Guidelines for the management of head injuries in remote and rural Alaska.

Numerous recommendations on the initial evaluation and treatment of the head injured patient have been proposed over the last several years. Most assume there is readily available access to computed tomography and neurosurgical specialists. Many clinicians in Alaska must evaluate and begin treatment of head injured patients in circumstances quite different from this.

Leptomeningeal carcinomatosis following craniofacial resection of an ethmoid tumor.

Leptomeningeal carcinomatosis (LMC) is a rare complication following treatment for head and neck cancer. In this paper, we report a case of LMC following surgery and localized radiation therapy for an ethmoid carcinoma, in which laceration of the dura during craniofacial resection may have provided an access for cancer cells into the cerebrospinal fluid (CSF). As a result, the patient developed LMC manifested as multiple spinal nerve root involvement.

Intradural extramedullary cysts of the spinal canal: clinical presentation, radiographic diagnosis, and surgical management.

Fourteen patients with intradural extramedullary cysts of the spinal canal are described. Histological classification included 11 arachnoid, 2 epithelial, and 1 ependymal cyst. There were 9 thoracic, 3 cervical, and 2 lumbar cysts.

Cerebral aneurysms associated with neurofibromatosis.

An uncommonly recognized complication of neurofibromatosis (NF) is an angiopathy of the intracranial and extracranial arteries. Most of the previously reported cases have presented as an occlusive process similar to Moyamoya disease. We present our experience over the past 3 years involving three patients with five cerebral aneurysms and associated NF.

Brain tumors occurring before 1 year of age: a retrospective reviews of 22 cases in an 11-year period (1977-1987).

Congenital brain tumors have been reported infrequently and their management remains ill defined. An 11-year review (1977-1987) of all children with brain tumors with the onset of symptoms before 1 year of age was completed. Twenty-two children with the following histological diagnoses were treated: astrocytoma (7 patients), primitive neuroectodermal tumor (6 patients), papilloma or carcinoma of the choroid plexus (3 patients), malignant teratoma (2 patients), dermoid tumor (2 patients), embryonal rhabdomyosarcoma (1 patient), and chloroma (1 patient).