Aneurysmal bone cyst concomitant with fibrous dysplasia in the frontal bone

Secondary aneurysmal bone cyst in fibrous dysplasia is exceedingly rare, especially in the skull and particularly in the frontal bone. We present a case of aneurysmal bone cyst concomitant with fibrous dysplasia in the frontal bone in a 15-year-old male patient presenting with headache and euphoria with an uncharacteristic imaging appearance and treated successfully by total resection

Venous air embolism associated morbidity and mortality in patients undergoing neurosurgical procedures in the sitting position

To identify the morbidity and the mortality related to Venous Air Embolism [VAE] during posterior fossa surgery in the sitting position. This study was conducted at Jordan University Hospital, Amman, Jordan. Records of 73 patients undergoing posterior fossa surgery in the sitting position from 1990 to 2005 were retrospectively reviewed to determine the incidence of VAE, the nature of perioperative morbidity and mortality and their relation to VAE. The incidence of VAE was 13.5%. Intraoperative hypotension secondary to VAE was [9.6%]. Intraoperative hypotension was 19% during the positioning of patients and 29% during the procedures. Patients who received blood transfusion were 10 [19.2%] children and 5 [9.6%] adults. Average blood transfusion in children was 200 mls and 360 mls in adults. Postoperatively, six [11.5%] patients were electively intubated and ventilated. Postoperative evacuation of posterior fossa haematoma was performed in seven [13.5%] patients. Six [11.5%] patients died within one month after surgery. There was no intraoperative or postoperative morbidity or mortality related to VAE. Our results indicate the absence of morbidity and mortality related to VAE. With early detection and prompt treatment of VAE, the sitting position is safe for neurosurgical procedures

Electrocorticography in the management of surgically treated epileptic patients

To report our experience on 8 patients with mean age of onset of seizures of 8 years, who had intra-operative electrocorticography monitoring during the surgical treatment of their medically intractable partial epilepsy. Post-resection electrocorticography grades were according to Jay et al and seizure outcome was a according to Kobayashi et al grades. Five patients had temporal lobe surgery and 3 patients had extra temporal surgery. Four patients had post-resection electrocorticography grade A [no residual epileptic activity], two of them had seizure outcome grade 1 [free of seizures] and the other 2 had grade 11 [free of seizures on medication]. The other 4 patients had post-resection electrocorticography grade B [minimal residual epileptic activity] and all had seizure outcome grade 11 except one patient who had grade 111 [more than 50% reduction in seizure frequency]. Despite the small size of our study, our results suggest that intra-operative electrocorticography may be an important tool in the surgical management of medically intractable epilepsy