Jeffrey Raskin, MS MD FAANS FAAP

Abdominal pseudocysts are inflammatory collections sometimes found around the distal shunt catheter. These are commonly indolent forms of bacterial infection, but not always. The management of an infectious vs inflammatory pseudocyst is entirely different, and some patients without evidence of infection can be discharged more quickly from the hospital on less medicine.

We identified a cohort of inflammatory pseudocysts using PCR. This may help distinguish between future patients.

Re-examining the classification of abdominal pseudocysts as surgical site infections through review of broad-range polymerase chain reaction results - PubMed Few abdominal pseudocysts had organisms identified by BRPCR, suggesting that not all pseudocysts are due to infectious causes. Consideration should be given to alternate causes of pseudocyst development when cultures are negative.

Combined ventral-dorsal rhizotomies (VDR) can be a reasonable choice for patients with non-generalized conditions because it can address their spasticity via dorsal rhizotomy and their dystonia through ventral rhizotomy. Though lumbosacral rhizotomy is more popular, cervical rhizotomy has shown success in the treatment of upper limb spasticity, traumatic hypertonia, and torticollis

There’s a paradigm shift happening towards the aggressive surgical management of hypertonia in children. Decreasing medically refractory hypertonia is likely to prevent joint and bone dysfunction and improve quality of life.

Have a look at this important manuscript applying ventral dorsal rhizotomy to the cervical nerve roots.

Cervicothoracic ventral-dorsal rhizotomy for treatment of brachial hypertonia in cerebral palsy - Child's Nervous System Purpose Cervicothoracic ventral-dorsal rhizotomy (VDR) is a potential treatment of medically refractory hypertonia in patients who are not candidates for intrathecal baclofen, particularly in cases of severe upper limb hypertonia with limited to no function. A longitudinal cohort was identified to h...