Review of therapeutic failures of microvascular decompression in trigeminal neuralgia at a tertiary hospital.

Introduction: Microvascular decompression (MVD) is a non-ablative technique aimed at relieving pain in trigeminal neuralgia (TN) by resolving a neurovascular conflict. Despite reported high success rates, a significant percentage of patients experience therapeutic failure.

Methods: Retrospective observational study of patients with suspected TN undergoing MVD was performed with the goal of identifying factors contributing to the persistence and recurrence of pain.

Endoscopic endonasal superomedial orbitectomy: How far is safe and possible?

Objectives: During the endoscopic endonasal approach (EEA) to the anterior cranial base, the lateral boundaries are the lamina papyracea (medial orbital walls) bilaterally but further extension in the coronal plane is possible by performing a superomedial orbitectomy. The aims of this study are to describe the technique of the endoscopic endonasal transethmoidal supraorbital approach to the anterior cranial base and to calculate the extension in the coronal plane added with the superomedial orbitectomy.

Methods: Thirty superomedial orbitectomies via EEA were completed in 15 fresh-frozen heads.

[Biology and mechanobiology of the intervertebral disc].

The intervertebral disc (IVD) is noted for its low cell content, and being the largest avascular structure of human body. The low amount of cells in the disc have to adapt to an anaerobic metabolism with low oxygen pressure and acidic pH. Apart from surviving in an adverse microenvironment, they are exposed to a high level of mechanical stress.

Does aqueductal stenosis influence the lumbar infusion test in normal-pressure hydrocephalus?

Background: Late-onset idiopathic aqueductal stenosis may present with clinical features indistinct from idiopathic normal-pressure hydrocephalus (NPH). Moreover, aqueductal stenosis (AS) is not always detected by conventional magnetic resonance imaging (MRI). The aim of this study was to compare the hydrodynamic pattern among NPH patients according to the patency of the aqueduct.

[Innervation of the intervertebral disc].

Until very recently, intervertebral disc innervation was a subject of considerable debate. Nowadays, the introduction of inmunohistochemical techniques associated to specific antibodies and studies with retrograde tracers in nerves have allowed greater understanding of disc innervation in physiological and pathological conditions and also endings characteristics and their patterns of distribution in both situations. The existing controversies regarding structural basis of discogenic pain, have raised the interest of knowing the influence of innervation in back pain from discal origin and its characteristics.

[Orbital leiomyoma. Case report and review of the literature].

Leiomyoma are slowly growing lesions arising from smooth muscle. Orbital location has been reported in 25 cases. Histological findings and no recurrence after total resection support their benign behaviour.

[Minimally invasive approach of extramedullary intradural spinal tumours. Review of 30 cases].

Objective: To analyse the safety and effectiveness of a microsurgical unilateral approach in minimally invasive surgery of extramedullary, intradural spinal tumours.

Materials And Methods: This was a retrospective study of 29 patients with 30 extramedullary, intradural spinal tumours approached through unilateral laminectomy -hemilaminectomy. Epidemiological data, location and histology of the lesions and radiological and clinical evolution of the patients were recorded.

Giant-cell granuloma of the axis.

Giant-cell granuloma is a benign and nonneoplastic lesion with an expansive and locally destructive behavior. It typically involves the mandible and the maxilla. Only 1 case arising from the odontoid process of the axis has been reported previously.

Brown tumor of the orbital roof as an initial and isolated manifestation of secondary hyperparathyroidism.

Brown tumors appear in advanced stages of hyperparathyroidism. Only 17 cases have been documented in the orbit. We report a case of a young woman with a brown tumor in the orbital roof.