Seerup Stage (shrinestep2)

OBJECTIVE YouTube is currently the second most popular website in the world and thus it is often used by patients to access health information regarding their condition(s). Our aim was to evaluate the content-quality of YouTube videos relating to hydrocephalus. METHODS We chose the first 35 videos for four different search phrases "water on the brain," "hydrocephalus," "pediatric hydrocephalus" and "adult hydrocephalus." Video contents were evaluated by two independent final year medical students with more than 5 years of experience using the DISCERN criteria (scoring system from 1-5 per question). Qualitative data, quantitative data and the upload source about each video was recorded for quality and optimization analysis. RESULTS Out of the total 140 videos, 63 videos met our inclusion criteria and were evaluated. The mean DISCERN score was 29.9 out of a total of 75 possible points. This indicates that the quality of YouTube videos on hydrocephalus is currently poor. Reliability between the two raters was excellent (intraclass correlation coefficient = 0.96). Most videos had clear information (90%), a doctor speaking (70%), and described the symptoms (62%). Videos were most commonly uploaded by hospitals (44%) or by educational channels (43%). Our study found that videos that contained the results of treatment had a much higher average daily view (P=0.0229) than videos that did not. CONCLUSION The quality of YouTube videos on hydrocephalus is poor, however, we indicated the top-quality videos in our paper as they may be effective tools for patient education. Our optimization analysis found that including diagrams and explaining the results of hydrocephalus treatment results in a higher audience engagement (in the form of likes, comments and views). BACKGROUND Nonlethal neural tube defects are developmental malformations with complex pathogenesis usually manifested at birth or in childhood. CASE DESCRIPTION We report the case of a 61-year-old woman without significant previous clinical history presenting for neck pain and stiffness. An extensive workup detected multiple lytic lesions within the occipital bone and cervical vertebrae, suspicious for multiple myeloma or metastatic disease. Surgical resection of the occipital bone lesions revealed ectopic cerebellar tissue, some containing folia with mature cortical lamination, and no evidence of malignancy. CONCLUSIONS To our knowledge, this study describes the oldest individual presenting with ectopic cerebellar tissue and the only instance in which oncologic workup for malignancy was carried out prior to resection. It also proposes surgical resection as a diagnostic and curative approach for this complex basicranium and neural developmental defect, and discusses retinoic acid toxicity as a possible cause of its occurrence. BACKGROUND Intraoperative manipulation of the craniocervical junction with the Cervical Management Base Unit (CMBU) has been used as an adjunct for achieving optimal anatomic alignment during instrumented fusion procedures in a variety of disease settings. Here, we present our experience using the CMBU as a supplement to achieving a successful reduction and fixation of a reducible craniocervical subluxation with associated basilar impression/medullary compression in the setting of Grisel syndrome. CASE DESCRIPTION Under fluoroscopy and neuromonitoring guidance, the elevator and axial translation mechanisms of the CMBU safely allowed for presurgical assessment of reducibility and facilitated complete reduction of the deformity with restitution of a normal atlantodental interval, spinolaminar line, and clivoaxial angle. Magnetic resonance imaging acquired 1 month after surgery and antibiotic therapy showed resolution of a large epidural abscess in the region of the dens and no evidence of residual neural impingement. Upright plain films at 9 months showed maintenance of the desired craniocervical alignment. CONCLUSIONS Intraoperative manipulation of the crani