[Embolization of AVM's of thoracic spinal cord with histoacryl glue]. / Embolizacja naczyniaków odcinka piersiowego rdzenia kregowego za pomoca kleju histoakrylowego.

The authors present two cases of inoperable AVM's of thoracic spinal cord successfully treated by embolization with histoacryl glue (B. Brown Melsungen AG). The glue used for embolization is characterized by instant polymerization when comes in contact with blood. A mass of polymer is visible on X-ray thanks to contrast medium Lipiodol and metallic powder Tungsten that are added to glue and injected together with the latter. In the first case, a female who presented with paraparesis and walked only with assistance embolization performed in one session resulted in neurological improvement enabling independent walking at follow-up 2 yrs later. In the second case of a young male not walking for severe paraparesis embolization performed in three sessions resulted in significant neurological recovery. 10 days after the first session the patient became ambulatory. 6 months after treatment he presented with mild paraparesis and was still ambulatory and leading independent life. In each case embolization was performed after balloon occlusion test during which the function of spinal cord was monitored by somatosensory evoked potentials and neurological assessment.

[A case of complete Th7-Th8 fracture-dislocation treated by one-stage posterior and transthoracic approach]. / Przypadek calkowitego podwichniecia Th7-Th8 bez uszkodzenia rdzenia kregowego operowany z jednoczasowego dojscia tylnego i przez klatke piersiowa.

The authors present a case of severe traumatic fracture-dislocation of Th8 with total anterior slippage of Th7 on Th8 without spinal cord injury. The patient underwent one-stage anterior and posterior decompression. Posterior surgery included Th4 to Th9 laminectomy and Th7-Th8 facetectomy and posterior bone graft. Anterior procedure included Th8 vertebrectomy, anterior interbody bone graft and anterior plating with usage of "Zespol" plate and screws anchored in Th6, Th7, Th8 and Th9 vertebral bodies. Postoperative period was uneventful and the patient remained neurologically intact. He was placed in a plaster jacket and mobilized of fifth day after surgery.

[Thoracic outlet syndrome: results of surgical treatment]. / Zespól górnego otworu klatki piersiowej--wyniki leczenia chirurgicznego.

21 patients with thoracic outlet syndrome (t.o.s.) were operated on in the Department of Neurosurgery of MMA in Lódz between 1982-1991. Early and long-term results of treatment were analyzed in the group of 13 cases. In early postoperative period 5 patients were free of pain and neurologic or vascular disturbances in the upper limb. In other 6 cases pain disappeared partially and mild neurological or vascular syndromes persisted. Altogether satisfactory results of treatment were obtained in 8 patients (85%). There was some improvement in 2 patients but pain and neurological or vascular disorders were still significant after surgery. Long-term results were assessed at least 1 year after operative treatment. Recurrent pain with or without mild neurological (vascular) syndromes appeared in 6 patients (46%). Recurrent t.o.s. occurred mainly in cases of young women with low position of shoulder girdle and poorly developed musculature of this region. Only 2 patients still remained free of preoperative syndromes. Altogether only 8 patients (61%) had acceptable results of surgical treatment at long-term follow-up. The remaining 5 patients (39%) had unsatisfactory long-term results.

[Diagnosis of the upper thoracic outlet syndrome]. / Diagnostyka zespolu górnego otworu klatki piersiowej.

Basing on a review of literature and own experience the authors present the aetiology and various diagnostic methods of thoracic outlet syndrome (t.o.s.), especially electrodiagnostic and Doppler studies. Provocative tests like Wright, Adson or hyperabduction manouvers are discussed and their role in modern diagnosis of t.o.s. is presented.

[The importance of computerized tomography and magnetic resonance imaging in the diagnosis of slowly growing cerebral gliomas]. / Znaczenie tomografii komputerowej i rezonansu magnetycznego w rozpoznawaniu wolno rosnacych glejaków mózgu.

The authors present diagnostic problem in slowly growing brain gliomas. Two illustrative cases are presented. Both were characterized by scant clinical manifestations and long-term course of the illness before the operation. CT examinations repeated in both patients several times in the preoperative period of a few years disclosed unchanging hypodense areas in cerebral hemispheres. No progress in clinical status of the patients and CT imaging of the lesions were observed throughout years of observation (2 and 5 years, respectively). Rapid deterioration of neurological condition in both patients associated with enlargement of the lesions in CT allowed to establish strong suspicion of brain tumour which was confirmed by examination in each case. Histopathological examination revealed malignant gliomas in both cases. The cases confirmed once again the necessity of early MRI examination in patients with hypodense lesions of the brain found in CT. The authors believe that every hypodense area of the brain should be verified by MRI as soon as possible, regardless their size, progress and neurological status of the patient. Such as approach to the diagnosis of hypodense areas in the CT of the brain may prevent a delay in proper treatment as well as malignant transformation of primarily benign lesion.

[Usefulness of computerized tomography in the diagnosis of peripheral nerve tumors]. / Uzytecznosc komputerowej tomografii w rozpoznawaniu guzów nerwów obwodowych.

After an analysis of cases of tumours situated on the peripheral nerves treated in hospital the authors stress the usefulness of computerized tomography in the diagnosis of these tumours. By demonstrating the internal structure of the tumour, its anatomical relationships to the surrounding tissues the investigation provides many important and practical data in the surgery of peripheral nerves.

[An hourglass-shaped enteric cyst of the cervico-thoracic region with extra- and intramedullary location]. / Klepsydrowata torbiel jelitowa (cystis enterica) pogranicza szyjno-piersiowego o zewnatrz-i wewnatrzrdzeniowym umiejscowieniu.

The authors report a case of a hourglass dysontogenetic tumour in a 7-year-old girl (enteric cyst) of the spine at the cervicothoracic region coexistent with a developmental anomaly of the spine and posture anomaly. Atypical symptoms (pains) suggesting a disease of the gastrointestinal tract or heart made the diagnosis very difficult. Contrast examination of the vertebral canal made possible a correct diagnosis and appropriate surgical intervention. Microsurgical technique permitted the tumour to be removed radically.

[Unilateral hyperostosis frontalis interna coexistent with cerebral angioma]. / Jednostronna hiperostoza wewnetrzna kosci czolowej wsólistniejaca z naczyniakiem mózgu.

The authors describe a rare case of coexistence of cerebral angioma with hyperostosis frontalis interna in a female patient aged 28 years, suffering from mental disturbances. The coexistence of these two diseases in one person caused considerable diagnostic and therapeutic difficulties. The described case points out that both these conditions may occur concomitantly. Another point of interest is the presence of hyperostosis frontalis interna in a young woman.