Reduction of the incidence of neuroma formation by proximal epineural stripping: an experimental study in rats.

The effect of proximal epineural stripping on neuroma formation was studied in the peroneal nerve stumps of the rat. After transection of the peroneal nerve, the epineurium of the proximal stump was stripped back by 6 to 8mm and the nerve fascicles left uncovered in the study group. The transected nerve was left untreated in the control group. All nerves were evaluated by light microscopy 6 months after the operation. Two neuromas occurred in 20 stumps after epineural stripping while 15 neuromas occurred in the control group. Based on histological data, we conclude that stripping of the epineurium may inhibit neuroma formation in the rat.

Solitary plasmacytoma of the calvarium.

A solitary plasmacytoma of the calvarium was removed radically without postoperative radiotherapy. A 69-year-old female patient was operated for a giant solitary plasmacytoma in the frontal region and the follow-up over 10 years revealed no recurrence. The authors discuss that solitary plasmacytoma of the calvarium may have a good prognosis if radically removed and the radiotherapy may not be necessary.

Bilateral vertebral artery occlusion following cervical spine trauma--case report.

A 41-year-old female presented with a rare case of bilateral vertebral artery occlusion following C5-6 cervical spine subluxation after a fall of 30 feet. Digital subtraction angiography showed occlusion of the bilateral vertebral arteries. Unlocking of the facet joint, posterior wiring with iliac crest grafting, and anterior fusion were performed. The patient died on the 3rd day after the operation. This type of injury has a grim prognosis with less than a third of the patients achieving a good outcome.

Is indomethacin harmful in spinal cord injury treatment? An experimental study.

This study was designed to analyze the effect of early indomethacin on the lipid peroxidation after spinal cord injury in rats. The use of anti-inflammatory drugs to affect delayed and secondary injury after trauma to the spinal cord has now become a matter of standard clinical practice. However, spinal cord injury remains an enormous clinical problem and research that may lead to improved treatment is to be encouraged and commended. Three experimental groups consisting of 40 rats each were formed. Using microsurgical technique, total laminectomy between T5 and T10 was performed. Spinal cord injury was achieved with an epidural aneurysm clip, and pharmacological treatment immediate after the injury was performed by injecting indomethacin intraperitoneally (i.p.) at a dose of 3 mg/kg to indomethacin-treated group. The three main groups were divided into subgroups of 8 rats each. It was planned to stop the biochemical reactions at a different time in each of these subgroups, by the application of liquid nitrogen to the spinal cord and paravertebral structures at the end of the 1st, 15th, 30th, 60th, and 90th minutes. All the spinal cords were removed and protected from further reactions by immersing in the liquid nitrogen tank. The lipid peroxidation levels were assessed by determining thiobarbituric acid reactive substances formation. The results of the study showed that the administration of 3 mg/kg indomethacin immediately after spinal cord injury induces lipid peroxidation to a significant degree (p<0.05 one-way ANOVA and Tukey HSD tests) when compared to the saline-treated group. This result suggests that early posttraumatic indomethacin treatment may be harmful in spinal cord injury.

The natural history of late diagnosed or untreated growing skull fractures: report on two cases.

Growing skull fractures (GSF) are rare complications of head trauma. Cases after childhood are extremely rare and demonstrate complicated pathological conditions which necessitate extensive treatment. We report on two rare cases of intracranial cysts related to growing skull fractures which are secondary to trauma sustained during childhood, and have been discovered in adolescence.

Intracranial tuberculoma mimicking metastasis from renal tumor--case report.

A 63-year-old female presented with intracranial tuberculoma manifesting as severe headache. Systemic examination found a mass in the left kidney. The histological diagnosis was tuberculoma after kidney biopsy. Cranial computed tomography found two lesions, in the right frontal and occipital lobes. The intracranial lesions were considered to be tuberculomas. Tuberculosis chemotherapy was continued for 15 months. Her neurological deficit was resolved. Cranial computed tomography showed the lesion in the frontal lobe had disappeared and the lesion in the occipital lobe was reduced in size.

Distal posterior inferior cerebellar artery aneurysm association with multiple aneurysms.

A rare case of distal aneurysm of the posterior inferior cerebellar artery (d PICA) found in association with distal anterior cerebral artery (d ACA) and middle cerebral artery (MCA) aneurysms is described. d PICA aneurysm causing subarachnoid hemorrhage was successfully clipped. The aneurysmal sac was excised and examined pathologically; no infectious etiology was found. Aneurysms at other locations were not operated. The association of vascular anomalies with d PICA aneurysms is discussed.

Von Hippel-Lindau disease: analysis of two families.

In this report we present two families with von Hippel-Lindau syndrome. We operated on haemangioblastomas in two members, one from each, in our clinic. In the first family we saw 17 lesions in 9 members. Although in the first family carcinoma of the kidney was often observed, in the second family retinal haemangioma was found to be predominant, namely, in eight out of nine patients. In both families there were 11 patients with retinal haemangioma; of these, 9 patients were blind (82%). In 6 patients with retinal haemangioblastoma blindness was unilateral and bilateral only in one. All the patients with renal carcinoma were male and died young. In one of our patients with renal carcinoma we found metastatic lesions in the distal and proximal parts of the femur, vertebral arch, cranium and the thoracic wall. In these two families 23 members had 32 lesions, from which eleven were retinal haemangiomas (3 + 8), nine haemangioblastomas of CNS (5 + 4), one a renal cyst (0 + 1), eight renal carcinomas (7 + 1), two pancreatic cysts (1 + 1) and one liver cyst (0 + 1).