Subarachnoid buprenorphine administered by implantable micropumps.

This report concerns 23 patients, the majority of whom are suffering from low back and chest pain caused by chest, urological or gynaecological cancer. These patients were treated with subarachnoid buprenorphine, administered in a single bolus or by slow infusion from micropumps, at a daily dose adapted to patients need (0.06-0.15 mg). The painful symptomatology was successfully controlled in all the cases treated, allowing the patients to live a virtually normal life. In no cases was respiratory depression or tolerance observed.

Bilateral brain abscesses. Report of 2 cases.

This is a report about two cases with bilateral brain abscesses, who will be extirpated with success. The preoperative treatment with antibiotics was without success. CT-control demonstrated the complete removal of both abscesses. The surgical treatment may be indicated in patients affected by supratentorial bilateral cerebral abscesses.

Bone dust and adhesive material for closing bony breaches of the skull. A new method.

Thirty one cases of patients affected by skull lesions are reported: 25 fractures of the frontal sinus, two fractures of ethmoidal bone, two fractures of the floor of the anterior cranial fossa, one fracture of the petrous bone, one opening of the mastoid cells. Five of these patients presented a cerebrospinal fluid fistula. All the patients were surgically treated with a mixture of autogenous sawdust and butyl-2-cyanoacrylate with favorable results in thirty cases. It was necessary to repeat the treatment only in one case and the patient recovered completely.

The CO2 laser beam in the surgical treatment of cerebral tumours.

Several cases of supratentorial gliomas and meningiomas were operated on since May 1977 with the help of CO2 laser infrared beam, generated by the Sharplan 791 He unit, with an adjustable output up to 50 Watts. Defocused laser beam has been found to be useful in direct attack on the tumour, through a vaporization of the neoplastic tissue. So the tumour could be progressively excavate with a loss of blood comparatively lower than with classical method. Haemostasis was quite good on diffuse capillary bleeding, but not on arterial or venous haemorragies, where the use of electrocoagulation was necessary. Extirpation especially, of meningiomas, was easier and less traumatic with the laser beam, and the destruction of infiltrating glial tumours was facilitated too.

Spontaneous pneumo-cephalus caused by otogenous temporal abscess.

The Authors report a rare case of spontaneous intraparenchymal and intraventricular pneumocephalus, caused by the external rupture of an otogenous temporal abscess.