The median effective dose of preemptive gabapentin on postoperative morphine consumption after posterior lumbar spinal fusion.

Background: A single dose of preemptive gabapentin reduces postoperative pain and postoperative analgesic consumption. However, the optimal dose of preemptive gabapentin remains to be evaluated.

Methods: In this prospective study, we defined the median effective analgesic dose using an up-and-down sequential allocation technique of preemptive gabapentin in 67 patients undergoing elective posterior lumbar spinal fusion.

[Hypophysis metastasis of a hypernephroma tumor revealed by a chiasma syndrome].

In a 45-year-old man with a hypernephroma tumor of the right kidney, a metastasis in the pituitary gland of this neoplasm was diagnosed 9 years after removal of this kidney. He complained of bitemporal hemianopsia and slight impairment of vision. A hypernephroma metastasis in the pituitary gland is very rare and few have been reported to date.

[Spinal cord histoplasmoma. A case report].

Over a period of 2 months, a 60-year-old man, a chicken breeder, experienced low back pain, lower limb weakness predominant on the right side, and urinary difficulties, leading progressively to a flaccid paraplegia with sphincter impairment. Concomitant poor cognitive performances were noted. MRI showed enlargement of the conus terminalis, with a low-intensity signal on T1-weighted images, high-intensity signal on T2-weighted images, and areas of intramedullar contrast enhancement.

[Ossification of ligamentum flavum unmasked by acute paraplegia].

A 30-year-old black man presented sudden-onset paraplegia during a foot-ball match, after a movement of hyperextension of the trunk. Moreover, the patient exhibited an hypoesthesia below the T11 level, with sphincter disturbances. The MRI and the CT-scan showed a stenosis of the spinal canal related to an ossification of hypertrophied ligamenta flava from T10 to T12.

[Vermian epidermal cyst developing in the fourth ventricle. A case report].

A 34-year-old man presented with recent severe headache. Neurological examination found gait disturbance and a static cerebellar syndrome. The CT scan showed a tumor located in the fourth ventricle and which presented with a density close to that of the cerebellar parenchyma, without contrast enhancement, associated with an enlargement of the third and the lateral ventricles.