This technical case report describes a novel definitive surgical treatment of venous sinus aneurysms. This technique does not necessitate long-term anticoagulation, has a low likelihood of reintervention, and provides immediate resolution of pulsatile tinnitus.

Background:Increasing efforts have been made to reduce the incidence and severity of concussion in high-contact sports. Despite these efforts, a relative lack of knowledge is available regarding modulating factors affecting concussion injury.Purpose:To analyze the potential influence of game characteristics and outcomes on concussion incidence and severity in professional football.Study Design:Descriptive epidemiology study.Methods:PBS Frontline Concussion Watch was used to collect concussion injury data from regular-season games of 32 National Football League (NFL) teams from 2012 to 2015. Game characteristic variables such as rushing and passing attempts, turnovers, and margin of victory were collected from ESPN. Analysis included descriptive statistics, analysis of variance, t tests, and correlation tests.Results:Away teams demonstrated a significantly greater concussion incidence per game than home teams. Losing teams had a significantly greater concussion incidence per game than winning teams. Being both the away team and the losing team appeared to have an additive effect. The home-versus-away and win-versus-loss effects were significant for offensive but not defensive positions. Within individual positions, significantly greater concussion incidence was associated with tight ends, running backs, wide receivers, and cornerbacks. When running versus passing positions were compared, passing positions (wide receiver, tight end, cornerback, safety) had significantly greater concussion incidence. A total of 626 games were missed as a result of reported concussions. Away teams had significantly more games missed due to concussion when they lost. Play time did not significantly differ before or after concussion injury. Other game characteristic variables did not significantly affect concussion frequency or intensity.Conclusion:Position, game location, and game outcome affect concussion incidence for professional football players. In a subset of analyses, the number of games missed aligned with concussion incidence, but this appeared to be an imperfect measure. These findings highlight new factors that may modulate concussion incidence and merit further study on how they may influence concussion evaluation.

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Background: Thoracic spine fracture-dislocations due to motor vehicle accidents (MVAs) rarely involve double- level, noncontiguous lesions. Case Description: A 19-year-old male following an MVA was paraplegic; he exhibited full motor/sensory loss below the T4 level (i.e., ASIA scale Grade A). The chest X-ray, magnetic resonance, and computed tomography studies confirmed T3–T5 and T11–12 fractures, warranting T3–L3 thoracolumbar decompression and fusion. Despite surgical intervention, the patient’s neurological status remained unchanged. Conclusion: This case illustrates the rare presentation of noncontiguous, posttraumatic thoracic spinal lesions requiring simultaneous decompression/fixation.

BackgroundSports-related concussion is a major cause of mild traumatic brain injury (mTBI). It is possible that environmental factors, such as temperature, humidity, and stadium's altitude, may influence the overall incidence of concussions during a game.PurposeTo examine the impact of environmental factors, such as temperature, humidity, barometric pressure, and dew point, on concussion incidence.MethodsPublic Broadcasting Service (PBS) FRONTLINE Concussion Watch was used to collect injury data on 32 NFL teams during regular season games from 2012 to 2015. Weather data points were collected from Weather Underground. Concussion incidence per game, the probability of a concussion during a game, and a difference in mean game-day temperature, humidity, dew point, and barometric pressure between concussion and concussion-free games were calculated. Our analysis included t-tests, analysis of variance (ANOVA), multivariate correlation tests, and logistic and Poisson regression. ResultsOverall, 564 concussions were reported. There were 411 games with concussions and 549 games without concussions. We observed a significant decrease in concussion incidence with increasing temperature, both when the temperature was divided into 20oF increments or into quartiles (p = 0.005 and p = 0.002, respectively). We identified a statistically significant lower mean-game day temperature in concussion games compared to concussion-free games (p < 0.0006). We also observed a significant decrease in the incidence of concussion per game with increasing dew point. There was no significant difference in concussion incidence in barometric pressure and humidity. The logistic regression model predicted a decrease in the probability of a concussion in games with higher temperatures and dew points.ConclusionsNational Football League (NFL) players experienced an increased risk of concussion during football games played in colder temperatures and at lower dew points. Further research on environmental effects on concussions may aid in improving player safety in football leagues.