Cervical myelopathy from dural substitute.

A case report of cervical spinal cord compression by infolding of a silicone-coated Dacron graft is presented. The possible complications of synthetic dural substitutes are discussed.

Conservative management of aplasia cutis congenita: case report.

A male newborn with a large scalp and skull defect and a cervical meningocele was transferred to the neonatal intensive care unit of the North Carolina Baptist Hospital. The scalp defect measured 8.5 x 9.5 cm, and the sagittal sinus was exposed. Because the defect was considered too large to be covered with a rotation skin flap, it was treated thrice daily with the topical application of bacitracin ointment and circumferential dressings. By the end of 3 months, the skull defect was covered with skin. The cervical meningocele was then removed without incident. At the 9-month follow-up examination, the scalp defect was well healed and the skull defect was closing slowly; the neurological findings were still normal for the patient's age.

Thrombosed aneurysm of the vein of Galen.

Computed tomography in a 3 1/2-year-old boy with ataxia, lethargy, fever, vomiting, and increasing irritability revealed moderate hydrocephalus and a blood density mass lesion lying superior and posterior to the 3rd ventricle. On several of the sections, the blood density was greater in the dependent than in the superior portion of the mass. The average attenuation number within the mass was 40 EMI units. The infusion of contrast agent demonstrated capsular enhancement (a target sign), which was also demonstrated by angiography. The diagnosis, which was confirmed at operation, was thrombosis of an aneurysm of the vein of Galen. The massive thrombus was resected, but the aneurysm was not excised. The patient's recovery was uneventful.

Epidermoid tumor presenting as tension pneumocephalus. Case report.

The authors report a patient with an epidermoid tumor that eroded through the frontal sinus, causing an acute neurological deficit secondary to tension pneumocephalus. The historical perspective, radiographic features, and pathophysiological mechanisms are discussed.

Brainstem hemorrhages and increased intracranial pressure: from Duret to computed tomography.

In the late nineteenth century, Henri Duret produced minute brainstem hemorrhage in dogs by rapidly increasing their intracranial pressure. Whether those hemorrhages were the same as those seen today associated with transtentorial herniation is not agreed upon, and the term Duret's hemorrhages is rarely used. Duret's report on his experiments is condensed here and the value of computed tomography for detecting brainstem hemorrhages is illustrated by a case report.

Resection and anastomosis of a cervical vertebral artery aneurysm.

A patient with a fusiform aneurysm of the cervical vertebral artery at C-1 presenting with posterior circulation infarctions is reported. Exposure via the posterolateral approach, resection of the aneurysm, and end-to-end anastomosis are described. The authors emphasize the importance of the surgical approach and ability to expose and mobilize a generous portion of the cervical vertebral artery.