[Fibro-osseous lesion of the central nervous system]. / A központi idegrendszer fibroosseosus laesiója.

The case of a 53-year-old woman with headache and progressive right sided decline of visual acuity is reported. Computed tomography scans of the brain revealed multiple circumscribed foci of mineralization located over the left frontal and parietal, as well as the right central brain parenchyma. Surgical sampling of the left frontal lesion yielded a conglomerate composed of mineralized vessels, myriad of psammoma bodies, and metaplastic lamellar bone entangled within poorly cellular collagen fibers. No evidence was found of an underlying vascular malformation or tumor, nor was there evidence of parenchymal necrosis of infectious origin. On account of the organoid association of the mesenchymal elements and the mineralized moiety, the lesion was consistent with fibro-osseous lesion of the central nervous system. Also known as "calcifying pseudotumor" of the brain, the origin of this exceedingly rare condition is, as yet, unknown. By analogy, its pathogenesis is likely to involve mechanisms underlying tumoral calcinosis of soft tissues.

[Surgical treatment of giant basilar artery aneurysm with induced hypothermia and circulatory arrest]. / Arteria basilaris óriásaneurysma mútéti kezelése hypothermiában végzett keringésmegállítás alatt.

Surgical management of giant and complex posterior circulation aneurysms continues to be a technically difficult task with high operative morbidity. To minimize morbidity we have used cardiopulmonary bypass and circulatory arrest for the treatment of a giant basilar aneurysm. A 48-year-old woman presented with sudden headache. Magnetic resonance angiography revealed a giant basilar aneurysm. On the 2nd hospital day she developed right sided hemiparesis and cranial nerve deficits as a result of the second rupture of the aneurysm. The aneurysm was successfully treated and no significant neurological complications were related to this technique. This initial experience indicates that patients with giant posterior circulation aneurysm that cannot be treated using conventional techniques might benefit from a surgical approach that included the use of deep hypothermic circulatory arrest.

[Management of trigeminal neuralgia by microvascular decompression]. / Trigeminus neuralgia kezelése microvascularis dekompresszióval.

The experience with a series of 28 posterior fossa exploration and microvascular decompression for trigeminal neuralgia is presented. All the patients were treated with carbamazepine previously and some of them were operated on by destructive methods. The diagnostic work-up consisted of an accurate history, CT or MRI in all cases, and recently (in 17 cases) the vascular compression of the trigeminal nerve was demonstrated directly by MR angiography in the plane of the trigeminal nerve. Microvascular decompression was performed through a suboccipital retromastoid craniotomy. At the operations 21 arterial, 4 venous, 2 combined (arterial + venous) and 1 arachnoid band compression were found. The mean follow up was 30 months. Immediate pain relief was achieved in all cases but one, and there were two recurrences 6 and 12 months later (both of them were venous compression), which have been controllable medically since then. There were 3 permanent hypaesthesia of the face (one of them loss of corneal reflex), 2 hypacusis, 1 cerebrospinal fluid leakage and 1 cerebellar edema as complications. Microvascular decompression is a safe and effective treatment for trigeminal neuralgia and advised if the medical treatment is failed, the patient suitable for general anaesthesia, and there is the evidence of vascular compression of trigeminal nerve on MR angiography.