Combined isotope ventriculography and lumbar myelocisternography in the diagnosis of communicating syringomyelia. Case report.

Several investigative procedures are currently used to diagnose communicating syringomyelia. The combination of isotope ventriculography and lumbar myelocisternography has never proposed nor carried out to verify this condition. We feel that this is a safe and valuable procedure to identify a patent central canal communicating with the fourth ventricle and is worth considering when diagnosing communicating syringomyelia.

Three years experience with microsurgical technique in treatment of protruded lumbar disc.

The Authors report 120 cases of protruded lumbar disc operated on by microsurgical technique over the last 3 years. The operating technique is summarized and the indications for this type of surgery are discussed. Both immediate and long-term results are reported. Five patients were re-operated on because of recurrence in the same interspace. As the follow-up revealed there were favourable results, regarding especially the disappearance of pain and resumption of working activity. Microsurgical Lumbar Discectomy (MLD) represents an improvement and a valid alternative to standard technique: it enables to remove the disc with a very limited local damage which means a shorter period of convalescence and a better aesthetic result.

Pseudotumor cerebri. Lumboperitoneal shunt in long lasting cases.

The Authors report three cases of pseudotumor cerebri with noteworthy visual defect. Lumboperitoneal shunt enables good recovery where there was no atrophy of the optic nerve and demonstrated its usefulness also in serious situations.

Myelography with metrizamide in the study of the lumbosacral tract.

The authors report their experience with Metrizamide (Amipaque) in the myelographic study of the lubosacrale) in the myelographic study of the lumbosacral tract. They compare their results with those obtained with other hydrosoluble contrast agents and correlate them with surgical findings. Metrizamide appears to be preferable to other hydrosoluble contrast agents due to its better radiological definition and because of the lower frequency of complications related to its use.

Ossifying parasellar chondroma. Case report.

The Authors report a case of cartilaginous tumor of the parasellar region, diagnosed as ossifying chondroma by virtue of the intense calcification it presented. Preoperative diagnosis was suggested by CT, which showed a characteristic honeycomb conformation, with alternate areas of greater or lesser density, without contrast enhancement. Angiography is, however, essential in planning the operation, which must on occasion be confined to partial resection only. This limitation may be acceptable where functionally important areas are concerned, since these neoplasms show an apparent tendency to only modest growth.

[Synovial lumbar cyst]. / Cisti sinoviale lombare.

The Authors report a case of low back pain with sciatica due to a synovial cyst of the interapophyseal joint of the lumbar spine. The diagnosis was made by CT and MRI. A review of the literature confirms the relative rarity of their lesion at the lumbar level and the necessity of radical surgery, best achieved with microsurgical technique. The Authors emphasize the importance of accurate diagnosis before surgery.

Meningeal melanocytoma of Meckel's cave associated with ipsilateral Ota's nevus.

A case of meningeal melanocytoma of the left Meckel's cave associated with ipsilateral Ota's nevus in a 43-year-old woman, was studied by light and electron microscopy. The cells of the tumor were characterized by the presence of dendritic cytoplasmic processes, melanosomes and premelanosomes; hence, they were deemed as neoplastic melanocytes. Moreover, the tumor was lacking in histologic and ultrastructural features of pigmented meningioma, melanotic Schwannoma and primary meningeal melanoma. The prolonged clinical course was different from primary and metastatic malignant melanomas of the meninges. The best treatment appears to be radical excision, when possible; otherwise, the local or partial enucleation followed by radiation therapy has been found to be the best curative to date. On the whole, meningeal melanocytoma cannot be considered as entirely benign, given its morphologic patterns that resemble those of uveal melanoma, and its potential for recurrence. The association of this tumor with Ota's nevus is referred to as having a common origin from an arrested migration of melanoblasts at different stages.

Aphasia and right hemiplegia after cervical myelography with metrizamide. A case report.

We report a case of aphasia and right hemiplegia, developing after myelography with metrizamide and lasting for an unusually long time. The neurological disorders, manifested 1 h after the examination was completed, were due to accidental passage of contrast medium into the basal cisterns. In the light of analogous case reports in the literature, as well as experimental data concerning the biochemical activity of metrizamide, possible aetiopathogenetic mechanisms responsible for such disturbances are indicated. The authors underline the lack of effective therapeutic measures after the onset of the disorders, and thus the importance of preventing such complications that behave functionally as true ictuses although with no anatomic substratum.

[Extradural hematoma in the posterior cranial fossa. Experience with 4 cases]. / L'ematoma extradurale in fossa cranica posteriore. Esperienza su 4 casi.

The authors report their experience on treatment of posterior fossa epidural hematoma. They emphasize the role of a quick diagnosis, in times past often difficult, novadey easier with the aid of the CT.

[Cerebral tuberculoma. Clinical case]. / Tubercoloma cerebrale. Caso clinico.

The authors report of a patients operated for a double encephalic mass in the left posterior parietal region. This lesion resulted a tubercoloma at a later investigation. This pathology is relatively common in underdeveloped countries, declining in western countries. The authors emphasize the need of a careful evaluation in searching tuberculous infection in presence of encephalic granulomatous masses.

Gadolinium-DTPA-enhanced MR imaging in the diagnosis of spinal epidural haematoma. Report of a case.

A case of spinal epidural haematoma diagnosed by means of Gadolinium-DTPA-enhanced MR imaging is described. The sensitivity of this recent technique is underlined.

Metrizamide-enhanced computed tomography of intracranial arachnoid cysts.

Between July 1981 and August 1983 the authors studied 21 patients with intracranial arachnoid cysts using metrizamide-enhanced CT. With this method we are able to determine the degree of communication between the cysts and the surrounding subarachnoid space as well as to assess the evolving character of some of these lesions. This information will allow a more rational choice of surgical treatment.

[Monitoring of intracranial pressure]. / In tema di monitorizzazione della pressione intracranica (PIC).

A very small fiberoptic catheter initially developed as an intravascular pressure sensor was incorporated into a system to be used as an intracranial pressure (ICP) monitor. 13 patients with intracranial hypertension have been studied with this probe. The clinical experience confirmed the safety, accuracy and reliability of the device. The monitor has functioned very well, and there have been no complications except for two breakages of optic fiber as a result of nursing manoeuvres. This new device can be placed into the ventricular, subdural and epidural space. Camino System appears to offer advantages over other monitors presently in use.