A5068202237- Cerebrospinal fluid and hydrocephalus
- Spinal Dysraphism and Malformations
- Traumatic Brain Injury and Neurovascular Disturbances
- Fetal and Pediatric Neurological Disorders
- Craniofacial Disorders and Treatments
- Cleft Lip and Palate Research
- Head and Neck Surgical Oncology
- Neonatal and fetal brain pathology
- Glioma Diagnosis and Treatment
- Intracranial Aneurysms: Treatment and Complications
- Vascular Malformations Diagnosis and Treatment
- Neonatal Respiratory Health Research
- History of Medical Practice
- Meningioma and schwannoma management
- Cardiac, Anesthesia and Surgical Outcomes
- Spinal Fractures and Fixation Techniques
- Health Systems, Economic Evaluations, Quality of Life
- Spine and Intervertebral Disc Pathology
- dental development and anomalies
- Facial Trauma and Fracture Management
- Botulinum Toxin and Related Neurological Disorders
- Management of metastatic bone disease
- Bacterial Infections and Vaccines
- Cerebral Palsy and Movement Disorders
- Neurofibromatosis and Schwannoma Cases
University of Utah
2016-2025
Primary Children's Hospital
2015-2024
University of California, San Diego
2023
Children's of Alabama
2022
ORCID
2021
Magna International (Germany)
2021
University of Utah Hospital
2020
Oxford University Press (United Kingdom)
2018
Creative Commons
2018
Center for Neurosciences
2017
BACKGROUND Cerebral metastasis is a common oncologic problem that occurs in 15–30% of cancer patients; approximately half such metastases are single. Previous retrospective studies and two randomized trials reported the addition surgical extirpation prior to radiation therapy increased survival, neurologic function, quality life compared with alone patients single brain metastasis. METHODS A controlled trial was conducted which were allocated undergo or surgery plus radiation. Radiation...
✓ To determine the natural history of brain cavernous malformations, authors entered patients referred to their center into a prospective registry between 1987 and 1993. All underwent magnetic resonance imaging, which showed typical appearance this lesion, conservative management was recommended in all. Patients or referring physicians were contacted for follow-up data. The purpose study define rate symptomatic hemorrhage outcome those who had suffered seizures. Follow-up data available 122...
OBJECTIVE: Forty percent of standard cerebrospinal fluid shunts implanted for the treatment pediatric hydrocephalus fail within first year. Two new shunt valves designed to limit excess flow, particularly in upright positions, were studied compare failure rates with those differential-pressure valves. METHODS: Three hundred-forty-four hydrocephalic children (age, birth 18 yr) undergoing their insertion randomized at 12 North American or European neurosurgical centers. Patients received one...
Object The aims of this study were to measure inpatient health care for pediatric hydrocephalus in the US; describe patient, hospital, and hospitalization characteristics care; determine associated with death. Methods A cross-sectional was performed using 1997, 2000, 2003 Healthcare Cost Utilization Project Kids' Inpatient Databases (KID), nationally representative weighted data sets hospital discharges patients. hydrocephalus-related classified as either cerebrospinal fluid (CSF)...
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 at 4 centers Hydrocephalus Clinical Research Network (HCRN).The sequentially by HCRN members using current literature prior institutional experience until consensus obtained. The prospectively applied each center all children undergoing insertion or revision procedure. Infections were defined on basis...
OBJECT The rate of CSF shunt failure remains unacceptably high. Hydrocephalus Clinical Research Network (HCRN) conducted a comprehensive prospective observational study hydrocephalus management, the aim which was to isolate specific risk factors for failure. METHODS followed all first-time insertions in children younger than 19 years at 6 HCRN centers. Investigator Committee selected, priori, 21 variables be examined, including clinical, radiographic, and design variables. Shunt defined as...
Objectives To study cerebral blood flow and oxygen consumption in severe head-injured children also to assess the effect of hyperventilation on regional flow. Design Prospective cohort study. Setting Pediatric intensive care unit at a tertiary-level university children's hospital. Patients Twenty-three with isolated brain injury, whose admission Glasgow Coma Scores were <8. Interventions PaCO2 was adjusted by altering minute ventilation. Cerebral metabolic measurements made three levels...
The spatial accuracy of magnetic resonance imaging (MRI) has not been established for stereotactic surgery. Magnetic susceptibility artifacts may lead to anatomical distortion and inaccurate MRI coordinates, especially when targets are in regions the brain out center field. MRI-guided localization, however, provides better multiplanar target resolution than is available with computed tomographic (CT) scanning. Therefore, we compared coordinates determined by CT studies 41 patients (53...
✓ The benefits of radiosurgery for cavernous malformations are difficult to assess because the unclear natural history this vascular lesion, inability image malformation vessels, and lack an imaging technique that defines “cure.” authors selected 47 patients who harbored a hemorrhagic in critical intraparenchymal location remote from pial or ependymal surface. Of these, 44 had experienced at least two hemorrhages before radiosurgery. mean patient age was 39 years; six previously undergone...
Object Cerebral vasospasm after subarachnoid hemorrhage (SAH) continues to be a major source of morbidity in patients despite significant clinical and basic science research. Efforts prevent by removing spasmogens from the space have produced mixed results. The authors hypothesize that lumbar cisternal drainage can remove blood basal spaces more effectively than an external ventricular drain (EVD). This nonrandomized, controlled-cohort study was undertaken evaluate effectiveness with SAH...
The postoperative angiograms in 66 patients who underwent craniotomy for clipping of 78 cerebral aneurysms were reviewed. Indications urgent angiography included neurological deficit or repeat subarachnoid hemorrhage. Routine carried out the remaining patients. Postoperative reviewed to determine incidence unexpected findings such as unclipped aneurysms, residual and unforeseen major vessel occlusions. Logistic regression analysis was used test if following factors that predicted an finding...
Object Reported rates of CSF shunt infection vary widely across studies. The study objective was to determine the after initial placement at multiple US pediatric hospitals. authors hypothesized that between hospitals would even adjustment for patient, hospital, and surgeon factors. Methods This retrospective cohort included children 0–18 years age with uncomplicated performed January 1, 2001, December 31, 2005, recorded in Pediatric Health Information System (PHIS) longitudinal...
Object The authors recently developed and internally validated the ETV Success Score (ETVSS)—a simplified means of predicting 6-month success rate endoscopic third ventriculostomy (ETV) for a child with hydrocephalus, based on age, etiology presence previous shunt. A high ETVSS predicts chance early success. In this paper, they assess clinical utility by determining whether long-term survival outcomes versus shunt insertion are different within strata (low, moderate, scores). Methods...
Object. Endoscopically assisted ventricular catheter placement has been reported to reduce shunt failure in uncontrolled series. The authors investigated the efficacy of this procedure a prospective multicenter randomized trial. Methods. Children younger than 18 years old who were scheduled for their first ventriculoperitoneal (VP) undergo endoscopic or nonendoscopic insertion catheter. Eligibility and primary outcome (shunt failure) decided blinded fashion. An intention-to-treat analysis...
Object Severe traumatic brain injury (TBI) is often accompanied by early death due to transtentorial herniation. Decompressive craniectomy, performed alone or in conjunction with evacuation of the mass lesion, can reduce incidence raised intracranial pressure (ICP). In this paper authors evaluate mortality and morbidity long-term outcomes children who underwent decompressive craniectomy for severe TBI at a single institution. Methods Children Primary Children’s Medical Center between 1996...
The Hydrocephalus Clinical Research Network (HCRN), which comprises 7 pediatric neurosurgical centers in North America, provides a unique multicenter assessment of the current outcomes CSF shunting nonselected patients. authors present initial results for this cohort and compare them with from prospective trials performed 1990s.Analysis was restricted to patients newly diagnosed hydrocephalus undergoing first time. Detailed perioperative data 2008 through 2012 all HCRN were prospectively...
Endoscopic third ventriculostomy (ETV) has preferentially been offered to patients with more favorable prognostic features compared shunt.To use advanced statistical methods adjust for treatment selection bias determine whether ETV survival is superior shunt once the of patient-related factors removed.An international cohort children (< or = 19 years age) newly diagnosed hydrocephalus treated (n 489) 720) was analyzed. We used propensity score adjustment techniques account 2 important...
The use of endoscopic third ventriculostomy (ETV) with choroid plexus cauterization (CPC) has been advocated as an alternative to CSF shunting in infants hydrocephalus. There are limited reports this procedure the North American population, however. authors provide a retrospective review experience combined ETV + CPC within Hydrocephalus Clinical Research Network (HCRN).All children (< 2 years old) who underwent at one 7 HCRN centers before November 2012 were included. Data collected...
To quantify the extent to which cerebrospinal fluid (CSF) shunt revisions are associated with increased risk of CSF infection, after adjusting for patient factors that may contribute infection risk.We used Hydrocephalus Clinical Research Network registry assemble a large prospective 6-center cohort 1036 children undergoing initial placement between April 2008 and January 2012. The primary outcome interest was first infection. Data all subsequent prior where applicable, were obtained....