Asymtomatic Giant Benign Schwannoma Involving Cervical Vertebral Body: A Case Report-

Benign Schwannoma rarely involves the vertebral bodies extensively. Despite of huge amount of neoplastic mass and severe destructive bony changes, the neurologic deficits could not be discovered. The authors discussed the findings of plain X-rays, cervical CT, MRI, pathology as well as surgical procedure, and reviewed the literatures.

A Case of Intradural Spinal Lipoma

Intradural spinal lipomas are rare, primary genign tumor of the spinal canal. A case of intradural spinal lipoma with intramedullary extension is presented. Clinical feature was slowly progressing paraparesis. A subtotal excision was performed, and pathological studies confirmed the diagnosis.

Clinical Analysis of Chronic Subdural Hematomas: Review of 69 Operated Cases

The authors analysed retrospectively, 69 cases of chronic subdural hematoma admitted to the Department of Neurological Surgery, from January 1992 to February 1995. All hematomas were operated on by one burr hole trephination and continuous closed-system cather drainage system. The results were as follows: 1) Male was more frequently involved than female with ratio of 5.3:1 and the incidence was prredominent in the patients whose ages were over 50. 2) History of head trauma was found in 52 cases(75.4%), among which habitual alcoholism was found in 6 cases(8.7%). 3) The major symptoms and signs at admission were headache(55.1%), hemiparesis(44.9%), and mental changes(30.4%). 4) On the brain CT scan, hematoma showed low, iso, mixed, and high in density, and the shapes of hematoma were crescenteric, biconvex, planoconvex, and concave in order of frequency. 5) We have found a significant relationship between the neurological grade at admission and the prognosis, and noted full recovery in 45 cases(65.2%) and no d eath as a result of 1-burr hole trephination.

A Case of Extradural Spinal Tuberculoma

Extraosseous extradural tuberculosis of the spine is rare entity. A 21-year-old man with low back pain, left-sided sciatica & motor weakness was admitted. Simple X-ray were normal. At operation, extradural, extraosseous granuation tissue were removed, which proved upon histologic examination to be tuberculous granulomas. The authors report a rare case of extraosseous tuberculoma in the posterior extradural space of whole lumbar region with review of literatures.

Brain Tumor Immunology: Part II : Immunotherapy of Malignant Brain Tumors

The prognosis of patients with malignant brain tumors has improved only slightly despite the combined use of surgery, radiation therapy, and chemotherapy. Immunotherapy offers some possibilities and hopes as a fourth modality for the treatment of cancers although it is still in the early stages of development. It is possible to classify immunotherapy within four generally accepted modalities : 1) restorative or nonspecific immunotherapy 2) adoptive immunotherapy 3) passive immunotherapy 4) active immunotherapy. The techniques of recombinant DNA, genetic engineering, cell fusion and hybridoma production, and molecular biology will make these therapeutic approaches more successful and as the clinical applications expand the skillful cancertherapist will become increasingly familiar with these treatments and the problems associated with their use.

Intraoperative Visual Evoked Potential Responses to Preserve Vision in Operation with Sellar and Parasellar Lesions

Damage to the visual system is an unfortunate complication of surgery in the area of the optic nerve and chiasm. It is now possible to monitor the functional status of the visual system intraoperatively at regular intervals. We studied the patients during parasellar surgery to determine if this technique could be used to indicate potential danger to the visual system. Our objective was to determine if the visual evoked response was sensitive and dynamic enough to detect premoibid changes in the function of the visual system. This is accomplished by recording the Visual Evoked Potential Response to flash of light from light-emitting diodes goggle. 1) We studied two patients during sellar and parasellar surgery to determine if this technique could be used to indicate potential danger to the visual system. 2) It was benefit to determine if the intraoperative VEP was sensitive and dynamic enough to detect premorbid changes in the function of the visual system. 3) The VEP showed conduction was blocked when the optic nerve was manipulated and restored when the optic nerve was decompressed. 4) After the optic nerves were decompressed, VEP of nearly normal latency, amplitude and form was recorded. 5) Changes in the VEP pararell improvement of function after surgical removal of sellar and parasellar tumors. 6) Determination of improved nerve conduction permitted the prediciton of visual recovery during surgery.