Pediatric age, posterior fossa meningioma.

Meningiomas are benign, slow-growing tumors originating from arachnoid gap cells. They constitute 15%-20% of all intracranial tumors in adults and 04%-4% in the pediatric age group. Meningiomas in the posterior fossa in the pediatric period do not initially come to mind. In the case presented here, there was a cystic meningioma showing heterogenous contrast and obstructive hydrocephaly was observed associated with 4th ventricle pressure. the tumor was totally removed, then the ventriculo peritoneal shunt was applied.

Downward Laminotomy Technique for Hidden Zone Foraminal Disk Herniations: Technical Notes and Preliminary Results.

INTRODUCTION: Hidden zone foraminal herniations are among the more rare forms of herniations. As exploration is difficult, and there is a close relationship between the nerve root and pedicle, many surgical approaches have been proposed. The aim of this study was to describe downward laminotomy as a new approach to these herniations. MATERIALS AND METHODS: A downward laminotomy technique was used in 5 cases with hidden zone foraminal disk herniation with no extension to the intervertebral disk space. RESULTS: The herniated disk fragment was located at L4-L5 in 4 cases and at L3-L4 in 1 case. Mean visual analog scale scores reduced from preoperative 8.2 to 2.1 postoperatively. The allodynia was resolved in two months. CONCLUSIONS: It was concluded that downward laminotomy provides a safe, less risky, and minimally invasive approach to hidden zone foraminal disk herniations.

Alternatives to surgical approach for giant spinal schwannomas.

OBJECTIVE: To review the diagnoses and surgical approach characteristics of giant spinal schwannomas (GSS) patients. METHODS: We reviewed the preoperative and postoperative radiological and clinical data, and the surgical aspects of 18 GSS patients who underwent surgery in the Department of Neurosurgery, Umraniye Teaching Hospital and Research State Hospital, Istanbul, Turkey between January 2008 and December 2013. RESULTS: There were 15 (83.3%) female and 3 (16.6%) male patients. The age range was 16-70 years (average: 45.8). Average symptom duration was 1.5 months (range: 1-48). There was local pain in 15 cases, and radicular pain in 6 cases. The GSSs were most frequently located in the lumbosacral area (11 cases, 61.1%). An extraforaminal surgical approach was employed in 7 cases, a posterior approach was employed in 6 cases, a combined anterior transabdominal and posterior approach was employed in 2 cases, a combined posterior and extraforaminal approach was employed in 2 cases, and a retroperitoneal approach was applied in one case. The tumors were completely excised in all cases. The mean follow-up period was 38.5 months (range: 20-68). CONCLUSION: Giant spinal schwannomas exhibit unique diagnostic and surgical factors. The selection of an appropriate approach significantly influences the success of the treatment.