Technical nuance of ventriculoperitoneal shunt placement in a patient with cutis verticis gyrata: illustrative case
Bibliographic record
Abstract
BACKGROUND: Cutis verticis gyrata (CVG) is a rare benign scalp condition that causes the formation of skin ridges and furrows. Because of the altered scalp anatomy, this condition can pose unique challenges in neurosurgical procedures. OBSERVATIONS: The authors report the case of a 47-year-old man with CVG and neurosarcoidosis who developed hydrocephalus requiring a ventriculoperitoneal shunt. Initial shunt placement at Kocher's point proceeded without complications. However, the patient presented several months later with shunt failure caused by migration of the proximal catheter. The cause of this was determined to be related to the patient's scalp hypermobility. After shunt revision and fixation of the hardware using titanium plates and screws, the patient had an uneventful recovery and a stable outcome at follow-up. LESSONS: This case emphasizes the importance of preoperative planning and intraoperative measures tailored to CVG patients. Further research is needed to elucidate the condition's neurosurgical implications and optimize procedural outcomes. https://thejns.org/doi/10.3171/CASE25174.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.003 | 0.003 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.006 | 0.005 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".