Intact intracranial breast prosthesis: a 28-year CT follow-up after treatment of late hemispherectomy complications.

Anatomical hemispherectomy has had excellent results in treating drug-resistant seizures of infantile hemiplegia. This technique of hemispherectomy consists in the removal of a whole hemisphere, with or without the basal ganglia, the end result being a large cavity left at the end of the operation. The technique, however, is considered to be weighted by important complications, in particular intracranial hemorrhages due to vessels tearing secondary to dislodgement of the remaining hemisphere. Several techniques have been consequently proposed to reduce the volume of the residual hemicranial cavity. An alternative measure is the filling of the cavity itself. We have demonstrated that this type of procedure can be carried out using a silicone breast prosthesis. In this report, we demonstrate also that such an implant can have a surprisingly long duration in its unusual location.

Hematoma of the quadrigeminal plate. Case report.

The authors report a case in which a hematoma of the quadrigeminal plate resulted from the rupture of a "cryptic" arteriovascular malformation (AVM) fed by the artery of the quadrigeminal plate. The AVM was symptomatic before rupturing and this clinical feature, associated with the lack of angiographic demonstration, led to the erroneous preoperative diagnosis of a tumor. In retrospect, the only finding that might have suggested the correct diagnosis was the beaded appearance on the ventriculogram of the aqueduct due to blood clots into this fluid space.

Vertebral thoracic osteoclastoma. A case report with emphasis on roentgenological findings.

A rare case of vertebral osteoclastoma in the body of T8 is presented. Attention is drawn to its unusual radiological features, not previously reported, and to the relative inefficiency of radiotherapy. The most rational treatment for such a tumour appears to be the widest surgical decompression possible, followed by low-dose irradiation.

Hemispherectomy complications in the light of craniocerebral disproportion: review of the literature and rationale for a filling-reduction cranioplasty.

Hemispherectomy has had excellent results in treating drug-resistant seizures of infantile hemiplegia, except for the vulnerability of the remaining hemisphere. The hemispherectomy cavity has been considered responsible for early and late complications. Modified techniques have been widely performed and are not without complications. CNS hemosiderosis is probably not the only explanation; the craniocerebral disproportion following the surgery, the shunt effect and low pressure of the cavity should also be taken into account. Splinting the remaining hemisphere to avoid its dislodgment could be important. One of our patients who suffered a series of complications hitherto unreported in the literature was eventually treated with a filling-reduction cranioplasty. The rationale for the technique can be inferred from the literature reviewed in the article. Our technique is validated by a follow-up of 28 years since the hemispherectomy and 13 years since treatment for complications.