A5016870372- Spinal Dysraphism and Malformations
- Cerebrospinal fluid and hydrocephalus
- Spinal Fractures and Fixation Techniques
- Traumatic Brain Injury and Neurovascular Disturbances
- Cerebrovascular and Carotid Artery Diseases
- Spinal Cord Injury Research
- Neurosurgical Procedures and Complications
- Head and Neck Surgical Oncology
- Optical Imaging and Spectroscopy Techniques
- Intraoperative Neuromonitoring and Anesthetic Effects
- Teratomas and Epidermoid Cysts
- Spine and Intervertebral Disc Pathology
- Connective tissue disorders research
- Neuroscience of respiration and sleep
- Fetal and Pediatric Neurological Disorders
- Renal and Vascular Pathologies
- Medical History and Innovations
- Vascular Malformations Diagnosis and Treatment
- Venous Thromboembolism Diagnosis and Management
- Oropharyngeal Anatomy and Pathologies
- Acute Ischemic Stroke Management
- Case Reports on Hematomas
- Dermatological and Skeletal Disorders
- Aortic aneurysm repair treatments
- Ocular Oncology and Treatments
South Nassau Communities Hospital
2016-2024
North Shore University Hospital
2003-2021
Neurological Surgery
1998-2021
Winthrop-University Hospital
2021
Northwell Health
2003-2012
Schrodinger (United States)
2008
Carolina Veterinary Specialists
2007
New York State College of Veterinary Medicine
2007
Cornell University
2007
State University of New York
1993-1998
Object Chiari malformation Type I (CM-I) is generally regarded as a disorder of the paraxial mesoderm. The authors report an association between CM-I and hereditary disorders connective tissue (HDCT) that can present with lower brainstem symptoms attributable to occipitoatlantoaxial hypermobility cranial settling. Methods prevalence HDCT was determined in prospectively accrued cohort 2813 patients CM-I. All underwent detailed medical neuroradiological workup included assessment articular...
We describe an operative technique for Chiari Type I malformation that uses color Doppler ultrasonography as a guide performing patient-specific posterior fossa decompressions. The has been used since 1999 in more than 300 operations.On the basis of real-time anatomic and physiological measurements, following goals surgery were monitored: 1) adequate decompression cervicomedullary junction; 2) creation retrocerebellar space 8 to 10 cm(3) volume; 3) establishment optimal cerebrospinal fluid...
Background Connective tissue disorders (CTDs) are a heterogeneous group of often presenting with variety comorbidities including musculoskeletal, autonomic, and immune dysfunction. Some CTDs such as hypermobile Ehlers-Danlos syndrome (hEDS), which is one the most common, have been associated neurological requiring surgical intervention. The frequency these in populations their subsequent requirement for neurosurgical intervention remains unclear. Methods Based on our initial experience this...
OBJECTIVE: The pathophysiological effects of syrinx distension are incompletely understood. Although it is generally assumed that the accumulation fluid within cavities can contribute to neurological dysfunction, there no reports describing intramedullary pressure in syringomyelia. purpose current study was measure pressures patients with progressive clinical deterioration and correlate these data deficits intraoperative physiological findings. METHODS: Intramedullary measured manometrically...
To describe a cranioplasty procedure used in conjunction with foramen magnum decompression (FMD) for the treatment of canine caudal occipital malformation syndrome (COMS), and to evaluate clinical outcome.Prospective study.Dogs (n=21) COMS diagnosed by magnetic resonance imaging (MRI).After FMD, titanium screws were placed around perimeter defect skull plate fashioned from mesh polymethylmethacrylate was attached back skull, using as anchor posts. Follow-up obtained direct examination...
A number of different surgical techniques have been used through the years to address Chiari I malformation (CMI).This article describes how we surgically manage CMI at two high-volume centers. We call technique minimally invasive subpial tonsillectomy (MIST). The consists a minimalistic dissection and craniectomy with short, linear durotomy for tonsillar resection. dura is closed without use duraplasty.We describe our current methods surgery CMI.
The management of Chiari I malformation (CMI) is controversial because treatment methods vary and decisions rest on incomplete understanding its complex symptom patterns, etiologies, natural history. Validity studies that attempt to compare CMI has been limited variable terminology used describe study subjects. goal this project was standardize by developing a comprehensive set Common Data Elements (CDEs), data definitions, case report forms (CRFs), outcome measure recommendations for use in...
Chronic occipital and suboccipital headache is a common symptom in patients with Chiari I malformation. These headaches may persist despite appropriate surgical treatment of the underlying pathology via decompression, duraplasty, cerebrospinal fluid diversion. Occipital nerve stimulation has been shown to be effective variety headache/pain syndromes.To review retrospectively our experience primary diagnosis malformation history chronic pain intractable medical therapies.We present...
Abstract OBJECTIVE AND IMPORTANCE Syringomyelia is generally regarded as a chronic, slowly progressive disorder. We describe case of acute dilation the central canal spinal cord that presented with rapidly segmental signs. CLINICAL PRESENTATION A 29-year-old female patient who had previously undergone surgical treatment for Chiari I malformation, syringomyelia, and hydrocephalus an 8-day history headaches, paraparesis, urinary retention. Magnetic resonance imaging scans demonstrated...
Introduction We investigated the mechanism of ptosis brain stem and cerebellum (hindbrain) in Chiari malformation type I (CM-I) classified CM-I according to pathogenesis, based on a morphometric study posterior cranial fossa (PCF) craniovertebral junction (CVJ). discuss appropriate surgical treatment for hindbrain ptosis. Materials Methods examined 500 patients with 100 healthy control individuals. calculated volume PCF (VPCF) measured axial length enchondral parts occipital bone hindbrain....
We investigated the mechanism underlying Chiari malformation type I (CM-I) and classified it according to morphometric analyses of posterior cranial fossa (PCF) craniocervical junction (CCJ). Three independent subtypes CM-I were confirmed (CM-I types A, B, C) for 484 cases 150 normal volunteers by multiple analyses. A had volume PCF (VPCF) occipital bone size. Type B VPCF small area surrounding foramen magnum (VAFM) C VPCF, VAFM, Morphometric during traction test demonstrated instability...
This case report examines internal jugular venous compression necessitating surgical intervention. The focal point is a 48-year-old female patient with Ehlers-Danlos syndrome, who developed intracranial hypertension due to bilateral of the veins. patient's symptomatic presentation, marked by persistent pain and pressure localized retroorbital occipital regions, accentuated during orthostatic conditions, propelled investigation that culminated in comprehensive evaluation via cranial cervical...
Object Chiari malformation Type I (CM-I) is generally regarded as a disorder of the paraxial mesoderm. The authors report an association between CM-I and hereditary disorders connective tissue (HDCT) that can present with lower brainstem symptoms attributable to occipitoatlantoaxial hypermobility cranial settling. Methods prevalence HDCT was determined in prospectively accrued cohort 2813 patients CM-I. All underwent detailed medical neuroradiological workup included assessment articular...
Cerebral vasospasm remains the principal cause of morbidity and mortality following successful clipping intracranial aneurysms. Current management often requires subjective judgments concerning presumed abnormalities cerebral blood flow. In this study, a combined pressure (ICP)-laser Doppler flowmetry (LDF) fiberoptic probe that permits continuous monitoring local flow (1CBF) was used in postoperative 20 aneurysm patients. Using probe, 1CBF simultaneously recorded integrated on real time...
We classified Chiari malformation type I (CM-I) according to the mechanism of ptosis brain stem and cerebellum, based on a morphometric study posterior cranial fossa (PCF) craniovertebral junction (CVJ). Surgery was performed manage hindbrain ptosis.
This report is the first to correlate data concerning intraoperative somatosensory evoked potentials (SSEPs) and local spinal cord blood flow (1SCBF) in patients with syringomyelia. In a consecutive study, bilateral median nerve SSEPs were recorded intraoperatively 13 undergoing syrinx shunt posterior fossa cisterns (syringocisternostomy). 1SCBF was measured five of these using laser doppler flowmetry (LDF) calibrated arbitrary units (AU). SSEP recordings obtained 30 min after decompression...
SummaryMaintaining cerebral perfusion pressure (CPP) above 70mm Hg is currently a mainstay of neurosurgical critical care. Shalmon, et al. recently showed poor correlation between CPP and regional blood flow (CBF) [1]. To study the relationship CBF, at microvascular level, we retrospectively analyzed multimodality digital data from 12 care patients in whom combined intracranial (ICP) — laser Doppler flowmetry (LDF) probe (Camino, San Diego) had been placed. Over entire interval continuous...
Chronic occipital and suboccipital headache is a common symptom in patients with Chiari I malformation (CMI). These headaches may persist despite appropriate surgical treatment of the underlying pathology via decompression, duraplasty related procedures. Occipital stimulation has been shown to be effective variety headache/pain syndromes. We present our series 18 CMI persistent who underwent neurostimulator trials and, following successful trials, permanent stimulator placement. Seventy-two...