Polypropylene-polyester cranial prostheses prepared with CAD/CAM technology. Report of first 15 cases.

OBJECTIVES: The authors described a new cranioplastic method where polypropylene-polyester knitwear was shaped according to individual patient's skull 3D model. The material was formed in a customized manner and preoperatively adjusted to the patient needs with modern CAD/CAM techniques. PATIENTS AND METHODS: The procedure consisted of a CT scan with a simple but unorthodox protocol, 3D modeling of the bone defect and planned prosthesis, finally the preparation of the plate itself. Prostheses were used in the 15 cases of cranial defects. RESULTS: Sample cases were shown with preoperative and postoperative CT scans, patient pictures, and 3D models of the prostheses. The size of the defect ranged from 15 to 95 cm(2), and the observation period after the reconstructive operation ranged from 3 to 23 months. The results were very good in all cases of cranioplasties performed after craniectomies of various origins. CONCLUSION: CAD/CAM shaping gave better adjustment to requirements of specific defect than any standard preformed plate. Such method seemed to be a reasonable alternative to other cranioplastic solutions and can be recommended even for cases of large or complicated shape cranioplasties.

[Hemifacial spasm as an early symptom of posterior fossa meningioma]. / Polowiczy skurcz twarzy jako poczatkowy objaw oponiaka tylnej jamy czaszki.

A rare case of a 47-year old female with hemifacial spasm of the one-year duration as the initial and only symptom of posterior fossa meningioma is reported. At first the patient did not consent to surgery and was unsuccessfully treated with anticonvulsants. A month prior to her admission she started to complain of headache and balance disorder, and developed sensory loss to light touch in II and III branches of the right V nerve. CT revealed a huge posterior fossa meningioma. After a total removal of meningioma, the patient's hemifacial spasm disappeared.

Colloid-like cyst located in the prepontine region.

BACKGROUND: The term "colloid cysts" refers to nonneoplastic lesions located in the anterior part of the third ventricle. However, cysts morphologically identical to colloid cysts are found, albeit extremely rarely, through the neuraxis. CASE DESCRIPTION: We report a case of a 44-year-old man with a short history of headache and 5 years of bilateral hearing loss. Computed tomography (CT) and magnetic resonance imaging (MRI) scans showed an oval lesion located at the anterior surface of the pons. The tumor was excised through a right pterional transsylvian approach. Postoperatively, the hearing deficit remained unchanged. Otherwise, the patient made an excellent recovery. Histopathological examination showed a colloid-like cyst. CONCLUSIONS: Colloid-like cysts growing in the prepontine region are extremely rare. To date, only two similar cases have been reported in the literature. Patients present with headaches, hearing loss, or blurred vision.

[Trigeminal neuralgia due to lengthy AVM treatment. A case report]. / Neuralgia nerwu trójdzielnego po embolizacji wewnatrzczaszkowego oponowego znieksztalcenia tetniczo-zylnego. Opis przypadku.

The authors presented a case of iatrogenic trigeminal neuralgia in a 46-year-old man with a dural arteriovenous malformation (AVM) previously treated by means of intravascular embolization. At first, microvascular decompression (MVD) in the posterior fossa was performed, but unfortunately the pain persisted. Subsequently, percutaneous stereotactic radiofrequency rhizotomy was carried out. The procedure was uneventful and brought about an immediate pain relief.

[Sixteen-year experience in the treatment of trigeminal neuralgia by percutaneous retrogasserian thermorhizotomy]. / Szesnascie lat doswiadczen w leczeniu nerwobólu nerwu trójdzielnego metoda termokoagulacji zwoju Gassera.

The authors present a series of 143 consecutive patients with trigeminal neuralgia who were treated with percutaneous retrogasserian thermorhizotomy between 1984 and 2000. Long time results (follow-up of 16 years) revealed full pain relief in 80% of patients, mainly in those with postoperative sensory deficit, 16% suffered pain recurrence and required additional treatment.