Mature Teratoma in the Cerebellar Hemisphere of an Adult

Intracranial teratomas are diagnosed mostly in young population and usually involve midline structure. We report a case of mature teratoma in an adult patient with unusual location in cerebellar hemisphere. A 47-year-old woman presented with severe headache and nausea. Computed tomography and magnetic resonance imaging demonstrated a posterior fossa lesion with cerebellar hemispheric location not involving midline. Histological examination of surgical specimen showed fully matured representative tissues of the three germ layers confirming teratoma. This is a rare example of mature teratoma with unusual age of the patient and location.

Outcome of the Expansive Open-door Laminoplasty with Titanium Miniplate in Cervical Stenosis

OBJECTIVE: The purpose of this study is to introduce a simple yet effective technique to secure the posterior elements in the open position after expansive open-door laminoplasty and to evaluate factors contributing to surgical results after laminoplasty. METHODS: Twenty two myelopathic or radiculopathic patients with multilevel cervical canal stenosis or ossification of the posterior longitudinal ligament were treated with an expansive open-door laminoplasty. Thirteen patients were cervical spinal stenosis and the other 9 patients were diagnosed as the ossification of the posterior longitudinal ligament. The posterior elements were stabilized in the open position with titanium miniplates without spacers. Morphometric analysis was performed on preoperative and postoperative plain radiographs to obtain spinal canal dimensions and to monitor construct integrity. RESULTS: The mean preoperative sagittal canal diameter was 10.3+/-2.2mm. These dimensions increased to 17.4+/-2.8mm after surgery. Most patients improved from the myelopathy or the radiculopathy and the mean recovery rate was 52.4+/-17.1%. The titanium miniplate constructs did not fail during the follow-up period (mean, 38.5 months) and the decompression was maintained. Serious complications such as instability and kyphosis did not develop in any cases. There were no significant factors that predict surgical outcome. CONCLUSION: Expansive open-door laminoplasty using titanium miniplates can be easily performed and is effective technique for decompression and maintenance of the spinal canal diameter.