Reoperation after lumbar disc surgery: results in 130 cases.

Out of a series of 1850 cases operated upon for lumbar disc herniation 130 underwent re-operation because of persistent or recurrent symptoms. Re-operation was successful in 62%. The prognosis of re-operation was not related to special clinical symptoms and signs but only to the operative findings. Herniations at other levels and recurrences of lumbar disc herniations had the best results (excellent in 98% respectively 54%), but scar formations alone came out much less satisfactory (only 38% excellent results). Computed tomography (CT) findings were less reliable in distinguishing between disc prolapse and fibrosis than magnet resonance imaging (MR). Therefore MR is the diagnostic method of choice in these conditions, and scar formations alone should be considered a contra-indication for re-operation.

Malignant mesenchymoma of the brain. A case report.

A case of malignant mesenchymoma of the brain, containing rhabdomyosarcomatous, osteoid and cartilaginous components is presented. The patient received surgery and irradiation for his tumor, but died 10 months after the operation. Previous reports of malignant mesenchymoma of the brain are exceptional. The neurobiological behavior of this tumor is yet to be determined.

Clinical and radiographic response of fourth ventricle cysticercosis to praziquantel therapy.

A case of fourth ventricle cysticercosis treated with praziquantel is presented. The disappearance of the lesion six months after the treatment was demonstrated by CT scan. A review of the literature indicates that this is a very exceptional result, because with recently intraventricular cysticercosis was considered to be non-responsive to praziquantel treatment, making surgery necessary.

[Ventriculoperitoneal shunt in the treatment of hydrocephalus in children. Results and complications]. / Derivación ventrículo peritoneal en el tratamiento de la hidrocefalia infantil. Resultados y complicaciones.

Shunting the ventricular fluid to a body cavity out side the cranium is the preferred method of treatment of progressive hydrocephalus of whatever cause. The distal end of the shunt should be in the peritoneal cavity or in the right atrium by way of the jugular vein and superior vena cava. The advantages of peritoneal over atrial placement of the distal catheter are: avoidance of cardiopulmonary complications: faster and simpler placement of the distal catheter; space to place a longer distal catheter, prolonging the interval before revision. A series of 173 extracranial cerebrospinal fluid shunts (CSF) performed between 1978 and 1986 for hydrocephalus in children is reviewed. Ventriculoperitoneal shunt was used essentially. The most common complications we catheter obstruction peritoneal and ventricular.

[Surgical treatment of unique cerebral metastasis: survival factors]. / Tratamiento quirúrgico de la metástasis cerebral única: factores de supervivencia.

Ninety patients operated for single cerebral metastasis in the Hospital General de Vigo between 1978 and 1986 were retrospectively studied. All of them also received radiotherapy after surgery. Several prognosis factors were studied with the aim of using them in future patients. The most significant factors were: histologic diagnosis Karnofsky's presurgery index, gap between diagnosis of the primary tumor and the time when the metastasis showed up, age and the TAC's morphology of the metastasis. These results are an important help when considering either surgery or a more conservative attitude.

[Cerebral cysticercosis. 10 cases]. / Cysticercose cérébrale. Dix cas.

Ten patients with cerebral cysticercosis seen between 1983 and 1986 were treated with praziquantel and in some cases by a ventriculoperitoneal shunt and/or surgical excision of cysts. Clinical and biological data were of no prognostic value. CT only was useful in orientating therapy and establishing the prognosis. A favorable course was obtained in 7 parenchymatous and meningeal forms, the fatal cases being of the mixed type. Praziquantel was inactive against intraventricular cysts.

Aspergillosis of the sphenoid sinus simulating a pituitary tumor.

Sphenoidal aspergillosis is an unusual cause of sella turcica enlargement. Pituitary abscess secondary to Aspergillus had been reported. In the present case, a woman with sphenoid sinus aspergillosis mimicked a pituitary tumor. This patient survived her infection with intact pituitary function following a transsphenoidal approach. No postoperative amphotericine-B and 5-fluorocytosine were necessary. CT scan revealed a mass occupying the sphenoid sinus extending to the sella turcica. Factors that should alert the clinican to the presence of a sphenoidal and pituitary abscess in a patient with sella turcica enlargement are prior episodes of sinusitis, meningitis and immunosuppression and, as in the present case, hyperglycemia.

Congenital meningioma.

The clinical, operative and autopsy findings associated with a huge meningioma in an 8-month-old boy are described. Especially noteworthy are the patient's age, the size of the tumour and the poorness of neurological symptoms.