The anterior cervical approach for traumatic injuries to the cervical spine in children.

In most cases of traumatic cervical spine injuries in children, nonoperative treatment, mainly external stabilization, is sufficient. When operative treatment is chosen, surgeons often recommend posterior stabilization. In a subset of pediatric patients, the anterior approach is indicated.

Silicon prevents post laminectomy epidural root adhesions. An experimental study in rats.

An experimental study was designed to test the efficacy of a silicon barrier around a nerve root in order to prevent post operative epidural root scar adhesions. In 32 Sprague-Dawley rats a lumbar nerve root was microsurgically exposed bilaterally. In 16 animals a silicon tube, prepared with a longitudinal cut along half of its wall, was placed around one nerve root, while the contralateral side served as control.

Postoperative spinal epidural empyema. Clinical and computed tomography features.

Epidural empyema is a rare complication of elective spinal surgery. Four such cases are described. The clinical features of this postoperative complication were surprisingly vague and misleading.

Magnesium sulfate reverses experimental delayed cerebral vasospasm after subarachnoid hemorrhage in rats.

We induced experimental delayed cerebral vasospasm by the intracisternal injection of greater than 0.5 ml blood in 30 rats. Seventy-two hours later the basilar artery was exposed via the transclival approach and photographed at high-power magnification through an operating microscope.

Delayed nonhemorrhagic encephalopathy following mild head trauma. Case report.

Delayed nonhemorrhagic encephalopathy following mild head trauma is a rare condition with an unknown etiology. The few cases reported in the literature are in young adults, all of them in the era before computerized tomography (CT) became available, and all had a devastating clinical course with multifocal ischemia or necrotic lesions found at autopsy. A case is presented of a young man with this syndrome who survived the acute encephalopathic phase with severe residual neurological deficits.

Upward transtentorial herniation: a complication of postoperative edema at the cervicomedullary junction.

Local edema at the operative bed developed a few hours after uneventful subtotal removal of a lesion occupying the lower medulla and upper cervical cord. The patient experienced apnea, quadriplegia, and circulatory collapse followed by acute respiratory insufficiency. Hydrocephalus secondary to aqueductal occlusion occurred on the 3rd postoperative day.

Intratumoural cyst formation in pituitary macroadenomas.

Twenty-one patients with various types of pituitary macroadenomas underwent hypophysectomy at the Chaim Sheba Medical Centre between 1985 to 1987. Intraoperative fine needle aspiration of the tumoural content was attempted prior to tumour excision. Although none of the patients had a history compatible with pituitary apoplexy, intratumoural fluid suggestive of a cyst within the tumour was found in 57% of the patients.

Hemangioma of the thoracic spine involving multiple adjacent levels: case report.

An unusual case of hemangioma involving three adjacent dorsal vertebrae with a clinical picture of progressive paraparesis is presented. Radiological verification of the lesion can be expected if possible, using plain X-Rays, tomography, CT scan and myelography. The roentgenographic appearances of vertebral hemangioma were characteristic, but only CT revealed the true extent of the disease.

Ventriculoperitoneal shunt malfunction due to migration of the abdominal catheter into the scrotum.

A case is reported in which the peritoneal portion of a ventriculoperitoneal shunt migrated into the scrotum via an indirect inguinal hernia and caused cerebrospinal fluid hydrocele with shunt malfunction.

Intermittent priapism in spinal canal stenosis.

A case of spontaneous intermittent priapism in a patient with spinal canal stenosis is presented. Erection, as well as intermittent neurogenic claudication and urinary incontinence were provoked by physical exertion, mainly walking. The symptoms completely resolved after decompressive lumbar laminectomy.

Entrapped lumbar nerve root in pseudomeningocele after laminectomy: report of three cases.

The authors report three patients with symptomatic postlaminectomy pseudomeningocele. At operation a loop of a nerve root was found to be trapped within the dural defect. All three patients exhibited a delayed onset of radicular symptoms and signs after disc surgery.

Basal encephalocele associated with suprasellar epidermoid cyst.

A 27-year-old woman suffered from multiple congenital defects, including transsphenoidal encephalocele. Recent progressive visual loss was at first attributed to this encephalocele, but was later proved to be caused by a suprasellar epidermoid cyst. Its removal was followed by improvement of vision.

Vascular malformation of the posterior corpus callosum: surgical treatment.

Arteriovenous malformations in the vicinity of the splenium are a rare cause of subarachnoid bleeding. They are usually unaccompanied by neurological deficits. Three such cases are described and methods of identification and surgical approach discussed.

Use of surgical laser in the removal of an osteoma of the skull.

The laser beam can be adapted for use as a surgical cutting instrument. It was chosen for this purpose in the extirpation of an osteoma of the skull. Its removal by conventional means was believed to be too dangerous, because of surrounding vascularity.

Spinal epidural hematoma due to hemangioma of vertebra.

A case of acute flaccid paraplegia is reported, due to epidural bleeding in the dorso-lumbar region. A hitherto undiagnosed and asymptomatic hemangioma of a dorsal vertebra was considered to be the source of the haemorrhage. Recovery followed early laminectomy and evacuation of blood clots.

Microsurgery in anterior approach to cervical discs.

Removal of intervertebral discs and osteophytes with the aid of an operating microscope was performed in ten patients suffering from cervical spondylotic radicular or radiculomyelopathic syndromes, using an anterior approach. The method permits more complete removal of disc, posterior and lateral osteophytes, without the necessity of drilling or otherwise injuring the vertebral bodies. In five patients, a bone graft was inserted into the vacated space after disc removal.