Percutaneous twist-drill craniostomy for the treatment of chronic subdural haematoma.

A consecutive series of 65 adult patients with chronic subdural haematoma was reviewed to ascertain the efficacy of twist-drill craniostomy and closed-system catheter drainage. In all patients but two the percutaneous evacuation of the haematoma alone was enough to bring about their recovery. Infections or neurological complications were never observed.

Radiation-induced cerebral lesions in childhood.

Post-irradiation cerebral pathologies may appear in various forms from localized radiation necrosis to a plurifocal type or from local to diffuse vasculopathies. Contrary to the current prevalent opinion, these lesions are not rare in children since young nerve tissue is particularly sensitive to ionizing radiation. Given the seriousness of some of these lesions, the authors recommend careful evaluation of the risk involved in relation to the real necessity of administering irradiation therapy in childhood.

Surgical treatment of Graves' ophthalmopathy by decompressive orbitotomy.

Malignant exophthalmos is often not resolvable using only medical or radiation therapy. The pressure on the optic nerve which is generally associated with it evolves rapidly in many cases towards optic atrophy and subsequently loss of vision. Only surgical treatment offers any guarantee of success and of the various techniques proposed, subfrontal orbital decompression seems clearly the more effective, in that it makes for an optimal alleviation of pressure in the optic pathways.

Peritoneal cerebrospinal fluid pseudocysts: a complication of ventriculoperitoneal shunts.

The authors report seven cases of peritoneal pseudocysts in children with ventriculoperitoneal shunts. After describing the etiopathogenetic hypotheses, the symptomatology and the diagnostic investigations, they review the various types of treatment adopted to date and propose a simple and effective method, which has resulted in rapid resolution of all seven cases.

[Syndrome of ventricular overdrainage in children with fluid shunts].

The authors emphasize the possible complications following the surgical operation by ventriculocaval or ventriculoperitoneal shunts in the neonatal hydrocephalus. These complications are mainly caused by the liquoral hyperdrenage which occurs for the differential pressure of the valve system, since this valve is operating by the differential pressure between cerebral ventricles and the receiving cavities and not by the absolute pressure existing in the ventricular cavity. The following late complications are examined: a) chronic subdural haematoma; b) slit ventricle syndrome.