standard intrathecal placement to maximize intracranial concentrations of baclofen. The authors describe their experience with a novel technique for stereotactic endoscopic insertion of baclofen infusion catheters in the third ventricle in 3 patients with severe secondary generalized dystonia. Insertion was successful in all 3 patients, and all of them experienced significant improvement in dystonia scores on the Barry-Albright Dystonia Scale. Follow-up ranged from 5.5 to 7 months (mean 6 months), and no mechanical complications or CSF leaks were observed. The stereotactic endoscopic insertion of a baclofen infusion catheter into the third ventricle appears to be a safe method for continuous intraventricular baclofen infusion in patients with generalized secondary dystonia.","publication_date":{"day":null,"month":null,"year":2012,"errors":{}},"publication_name":"Journal of neurosurgery. Pediatrics"},"translated_abstract":"Continuous infusion of baclofen is a treatment option for severe generalized dystonia. Catheter insertion within the third ventricle has been described as an alternative to standard intrathecal placement to maximize intracranial concentrations of baclofen. The authors describe their experience with a novel technique for stereotactic endoscopic insertion of baclofen infusion catheters in the third ventricle in 3 patients with severe secondary generalized dystonia. Insertion was successful in all 3 patients, and all of them experienced significant improvement in dystonia scores on the Barry-Albright Dystonia Scale. Follow-up ranged from 5.5 to 7 months (mean 6 months), and no mechanical complications or CSF leaks were observed. The stereotactic endoscopic insertion of a baclofen infusion catheter into the third ventricle appears to be a safe method for continuous intraventricular baclofen infusion in patients with generalized secondary dystonia.","internal_url":"https://www.academia.edu/21730917/Stereotactic_endoscopic_placement_of_third_ventricle_catheter_for_long_term_infusion_of_baclofen_in_patients_with_secondary_generalized_dystonia","translated_internal_url":"","created_at":"2016-02-09T06:53:12.841-08:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":42923259,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":15027093,"work_id":21730917,"tagging_user_id":42923259,"tagged_user_id":33852416,"co_author_invite_id":null,"email":"m***r@hsc.utah.edu","affiliation":"University of Utah","display_order":0,"name":"Marion L Walker","title":"Stereotactic endoscopic placement of third ventricle catheter for long-term infusion of baclofen in patients with secondary generalized dystonia"},{"id":22578499,"work_id":21730917,"tagging_user_id":33852416,"tagged_user_id":null,"co_author_invite_id":503368,"email":"r***o@hsc.utah.edu","display_order":4194304,"name":"Robert Bollo","title":"Stereotactic endoscopic placement of third ventricle catheter for long-term infusion of baclofen in patients with secondary generalized dystonia"}],"downloadable_attachments":[],"slug":"Stereotactic_endoscopic_placement_of_third_ventricle_catheter_for_long_term_infusion_of_baclofen_in_patients_with_secondary_generalized_dystonia","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"Continuous infusion of baclofen is a treatment option for severe generalized dystonia. Catheter insertion within the third ventricle has been described as an alternative to standard intrathecal placement to maximize intracranial concentrations of baclofen. The authors describe their experience with a novel technique for stereotactic endoscopic insertion of baclofen infusion catheters in the third ventricle in 3 patients with severe secondary generalized dystonia. Insertion was successful in all 3 patients, and all of them experienced significant improvement in dystonia scores on the Barry-Albright Dystonia Scale. Follow-up ranged from 5.5 to 7 months (mean 6 months), and no mechanical complications or CSF leaks were observed. The stereotactic endoscopic insertion of a baclofen infusion catheter into the third ventricle appears to be a safe method for continuous intraventricular baclofen infusion in patients with generalized secondary dystonia.","owner":{"id":42923259,"first_name":"Judith","middle_initials":null,"last_name":"Gooch","page_name":"GoochJudith","domain_name":"independent","created_at":"2016-02-09T06:52:47.536-08:00","display_name":"Judith Gooch","url":"https://independent.academia.edu/GoochJudith"},"attachments":[],"research_interests":[{"id":22506,"name":"Adolescent","url":"https://www.academia.edu/Documents/in/Adolescent"},{"id":64933,"name":"Child","url":"https://www.academia.edu/Documents/in/Child"},{"id":298288,"name":"Baclofen","url":"https://www.academia.edu/Documents/in/Baclofen"},{"id":451510,"name":"Neuroendoscopy","url":"https://www.academia.edu/Documents/in/Neuroendoscopy"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="26980653"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/26980653/Shunt_failure_due_to_intracranial_migration_of_BioGlide_ventricular_catheters"><img alt="Research paper thumbnail of Shunt failure due to intracranial migration of BioGlide ventricular catheters" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/26980653/Shunt_failure_due_to_intracranial_migration_of_BioGlide_ventricular_catheters">Shunt failure due to intracranial migration of BioGlide ventricular catheters</a></div><div class="wp-workCard_item"><span>Journal of neurosurgery. Pediatrics</span><span>, 2011</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">In late 2008, the authors recognized a new type of ventriculoperitoneal shunt failure specific to...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">In late 2008, the authors recognized a new type of ventriculoperitoneal shunt failure specific to the Bio-Glide Snap Shunt ventricular catheters. This prompted a retrospective review of the patient cohort and resulted in a recall by the FDA in the US. After the index cases were identified, the FDA was notified by the hospital, leading to a recall of the product. Hospital operative logs were used to identify patients in whom the affected products were used. A letter describing the risk was sent to all patients offering a free screening CT scan to look for disconnection. A call center was established to respond to patient questions, and an informational video was made available on the hospital website. The authors reviewed the records of the index cases and other cases subsequently identified. Seven index cases and an additional 16 cases of disconnection were identified in the 466 patients in whom a BioGlide Snap Shunt ventricular catheter had been implanted. Mean time to disconnectio...</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="26980653"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="26980653"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 26980653; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=26980653]").text(description); $(".js-view-count[data-work-id=26980653]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 26980653; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='26980653']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 26980653, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=26980653]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":26980653,"title":"Shunt failure due to intracranial migration of BioGlide ventricular catheters","translated_title":"","metadata":{"abstract":"In late 2008, the authors recognized a new type of ventriculoperitoneal shunt failure specific to the Bio-Glide Snap Shunt ventricular catheters. This prompted a retrospective review of the patient cohort and resulted in a recall by the FDA in the US. After the index cases were identified, the FDA was notified by the hospital, leading to a recall of the product. Hospital operative logs were used to identify patients in whom the affected products were used. A letter describing the risk was sent to all patients offering a free screening CT scan to look for disconnection. A call center was established to respond to patient questions, and an informational video was made available on the hospital website. The authors reviewed the records of the index cases and other cases subsequently identified. Seven index cases and an additional 16 cases of disconnection were identified in the 466 patients in whom a BioGlide Snap Shunt ventricular catheter had been implanted. Mean time to disconnectio...","publication_date":{"day":null,"month":null,"year":2011,"errors":{}},"publication_name":"Journal of neurosurgery. Pediatrics"},"translated_abstract":"In late 2008, the authors recognized a new type of ventriculoperitoneal shunt failure specific to the Bio-Glide Snap Shunt ventricular catheters. This prompted a retrospective review of the patient cohort and resulted in a recall by the FDA in the US. After the index cases were identified, the FDA was notified by the hospital, leading to a recall of the product. Hospital operative logs were used to identify patients in whom the affected products were used. A letter describing the risk was sent to all patients offering a free screening CT scan to look for disconnection. A call center was established to respond to patient questions, and an informational video was made available on the hospital website. The authors reviewed the records of the index cases and other cases subsequently identified. Seven index cases and an additional 16 cases of disconnection were identified in the 466 patients in whom a BioGlide Snap Shunt ventricular catheter had been implanted. Mean time to disconnectio...","internal_url":"https://www.academia.edu/26980653/Shunt_failure_due_to_intracranial_migration_of_BioGlide_ventricular_catheters","translated_internal_url":"","created_at":"2016-07-14T05:40:27.969-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":33852416,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[],"downloadable_attachments":[],"slug":"Shunt_failure_due_to_intracranial_migration_of_BioGlide_ventricular_catheters","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"In late 2008, the authors recognized a new type of ventriculoperitoneal shunt failure specific to the Bio-Glide Snap Shunt ventricular catheters. This prompted a retrospective review of the patient cohort and resulted in a recall by the FDA in the US. After the index cases were identified, the FDA was notified by the hospital, leading to a recall of the product. Hospital operative logs were used to identify patients in whom the affected products were used. A letter describing the risk was sent to all patients offering a free screening CT scan to look for disconnection. A call center was established to respond to patient questions, and an informational video was made available on the hospital website. The authors reviewed the records of the index cases and other cases subsequently identified. Seven index cases and an additional 16 cases of disconnection were identified in the 466 patients in whom a BioGlide Snap Shunt ventricular catheter had been implanted. Mean time to disconnectio...","owner":{"id":33852416,"first_name":"Marion","middle_initials":"L","last_name":"Walker","page_name":"MarionWalker","domain_name":"utah","created_at":"2015-08-12T08:15:14.624-07:00","display_name":"Marion L Walker","url":"https://utah.academia.edu/MarionWalker"},"attachments":[],"research_interests":[{"id":8207,"name":"Risk","url":"https://www.academia.edu/Documents/in/Risk"},{"id":134346,"name":"Infant","url":"https://www.academia.edu/Documents/in/Infant"},{"id":745088,"name":"FOREIGN BODY MIGRATION","url":"https://www.academia.edu/Documents/in/FOREIGN_BODY_MIGRATION"},{"id":773847,"name":"Catheters","url":"https://www.academia.edu/Documents/in/Catheters"},{"id":959921,"name":"X ray Computed Tomography","url":"https://www.academia.edu/Documents/in/X_ray_Computed_Tomography"},{"id":1423078,"name":"Nervous System Diseases","url":"https://www.academia.edu/Documents/in/Nervous_System_Diseases"},{"id":2482067,"name":"Reoperation","url":"https://www.academia.edu/Documents/in/Reoperation"},{"id":2489700,"name":"Child preschool","url":"https://www.academia.edu/Documents/in/Child_preschool"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="26980652"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/26980652/The_posterior_petrosal_approach_technique_and_applications_in_pediatric_neurosurgery"><img alt="Research paper thumbnail of The posterior petrosal approach: technique and applications in pediatric neurosurgery" class="work-thumbnail" src="https://attachments.academia-assets.com/47243005/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/26980652/The_posterior_petrosal_approach_technique_and_applications_in_pediatric_neurosurgery">The posterior petrosal approach: technique and applications in pediatric neurosurgery</a></div><div class="wp-workCard_item"><span>Journal of neurosurgery. Pediatrics</span><span>, 2009</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Various lesions occur in deep locations or at the skull base in pediatric patients and require sk...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Various lesions occur in deep locations or at the skull base in pediatric patients and require skull base approaches for resection. Skull base surgery confers the advantages of improved line of sight, a wider operative corridor, and reduced brain retraction. The posterior petrosal approach provides simultaneous access to lesions in the posterior middle fossa and posterior fossa from the top of the clivus to the level of the jugular foramen. It allows visualization of the ventrolateral brainstem and may be combined with various other supra- and infratentorial approaches, thus giving the surgeon a wide array of access routes to the lesion. The authors conducted a retrospective review of all cases involving pediatric patients undergoing a posterior petrosal approach, either alone or in combination with other cranial approaches. Preoperative and postoperative data were collected, including presentation, neurological examination, imaging findings, pathological condition, operative detail...</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="8aaa456843e78db127c991901c4f631e" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":47243005,"asset_id":26980652,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/47243005/download_file?st=MTczMzkxNzc3NCw4LjIyMi4yMDguMTQ2&st=MTczMzkxNzc3NCw4LjIyMi4yMDguMTQ2&s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="26980652"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="26980652"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 26980652; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=26980652]").text(description); $(".js-view-count[data-work-id=26980652]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 26980652; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='26980652']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 26980652, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "8aaa456843e78db127c991901c4f631e" } } $('.js-work-strip[data-work-id=26980652]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":26980652,"title":"The posterior petrosal approach: technique and applications in pediatric neurosurgery","translated_title":"","metadata":{"abstract":"Various lesions occur in deep locations or at the skull base in pediatric patients and require skull base approaches for resection. Skull base surgery confers the advantages of improved line of sight, a wider operative corridor, and reduced brain retraction. The posterior petrosal approach provides simultaneous access to lesions in the posterior middle fossa and posterior fossa from the top of the clivus to the level of the jugular foramen. It allows visualization of the ventrolateral brainstem and may be combined with various other supra- and infratentorial approaches, thus giving the surgeon a wide array of access routes to the lesion. The authors conducted a retrospective review of all cases involving pediatric patients undergoing a posterior petrosal approach, either alone or in combination with other cranial approaches. Preoperative and postoperative data were collected, including presentation, neurological examination, imaging findings, pathological condition, operative detail...","publication_date":{"day":null,"month":null,"year":2009,"errors":{}},"publication_name":"Journal of neurosurgery. Pediatrics"},"translated_abstract":"Various lesions occur in deep locations or at the skull base in pediatric patients and require skull base approaches for resection. Skull base surgery confers the advantages of improved line of sight, a wider operative corridor, and reduced brain retraction. The posterior petrosal approach provides simultaneous access to lesions in the posterior middle fossa and posterior fossa from the top of the clivus to the level of the jugular foramen. It allows visualization of the ventrolateral brainstem and may be combined with various other supra- and infratentorial approaches, thus giving the surgeon a wide array of access routes to the lesion. The authors conducted a retrospective review of all cases involving pediatric patients undergoing a posterior petrosal approach, either alone or in combination with other cranial approaches. Preoperative and postoperative data were collected, including presentation, neurological examination, imaging findings, pathological condition, operative detail...","internal_url":"https://www.academia.edu/26980652/The_posterior_petrosal_approach_technique_and_applications_in_pediatric_neurosurgery","translated_internal_url":"","created_at":"2016-07-14T05:40:27.718-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":33852416,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[],"downloadable_attachments":[{"id":47243005,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/47243005/thumbnails/1.jpg","file_name":"The_posterior_petrosal_approach_Techniqu20160714-1086-1ludnaz.pdf","download_url":"https://www.academia.edu/attachments/47243005/download_file?st=MTczMzkxNzc3NCw4LjIyMi4yMDguMTQ2&st=MTczMzkxNzc3NCw4LjIyMi4yMDguMTQ2&","bulk_download_file_name":"The_posterior_petrosal_approach_techniqu.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/47243005/The_posterior_petrosal_approach_Techniqu20160714-1086-1ludnaz-libre.pdf?1468500401=\u0026response-content-disposition=attachment%3B+filename%3DThe_posterior_petrosal_approach_techniqu.pdf\u0026Expires=1733921374\u0026Signature=B2U8EBr7I6gpyHUYmFaKoMH0p6M7U-BU2mAcUihzGumE~baxMKz~R1O9ROUzTQN4-dzp5Id5SvCITnnphFbTnuWSq531ACIOMz9Kk70W~1l19RXpmTQDsBPpKo7G5Zr-hi7u5l7U44QcSWQXW3cQXRCdnVW41fxbJanLYuDBnGHVU9Hrf3UeilKQlDKWiXVPchIPgytkJ04ZwueiKTaKUuHWvwbTWFKNxkuhAxAnUbn7D9hKrzzF2AaKSnubK298hF7XOuCN6G7nROUp4k3NAjUqQAZZWZlW7fCgTcNplyDWff5rwVO7cAkwwpokr6KAfkUDlFi5M3fokt31-58V8Q__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"slug":"The_posterior_petrosal_approach_technique_and_applications_in_pediatric_neurosurgery","translated_slug":"","page_count":5,"language":"en","content_type":"Work","summary":"Various lesions occur in deep locations or at the skull base in pediatric patients and require skull base approaches for resection. Skull base surgery confers the advantages of improved line of sight, a wider operative corridor, and reduced brain retraction. The posterior petrosal approach provides simultaneous access to lesions in the posterior middle fossa and posterior fossa from the top of the clivus to the level of the jugular foramen. It allows visualization of the ventrolateral brainstem and may be combined with various other supra- and infratentorial approaches, thus giving the surgeon a wide array of access routes to the lesion. The authors conducted a retrospective review of all cases involving pediatric patients undergoing a posterior petrosal approach, either alone or in combination with other cranial approaches. 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="26980651"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/26980651/Risk_factors_and_rates_of_bone_flap_resorption_in_pediatric_patients_after_decompressive_craniectomy_for_traumatic_brain_injury"><img alt="Research paper thumbnail of Risk factors and rates of bone flap resorption in pediatric patients after decompressive craniectomy for traumatic brain injury" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/26980651/Risk_factors_and_rates_of_bone_flap_resorption_in_pediatric_patients_after_decompressive_craniectomy_for_traumatic_brain_injury">Risk factors and rates of bone flap resorption in pediatric patients after decompressive craniectomy for traumatic brain injury</a></div><div class="wp-workCard_item"><span>Journal of Neurosurgery: Pediatrics</span><span>, 2013</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Decompressive craniectomy with subsequent autologous cranioplasty, or the replacement of the nati...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Decompressive craniectomy with subsequent autologous cranioplasty, or the replacement of the native bone flap, is often used for pediatric patients with traumatic brain injury (TBI) who have a mass lesion and intractable intracranial hypertension. Bone flap resorption is common after bone flap replacement, necessitating additional surgery. The authors reviewed their large database of pediatric patients with TBI who underwent decompressive craniectomy followed by bone flap replacement to determine the rate of bone flap resorption and identify associated risk factors. A retrospective cohort chart review was performed to identify long-term survivors who underwent decompressive craniectomy for severe TBI with bone flap replacement from January 1, 1996, to December 31, 2011. The risk factors investigated in a univariate statistical analysis were age, sex, underlying parenchymal contusion, Glasgow Coma Scale score on arrival, comminuted skull fracture, posttraumatic hydrocephalus, bone flap wound infection, and freezer time (the amount of time the bone flap was stored in the freezer before replacement). A multivariate logistic regression model was then used to determine which of these were independent risk factors for bone flap resorption. Bone flap replacement was performed at an average of 2.1 months after decompressive craniectomy. Of the 54 patients identified (35 boys, 19 girls; mean age 6.2 years), 27 (50.0%) experienced bone flap resorption after an average of 4.8 months. Underlying parenchymal contusion, comminuted skull fracture, age ≤ 2.5 years, and posttraumatic hydrocephalus were significant, or nearly significant, on univariate analysis. Multivariate analysis identified underlying contusion (p = 0.004, OR 34.4, 95% CI 3.0-392.7), comminuted skull fractures (p = 0.046, OR 8.5, 95% CI 1.0-69.6), posttraumatic hydrocephalus (p = 0.005, OR 35.9, 95% CI 2.9-436.6), and age ≤ 2.5 years old (p = 0.01, OR 23.1, 95% CI 2.1-257.7) as independent risk factors for bone flap resorption. After decompressive craniectomy for pediatric TBI, half of the patients (50%) who underwent bone flap replacement experienced resorption. Multivariate analysis indicated young age (≤ 2.5 years), hydrocephalus, underlying contusion as opposed to a hemispheric acute subdural hematoma, and a comminuted skull fracture were all independent risk factors for bone flap resorption. Freezer time was not found to be associated with bone flap resorption.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="26980651"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="26980651"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 26980651; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=26980651]").text(description); $(".js-view-count[data-work-id=26980651]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 26980651; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='26980651']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 26980651, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=26980651]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":26980651,"title":"Risk factors and rates of bone flap resorption in pediatric patients after decompressive craniectomy for traumatic brain injury","translated_title":"","metadata":{"abstract":"Decompressive craniectomy with subsequent autologous cranioplasty, or the replacement of the native bone flap, is often used for pediatric patients with traumatic brain injury (TBI) who have a mass lesion and intractable intracranial hypertension. Bone flap resorption is common after bone flap replacement, necessitating additional surgery. The authors reviewed their large database of pediatric patients with TBI who underwent decompressive craniectomy followed by bone flap replacement to determine the rate of bone flap resorption and identify associated risk factors. A retrospective cohort chart review was performed to identify long-term survivors who underwent decompressive craniectomy for severe TBI with bone flap replacement from January 1, 1996, to December 31, 2011. The risk factors investigated in a univariate statistical analysis were age, sex, underlying parenchymal contusion, Glasgow Coma Scale score on arrival, comminuted skull fracture, posttraumatic hydrocephalus, bone flap wound infection, and freezer time (the amount of time the bone flap was stored in the freezer before replacement). A multivariate logistic regression model was then used to determine which of these were independent risk factors for bone flap resorption. Bone flap replacement was performed at an average of 2.1 months after decompressive craniectomy. Of the 54 patients identified (35 boys, 19 girls; mean age 6.2 years), 27 (50.0%) experienced bone flap resorption after an average of 4.8 months. Underlying parenchymal contusion, comminuted skull fracture, age ≤ 2.5 years, and posttraumatic hydrocephalus were significant, or nearly significant, on univariate analysis. Multivariate analysis identified underlying contusion (p = 0.004, OR 34.4, 95% CI 3.0-392.7), comminuted skull fractures (p = 0.046, OR 8.5, 95% CI 1.0-69.6), posttraumatic hydrocephalus (p = 0.005, OR 35.9, 95% CI 2.9-436.6), and age ≤ 2.5 years old (p = 0.01, OR 23.1, 95% CI 2.1-257.7) as independent risk factors for bone flap resorption. After decompressive craniectomy for pediatric TBI, half of the patients (50%) who underwent bone flap replacement experienced resorption. Multivariate analysis indicated young age (≤ 2.5 years), hydrocephalus, underlying contusion as opposed to a hemispheric acute subdural hematoma, and a comminuted skull fracture were all independent risk factors for bone flap resorption. Freezer time was not found to be associated with bone flap resorption.","publication_date":{"day":null,"month":null,"year":2013,"errors":{}},"publication_name":"Journal of Neurosurgery: Pediatrics"},"translated_abstract":"Decompressive craniectomy with subsequent autologous cranioplasty, or the replacement of the native bone flap, is often used for pediatric patients with traumatic brain injury (TBI) who have a mass lesion and intractable intracranial hypertension. Bone flap resorption is common after bone flap replacement, necessitating additional surgery. The authors reviewed their large database of pediatric patients with TBI who underwent decompressive craniectomy followed by bone flap replacement to determine the rate of bone flap resorption and identify associated risk factors. A retrospective cohort chart review was performed to identify long-term survivors who underwent decompressive craniectomy for severe TBI with bone flap replacement from January 1, 1996, to December 31, 2011. The risk factors investigated in a univariate statistical analysis were age, sex, underlying parenchymal contusion, Glasgow Coma Scale score on arrival, comminuted skull fracture, posttraumatic hydrocephalus, bone flap wound infection, and freezer time (the amount of time the bone flap was stored in the freezer before replacement). A multivariate logistic regression model was then used to determine which of these were independent risk factors for bone flap resorption. Bone flap replacement was performed at an average of 2.1 months after decompressive craniectomy. Of the 54 patients identified (35 boys, 19 girls; mean age 6.2 years), 27 (50.0%) experienced bone flap resorption after an average of 4.8 months. Underlying parenchymal contusion, comminuted skull fracture, age ≤ 2.5 years, and posttraumatic hydrocephalus were significant, or nearly significant, on univariate analysis. Multivariate analysis identified underlying contusion (p = 0.004, OR 34.4, 95% CI 3.0-392.7), comminuted skull fractures (p = 0.046, OR 8.5, 95% CI 1.0-69.6), posttraumatic hydrocephalus (p = 0.005, OR 35.9, 95% CI 2.9-436.6), and age ≤ 2.5 years old (p = 0.01, OR 23.1, 95% CI 2.1-257.7) as independent risk factors for bone flap resorption. After decompressive craniectomy for pediatric TBI, half of the patients (50%) who underwent bone flap replacement experienced resorption. Multivariate analysis indicated young age (≤ 2.5 years), hydrocephalus, underlying contusion as opposed to a hemispheric acute subdural hematoma, and a comminuted skull fracture were all independent risk factors for bone flap resorption. Freezer time was not found to be associated with bone flap resorption.","internal_url":"https://www.academia.edu/26980651/Risk_factors_and_rates_of_bone_flap_resorption_in_pediatric_patients_after_decompressive_craniectomy_for_traumatic_brain_injury","translated_internal_url":"","created_at":"2016-07-14T05:40:27.544-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":33852416,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[],"downloadable_attachments":[],"slug":"Risk_factors_and_rates_of_bone_flap_resorption_in_pediatric_patients_after_decompressive_craniectomy_for_traumatic_brain_injury","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"Decompressive craniectomy with subsequent autologous cranioplasty, or the replacement of the native bone flap, is often used for pediatric patients with traumatic brain injury (TBI) who have a mass lesion and intractable intracranial hypertension. Bone flap resorption is common after bone flap replacement, necessitating additional surgery. The authors reviewed their large database of pediatric patients with TBI who underwent decompressive craniectomy followed by bone flap replacement to determine the rate of bone flap resorption and identify associated risk factors. A retrospective cohort chart review was performed to identify long-term survivors who underwent decompressive craniectomy for severe TBI with bone flap replacement from January 1, 1996, to December 31, 2011. The risk factors investigated in a univariate statistical analysis were age, sex, underlying parenchymal contusion, Glasgow Coma Scale score on arrival, comminuted skull fracture, posttraumatic hydrocephalus, bone flap wound infection, and freezer time (the amount of time the bone flap was stored in the freezer before replacement). A multivariate logistic regression model was then used to determine which of these were independent risk factors for bone flap resorption. Bone flap replacement was performed at an average of 2.1 months after decompressive craniectomy. Of the 54 patients identified (35 boys, 19 girls; mean age 6.2 years), 27 (50.0%) experienced bone flap resorption after an average of 4.8 months. Underlying parenchymal contusion, comminuted skull fracture, age ≤ 2.5 years, and posttraumatic hydrocephalus were significant, or nearly significant, on univariate analysis. Multivariate analysis identified underlying contusion (p = 0.004, OR 34.4, 95% CI 3.0-392.7), comminuted skull fractures (p = 0.046, OR 8.5, 95% CI 1.0-69.6), posttraumatic hydrocephalus (p = 0.005, OR 35.9, 95% CI 2.9-436.6), and age ≤ 2.5 years old (p = 0.01, OR 23.1, 95% CI 2.1-257.7) as independent risk factors for bone flap resorption. After decompressive craniectomy for pediatric TBI, half of the patients (50%) who underwent bone flap replacement experienced resorption. Multivariate analysis indicated young age (≤ 2.5 years), hydrocephalus, underlying contusion as opposed to a hemispheric acute subdural hematoma, and a comminuted skull fracture were all independent risk factors for bone flap resorption. Freezer time was not found to be associated with bone flap resorption.","owner":{"id":33852416,"first_name":"Marion","middle_initials":"L","last_name":"Walker","page_name":"MarionWalker","domain_name":"utah","created_at":"2015-08-12T08:15:14.624-07:00","display_name":"Marion L Walker","url":"https://utah.academia.edu/MarionWalker"},"attachments":[],"research_interests":[{"id":12426,"name":"Treatment Outcome","url":"https://www.academia.edu/Documents/in/Treatment_Outcome"},{"id":19295,"name":"Cryopreservation","url":"https://www.academia.edu/Documents/in/Cryopreservation"},{"id":60974,"name":"Hydrocephalus","url":"https://www.academia.edu/Documents/in/Hydrocephalus"},{"id":64933,"name":"Child","url":"https://www.academia.edu/Documents/in/Child"},{"id":132366,"name":"Glasgow Coma Scale","url":"https://www.academia.edu/Documents/in/Glasgow_Coma_Scale"},{"id":192721,"name":"Risk factors","url":"https://www.academia.edu/Documents/in/Risk_factors"},{"id":196189,"name":"Sample Size","url":"https://www.academia.edu/Documents/in/Sample_Size"},{"id":413192,"name":"Sex Factors","url":"https://www.academia.edu/Documents/in/Sex_Factors"},{"id":413194,"name":"Analysis of Variance","url":"https://www.academia.edu/Documents/in/Analysis_of_Variance"},{"id":413195,"name":"Time Factors","url":"https://www.academia.edu/Documents/in/Time_Factors"},{"id":469105,"name":"Retrospective Studies","url":"https://www.academia.edu/Documents/in/Retrospective_Studies"},{"id":546419,"name":"Age Factors","url":"https://www.academia.edu/Documents/in/Age_Factors"},{"id":620049,"name":"Risk Factors","url":"https://www.academia.edu/Documents/in/Risk_Factors-1"},{"id":874382,"name":"Medical Records","url":"https://www.academia.edu/Documents/in/Medical_Records"},{"id":959921,"name":"X ray Computed Tomography","url":"https://www.academia.edu/Documents/in/X_ray_Computed_Tomography"},{"id":1294607,"name":"Logistic Models","url":"https://www.academia.edu/Documents/in/Logistic_Models"},{"id":1399820,"name":"Bone Resorption","url":"https://www.academia.edu/Documents/in/Bone_Resorption"},{"id":1515979,"name":"Decompressive Craniectomy","url":"https://www.academia.edu/Documents/in/Decompressive_Craniectomy"},{"id":2450733,"name":"Brain injuries","url":"https://www.academia.edu/Documents/in/Brain_injuries"},{"id":2482067,"name":"Reoperation","url":"https://www.academia.edu/Documents/in/Reoperation"},{"id":2489700,"name":"Child preschool","url":"https://www.academia.edu/Documents/in/Child_preschool"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="26980650"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/26980650/Spinal_arteriovenous_fistulas_in_children_with_hereditary_hemorrhagic_telangiectasia"><img alt="Research paper thumbnail of Spinal arteriovenous fistulas in children with hereditary hemorrhagic telangiectasia" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/26980650/Spinal_arteriovenous_fistulas_in_children_with_hereditary_hemorrhagic_telangiectasia">Spinal arteriovenous fistulas in children with hereditary hemorrhagic telangiectasia</a></div><div class="wp-workCard_item"><span>Journal of Neurosurgery: Pediatrics</span><span>, 2012</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant angiodysplasia with high pen...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant angiodysplasia with high penetrance and variable expression. The manifestations of HHT are often age related, and spinal arteriovenous fistula (AVF) may be the initial presentation of HHT in young children. Because spinal AVFs are rarely reported, however, screening is not incorporated into current clinical recommendations for the treatment of patients with HHT. The authors describe 2 cases of children younger than 2 years of age with acute neurological deterioration in the context of a spinal AVF and in whom HHT was subsequently diagnosed. One patient presented with intraventricular and subarachnoid hemorrhage and the other with acute thrombosis of an intramedullary varix. These cases highlight the potential for significant neurological morbidity from a symptomatic AVF in very young children with HHT. Given the lack of data regarding the true incidence and natural history of these lesions, these cases raise the question of whether spinal cord imaging should be incorporated into screening recommendations for patients with HHT.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="26980650"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="26980650"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 26980650; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=26980650]").text(description); $(".js-view-count[data-work-id=26980650]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 26980650; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='26980650']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 26980650, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=26980650]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":26980650,"title":"Spinal arteriovenous fistulas in children with hereditary hemorrhagic telangiectasia","translated_title":"","metadata":{"abstract":"Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant angiodysplasia with high penetrance and variable expression. The manifestations of HHT are often age related, and spinal arteriovenous fistula (AVF) may be the initial presentation of HHT in young children. Because spinal AVFs are rarely reported, however, screening is not incorporated into current clinical recommendations for the treatment of patients with HHT. The authors describe 2 cases of children younger than 2 years of age with acute neurological deterioration in the context of a spinal AVF and in whom HHT was subsequently diagnosed. One patient presented with intraventricular and subarachnoid hemorrhage and the other with acute thrombosis of an intramedullary varix. These cases highlight the potential for significant neurological morbidity from a symptomatic AVF in very young children with HHT. Given the lack of data regarding the true incidence and natural history of these lesions, these cases raise the question of whether spinal cord imaging should be incorporated into screening recommendations for patients with HHT.","publication_date":{"day":null,"month":null,"year":2012,"errors":{}},"publication_name":"Journal of Neurosurgery: Pediatrics"},"translated_abstract":"Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant angiodysplasia with high penetrance and variable expression. The manifestations of HHT are often age related, and spinal arteriovenous fistula (AVF) may be the initial presentation of HHT in young children. Because spinal AVFs are rarely reported, however, screening is not incorporated into current clinical recommendations for the treatment of patients with HHT. The authors describe 2 cases of children younger than 2 years of age with acute neurological deterioration in the context of a spinal AVF and in whom HHT was subsequently diagnosed. One patient presented with intraventricular and subarachnoid hemorrhage and the other with acute thrombosis of an intramedullary varix. These cases highlight the potential for significant neurological morbidity from a symptomatic AVF in very young children with HHT. Given the lack of data regarding the true incidence and natural history of these lesions, these cases raise the question of whether spinal cord imaging should be incorporated into screening recommendations for patients with HHT.","internal_url":"https://www.academia.edu/26980650/Spinal_arteriovenous_fistulas_in_children_with_hereditary_hemorrhagic_telangiectasia","translated_internal_url":"","created_at":"2016-07-14T05:40:27.379-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":33852416,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[],"downloadable_attachments":[],"slug":"Spinal_arteriovenous_fistulas_in_children_with_hereditary_hemorrhagic_telangiectasia","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant angiodysplasia with high penetrance and variable expression. The manifestations of HHT are often age related, and spinal arteriovenous fistula (AVF) may be the initial presentation of HHT in young children. Because spinal AVFs are rarely reported, however, screening is not incorporated into current clinical recommendations for the treatment of patients with HHT. The authors describe 2 cases of children younger than 2 years of age with acute neurological deterioration in the context of a spinal AVF and in whom HHT was subsequently diagnosed. One patient presented with intraventricular and subarachnoid hemorrhage and the other with acute thrombosis of an intramedullary varix. These cases highlight the potential for significant neurological morbidity from a symptomatic AVF in very young children with HHT. Given the lack of data regarding the true incidence and natural history of these lesions, these cases raise the question of whether spinal cord imaging should be incorporated into screening recommendations for patients with HHT.","owner":{"id":33852416,"first_name":"Marion","middle_initials":"L","last_name":"Walker","page_name":"MarionWalker","domain_name":"utah","created_at":"2015-08-12T08:15:14.624-07:00","display_name":"Marion L Walker","url":"https://utah.academia.edu/MarionWalker"},"attachments":[],"research_interests":[{"id":6200,"name":"Magnetic Resonance Imaging","url":"https://www.academia.edu/Documents/in/Magnetic_Resonance_Imaging"},{"id":99421,"name":"Spinal Cord","url":"https://www.academia.edu/Documents/in/Spinal_Cord"},{"id":154732,"name":"Hereditary Hemorrhagic Telangiectasia (HHT)","url":"https://www.academia.edu/Documents/in/Hereditary_Hemorrhagic_Telangiectasia_HHT_"},{"id":247701,"name":"Angiography","url":"https://www.academia.edu/Documents/in/Angiography"},{"id":253560,"name":"Newborn Infant","url":"https://www.academia.edu/Documents/in/Newborn_Infant"},{"id":959921,"name":"X ray Computed Tomography","url":"https://www.academia.edu/Documents/in/X_ray_Computed_Tomography"},{"id":2489700,"name":"Child preschool","url":"https://www.academia.edu/Documents/in/Child_preschool"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="26980649"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/26980649/Factors_associated_with_ventricular_catheter_movement_and_inaccurate_catheter_location_post_hoc_analysis_of_the_Hydrocephalus_Clinical_Research_Network_Ultrasound_Guided_Shunt_Placement_study"><img alt="Research paper thumbnail of Factors associated with ventricular catheter movement and inaccurate catheter location: post hoc analysis of the Hydrocephalus Clinical Research Network Ultrasound-Guided Shunt Placement study" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/26980649/Factors_associated_with_ventricular_catheter_movement_and_inaccurate_catheter_location_post_hoc_analysis_of_the_Hydrocephalus_Clinical_Research_Network_Ultrasound_Guided_Shunt_Placement_study">Factors associated with ventricular catheter movement and inaccurate catheter location: post hoc analysis of the Hydrocephalus Clinical Research Network Ultrasound-Guided Shunt Placement study</a></div><div class="wp-workCard_item"><span>Journal of Neurosurgery: Pediatrics</span><span>, 2014</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Shunt survival may improve when ventricular catheters are placed into the frontal horn or trigone...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Shunt survival may improve when ventricular catheters are placed into the frontal horn or trigone of the lateral ventricle. However, techniques for accurate catheter placement have not been developed. The authors recently reported a prospective study designed to test the accuracy of catheter placement with the assistance of intraoperative ultrasound, but the results were poor (accurate placement in 59%). A major reason for the poor accurate placement rate was catheter movement that occurred between the time of the intraoperative ultrasound image and the first postoperative scan (33% of cases). The control group of non-ultrasound using surgeons also had a low rate of accurate placement (accurate placement in 49%). The authors conducted an exploratory post hoc analysis of patients in their ultrasound study to identify factors associated with either catheter movement or poor catheter placement so that improved surgical techniques for catheter insertion could be developed. The authors investigated the following risk factors for catheter movement and poor catheter placement: age, ventricular size, cortical mantle thickness, surgeon experience, surgeon experience with ultrasound prior to trial, shunt entry site, shunt hardware at entry site, ventricular catheter length, and use of an ultrasound probe guide for catheter insertion. Univariate analysis followed by multivariate logistic regression models were used to determine which factors were independent risk factors for either catheter movement or inaccurate catheter location. In the univariate analyses, only age &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 6 months was associated with catheter movement (p = 0.021); cortical mantle thickness &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 1 cm was near-significant (p = 0.066). In a multivariate model, age remained significant after adjusting for cortical mantle thickness (OR 8.35, exact 95% CI 1.20-infinity). Univariate analyses of factors associated with inaccurate catheter placement showed that age &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 6 months (p = 0.001) and a posterior shunt entry site (p = 0.021) were both associated with poor catheter placement. In a multivariate model, both age &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 6 months and a posterior shunt entry site were independent risk factors for…</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="26980649"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="26980649"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 26980649; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=26980649]").text(description); $(".js-view-count[data-work-id=26980649]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 26980649; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='26980649']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 26980649, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=26980649]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":26980649,"title":"Factors associated with ventricular catheter movement and inaccurate catheter location: post hoc analysis of the Hydrocephalus Clinical Research Network Ultrasound-Guided Shunt Placement study","translated_title":"","metadata":{"abstract":"Shunt survival may improve when ventricular catheters are placed into the frontal horn or trigone of the lateral ventricle. However, techniques for accurate catheter placement have not been developed. The authors recently reported a prospective study designed to test the accuracy of catheter placement with the assistance of intraoperative ultrasound, but the results were poor (accurate placement in 59%). A major reason for the poor accurate placement rate was catheter movement that occurred between the time of the intraoperative ultrasound image and the first postoperative scan (33% of cases). The control group of non-ultrasound using surgeons also had a low rate of accurate placement (accurate placement in 49%). The authors conducted an exploratory post hoc analysis of patients in their ultrasound study to identify factors associated with either catheter movement or poor catheter placement so that improved surgical techniques for catheter insertion could be developed. The authors investigated the following risk factors for catheter movement and poor catheter placement: age, ventricular size, cortical mantle thickness, surgeon experience, surgeon experience with ultrasound prior to trial, shunt entry site, shunt hardware at entry site, ventricular catheter length, and use of an ultrasound probe guide for catheter insertion. Univariate analysis followed by multivariate logistic regression models were used to determine which factors were independent risk factors for either catheter movement or inaccurate catheter location. In the univariate analyses, only age \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 6 months was associated with catheter movement (p = 0.021); cortical mantle thickness \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 1 cm was near-significant (p = 0.066). In a multivariate model, age remained significant after adjusting for cortical mantle thickness (OR 8.35, exact 95% CI 1.20-infinity). Univariate analyses of factors associated with inaccurate catheter placement showed that age \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 6 months (p = 0.001) and a posterior shunt entry site (p = 0.021) were both associated with poor catheter placement. In a multivariate model, both age \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 6 months and a posterior shunt entry site were independent risk factors for…","publication_date":{"day":null,"month":null,"year":2014,"errors":{}},"publication_name":"Journal of Neurosurgery: Pediatrics"},"translated_abstract":"Shunt survival may improve when ventricular catheters are placed into the frontal horn or trigone of the lateral ventricle. However, techniques for accurate catheter placement have not been developed. The authors recently reported a prospective study designed to test the accuracy of catheter placement with the assistance of intraoperative ultrasound, but the results were poor (accurate placement in 59%). A major reason for the poor accurate placement rate was catheter movement that occurred between the time of the intraoperative ultrasound image and the first postoperative scan (33% of cases). The control group of non-ultrasound using surgeons also had a low rate of accurate placement (accurate placement in 49%). The authors conducted an exploratory post hoc analysis of patients in their ultrasound study to identify factors associated with either catheter movement or poor catheter placement so that improved surgical techniques for catheter insertion could be developed. The authors investigated the following risk factors for catheter movement and poor catheter placement: age, ventricular size, cortical mantle thickness, surgeon experience, surgeon experience with ultrasound prior to trial, shunt entry site, shunt hardware at entry site, ventricular catheter length, and use of an ultrasound probe guide for catheter insertion. Univariate analysis followed by multivariate logistic regression models were used to determine which factors were independent risk factors for either catheter movement or inaccurate catheter location. In the univariate analyses, only age \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 6 months was associated with catheter movement (p = 0.021); cortical mantle thickness \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 1 cm was near-significant (p = 0.066). In a multivariate model, age remained significant after adjusting for cortical mantle thickness (OR 8.35, exact 95% CI 1.20-infinity). Univariate analyses of factors associated with inaccurate catheter placement showed that age \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 6 months (p = 0.001) and a posterior shunt entry site (p = 0.021) were both associated with poor catheter placement. In a multivariate model, both age \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 6 months and a posterior shunt entry site were independent risk factors for…","internal_url":"https://www.academia.edu/26980649/Factors_associated_with_ventricular_catheter_movement_and_inaccurate_catheter_location_post_hoc_analysis_of_the_Hydrocephalus_Clinical_Research_Network_Ultrasound_Guided_Shunt_Placement_study","translated_internal_url":"","created_at":"2016-07-14T05:40:27.224-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":33852416,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[],"downloadable_attachments":[],"slug":"Factors_associated_with_ventricular_catheter_movement_and_inaccurate_catheter_location_post_hoc_analysis_of_the_Hydrocephalus_Clinical_Research_Network_Ultrasound_Guided_Shunt_Placement_study","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"Shunt survival may improve when ventricular catheters are placed into the frontal horn or trigone of the lateral ventricle. However, techniques for accurate catheter placement have not been developed. The authors recently reported a prospective study designed to test the accuracy of catheter placement with the assistance of intraoperative ultrasound, but the results were poor (accurate placement in 59%). A major reason for the poor accurate placement rate was catheter movement that occurred between the time of the intraoperative ultrasound image and the first postoperative scan (33% of cases). The control group of non-ultrasound using surgeons also had a low rate of accurate placement (accurate placement in 49%). The authors conducted an exploratory post hoc analysis of patients in their ultrasound study to identify factors associated with either catheter movement or poor catheter placement so that improved surgical techniques for catheter insertion could be developed. The authors investigated the following risk factors for catheter movement and poor catheter placement: age, ventricular size, cortical mantle thickness, surgeon experience, surgeon experience with ultrasound prior to trial, shunt entry site, shunt hardware at entry site, ventricular catheter length, and use of an ultrasound probe guide for catheter insertion. Univariate analysis followed by multivariate logistic regression models were used to determine which factors were independent risk factors for either catheter movement or inaccurate catheter location. In the univariate analyses, only age \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 6 months was associated with catheter movement (p = 0.021); cortical mantle thickness \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 1 cm was near-significant (p = 0.066). In a multivariate model, age remained significant after adjusting for cortical mantle thickness (OR 8.35, exact 95% CI 1.20-infinity). Univariate analyses of factors associated with inaccurate catheter placement showed that age \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 6 months (p = 0.001) and a posterior shunt entry site (p = 0.021) were both associated with poor catheter placement. In a multivariate model, both age \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 6 months and a posterior shunt entry site were independent risk factors for…","owner":{"id":33852416,"first_name":"Marion","middle_initials":"L","last_name":"Walker","page_name":"MarionWalker","domain_name":"utah","created_at":"2015-08-12T08:15:14.624-07:00","display_name":"Marion L Walker","url":"https://utah.academia.edu/MarionWalker"},"attachments":[],"research_interests":[{"id":60974,"name":"Hydrocephalus","url":"https://www.academia.edu/Documents/in/Hydrocephalus"},{"id":62112,"name":"Prospective studies","url":"https://www.academia.edu/Documents/in/Prospective_studies"},{"id":78467,"name":"Cerebral Cortex","url":"https://www.academia.edu/Documents/in/Cerebral_Cortex"},{"id":90702,"name":"Ultrasonography","url":"https://www.academia.edu/Documents/in/Ultrasonography"},{"id":134346,"name":"Infant","url":"https://www.academia.edu/Documents/in/Infant"},{"id":192721,"name":"Risk factors","url":"https://www.academia.edu/Documents/in/Risk_factors"},{"id":546419,"name":"Age Factors","url":"https://www.academia.edu/Documents/in/Age_Factors"},{"id":620049,"name":"Risk Factors","url":"https://www.academia.edu/Documents/in/Risk_Factors-1"},{"id":745088,"name":"FOREIGN BODY MIGRATION","url":"https://www.academia.edu/Documents/in/FOREIGN_BODY_MIGRATION"},{"id":773847,"name":"Catheters","url":"https://www.academia.edu/Documents/in/Catheters"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="21730914"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/21730914/Selective_dorsal_rhizotomy_in_children_with_spastic_hemiparesis"><img alt="Research paper thumbnail of Selective dorsal rhizotomy in children with spastic hemiparesis" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/21730914/Selective_dorsal_rhizotomy_in_children_with_spastic_hemiparesis">Selective dorsal rhizotomy in children with spastic hemiparesis</a></div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/GoochJudith">Judith Gooch</a>, <a class="" data-click-track="profile-work-strip-authors" href="https://utah.academia.edu/MarionWalker">Marion L Walker</a>, and <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/AllisonOki">Allison Oki</a></span></div><div class="wp-workCard_item"><span>Journal of Neurosurgery: Pediatrics</span><span>, 2010</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Neurological conditions including cerebral palsy, brain injury, and stroke often result in severe...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Neurological conditions including cerebral palsy, brain injury, and stroke often result in severe spasticity, which can lead to significant deformity and interfere with function. Treatments for spasticity include oral medications, intramuscular botulinum toxin type A injections, orthopedic surgeries, intrathecal baclofen pump implantation, and selective dorsal rhizotomy (SDR). Selective dorsal rhizotomy, which has been well studied in children with spastic diplegia, results in significant reduction in spasticity and improved function in children. To the authors&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; knowledge, there are no published outcome data for SDR in patients with spastic hemiparesis. The object of this study was to examine the effects of SDR on spastic hemiparesis. A 2-year study was undertaken including all children with spastic hemiparesis who underwent SDR at the authors&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; institution. The degree of spasticity, as measured by the Modified Ashworth Scale or quality of gait rated using the visual gait assessment scale, the gait parameters, and velocity were compared in patients before and after undergoing SDR. Thirteen children (mean age 6 years 7 months) with spastic hemiparesis underwent SDR performed by the same surgeon during a 2-year period. All of the patients had a decrease in tone in the affected lower extremity after the procedure. The mean reduction in tone in 4 muscle groups (hip adductors, knee flexors, knee extensors, and ankle plantar flexors) according to the modified Ashworth scale score was 2.6 ± 1.26 (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001). The quality of gait was assessed in 7 patients by using the visual gait assessment scale. This score improved in 6 patients and remained the same in 1. Stride length and gait velocity were measured in 4 children. Velocity increased in 3 patients and decreased in a 3-year-old child. Parents and clinicians reported an improvement in quality of gait after the procedure. Stride length increased bilaterally in 3 patients and increased on one side and decreased on the other in the other patient. Selective dorsal rhizotomy showed efficacy in the treatment of spastic hemiparesis in children. All of the patients had decreased tone after SDR as measured by the modified Ashworth scale. The majority of patients had qualitative and quantitative improvements in gait.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="21730914"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="21730914"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 21730914; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=21730914]").text(description); $(".js-view-count[data-work-id=21730914]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 21730914; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='21730914']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 21730914, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=21730914]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":21730914,"title":"Selective dorsal rhizotomy in children with spastic hemiparesis","translated_title":"","metadata":{"abstract":"Neurological conditions including cerebral palsy, brain injury, and stroke often result in severe spasticity, which can lead to significant deformity and interfere with function. Treatments for spasticity include oral medications, intramuscular botulinum toxin type A injections, orthopedic surgeries, intrathecal baclofen pump implantation, and selective dorsal rhizotomy (SDR). Selective dorsal rhizotomy, which has been well studied in children with spastic diplegia, results in significant reduction in spasticity and improved function in children. To the authors\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; knowledge, there are no published outcome data for SDR in patients with spastic hemiparesis. The object of this study was to examine the effects of SDR on spastic hemiparesis. A 2-year study was undertaken including all children with spastic hemiparesis who underwent SDR at the authors\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; institution. The degree of spasticity, as measured by the Modified Ashworth Scale or quality of gait rated using the visual gait assessment scale, the gait parameters, and velocity were compared in patients before and after undergoing SDR. Thirteen children (mean age 6 years 7 months) with spastic hemiparesis underwent SDR performed by the same surgeon during a 2-year period. All of the patients had a decrease in tone in the affected lower extremity after the procedure. The mean reduction in tone in 4 muscle groups (hip adductors, knee flexors, knee extensors, and ankle plantar flexors) according to the modified Ashworth scale score was 2.6 ± 1.26 (p \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001). The quality of gait was assessed in 7 patients by using the visual gait assessment scale. This score improved in 6 patients and remained the same in 1. Stride length and gait velocity were measured in 4 children. Velocity increased in 3 patients and decreased in a 3-year-old child. Parents and clinicians reported an improvement in quality of gait after the procedure. Stride length increased bilaterally in 3 patients and increased on one side and decreased on the other in the other patient. Selective dorsal rhizotomy showed efficacy in the treatment of spastic hemiparesis in children. All of the patients had decreased tone after SDR as measured by the modified Ashworth scale. The majority of patients had qualitative and quantitative improvements in gait.","publication_date":{"day":null,"month":null,"year":2010,"errors":{}},"publication_name":"Journal of Neurosurgery: Pediatrics"},"translated_abstract":"Neurological conditions including cerebral palsy, brain injury, and stroke often result in severe spasticity, which can lead to significant deformity and interfere with function. Treatments for spasticity include oral medications, intramuscular botulinum toxin type A injections, orthopedic surgeries, intrathecal baclofen pump implantation, and selective dorsal rhizotomy (SDR). Selective dorsal rhizotomy, which has been well studied in children with spastic diplegia, results in significant reduction in spasticity and improved function in children. To the authors\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; knowledge, there are no published outcome data for SDR in patients with spastic hemiparesis. The object of this study was to examine the effects of SDR on spastic hemiparesis. A 2-year study was undertaken including all children with spastic hemiparesis who underwent SDR at the authors\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; institution. The degree of spasticity, as measured by the Modified Ashworth Scale or quality of gait rated using the visual gait assessment scale, the gait parameters, and velocity were compared in patients before and after undergoing SDR. Thirteen children (mean age 6 years 7 months) with spastic hemiparesis underwent SDR performed by the same surgeon during a 2-year period. All of the patients had a decrease in tone in the affected lower extremity after the procedure. The mean reduction in tone in 4 muscle groups (hip adductors, knee flexors, knee extensors, and ankle plantar flexors) according to the modified Ashworth scale score was 2.6 ± 1.26 (p \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001). The quality of gait was assessed in 7 patients by using the visual gait assessment scale. This score improved in 6 patients and remained the same in 1. Stride length and gait velocity were measured in 4 children. Velocity increased in 3 patients and decreased in a 3-year-old child. Parents and clinicians reported an improvement in quality of gait after the procedure. Stride length increased bilaterally in 3 patients and increased on one side and decreased on the other in the other patient. Selective dorsal rhizotomy showed efficacy in the treatment of spastic hemiparesis in children. All of the patients had decreased tone after SDR as measured by the modified Ashworth scale. The majority of patients had qualitative and quantitative improvements in gait.","internal_url":"https://www.academia.edu/21730914/Selective_dorsal_rhizotomy_in_children_with_spastic_hemiparesis","translated_internal_url":"","created_at":"2016-02-09T06:53:12.258-08:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":42923259,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":15027090,"work_id":21730914,"tagging_user_id":42923259,"tagged_user_id":33852416,"co_author_invite_id":null,"email":"m***r@hsc.utah.edu","affiliation":"University of Utah","display_order":0,"name":"Marion L Walker","title":"Selective dorsal rhizotomy in children with spastic hemiparesis"},{"id":22578498,"work_id":21730914,"tagging_user_id":33852416,"tagged_user_id":51198650,"co_author_invite_id":5039624,"email":"a***i@hsc.utah.edu","display_order":4194304,"name":"Allison Oki","title":"Selective dorsal rhizotomy in children with spastic hemiparesis"}],"downloadable_attachments":[],"slug":"Selective_dorsal_rhizotomy_in_children_with_spastic_hemiparesis","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"Neurological conditions including cerebral palsy, brain injury, and stroke often result in severe spasticity, which can lead to significant deformity and interfere with function. Treatments for spasticity include oral medications, intramuscular botulinum toxin type A injections, orthopedic surgeries, intrathecal baclofen pump implantation, and selective dorsal rhizotomy (SDR). Selective dorsal rhizotomy, which has been well studied in children with spastic diplegia, results in significant reduction in spasticity and improved function in children. To the authors\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; knowledge, there are no published outcome data for SDR in patients with spastic hemiparesis. The object of this study was to examine the effects of SDR on spastic hemiparesis. A 2-year study was undertaken including all children with spastic hemiparesis who underwent SDR at the authors\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; institution. The degree of spasticity, as measured by the Modified Ashworth Scale or quality of gait rated using the visual gait assessment scale, the gait parameters, and velocity were compared in patients before and after undergoing SDR. Thirteen children (mean age 6 years 7 months) with spastic hemiparesis underwent SDR performed by the same surgeon during a 2-year period. All of the patients had a decrease in tone in the affected lower extremity after the procedure. The mean reduction in tone in 4 muscle groups (hip adductors, knee flexors, knee extensors, and ankle plantar flexors) according to the modified Ashworth scale score was 2.6 ± 1.26 (p \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001). The quality of gait was assessed in 7 patients by using the visual gait assessment scale. This score improved in 6 patients and remained the same in 1. Stride length and gait velocity were measured in 4 children. Velocity increased in 3 patients and decreased in a 3-year-old child. Parents and clinicians reported an improvement in quality of gait after the procedure. Stride length increased bilaterally in 3 patients and increased on one side and decreased on the other in the other patient. Selective dorsal rhizotomy showed efficacy in the treatment of spastic hemiparesis in children. All of the patients had decreased tone after SDR as measured by the modified Ashworth scale. The majority of patients had qualitative and quantitative improvements in gait.","owner":{"id":42923259,"first_name":"Judith","middle_initials":null,"last_name":"Gooch","page_name":"GoochJudith","domain_name":"independent","created_at":"2016-02-09T06:52:47.536-08:00","display_name":"Judith Gooch","url":"https://independent.academia.edu/GoochJudith"},"attachments":[],"research_interests":[{"id":12426,"name":"Treatment Outcome","url":"https://www.academia.edu/Documents/in/Treatment_Outcome"},{"id":17845,"name":"Cerebral Palsy","url":"https://www.academia.edu/Documents/in/Cerebral_Palsy"},{"id":60256,"name":"Gait","url":"https://www.academia.edu/Documents/in/Gait"},{"id":64933,"name":"Child","url":"https://www.academia.edu/Documents/in/Child"},{"id":137516,"name":"Follow-up studies","url":"https://www.academia.edu/Documents/in/Follow-up_studies"},{"id":145032,"name":"Rhizotomy","url":"https://www.academia.edu/Documents/in/Rhizotomy"},{"id":263281,"name":"Postoperative pain","url":"https://www.academia.edu/Documents/in/Postoperative_pain"},{"id":469105,"name":"Retrospective Studies","url":"https://www.academia.edu/Documents/in/Retrospective_Studies"},{"id":1929419,"name":"Nino","url":"https://www.academia.edu/Documents/in/Nino"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="26980648"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/26980648/A_standardized_protocol_to_reduce_cerebrospinal_fluid_shunt_infection_The_Hydrocephalus_Clinical_Research_Network_Quality_Improvement_Initiative"><img alt="Research paper thumbnail of A standardized protocol to reduce cerebrospinal fluid shunt infection: The Hydrocephalus Clinical Research Network Quality Improvement Initiative" class="work-thumbnail" src="https://attachments.academia-assets.com/47243008/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/26980648/A_standardized_protocol_to_reduce_cerebrospinal_fluid_shunt_infection_The_Hydrocephalus_Clinical_Research_Network_Quality_Improvement_Initiative">A standardized protocol to reduce cerebrospinal fluid shunt infection: The Hydrocephalus Clinical Research Network Quality Improvement Initiative</a></div><div class="wp-workCard_item"><span>Journal of Neurosurgery: Pediatrics</span><span>, 2011</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Object-Quality improvement techniques are being implemented in many areas of medicine. In an effo...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Object-Quality improvement techniques are being implemented in many areas of medicine. In an effort to reduce the ventriculoperitoneal shunt infection rate, a standardized protocol was developed and implemented at 4 centers of the Hydrocephalus Clinical Research Network (HCRN).</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="453cefb205570d25cfc15ced038d84e3" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":47243008,"asset_id":26980648,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/47243008/download_file?st=MTczMzkxNzc3NCw4LjIyMi4yMDguMTQ2&st=MTczMzkxNzc3NCw4LjIyMi4yMDguMTQ2&s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="26980648"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="26980648"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 26980648; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=26980648]").text(description); $(".js-view-count[data-work-id=26980648]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 26980648; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='26980648']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 26980648, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "453cefb205570d25cfc15ced038d84e3" } } $('.js-work-strip[data-work-id=26980648]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":26980648,"title":"A standardized protocol to reduce cerebrospinal fluid shunt infection: The Hydrocephalus Clinical Research Network Quality Improvement Initiative","translated_title":"","metadata":{"ai_title_tag":"Standardized Protocol to Lower Shunt Infection Rates","grobid_abstract":"Object-Quality improvement techniques are being implemented in many areas of medicine. 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Developing surgical techniques for accurate catheter insertion could, therefore, be beneficial to patients. This study was conducted to determine if the rate of accurate catheter location with intraoperative ultrasound guidance could exceed 80%. The authors conducted a prospective, multicenter study of children (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 18 years) requiring first-time treatment for hydrocephalus with a ventriculoperitoneal shunt. Using intraoperative ultrasound, surgeons were required to target the frontal horn or trigone for catheter tip placement. An intraoperative ultrasound image was obtained at the time of catheter insertion. Ventricular catheter location, the primary outcome measure, was determined from the first postoperative image. A control group of patients treated by nonultrasound surgeons (conventional surgeons) were enrolled using the same study criteria. Conventional shunt surgeons also agreed to target the frontal horn or trigone for all catheter insertions. Patients were triaged to participating surgeons based on call schedules at each center. A pediatric neuroradiologist blinded to method of insertion, center, and surgeon determined ventricular catheter tip location. Eleven surgeons enrolled as ultrasound surgeons and 6 as conventional surgeons. Between February 2009 and February 2010, 121 patients were enrolled at 4 Hydrocephalus Clinical Research Network centers. Experienced ultrasound surgeons (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 15 cases prior to study) operated on 67 patients; conventional surgeons operated on 52 patients. Experienced ultrasound surgeons achieved accurate catheter location in 39 (59%) of 66 patients, 95% CI (46%-71%). Intraoperative ultrasound images were compared with postoperative scans. In 32.7% of cases, the catheter tip moved from an accurate location on the intraoperative ultrasound image to an inaccurate location on the postoperative study. This was the most significant factor affecting accuracy. In comparison, conventional surgeons achieved accurate location in 24 (49.0%) of 49 cases (95% CI [34%-64%]). The shunt survival rate at 1 year was 70.8% in the experienced ultrasound group and 66.9% in the conventional group (p = 0.66). Ultrasound surgeons had more catheters surrounded by CSF (30.8% vs 6.1%, p = 0.0012) and away from the choroid plexus (72.3% vs 58.3%, p = 0.12), and fewer catheters in the brain (3% vs 22.4%, p = 0.0011) and crossing the midline (4.5% vs 34.7%, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), but they had a higher proportion of postoperative pseudomeningocele (10.1% vs 3.8%, p = 0.30), wound dehiscence (5.8% vs 0%, p = 0.13), CSF leak (10.1% vs 1.9%, p = 0.14), and shunt infection (11.6% vs 5.8%, p = 0.35). Ultrasound-guided shunt insertion as performed in this study was unable to consistently place catheters into the frontal horn or trigone. The technique is safe and achieves outcomes similar to other conventional shunt insertion techniques. Further efforts to improve accurate catheter location should focus on prevention of catheter migration that occurs between intraoperative placement and postoperative imaging. Clinical trial registration no.: NCT01007786 ( ClinicalTrials.gov ).</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="26980647"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="26980647"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 26980647; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=26980647]").text(description); $(".js-view-count[data-work-id=26980647]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 26980647; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='26980647']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 26980647, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=26980647]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":26980647,"title":"No significant improvement in the rate of accurate ventricular catheter location using ultrasound-guided CSF shunt insertion: a prospective, controlled study by the Hydrocephalus Clinical Research Network","translated_title":"","metadata":{"abstract":"Cerebrospinal fluid shunt ventricular catheters inserted into the frontal horn or trigone are associated with prolonged shunt survival. Developing surgical techniques for accurate catheter insertion could, therefore, be beneficial to patients. This study was conducted to determine if the rate of accurate catheter location with intraoperative ultrasound guidance could exceed 80%. The authors conducted a prospective, multicenter study of children (\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 18 years) requiring first-time treatment for hydrocephalus with a ventriculoperitoneal shunt. Using intraoperative ultrasound, surgeons were required to target the frontal horn or trigone for catheter tip placement. An intraoperative ultrasound image was obtained at the time of catheter insertion. Ventricular catheter location, the primary outcome measure, was determined from the first postoperative image. A control group of patients treated by nonultrasound surgeons (conventional surgeons) were enrolled using the same study criteria. Conventional shunt surgeons also agreed to target the frontal horn or trigone for all catheter insertions. Patients were triaged to participating surgeons based on call schedules at each center. A pediatric neuroradiologist blinded to method of insertion, center, and surgeon determined ventricular catheter tip location. Eleven surgeons enrolled as ultrasound surgeons and 6 as conventional surgeons. Between February 2009 and February 2010, 121 patients were enrolled at 4 Hydrocephalus Clinical Research Network centers. Experienced ultrasound surgeons (\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 15 cases prior to study) operated on 67 patients; conventional surgeons operated on 52 patients. Experienced ultrasound surgeons achieved accurate catheter location in 39 (59%) of 66 patients, 95% CI (46%-71%). Intraoperative ultrasound images were compared with postoperative scans. In 32.7% of cases, the catheter tip moved from an accurate location on the intraoperative ultrasound image to an inaccurate location on the postoperative study. This was the most significant factor affecting accuracy. In comparison, conventional surgeons achieved accurate location in 24 (49.0%) of 49 cases (95% CI [34%-64%]). The shunt survival rate at 1 year was 70.8% in the experienced ultrasound group and 66.9% in the conventional group (p = 0.66). Ultrasound surgeons had more catheters surrounded by CSF (30.8% vs 6.1%, p = 0.0012) and away from the choroid plexus (72.3% vs 58.3%, p = 0.12), and fewer catheters in the brain (3% vs 22.4%, p = 0.0011) and crossing the midline (4.5% vs 34.7%, p \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), but they had a higher proportion of postoperative pseudomeningocele (10.1% vs 3.8%, p = 0.30), wound dehiscence (5.8% vs 0%, p = 0.13), CSF leak (10.1% vs 1.9%, p = 0.14), and shunt infection (11.6% vs 5.8%, p = 0.35). Ultrasound-guided shunt insertion as performed in this study was unable to consistently place catheters into the frontal horn or trigone. The technique is safe and achieves outcomes similar to other conventional shunt insertion techniques. Further efforts to improve accurate catheter location should focus on prevention of catheter migration that occurs between intraoperative placement and postoperative imaging. Clinical trial registration no.: NCT01007786 ( ClinicalTrials.gov ).","publication_date":{"day":null,"month":null,"year":2013,"errors":{}},"publication_name":"Journal of Neurosurgery: Pediatrics"},"translated_abstract":"Cerebrospinal fluid shunt ventricular catheters inserted into the frontal horn or trigone are associated with prolonged shunt survival. Developing surgical techniques for accurate catheter insertion could, therefore, be beneficial to patients. This study was conducted to determine if the rate of accurate catheter location with intraoperative ultrasound guidance could exceed 80%. The authors conducted a prospective, multicenter study of children (\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 18 years) requiring first-time treatment for hydrocephalus with a ventriculoperitoneal shunt. Using intraoperative ultrasound, surgeons were required to target the frontal horn or trigone for catheter tip placement. An intraoperative ultrasound image was obtained at the time of catheter insertion. Ventricular catheter location, the primary outcome measure, was determined from the first postoperative image. A control group of patients treated by nonultrasound surgeons (conventional surgeons) were enrolled using the same study criteria. Conventional shunt surgeons also agreed to target the frontal horn or trigone for all catheter insertions. Patients were triaged to participating surgeons based on call schedules at each center. A pediatric neuroradiologist blinded to method of insertion, center, and surgeon determined ventricular catheter tip location. Eleven surgeons enrolled as ultrasound surgeons and 6 as conventional surgeons. Between February 2009 and February 2010, 121 patients were enrolled at 4 Hydrocephalus Clinical Research Network centers. Experienced ultrasound surgeons (\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 15 cases prior to study) operated on 67 patients; conventional surgeons operated on 52 patients. Experienced ultrasound surgeons achieved accurate catheter location in 39 (59%) of 66 patients, 95% CI (46%-71%). Intraoperative ultrasound images were compared with postoperative scans. In 32.7% of cases, the catheter tip moved from an accurate location on the intraoperative ultrasound image to an inaccurate location on the postoperative study. This was the most significant factor affecting accuracy. In comparison, conventional surgeons achieved accurate location in 24 (49.0%) of 49 cases (95% CI [34%-64%]). The shunt survival rate at 1 year was 70.8% in the experienced ultrasound group and 66.9% in the conventional group (p = 0.66). Ultrasound surgeons had more catheters surrounded by CSF (30.8% vs 6.1%, p = 0.0012) and away from the choroid plexus (72.3% vs 58.3%, p = 0.12), and fewer catheters in the brain (3% vs 22.4%, p = 0.0011) and crossing the midline (4.5% vs 34.7%, p \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), but they had a higher proportion of postoperative pseudomeningocele (10.1% vs 3.8%, p = 0.30), wound dehiscence (5.8% vs 0%, p = 0.13), CSF leak (10.1% vs 1.9%, p = 0.14), and shunt infection (11.6% vs 5.8%, p = 0.35). Ultrasound-guided shunt insertion as performed in this study was unable to consistently place catheters into the frontal horn or trigone. The technique is safe and achieves outcomes similar to other conventional shunt insertion techniques. Further efforts to improve accurate catheter location should focus on prevention of catheter migration that occurs between intraoperative placement and postoperative imaging. Clinical trial registration no.: NCT01007786 ( ClinicalTrials.gov ).","internal_url":"https://www.academia.edu/26980647/No_significant_improvement_in_the_rate_of_accurate_ventricular_catheter_location_using_ultrasound_guided_CSF_shunt_insertion_a_prospective_controlled_study_by_the_Hydrocephalus_Clinical_Research_Network","translated_internal_url":"","created_at":"2016-07-14T05:40:26.626-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":33852416,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[],"downloadable_attachments":[],"slug":"No_significant_improvement_in_the_rate_of_accurate_ventricular_catheter_location_using_ultrasound_guided_CSF_shunt_insertion_a_prospective_controlled_study_by_the_Hydrocephalus_Clinical_Research_Network","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"Cerebrospinal fluid shunt ventricular catheters inserted into the frontal horn or trigone are associated with prolonged shunt survival. Developing surgical techniques for accurate catheter insertion could, therefore, be beneficial to patients. This study was conducted to determine if the rate of accurate catheter location with intraoperative ultrasound guidance could exceed 80%. The authors conducted a prospective, multicenter study of children (\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 18 years) requiring first-time treatment for hydrocephalus with a ventriculoperitoneal shunt. Using intraoperative ultrasound, surgeons were required to target the frontal horn or trigone for catheter tip placement. An intraoperative ultrasound image was obtained at the time of catheter insertion. Ventricular catheter location, the primary outcome measure, was determined from the first postoperative image. A control group of patients treated by nonultrasound surgeons (conventional surgeons) were enrolled using the same study criteria. Conventional shunt surgeons also agreed to target the frontal horn or trigone for all catheter insertions. Patients were triaged to participating surgeons based on call schedules at each center. A pediatric neuroradiologist blinded to method of insertion, center, and surgeon determined ventricular catheter tip location. Eleven surgeons enrolled as ultrasound surgeons and 6 as conventional surgeons. Between February 2009 and February 2010, 121 patients were enrolled at 4 Hydrocephalus Clinical Research Network centers. Experienced ultrasound surgeons (\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 15 cases prior to study) operated on 67 patients; conventional surgeons operated on 52 patients. Experienced ultrasound surgeons achieved accurate catheter location in 39 (59%) of 66 patients, 95% CI (46%-71%). Intraoperative ultrasound images were compared with postoperative scans. In 32.7% of cases, the catheter tip moved from an accurate location on the intraoperative ultrasound image to an inaccurate location on the postoperative study. This was the most significant factor affecting accuracy. In comparison, conventional surgeons achieved accurate location in 24 (49.0%) of 49 cases (95% CI [34%-64%]). The shunt survival rate at 1 year was 70.8% in the experienced ultrasound group and 66.9% in the conventional group (p = 0.66). Ultrasound surgeons had more catheters surrounded by CSF (30.8% vs 6.1%, p = 0.0012) and away from the choroid plexus (72.3% vs 58.3%, p = 0.12), and fewer catheters in the brain (3% vs 22.4%, p = 0.0011) and crossing the midline (4.5% vs 34.7%, p \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), but they had a higher proportion of postoperative pseudomeningocele (10.1% vs 3.8%, p = 0.30), wound dehiscence (5.8% vs 0%, p = 0.13), CSF leak (10.1% vs 1.9%, p = 0.14), and shunt infection (11.6% vs 5.8%, p = 0.35). Ultrasound-guided shunt insertion as performed in this study was unable to consistently place catheters into the frontal horn or trigone. The technique is safe and achieves outcomes similar to other conventional shunt insertion techniques. Further efforts to improve accurate catheter location should focus on prevention of catheter migration that occurs between intraoperative placement and postoperative imaging. Clinical trial registration no.: NCT01007786 ( ClinicalTrials.gov ).","owner":{"id":33852416,"first_name":"Marion","middle_initials":"L","last_name":"Walker","page_name":"MarionWalker","domain_name":"utah","created_at":"2015-08-12T08:15:14.624-07:00","display_name":"Marion L Walker","url":"https://utah.academia.edu/MarionWalker"},"attachments":[],"research_interests":[{"id":12426,"name":"Treatment Outcome","url":"https://www.academia.edu/Documents/in/Treatment_Outcome"},{"id":15639,"name":"Ultrasound","url":"https://www.academia.edu/Documents/in/Ultrasound"},{"id":22506,"name":"Adolescent","url":"https://www.academia.edu/Documents/in/Adolescent"},{"id":60974,"name":"Hydrocephalus","url":"https://www.academia.edu/Documents/in/Hydrocephalus"},{"id":62112,"name":"Prospective studies","url":"https://www.academia.edu/Documents/in/Prospective_studies"},{"id":64933,"name":"Child","url":"https://www.academia.edu/Documents/in/Child"},{"id":134346,"name":"Infant","url":"https://www.academia.edu/Documents/in/Infant"},{"id":196189,"name":"Sample Size","url":"https://www.academia.edu/Documents/in/Sample_Size"},{"id":253560,"name":"Newborn Infant","url":"https://www.academia.edu/Documents/in/Newborn_Infant"},{"id":413195,"name":"Time Factors","url":"https://www.academia.edu/Documents/in/Time_Factors"},{"id":704648,"name":"Clinical Competence","url":"https://www.academia.edu/Documents/in/Clinical_Competence"},{"id":745088,"name":"FOREIGN BODY MIGRATION","url":"https://www.academia.edu/Documents/in/FOREIGN_BODY_MIGRATION"},{"id":2489700,"name":"Child preschool","url":"https://www.academia.edu/Documents/in/Child_preschool"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="26980646"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/26980646/Adjustment_and_malfunction_of_a_programmable_valve_after_exposure_to_toy_magnets_Case_report"><img alt="Research paper thumbnail of Adjustment and malfunction of a programmable valve after exposure to toy magnets. Case report" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/26980646/Adjustment_and_malfunction_of_a_programmable_valve_after_exposure_to_toy_magnets_Case_report">Adjustment and malfunction of a programmable valve after exposure to toy magnets. Case report</a></div><div class="wp-workCard_item"><span>Journal of neurosurgery</span><span>, 2004</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Inadvertent adjustments and malfunctions of programmable valves have been reported in cases in wh...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Inadvertent adjustments and malfunctions of programmable valves have been reported in cases in which patients have encountered powerful electromagnetic fields such as those involved in magnetic resonance imaging, but the effects of small magnetic fields are not well known. The authors present a case in which a child playing with a collection of commercially available toy magnets altered the pressure setting of an implanted valve and may have caused its permanent malfunction.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="26980646"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="26980646"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 26980646; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=26980646]").text(description); $(".js-view-count[data-work-id=26980646]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 26980646; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='26980646']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 26980646, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=26980646]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":26980646,"title":"Adjustment and malfunction of a programmable valve after exposure to toy magnets. Case report","translated_title":"","metadata":{"abstract":"Inadvertent adjustments and malfunctions of programmable valves have been reported in cases in which patients have encountered powerful electromagnetic fields such as those involved in magnetic resonance imaging, but the effects of small magnetic fields are not well known. The authors present a case in which a child playing with a collection of commercially available toy magnets altered the pressure setting of an implanted valve and may have caused its permanent malfunction.","publication_date":{"day":null,"month":null,"year":2004,"errors":{}},"publication_name":"Journal of neurosurgery"},"translated_abstract":"Inadvertent adjustments and malfunctions of programmable valves have been reported in cases in which patients have encountered powerful electromagnetic fields such as those involved in magnetic resonance imaging, but the effects of small magnetic fields are not well known. The authors present a case in which a child playing with a collection of commercially available toy magnets altered the pressure setting of an implanted valve and may have caused its permanent malfunction.","internal_url":"https://www.academia.edu/26980646/Adjustment_and_malfunction_of_a_programmable_valve_after_exposure_to_toy_magnets_Case_report","translated_internal_url":"","created_at":"2016-07-14T05:40:26.432-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":33852416,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[],"downloadable_attachments":[],"slug":"Adjustment_and_malfunction_of_a_programmable_valve_after_exposure_to_toy_magnets_Case_report","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"Inadvertent adjustments and malfunctions of programmable valves have been reported in cases in which patients have encountered powerful electromagnetic fields such as those involved in magnetic resonance imaging, but the effects of small magnetic fields are not well known. The authors present a case in which a child playing with a collection of commercially available toy magnets altered the pressure setting of an implanted valve and may have caused its permanent malfunction.","owner":{"id":33852416,"first_name":"Marion","middle_initials":"L","last_name":"Walker","page_name":"MarionWalker","domain_name":"utah","created_at":"2015-08-12T08:15:14.624-07:00","display_name":"Marion L Walker","url":"https://utah.academia.edu/MarionWalker"},"attachments":[],"research_interests":[{"id":650,"name":"Neurosurgery","url":"https://www.academia.edu/Documents/in/Neurosurgery"},{"id":60974,"name":"Hydrocephalus","url":"https://www.academia.edu/Documents/in/Hydrocephalus"},{"id":131236,"name":"Electromagnetic Fields","url":"https://www.academia.edu/Documents/in/Electromagnetic_Fields"},{"id":211387,"name":"Electromagnetic Field","url":"https://www.academia.edu/Documents/in/Electromagnetic_Field"},{"id":244814,"name":"Clinical Sciences","url":"https://www.academia.edu/Documents/in/Clinical_Sciences"},{"id":1239755,"name":"Neurosciences","url":"https://www.academia.edu/Documents/in/Neurosciences"},{"id":2489700,"name":"Child preschool","url":"https://www.academia.edu/Documents/in/Child_preschool"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="26980645"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/26980645/Complications_of_intracranial_pressure_monitoring_in_children_with_head_trauma"><img alt="Research paper thumbnail of Complications of intracranial pressure monitoring in children with head trauma" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/26980645/Complications_of_intracranial_pressure_monitoring_in_children_with_head_trauma">Complications of intracranial pressure monitoring in children with head trauma</a></div><div class="wp-workCard_item"><span>Journal of neurosurgery</span><span>, 2004</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Intracranial pressure (ICP) monitoring has become routine in the management of patients with trau...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Intracranial pressure (ICP) monitoring has become routine in the management of patients with traumatic brain injury (TBI). Many surgeons prefer to use external ventricular drains (EVDs) over fiberoptic monitors to measure ICP because of the added benefit of cerebrospinal fluid drainage. The purpose of this study was to examine a consecutive series of children with TBI and compare the incidence of complications after placement of an EVD, a fiberoptic intraparencyhmal monitor, or both. A retrospective chart review was conducted to identify children with TBI who met the criteria for insertion of an ICP monitor. All patients underwent head CT scanning on admission and after placement of an ICP monitor. During a 5-year period 80 children met the criteria for inclusion in the study. Eighteen children (22.5%) underwent EVD placement only, 18 (22.5%) underwent placement of a fiberoptic device only, and 44 (55%) received both. A total of 62 fiberoptic devices (48%) were inserted, and 68 EVDs...</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="26980645"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="26980645"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 26980645; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=26980645]").text(description); $(".js-view-count[data-work-id=26980645]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 26980645; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='26980645']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 26980645, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=26980645]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":26980645,"title":"Complications of intracranial pressure monitoring in children with head trauma","translated_title":"","metadata":{"abstract":"Intracranial pressure (ICP) monitoring has become routine in the management of patients with traumatic brain injury (TBI). Many surgeons prefer to use external ventricular drains (EVDs) over fiberoptic monitors to measure ICP because of the added benefit of cerebrospinal fluid drainage. The purpose of this study was to examine a consecutive series of children with TBI and compare the incidence of complications after placement of an EVD, a fiberoptic intraparencyhmal monitor, or both. A retrospective chart review was conducted to identify children with TBI who met the criteria for insertion of an ICP monitor. All patients underwent head CT scanning on admission and after placement of an ICP monitor. During a 5-year period 80 children met the criteria for inclusion in the study. Eighteen children (22.5%) underwent EVD placement only, 18 (22.5%) underwent placement of a fiberoptic device only, and 44 (55%) received both. A total of 62 fiberoptic devices (48%) were inserted, and 68 EVDs...","publication_date":{"day":null,"month":null,"year":2004,"errors":{}},"publication_name":"Journal of neurosurgery"},"translated_abstract":"Intracranial pressure (ICP) monitoring has become routine in the management of patients with traumatic brain injury (TBI). Many surgeons prefer to use external ventricular drains (EVDs) over fiberoptic monitors to measure ICP because of the added benefit of cerebrospinal fluid drainage. The purpose of this study was to examine a consecutive series of children with TBI and compare the incidence of complications after placement of an EVD, a fiberoptic intraparencyhmal monitor, or both. A retrospective chart review was conducted to identify children with TBI who met the criteria for insertion of an ICP monitor. All patients underwent head CT scanning on admission and after placement of an ICP monitor. During a 5-year period 80 children met the criteria for inclusion in the study. Eighteen children (22.5%) underwent EVD placement only, 18 (22.5%) underwent placement of a fiberoptic device only, and 44 (55%) received both. A total of 62 fiberoptic devices (48%) were inserted, and 68 EVDs...","internal_url":"https://www.academia.edu/26980645/Complications_of_intracranial_pressure_monitoring_in_children_with_head_trauma","translated_internal_url":"","created_at":"2016-07-14T05:40:26.256-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":33852416,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[],"downloadable_attachments":[],"slug":"Complications_of_intracranial_pressure_monitoring_in_children_with_head_trauma","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"Intracranial pressure (ICP) monitoring has become routine in the management of patients with traumatic brain injury (TBI). Many surgeons prefer to use external ventricular drains (EVDs) over fiberoptic monitors to measure ICP because of the added benefit of cerebrospinal fluid drainage. The purpose of this study was to examine a consecutive series of children with TBI and compare the incidence of complications after placement of an EVD, a fiberoptic intraparencyhmal monitor, or both. A retrospective chart review was conducted to identify children with TBI who met the criteria for insertion of an ICP monitor. All patients underwent head CT scanning on admission and after placement of an ICP monitor. During a 5-year period 80 children met the criteria for inclusion in the study. Eighteen children (22.5%) underwent EVD placement only, 18 (22.5%) underwent placement of a fiberoptic device only, and 44 (55%) received both. A total of 62 fiberoptic devices (48%) were inserted, and 68 EVDs...","owner":{"id":33852416,"first_name":"Marion","middle_initials":"L","last_name":"Walker","page_name":"MarionWalker","domain_name":"utah","created_at":"2015-08-12T08:15:14.624-07:00","display_name":"Marion L Walker","url":"https://utah.academia.edu/MarionWalker"},"attachments":[],"research_interests":[{"id":650,"name":"Neurosurgery","url":"https://www.academia.edu/Documents/in/Neurosurgery"},{"id":22506,"name":"Adolescent","url":"https://www.academia.edu/Documents/in/Adolescent"},{"id":64933,"name":"Child","url":"https://www.academia.edu/Documents/in/Child"},{"id":134346,"name":"Infant","url":"https://www.academia.edu/Documents/in/Infant"},{"id":192721,"name":"Risk factors","url":"https://www.academia.edu/Documents/in/Risk_factors"},{"id":244814,"name":"Clinical Sciences","url":"https://www.academia.edu/Documents/in/Clinical_Sciences"},{"id":253560,"name":"Newborn Infant","url":"https://www.academia.edu/Documents/in/Newborn_Infant"},{"id":424621,"name":"Drainage","url":"https://www.academia.edu/Documents/in/Drainage"},{"id":469105,"name":"Retrospective Studies","url":"https://www.academia.edu/Documents/in/Retrospective_Studies"},{"id":620049,"name":"Risk Factors","url":"https://www.academia.edu/Documents/in/Risk_Factors-1"},{"id":959921,"name":"X ray Computed Tomography","url":"https://www.academia.edu/Documents/in/X_ray_Computed_Tomography"},{"id":967566,"name":"Fiber Optic Technology","url":"https://www.academia.edu/Documents/in/Fiber_Optic_Technology"},{"id":1185386,"name":"Ventriculostomy","url":"https://www.academia.edu/Documents/in/Ventriculostomy"},{"id":1239755,"name":"Neurosciences","url":"https://www.academia.edu/Documents/in/Neurosciences"},{"id":1337669,"name":"Intracranial Pressure","url":"https://www.academia.edu/Documents/in/Intracranial_Pressure"},{"id":2489700,"name":"Child preschool","url":"https://www.academia.edu/Documents/in/Child_preschool"}],"urls":[]}, dispatcherData: dispatcherData }); 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