ABSTRACT
A consecutive series of 65 adult patients with chronic subdural haematoma was reviewed to ascertain the efficacy of twist-drill craniostomy and closed-system catheter drainage. In all patients but two the percutaneous evacuation of the haematoma alone was enough to bring about their recovery. Infections or neurological complications were never observed. Pneumocephalus was likewise absent in all patients. Therefore this technique should be recommended as the "first intention" management of the disease, particularly in elderly patients.
Subject(s)
Craniotomy/instrumentation , Drainage/instrumentation , Hematoma, Subdural/surgery , Trephining/instrumentation , Aged , Chronic Disease , Female , Hematoma, Subdural/diagnosis , Humans , Male , Middle Aged , Neurologic Examination , Postoperative Complications/diagnosis , Subdural Effusion/diagnosis , Subdural Effusion/surgery , Tomography, X-Ray ComputedABSTRACT
Post-irradiation cerebral pathologies may appear in various forms from localized radiation necrosis to a plurifocal type or from local to diffuse vasculopathies. Contrary to the current prevalent opinion, these lesions are not rare in children since young nerve tissue is particularly sensitive to ionizing radiation. Given the seriousness of some of these lesions, the authors recommend careful evaluation of the risk involved in relation to the real necessity of administering irradiation therapy in childhood.
Subject(s)
Brain Diseases/etiology , Radiation Injuries , Astrocytoma/diagnostic imaging , Astrocytoma/radiotherapy , Brain Diseases/diagnosis , Brain Diseases/diagnostic imaging , Brain Neoplasms/diagnostic imaging , Brain Neoplasms/radiotherapy , Cerebral Angiography , Child , Child, Preschool , Female , Humans , Magnetic Resonance Spectroscopy , Male , Meningeal Neoplasms/diagnosis , Meningeal Neoplasms/diagnostic imaging , Meningeal Neoplasms/radiotherapy , Meningioma/diagnosis , Meningioma/diagnostic imaging , Meningioma/radiotherapy , Necrosis , Tomography, X-Ray ComputedABSTRACT
Malignant exophthalmos is often not resolvable using only medical or radiation therapy. The pressure on the optic nerve which is generally associated with it evolves rapidly in many cases towards optic atrophy and subsequently loss of vision. Only surgical treatment offers any guarantee of success and of the various techniques proposed, subfrontal orbital decompression seems clearly the more effective, in that it makes for an optimal alleviation of pressure in the optic pathways. The Authors describe their technique, a variation on the original approach, and report the results achieved with it.
Subject(s)
Exophthalmos/surgery , Graves Disease/surgery , Orbit/surgery , Adult , Exophthalmos/etiology , Female , Graves Disease/drug therapy , Humans , MaleABSTRACT
The authors report seven cases of peritoneal pseudocysts in children with ventriculoperitoneal shunts. After describing the etiopathogenetic hypotheses, the symptomatology and the diagnostic investigations, they review the various types of treatment adopted to date and propose a simple and effective method, which has resulted in rapid resolution of all seven cases.
Subject(s)
Cerebrospinal Fluid Shunts/adverse effects , Cysts/etiology , Peritoneal Diseases/etiology , Cerebrospinal Fluid Shunts/methods , Female , Humans , Infant , Infant, Newborn , Male , Peritoneum , Staphylococcal Infections/drug therapyABSTRACT
The authors emphasize the possible complications following the surgical operation by ventriculocaval or ventriculoperitoneal shunts in the neonatal hydrocephalus. These complications are mainly caused by the liquoral hyperdrenage which occurs for the differential pressure of the valve system, since this valve is operating by the differential pressure between cerebral ventricles and the receiving cavities and not by the absolute pressure existing in the ventricular cavity. The following late complications are examined: a) chronic subdural haematoma; b) slit ventricle syndrome. Their evolution often is deceitful and severe problems of differential diagnosis with others pathological infantile states arise.
Subject(s)
Brain Diseases/etiology , Cerebrospinal Fluid Shunts/adverse effects , Hydrocephalus/surgery , Brain Diseases/diagnostic imaging , Cerebral Ventriculography , Child , Child, Preschool , Female , Hematoma, Subdural/etiology , Humans , Infant , Infant, Newborn , Male , SyndromeABSTRACT
Trigeminal neurinomas, unlike those of the acoustic nerve or of other cranial nerves, are relatively frequent in adolescence, making up 10% of the total. Two cases are described, bringing the number of reports in the world literature up to 13. The clinical, radiological and surgical data on these tumors are analyzed, and some particular aspects present in adolescence are pointed out.
Subject(s)
Cranial Nerve Neoplasms/surgery , Neurilemmoma/surgery , Adult , Cranial Nerve Neoplasms/diagnostic imaging , Female , Humans , Male , Neurilemmoma/diagnostic imaging , Tomography, X-Ray Computed , Trigeminal NerveABSTRACT
A case of meningioma of the posterior cranial fossa is reported. The tumor developed 12 years after radiation treatment for a polar spongioblastoma of the cerebellum in an 8-year-old boy. The possible role of the radiation in the oncogenesis of the second tumor is discussed. In light of the information in the literature concerning the malignancy of such postirradiation tumors, the authors recommend careful evaluation for the real necessity of radiation therapy, particularly for children in whom the meninges may be hypersensitive to ionizing radiation.
Subject(s)
Meningeal Neoplasms/etiology , Meningioma/etiology , Radiation Injuries , Adult , Astrocytoma/radiotherapy , Cerebellar Neoplasms/radiotherapy , Cranial Fossa, Posterior , Humans , Male , Meningeal Neoplasms/diagnostic imaging , Meningeal Neoplasms/surgery , Meningioma/diagnostic imaging , Meningioma/surgery , Tomography, X-Ray ComputedABSTRACT
To repair the infant skull as completely and efficiently as possible, the authors describe and recommend greater use of an autogenous graft taking the outer table of the skull from adjacent or symmetrical sites to the defect.
