Spinal Cord Herniation into a Pseudomeningocele-A Delayed Presentation following a Traumatic Cervical Root Avulsion Injury.

 Spinal cord herniation into a traumatic pseudomeningocele is a rare clinical entity. We present the sixth known case and describe surgical management.  A 44-year-old male presented with Brown-Sequard syndrome three decades after a cervical nerve root avulsion injury.

Spontaneous and recurrent subdural haematoma in a patient with May-Hegglin anomaly.

Both acute and chronic subdural haematomas typically occur following trauma. Non-traumatic causes are less common, but aetiologies include arteriovenous malformation, intracranial aneurysm rupture, tumour-associated haemorrhage and coagulopathies. May-Hegglin anomaly is an example of a coagulopathy, which is caused by a mutation in the gene encoding non-muscle myosin heavy chain 9 (MYH9) and therefore falls into a group of diseases referred to as MYH9-related diseases (MYH9-RD).

Management Challenges of Metastatic Spinal Cord Compression in Pregnancy.

Primary and secondary spinal tumours with cord compression often represent a challenging condition for the patient and clinicians alike, even more so during pregnancy. The balance between safe delivery of a healthy baby and management of the mother's disease bears many clinical, psychological, and ethical dilemmas. Pregnancy sets a conflict between the optimal surgical and oncological managements of the mother's tumour and the well-being of her foetus.

External Immobilization of Odontoid Fractures: A Systematic Review to Compare the Halo and Hard Collar.

Background: The aim of this systematic review was to compare the halo and hard collar in the management of adult odontoid fractures.

Methods: Systematic and independent searches on MEDLINE (PubMed) and the Cochrane Database of Systematic Reviews. Inclusion criteria included studies 1) with clinical outcomes, 2) in adults (18 years of age or order), 3) with odontoid fractures, 4) with patients immobilized using a halo or hard collar, and 5) in multiple (more than 5) patients.

Short versus long-segment posterior fixation in the treatment of thoracolumbar junction fractures: a comparison of outcomes.

Purpose: To compare clinical and radiological outcomes between short (SSPF) and long-segment (LSPF) posterior fixation for thoracolumbar junction (TLJ) fractures.

Materials And Methods: Retrospective review of adult patients, with single-level, TLJ (T11-L2) fractures, treated with posterior fixation between 2007 and 2014 at a regional spinal centre. SSPF and LSPF were defined as transpedicular screw fixation at one and two levels above and below the fractured vertebra, respectively.

Conservative management of type II and III odontoid fractures in the elderly at a regional spine centre: A prospective and retrospective cohort study.

Background: The optimal management of odontoid fractures in the elderly population is unclear and management of this group of patients is complicated by multiple co-morbidities. This study aimed to determine the outcomes after conservative management strategies were applied in this patient group.

Methods: We carried out retrospective and prospective analyses of all patients with axial cervical spine injuries, at a single centre.

The long-term outcome of microvascular decompression for trigeminal neuralgia.

Objective: Evaluation of the effectiveness of Microvascular Decompression (MVD) for Trigeminal Neuralgia (TGN), with emphasis on patient's perception of outcome, and satisfaction with the procedure.

Materials And Methods: A cohort of 372 MVD operations carried out between 1982 and 2005 were reviewed, contact could be attempted with 319 patients. Questionnaires assessing the patient's perception of outcome returned by 266 patients (71%).

Educational section: picture quiz. Cervical spine.

The picture quiz provides questions on the mechanism of cervical spine injuries and related radiological findings.

External ventricular drains: is there a time limit in children?

Background/purpose: The time limit for the use of external ventricular drains (EVDs) has always been controversial. The purpose of this study is to find out if there is a time limit with regard to infection of EVDs and their duration of use in children.

Methods: The records of 28 patients who had a total of 46 EVDs over a 4-year period at the Regional Paediatric Neurosurgical Centre at the Royal Liverpool Children's Hospital, Alder Hey, Liverpool, UK, were retrieved.