Desmoplastic Infantile Astrocytoma

Desmoplastic infantile astrocytoma is a huge cystic tumor, typically occurring in the cerebral hemispheres of infants. The authors report a 4-month-old baby presented with increased head circumference, bulging fontanel, and the setting-sun sign. Magnetic resonance imaging revealed a round mass with huge cystic component in the right cerebral hemisphere. Microsurgical gross total resection of the tumor was performed and pathological examination of the specimen showed features of desmoplastic infantile astrocytoma. The postoperative course was complicated by subdural hygroma which was managed by the placement of subduroperitoneal shunt. Although desmoplastic infantile astrocytomas are rare, it must be distinguished from other hemispheric tumors in infancy or childhood because of good prognosis.

Clinical Results of Microsurgical Anterior Foraminotomy for Cervical Radiculopathy

OBJECTIVE: The authors present the clinical and radiologic outcomes of microsurgical anterior foraminotomy in 36 cases of cervival radiculopathy. METHODS: Thirty-six patients were treated with anterior cervical foraminotomy between January 1998 and June 2002. There were 13 men and 23 women(age range, 34-74 years). Twenty-nine had symptomatic soft disc herniation and 7 had uncovertebral osteophytes confirmed by magnetic resonance imaging and computed tomography. Thirty-one patients had single anterior cervical microforaminotomy and five had procedures at adjacent levels. RESULTS: Good or excellent result were obtained in 75% of the patients. On roentgenographic examination, the height of intervertebral space was maintained at twenty-one levels(51%) and was decreased at seventeen levels(42%). Two patients who underwent anterior cervical microforaminotomy developed kyphosis of the cervical spine and one patient developed instability of the cervical spine. CONCLUSION: Anterior cervical foraminotomy appears to be a good alternative procedure for carefully selected patients with unilateral cervical radiculopathy and avoids a fusion of the disc space.