A brain surgery called a craniectomy is performed to remove a part of your skull in order to relieve pressure in an area when your brain swells from a traumatic brain injury. It is also performed to treat medical conditions that cause your brain to swell or bleed that can be caused by an aneurysm, brain tumor or other cancer.

This 3d animation shows how the surgical procedure decreases intracranial pressure (ICP), intracranial hypertension (ICHT), or heavy bleeding (also called hemorrhaging) inside your skull. If left untreated, pressure or bleeding can compress your brain and push it down onto the brain stem. This can be fatal or cause permanent brain damage.

Brain surgery is a very serious procedure under any circumstances, but a craniectomy is done when there is an immediate risk to the brain and neurological function due to severe brain injury or stroke.

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Dr. Debbie Song at Gillette Children's describes in detail selective rhizotomy surgery.

A selective dorsal rhizotomy is an operation performed to treat spasticity. It is thought that high tone and spasticity arise from abnormal signals that are transmitted through sensory or dorsal nerve roots to the spinal cord. In a selective dorsal rhizotomy we identify and cut portions of the dorsal nerve roots that carry abnormal signals thereby disrupting the mechanisms that lead to spasticity. Potential patients go through a rigorous assessment that includes an in-depth gait and motion analysis as well as a physical therapy evaluation.

They are evaluated by a multidisciplinary team that includes a pediatric rehabilitation doctor, a neurosurgeon, and an orthopedist, Appropriate patient selection is vital. Ideal candidates for selective dorsal rhizotomy are children who are between four and ten years of age, have a history of being born prematurely, and have a diagnosis of diplegia cerebral palsy. These patients usually walk independently or with the assistance of crutches or a walker. They typically function at a level one, two, or three in the gross motor function classification system or gmfcs. A selective dorsal rhizotomy involves the coordinated efforts of the neurosurgery, physiatry, anesthesia and nursing teams. The operation entails making an incision in the lower back that is approximately six to eight inches long. We perform what we call a laminoplasty in which we remove the back part of the spinal elements from the lumbar one or l1 to l5 levels. At the end of the procedure the bone is put back on. We identify and open up the Dural sac that contain the spinal fluid spinal cord and nerve roots. Once the Dural sac is opened ,we expose the lumbar and upper sacral nerve roots that transmit information to and from the muscles of the lower extremities.

At each level we isolate the dorsal nerve root, which in turn is separated into as many as 30 smaller thread light fruitlets.

Each rootlet is then electrically stimulated. Specialized members of the physiatry team look for abnormal responses in the muscles of the legs as each rootless is being stimulated. If an abnormal response is observed then the rootlet is cut.

If a normal response is observed, then the rootlet is not cut. We usually end up cutting approximately 20 to 40 percent of the rootlets. The Dural sac is sutured closed and the l1 through l5 spinal elements are put back into anatomic position, thus restoring normal spinal alignment. The overlying tissues and skin are then closed and the patient is awoken from surgery. The entire operation takes between four and five hours. A crucial component to the success of our rhizotomy program is the extensive rehabilitation course following surgery. With their tone significantly reduced after a rhizotomy, patients relearn how to use their muscles to walk more efficiently through stretching, strengthening, and gait training. Approximately one to two years after a rhizotomy patients undergo repeat gait and motion analysis. The orthopedic surgeons assess the need for interventions to correct bone deformities, muscle contractures, poor motor control, impaired balance, or other problems related to cerebral palsy.

At Gillette we work closely with patients and families to ensure that our selective dorsal rhizotomy program meets their goals for enhancing their function and improving their quality of life.

VISIT https://www.gillettechildrens.org/ to learn more

0:00 Why choose selective dorsal rhizotomy?
0:56 Who is a good candidate for selective dorsal rhizotomy?
1:31 What does a selective dorsal rhizotomy entail?
3:26 What is recovery from selective dorsal rhizotomy like?

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symptoms of kidney dysfunction. I find kidney dysfunction in my patients very frequently. Lower back pain is a common indicator that the kidneys are starting to become irritated. Yes, lower back pain can come from many different areas, but one of the areas I always rule out is kidney congestion.

Dr. James Wall performs a bilateral inguinial hernia repair surgical procedure.

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A breech birth is the birth of a baby from a breech presentation. In the breech presentation the baby enters the birth canal with the buttocks or feet first as opposed to the normal head first presentation.

There are either three or four main categories of breech births, depending upon the source:

* Frank breech - the baby's bottom comes first, and his or her legs are flexed at the hip and extended at the knees (with feet near the ears). 65-70% of breech babies are in the frank breech position.

* Complete breech - the baby's hips and knees are flexed so that the baby is sitting crosslegged, with feet beside the bottom.

* Footling breech - one or both feet come first, with the bottom at a higher position. This is rare at term but relatively common with premature fetuses.

* Kneeling breech - the baby is in a kneeling position, with one or both legs extended at the hips and flexed at the knees. This is extremely rare, and is excluded from many classifications.

As in labour with a baby in a normal head-down position, uterine contractions typically occur at regular intervals and gradually cause the cervix to become thinner and to open. In the more common breech presentations, the baby’s bottom (rather than feet or knees) is what is first to descend through the maternal pelvis and emerge from the vagina.

At the beginning of labour, the baby is generally in an oblique position, facing either the right or left side of the mother's back. As the baby's bottom is the same size in the term baby as the baby's head. Descent is thus as for the presenting fetal head and delay in descent is a cardinal sign of possible problems with the delivery of the head.

In order to begin the birth, internal rotation needs to occur. This happens when the mother's pelvic floor muscles cause the baby to turn so that it can be born with one hip directly in front of the other. At this point the baby is facing one of the mother's inner thighs. Then, the shoulders follow the same path as the hips did. At this time the baby usually turns to face the mother's back. Next occurs external rotation, which is when the shoulders emerge as the baby’s head enters the maternal pelvis. The combination of maternal muscle tone and uterine contractions cause the baby’s head to flex, chin to chest. Then the back of the baby's head emerges and finally the face.

Due to the increased pressure during labour and birth, it is normal for the baby's leading hip to be bruised and genitalia to be swollen. Babies who assumed the frank breech position in utero may continue to hold their legs in this position for some days after birth.

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The dilatation and Curettage procedure that is commonly performed (D and C)Part 2

Your baby's sex is set at conception. At around 7 weeks, your baby's internal sex organs – such as ovaries and testes – begin to form in the abdomen. Male and female sex organs and genitalia look the same at this stage because they're derived from the same structures. At around 9 weeks, boys and girls begin to develop differently. In girls, a tiny bud emerges between the tissue of the legs. This bud will become the clitoris. The membrane that forms a groove below the bud separates to become the labia minora and the vaginal opening. By 22 weeks, the ovaries are completely formed and move from the abdomen to the pelvis. They already contain a lifetime supply of 6 million eggs. In boys, the bud develops into the penis and starts to elongate at around 12 weeks. The outer membrane grows into the scrotal sac that will later house the testicles. By 22 weeks, the testes have formed in the abdomen. They already contain immature sperm. Soon they'll begin their descent to the scrotum, but it's a long journey. They'll reach their destination late in pregnancy, or for some boys, after birth. If you're eager to find out whether you're having a girl or a boy, you'll have to wait until you're at least 17 weeks pregnant. That's when the genitals have developed enough to be seen on an ultrasound.

Are most spiders poisonous? The majority of the 3,000 spiders in the United States aren’t poisonous. Even if most spiders did bite, their fangs are too small or weak to puncture human skin. Their bites may leave itchy, red wounds that heal within a week or so. The spiders that do manage to bite through our skin and insert toxic venom can cause serious health complications. Read on to learn what spider bites look like, what spider varieties leave certain bites, and how to treat spider bites. What do spider bites look like? Identifying a spider bite is easier if you saw the spider that bit you, but it’s possible that you won’t notice the wound until hours later. Look for things like: swelling a red welt skin damage any troubling symptoms that accompany the bite Other possible symptoms that may accompany a spider bite include: itching or rash pain around the area of the bite muscle pain or cramping blister that’s red or purple in color sweating difficulty breathing headache nausea and vomiting fever chills anxiety or restlessness rashes swollen lymph glands high blood pressure Spider bites often take longer to heal than other insect bites, and they may affect skin tissues. It’s important to keep the bite clean to reduce the risk of infection. How to treat a spider bite at home In some cases, you can treat spider bites at home. For nonvenomous spider bites, follow these steps: Apply an ice pack on and off the bite for 10 minutes at a time. Elevate the area to reduce swelling. Take an antihistamine, such as diphenhydramine (Benadryl), to help with itching. Clean the area with soap and water to prevent infection. Apply antibiotic ointment to the area if blisters develop. Seek medical attention if you’re showing symptoms of a spider bite or if the symptoms don’t go away over time. Always seek medical attention if you suspect you’ve been bitten by one of the following species: brown recluse black widow hobo spider tarantula Brazilian wandering spider

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The term labiaplasty refers to a procedure that reduces the length of the labia minora. It is the most commonly performed female genital plastic surgery procedure and it can relieve symptoms women experience from twisting and tugging of the labia. Women opt for surgery for a variety of reasons, including pain from twisting and tugging of the labia when riding a bike or during intercourse, itching and irritation, and self-consciousness.

An excellent video demonstrating how a laparoscopy is performed to evaluate the uterus (note a small fibroid appearing as a bulge in the uterus), fallopian tubes and ovaries. Blue dye is injected into the uterus, entering the fallopian tubes and spilling from the end of the tubes into the abdominal cavity, confirming that both tubes are open