Traumatic Occipitocervical Distraction Injuries in Children: A Systematic Review

Background: Occipitocervical distraction injuries (OCDI) in children occur on a wide spectrum of severity, and decisions about treatment suffer from a lack of rigorous guidelines and significant inter-institutional variability. While clear cases of frank atlanto-occipital dislocation (AOD) are treated with surgical stabilization, the approach for less severe cases of OCDI is not standardized. These patients require a careful assessment of both radiographic and clinical criteria, as part of a complex risk-benefit analysis, to establish whether occipitocervical fusion (OCF) is indicated. Here, we performed a systematic review of the literature that describes traumatic OCDI in children #x3c; 18 years of age.Summary: We performed a systematic review, according to PRISMA guidelines, of children #x3c; 18 years of age presenting with traumatic etiologies of OCDI. We searched PubMed to identify papers congruent with these criteria. Exclusion criteria included (1) reports on atraumatic causes of OCDI and (2) studies with insufficient clinical and radiographic details on individual patients. We identified 16 reports describing a total of 144 patients treated for pediatric traumatic OCDI. Based on the synthesis of these findings and the collective experience of the authors, we present the demographic, clinical, and radiographic factors that underlie OC instability, which we hope will serve as components of a grading system in the future. We considered various clinical and radiographic f...
Source: Pediatric Neurosurgery - Category: Neurosurgery Source Type: research

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By STEPHEN BORSTELMANN, MD Occasionally, you get handed a question you know little about, but it’s clear you need to know more.  Like most of us these days, I was chatting with my colleagues about the novel coronavirus. It goes by several names: SARS-CoV-2, 2019-nCoV or COVID-19 but I’ll just call it COVID.  Declared a pandemic on March 12, 2020 by the World Health Organization (WHO), COVID is diagnosed by laboratory test – PCR.  The early PCR test used in Wuhan was apparently low sensitivity (30-60%), lengthy to run (days), and in short supply.  As CT scanning was relatively availa...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: COVID-19 Hospitals Medical Practice Physicians coronavirus CT scans Imaging infecton control Pandemic Radiology Stephen Borstelmann Source Type: blogs
J reconstr Microsurg DOI: 10.1055/s-0040-1702176 Background Given the national trends in obesity, reconstructive surgeons are faced with an increasing number of overweight and obese women interested in postmastectomy breast reconstruction. While the link between obesity and adverse postoperative outcomes is well established, few studies have explored the relationship between body mass index (BMI) and the vasculature of the anterior abdominal wall. Methods A radiographic review was conducted on female patients who underwent computed tomographic angiography (CTA) of the anterior abdominal wall. CTA studies we...
Source: Journal of Reconstructive Microsurgery - Category: Surgery Authors: Tags: Original Article Source Type: research
ARTIS Pheno-Interventional Fluoroscopic X-Ray System Model Number: 10849000 - Product Usage:AXIOM Artis is a family of dedicated angiography systems developed for single and biplane diagnostic imaging and interventional procedures including, but not limited to, pediatric and obese patients. Procedures that can be performed with the AXIOM Artis family include cardiac angiography, neuro angiography, general angiography, rotational angiography, operating room angiography, multipurpose angiography and whole body radiographic/fluoroscopic procedures. Axiom Artis can also support the acquisition of position triggered imaging for...
Source: Medical Device Recalls - Category: Medical Devices Source Type: alerts
Authors: Akkemik O, Kazaz H, Tamsel S, Dündar N, Sahinalp S, Ellidokuz H Abstract OBJECTIVE: To evaluate the diagnostic accuracy of digital panoramic radiograph (DPR) for detection of carotid artery calcification (CAC) confirmed by Doppler Ultrasonography (DUSG) and to clarify the relationship between between CAC identified by DPR and cardiovascular events through a 5 year follow-up period. METHODS: Of 3600 consecutive patients examined, 158 patients presented with CAC as detected by DPR. The final study group was composed of 96 patients who had CAC confirmed by DUSG or CT angiogram. The control gro...
Source: Dentomaxillofacial Radiology - Category: Radiology Tags: Dentomaxillofac Radiol Source Type: research
The recent article from McCluskey et al “Radiological Eye Deviation as a Predictor of Large Vessel Occlusion in Acute Ischaemic Stroke” J of Stroke and Cerebrovasc Dis. 2019; 28:2318-23231 provides valuable information that may lead to early stroke intervention. They found that subjective visual detection of radiographic eye deviation on nonenhanced computed tomography (NECT) brain is strongly associated with large vessel occlusion (LVO). This compelling association may expedite patients for timely angiographic testing and endovascular therapy.
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Tags: Letter to the Editor Source Type: research
ConclusionThe clinical presentation and genetic studies confirmed a diagnosis of Cockayne syndrome in both sisters caused by compound heterozygous mutations in theERCC8 gene on chromosome 10. Multimodal ocular imaging and systemic findings revealed wide phenotypic variability between the affected siblings.
Source: Documenta Ophthalmologica - Category: Opthalmology Source Type: research
ConclusionOur specifically trained, radiographer ‐led PICC insertion service proved to be successful. Both straightforward and complex insertions, for example in CF patients could be adequately and efficiently performed.
Source: Journal of Medical Imaging and Radiation Oncology - Category: Radiology Authors: Tags: Medical Imaging —Radiation Oncology—Original Article Source Type: research
We describe a comprehensive, multidisciplinary treatment approach for lumbar vertebral hemangiomas (VHs) with spinal stenosis and radiculopathy. A 59-year-old female presented with 1 year of pain predominantly in the lower back, with pain in the left buttock and proximal left anterior thigh as well and magnetic resonance imaging of the lumbar spine demonstrated lumbar scoliosis and an L3 vertebral lesion suspicious for hemangioma. A computed tomography guided biopsy was done, which supported the diagnosis. Definitive treatment entailed preoperative angiography and embolization, followed by L3 laminectomy, right L3 pedicle ...
Source: Journal of Craniovertebral Junction and Spine - Category: Orthopaedics Authors: Source Type: research
ConclusionSternal wire complications secondary to migration beyond the sternum are rare but potentially fatal. Precise wire location and risk assessment with CT are more appropriate when wire location cannot be clearly delineated by plain film radiography.
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: CASE REPORT Source Type: research
Authors: Yang G, Wilson TD, Lehman MN, Cui D Abstract In this paper, we will discuss and compare the stereoscopic models developed from two types of radiographic data, Magnetic Resonance Angiography (MRA) images and Computed Tomography Angiography (CTA) images. Stereoscopic models were created using surface or volume segmentation and semi-auto combined segmentation techniques. Although, the CTA data were found to improve the speed and quality of constructing virtual vascular models compared to conventional CT data, small blood vessels were difficult to capture during the imaging and reconstruction process thereby l...
Source: Advances in Experimental Medicine and Biology - Category: Research Tags: Adv Exp Med Biol Source Type: research
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