Percutaneous lumboperitoneal shunt: review of 130 cases.

One hundred thirty consecutive cases of percutaneous lumboperitoneal shunting are reviewed. The efficacy of this procedure in the management of cerebrospinal fluid fistulas and bulging craniotomies is documented. The place of lumboperitoneal shunts in the management of communicating hydrocephalus, with particular emphasis on "normal pressure" hydrocephalus, is discussed.

Paramesencephalic arachnoid cysts.

The term "paramesencephalic" is proposed to describe the location of a general class of arachnoid cysts observed in four patients. These cysts, which appear to arise within the subarachnoid space, are characterized by a lack of communication with the ventricular system. Usually, the arachnoid tissue is normal, and the cyst fluid resembles cerebrospinal fluid both macroscopically and microscopically.

Percutaneous lumboperitoneal shunt. Technical note.

The authors describe a new catheter for use in percutaneous lumboperitoneal shunting, designed to overcome the problem of kinking. They present their experience with the catheter in 14 patients.

Clinical, arteriographic, and cisternographic observations after removal of acute subdural hematoma.

The authors review 47 patients with closed-head injuries requiring treatment for acute subdural hematoma and report that 21 (45%) survived for 5 days or more. Follow-up study of these 21 survivors led to the following observations: that clinical evaluation of these patients is the most reliable index of their postoperative progress; that the diagnostic usefulness of postoperative cerebral arteriograms is limited because immediate postoperative changes tend to persist; that craniotomy is preferable to burr holes for removal of an acute hematoma; and that the value of cisternography, unless done serially, is limited since posttraumatic hydrocephalus develops rapidly and may persist indefinitely.

Spontaneous spinal epidural haemorrhage: good results after early treatment.

Extravasation of blood in the spinal epidural space is an uncommon but often disastrous problem. Severe trauma, anticoagulants, bleeding diatheses, and intraspinal vascular malformations have been associated with such haemorrhage, but occasionally it occurs without apparent cause. It may then be confused with transverse myelopathy or vascular occlusion.

Surgical experience with a microscopic transsphenoidal approach to pituitary tumors and non-neoplastic parasellar conditions.

Improved surgical microscopes and intraoperative radiofluoroscopic television have revived the transsphenoidal approach to pituitary tumors. The transsphenoidal approach offers an alternative to craniotomy, and in certain situations it has distinct advantages. The reported experience includes the common pituitary tumors, hypersecreting microadenomas, cerebrospinal rhinorrhea and parasellar aneurysms.