Chordoma of the cervical spine. Case report.

We present a case of chordoma of cervical spine with spinal cord compression at the level C4-C5-C6 in a woman of 65 years old. The diagnosis depends on the results of the histological studies and especially the studies of the labeled elements as protein S 100. For the operation was used an anterior approach and a somatectomy of the interested vertebrae. The cervical spine was synthesized using a bone autograft and the stabilization was made possible through a HaloVest. The patient then underwent radiotherapy (50 Gy); the preoperative deficit disappeared totally and at the present moment there are no signs of clinical on radiological relapse.

[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.

Spontaneous priapism produced by stenosis of the lumbar canal.

A case of a 64-year-old man with stenosis of the lumbar canal and symptoms of compression of the cauda equina is described. This symptomatology increased after walking and was associated with spontaneous priapism. All symptoms were relieved after surgical decompression.

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.

Ventricular inundation due to rupture of an intracranial aneurysm during carotid angiography.

A case of rupture of an aneurysm of the right middle cerebral artery with ventricular inundation of the contrast medium during angiography is reported. The various causal factors in the rupture of the aneurysmatic sack during this examination are discussed. In particular, the implications of sudden changes in arteriolar pressure induced by the contrast medium when preexistent arterioral and encephalic lesions of organic or functional nature are present, are considered.

Study of cerebral flow with radionuclide: 99mTc-pertechnetate transit times and curves.

The transit of intravenously injected 99mTc-pertechnetate in the cerebrovascular tree can be monitored in patients in a supine position by means of a computer-assisted gamma-camera. When programmed properly, time-activity curves of the tracer in the region to be studied can be displayed, i.e. internal carotid arteries, brain hemispheres, etc. The application of the modified gamma function to these curves is employed in order to more accurately define the transit and transfer times in this region. Thirtyseven patients with cerebrovascular disturbances were examined. In most cases asymmetrical cerebral perfusion and a significant difference between right and left transit and/or transfer times were noted.