Chronic spinal subdural hematoma.

A 55-year-old woman with chronic spinal subdural hematoma, diagnosed by magnetic resonance (MR) is presented. There was no coagulation defect, anticoagulant therapy, or trauma.

Dandy-Walker syndrome: posterior fossa craniectomy and cyst fenestration after several shunt revisions.

Ventriculoperitoneal or cyst-peritoneal shunts are the usual treatment for children with Dandy-Walker syndrome. A combined ventricular and cyst shunt is often necessary and, in some cases, multiple revisions have to be done. Two patients with this syndrome were treated with posterior fossa exploration and cyst fenestration after several shunt revisions. The procedure was well tolerated with good results in both cases. The patients' data and preliminary results are presented here.

Hemispheric arteriovenous fistulae with giant venous dilation.

A direct fistula between cerebral cortical arteries and venous channels may result in an impressive aneurysm-like, saccular dilation of the venous portion. We had the opportunity to treat two children with this rare arteriovenous malformation, with excellent results. The controversy on the classification and treatment of this pathology is discussed briefly.

Encapsulated spinal epidural hematoma in an octogenarian.

An 88-year-old man was found at laminectomy to have an encapsulated spinal epidural hematoma. The surgical result was gratifying and reinforced a recent statement that spinal surgical procedures in the very elderly should not be withheld on the basis of age alone. Moreover, the rarity of this pathology in this age group and the clear identification of the lesion on the computed tomography scan of this case are to be noted.

Contralateral parafalcine approach for parasagittal and callosal arteriovenous malformations.

Most neurosurgeons prefer an ipsilateral approach for medial surface arteriovenous malformations. Based on recent surgical experiences, we believe that a contralateral approach has some advantages in dealing with such lesions. Two cases are reported, and the rationale for the contralateral approach is discussed.

More numerical results on red blood cell geometry.

The length of arc or circumference for the cross-section of the red blood cell has been determined for the normal range of dimensional values for mammalian red cells. Graphs for arc length vs. diameter and vs. cross-sectional area, for fixed thickness, are included. The graphs give an indication of the rates of change of the geometrical parameters contained therein. A special case of Fick's Law, based on the model geometry utilizing the Oval of Cassini, is presented for the mammalian red cell. The ratios of surface area to volume necessary for a complete Fick's Law formulation, are given for the normal range of dimensional values for the mammalian red cell.

Osteoblastoma de coluna cervical. / Osteoblastoma of the cervical spine

Os osteoblastomas sao tumores osseos benignos raros. Os autores descrevem os aspectos clinicos, o quadro radiologico, angiografico e cintilografico e a tomografia por computacao de 1 doente portador de osteoblastoma de coluna cervical. A remocao cirurgica seguida de artrodese de coluna resultou em alivio da sintomatologia apresentada pelo doente

Numerical results on red blood cell geometry.

The geometric quantities of cross-sectional area, volume, and surface area have been calculated, to three-decimal-place accuracy, using the normal range of dimensional values for mammalian red blood cells. The calculations are based on the formulas for the geometric quantities originally derived by Funaki and rederived by the authors. The calculations for the surface area differ from those found earlier by Funaki.

[Computed tomography in the follow-up of patients with intracranial tumors]. / Tomografia computadorizada no seguimento de pacientes com tumores intracranianos.

Computed Tomography (CT) has been very useful in the follow-up of patients with brain tumors. Soon after the craniotomy, CT would show any residual tumor if an incomplete excision was done. CT has been essential when one needs to evaluate any deterioration in the patient's neurological status post operatively. In such instances, CT may detect brain edema, hematoma, hydrocephalus and the presence of air. CT findings are more accurate than those obtained from conventional neuroradiology or from intracranial pressure monitoring, being also more innocuous than those methods. Later in the post operative follow-up, CT allows, besides precocious diagnosis of tumor recurrences, a good evaluation of the results obtained by chemiotherapy or radiotherapy. When hydrocephalus is accompanying the primary pathology, ventricular size can be rapidly evaluated by CT. Difficulties may arise when one wishes to differentiate CT images of radionecrosis from tumor recurrences at least in the initial stages.

Tomografia computadorizada no seguimento de pacientes com tumores intracranianos. / Computed tomography in the follow-up of patients with intracranial tumors

A tomografia computadorizada tem grande valor no controle dos pacientes com tumores cerebrais.Imediatamente apos o ato cirurgico pode ser util para avaliar a retirada do processo expansivo ou para comprovar a area atingida.Nos primeiros dias apos a intervencao tem sido indicada principalmente quando ha piora do quadro neurologico. Nestas condicoes, o exame permite verificar a existencia de ar, edema, hematoma, desvios ventriculares e hidrocefalo Os dados fornecidos sao mais precisos que os obtidos com outros exames neuroradiologicos ou com a medida continua da pressao intracraniana, metodos menos inocuos. A longo prazo a tomografia permite o diagnostico precoce de recidivas, a avaliacao da eficacia de tratamentos radio ou quimioterapicos e o controle do hidrocefalo. Ainda nao e possivel fazer o diagnostico diferencial entre radionecrose e recidiva tumoral

[Tumoral form of cerebral cysticercosis: diagnosis by computerized tomography]. / Forma tumoral da cisticercose cerebral: diagnóstico pela tomografia computadorizada.

Solitary granulomatous lesions due to cysticercosis in the brain were found by computed tomography in six patients. The CT images were in all cases very similar to those from brain neoplasms. The cerebrospinal fluid complement fixation test for cysticercosis was negative in all of the cases. The definite etiological diagnosis could only be made by craniotomy in this series.

[Computerized tomography in ventral and lateral prone position in the differential diagnosis of subdural hematoma and cortical atrophy]. / Tomografia computadorizada em decúbito ventral e lateral no diagnóstico diferencial entre hematoma subdural e atrofia cortical.

The differential diagnosis between brain atrophy versus subdural effusion in children has shown some difficulties in a few cases, mainly when the frontal subarachnoid space is very large on computed tomography. We think that a simple procedure, that is, CT scans in the lateral and prone position following the standard examination, may be worth to clarify those cases of doubtful diagnosis.

[Calcified papilloma of the choroid plexus. Report of a case]. / Papiloma calcificado do plexo coroide. Registro de um caso.

A case of calcified choroid plexus papilloma in a 7 years old child is reported. The radiologic findings are discussed.

Intracranial arterial aneurysms in infancy and childhood.

Eleven cases of intracranial arterial aneurysms in patients under 15 years of age, treated from 1959 to 1976, are presented. The preponderance of aneurysms at the internal carotid artery bifurcation and the peculiarities of the defects in this location are remarkable.

Carotid-ophthalmic aneurysms.

Carotid-ophthalmic aneurysms have intimate relationships with the ipsilateral optic nerve and other neighboring structures. Direct operation for treatment of these aneurysms has been considered particularly hazardous and difficult. Therefore, some authors have recommended an indirect operation (carotid artery ligation in the neck) as the procedure of choice. A Consecutive series of eight patients with carotid-ophthalmic aneurysms in presented; a direct operation was performed in seven instances. There was no operative mortality and the morbidity was very low. The direct attack seems to be reliable, and is recommended.