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In early November 2013, the authors started talking about visiting the Hurley School, a dual-language school in Boston, Massachusetts. The Hurley School had spent considerable time transitioning to the Common Core State Standards on literacy, but little time addressing the shifts in math. They worried that math classes were no longer rigorous enough to meet these more demanding standards. In this aritcle, a district math content specialist and a teacher leader use classroom observations to pinpoint strengths and challenges in math instruction, followed by common planning time that focuses learning around the results.

Case report:A case report of a 58-year-old man who sustained a laceration of his left vertebral artery during a routine corpectomy for cervical myelopathy is reported.Objective:To report iatrogenic injury of a tortuous vertebral artery during anterior cervical spine surgery and discuss appropriate diagnosis and treatment options for this complication.Setting:UMass Memorial Medical Center, Worcester, MA, USA.Background data:Vertebral artery anomalies, although rare, are typically present with degenerative processes and great care must be taken to avoid damage during a corpectomy. Cross-sectional imaging coupled with intraoperative angiography is helpful for the urgent evaluation of the injury site and identification of the contralateral vertebral artery's status.Methods:This is a single case of a patient sustaining a laceration of the left vertebral artery during surgery, which resulted in a lateral medullary stroke.Results:After the left vertebral artery laceration, hemostasis was achieved. With the intent to better visualize and possibly embolize or stent the injury, an angiographic study was carried out. The angiogram revealed a laceration of the left vertebral artery within the vertebral foramina at vertebral body level C6, but intact distal flow. The patient underwent angiographic embolization and a subsequent magnetic resonance imaging (MRI) revealed a left lateral medullary stroke consistent with the lack of flow through the left vertebral artery from C6 to the basilar artery.Conclusion:If a tortuous vertebral artery is suspected, then meticulous review of preoperative cross-sectional imaging should be implemented along with angiographic examination. If anomalies are detected and the standard procedure cannot be safely carried out, then alterations, such as preoperative stent placement, need to be considered. [ABSTRACT FROM AUTHOR]