Hemorrhagic colloid cyst with sudden coma.

BACKGROUND: Third ventricle colloid cysts are regarded as benign lesions. They may, however, present with dramatic and rapidly deteriorating neurological signs, leading to sudden death. Although the exact cause of this clinical course is unknown, acute hydrocephalus caused by occlusion of Monro's foramina has been suggested. This, in turn, may be the result of acute cyst swelling, which can exceptionally be due to an intralesional hemorrhage. CASE REPORT: This report illustrates the case of a young patient who deteriorated to sudden coma and was found to have a hemorrhagic colloid cyst of the third ventricle. This was removed via a purely endoscopic technique. Although the radiological results were excellent, the clinical outcome was poor. CONCLUSIONS: This case suggests once again the importance of the early recognition of colloid cysts of the third ventricle for appropriate treatment before potentially irreversible neurological deterioration sets in.

Evacuation of traumatic intracerebral haematomas using a simplified stereotactic procedure.

The authors present a series of 37 traumatic intracerebral haematomas (ICH) evacuated by a simplified stereotactic surgical procedure. The mortality rate was 80% in patients with Glasgow coma scale (G.C.S.) scores of 3-5 and 25% in patients with scores of 6-7. There were no deaths in patients with G.C.S. of 8 or more. With the exception of the first group of patients, the results were better than those achieved by wide craniotomy. The importance of reduced operative trauma in patients with ICH, which often are associated with multifocal or diffuse brain injuries, are discussed.

[Spinal cord and cauda equina compression in 2 patients with beta-thalassemia intermedia]. / Compression médullaire et de la queue de cheval chez deux patients atteints de béta-thalassémie intermédiaire.

Spinal cord compression as a consequence of mass lesions due to extramedullary hematopoiesis is a well described but rare syndrome occurring in thalassemia and some other hematologic conditions. The authors report two cases of patients with a genetic variant of beta-thalassemia, who suffered from a progressive compression of the spinal cord in one case, of the cauda equina in the other caused by epidural hematopoietic tissue. The first patient recovered after partial surgical removal of this tissue and subsequent radiotherapy. The second one recovered after only radiotherapy.

Surgical treatment of extradural spinal cord compression due to metastatic tumours.

The authors present a group of 23 patients with extradural spinal metastases who had undergone surgical treatment with different approaches, with reference to the anatomical site of the tumours. They report the results and discuss the criteria of the different surgical technical choices.

Considerations about the surgical indication of the spontaneous cerebral haematomas.

We analyzed 50 cases of spontaneous intracerebral haemorrhage, some treated by surgery, some by medical therapy. Our opinion is that, practically, the neurologic picture is the safer guide, in the selection of the patients by treated with surgery therapy. We concluded that surgical treatment by evacuation of haematoma increased the percentage of survival of the comatose patients. We described, besides, the technic that we made use for the evacuation of the haematoma.

Intracerebral pneumocephalus after ventriculoperitoneal shunt.

A case of pneumocephalus, secondary to a liquoral shunt operation, is described. The patient had a massive neuroma of cranial mixed nerves occupying the whole region of the cerebello-pontine angle. The diagnosis was possible by changing the position of the patient's head under radioscopic control, while repeatedly applying pressure with the fingers on the shunt reservoir.

Spontaneous cerebellar hematoma in childhood. Presentation of a new case.

In the present report, a case of spontaneous intracerebellar hematoma affecting a 8-year-old boy is related. This pathology is often associated with rupture of vascular malformations in posterior fossa and normally is quite rare in childhood. Authors support the necessity of surgical approach for favourable prognosis.

Effect of the law on compulsory helmets in the incidence of head injuries among motorcyclists.

The Authors report the data, relative to the province of Cagliari and its surroundings, on the rate of motorcycle road accidents, the reported head injuries, the morbidity and mortality referred to five analogous months, i.e., before and after the coming into force of the law on compulsory protective helmets. Examination of such data shows an absolute and percent reduction of the number of head injuries, serious injuries reported, and overall mortality.