Cessation and Resumption of Elective Neurointerventional Procedures during the Coronavirus Disease 2019 Pandemic and Future Pandemics

At the time of this writing, the coronavirus disease 2019 pandemic continues to be a global threat, disrupting usual processes, and protocols for delivering health care around the globe. There have been significant regional and national differences in the scope and timing of these disruptions. Many hospitals were forced to temporarily halt elective neurointerventional procedures with the first wave of the pandemic in the spring of 2020, in order to prioritize allocation of resources for acutely ill patients and also to minimize coronavirus disease 2019 transmission risks to non-acute patients, their families, and health care workers. This temporary moratorium on elective neurointerventional procedures is generally credited with helping to flatten the curve and direct scarce resources to more acutely ill patients; however, there have been reports of some delaying seeking medical care when it was in fact urgent, and other reports of patients having elective treatment delayed with the result of morbidity and mortality. Many regions have resumed elective neurointerventional procedures, only to now watch coronavirus disease 2019 positivity rates again climbing as winter of 2020 approaches. A new wave is now forecast which may have larger volumes of hospitalized coronavirus disease 2019 patients than the earlier wave(s) and may also coincide with a wave of patients hospitalized with seasonal influenza. This paper discusses relevant and practical elements of cessation and safe resumption of nonemergent neurointerventional services in the setting of a pandemic

Delayed Onset Craniosynostosis Presenting as Idiopathic Intracranial Hypertension

Craniosynostosis refers to premature fusion of one or more cranial sutures, and typically presents with abnormal head shape within the first year of life. Management includes cranial vault reconstruction (CVR) or observation. Rarely, suture fusion may occur later in childhood or go unnoticed. These delayed cases may not be associated with changes in head shape and come to attention only because of an elevation in intracranial pressure. We present five children referred for presumed pediatric idiopathic intracranial hypertension (IIH) who fulfilled the modified Dandy criteria for the disease but were ultimately found to have sagittal craniosynostosis as the cause of papilledema. We review presenting symptoms and signs, associated radiological findings, management and clinical course

Venous Sinus Stenting Improves Visual Fields and Cerebrospinal Fluid Opening Pressures in Idiopathic Intracranial Hypertension

Idiopathic intracranial hypertension (IIH) causes headache and potentially irreversible visual loss, mostly in obese women of childbearing age. Treatment includes weight loss, acetazolamide, and surgical interventions when medications fail. Venous sinus stenting (VSS) has recently emerged as a promising treatment for IIH patients with dural venous sinus stenosis (DSS) but only a minority of studies have studied post-stent opening pressure (OP) or quantitative visual field scores

Legislative Documents

Also, variously referred to as: House bills; House documents; House legislative documents; legislative documents; General Court documents

Summary of mean sinus measurements (D_max, area and perimeter), 95% confidence intervals and range of measurements based on acquisition technique.

<p>Summary of mean sinus measurements (D_max, area and perimeter), 95% confidence intervals and range of measurements based on acquisition technique.</p