title: A modification of the Mayfield horseshoe headrest allowing pin fixation and cranial immobilization in infants and young children.
abstract: OBJECTIVE
  Pin fixation and rigid immobilization of the head is desirable in many neurosurgical procedures. However, these techniques are associated with complications in infants and young children. A simple modification of a commonly used cranial fixation system allows rigid, safe immobilization of the head in infants and children.
  
  
  METHODS
  A standard Mayfield horseshoe headrest and cranial fixation system was adapted to allow simultaneous use of the headrest and three-point pin fixation. The system is compatible with most neuronavigational systems.
  
  
  RESULTS
  The combined horseshoe and pin system was used successfully in more than 30 patients ranging in age from 6 months to 14 years. No complications were encountered.
  
  
  CONCLUSIONS
  Rigid immobilization is achievable in the pediatric population, facilitating intracranial and frameless stereotaxy procedures.
authors.affiliation: Department of Neurological Surgery, University of California, San Francisco, San Francisco, California 94143-0112, USA. guptan@neurosurg.ucsf.edu
authors.forename: Nalin
authors.initials: N
authors.lastname: Gupta
mesh_terms: D000293:Adolescent; D001858:Bone Nails; D001927:Brain Diseases / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D003399:Craniotomy / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D005260:Female; D006801:Humans; D007103:Immobilization; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D013238:Stereotaxic Techniques / Q000295:instrumentation*