Successful treatment of intracerebral hydatid cysts with albendazole: case report and review of the literature.

Experience with the use of the drug albendazole in the management of cerebral hydatid disease is limited. We report a 33-year-old woman who was harboring multiple cerebral hydatid cysts and who was treated successfully with albendazole. No other treatment was used. The efficacy and the few reversible side effects of the drug are discussed, and the literature is reviewed.

Spontaneous intracerebral haematomas: surgical versus conservative treatment based on Glascow Coma Scale score and computer tomography data.

Eighty cases of spontaneous intracerebral haematomas were studied retrospectively in order to find clinical and computer tomography parameters; such parameters would be useful for the neurosurgeon, as criteria in the process of deciding surgical or conservative treatment. We found Glascow Coma Scale (GCS) score on admission an excellent criterion. Scores between 3-5 and 12-14 were a contraindication for surgery. Scores between 6-8 indicated surgery, while scores between 9-11 indicated an increased level of readiness. Up to a haematoma size of 16 cm2, size had no influence on GCS score and surgical mortality. For haematoma size larger than 16 cm2, the percentage of patients with low GCS score had increased substantially as well as the surgically mortality. This study has not revealed any lethal haematoma size. No effect of midline shift on mortality was found when shift did not exceed 5 mm. Hypertension was found in 40% of the patients and increased mortality in both types of treatment.

Paraplegia in a pregnant thalassemic woman due to extramedullary hematopoiesis: successful management with transfusions.

The investigation and treatment of a pregnant thalassemic woman who developed severe paraplegia is presented. Magnetic resonance imaging showed a paravertebral mass infiltrating the epidural space, resulting from extramedullary hematopoiesis (marrow heterotopia). The patient was treated successfully with repeated blood transfusions and made a complete recovery. The literature (36 cases) is reviewed and the magnetic resonance imaging features of spinal extramedullary hematopoiesis are presented. The efficacy of transfusions in the management of spinal cord compression due to marrow heterotopia in thalassemic patients is discussed.

Thoracic disc protrusion. (Analysis of 8 cases).

Eight cases of thoracic disc protrusion, observed over a period of four years, are reported. The literature was also reviewed. It is emphasized that in chronic midline disc protrusions a careful laminectomy without removal of the disc can give satisfactory results.

Terminal ventriculostomy in syringomyelia.

The authors report their experiences with two patients suffering from syringomyelia on whom terminal ventriculostomies were carried out. The good results which can be obtained if the patient is in a relatively good neurological condition are pointed out. The principle of terminal ventriculostomy is based on the assumption that syringomyelia is hydromyelia that has become symptomatic; with this in mind, it seems reasonable to relieve the patient's symptoms by draining the distended central canal at the lowest possible level. The father of the operation is Dr. Gardner, who has thoroughly studied syringomyelia, and proved that syringomyelia is not only an active hydromyelia but, that a "non-communicating" syringomyelia is a non-existent entity (1976, 1977).

Proximal ligation of the anterior cerebral artery for the treatment of the anterior communicating aneurysms.

Forty-six patients with aneurysms of the anterior communicating complex, have been operated on in our clinic, by proximal ligation of the anterior cerebral artery. All but two are back at their previous employment and two deaths have been reported. We feel that this operation should still retain a place in the treatment of these aneurysms, if cases are carefully selected.

Lumbar spondylosis and narrow spinal canal.

Thirty four cases of spondylosis and narrow spinal canal were analysed and the possible mechanism of the syndrome of the narrow canal discussed. In spondylotic cases early operation is advisable.

Brain abscess (analysis of ten consecutive cases).

From our small series of ten consecutive cases five points should be emphasized. 1. In chronic cases radical excision is the treatment of choice. 2. In acute cases radical excision is the treatment of choice, if the lesion is in such a site that can be removed easily without worsening the patient's neurological condition. 3. In acute or chronic deep seated abscess, as the abscess in the parietal lobe, the best way to treat it is by drainage as a first stage. 4. Our mortality is one of the lowest reported, and 5. Patients in relatively good neurological condition and conscious level give the best results but a radical excision is recommended even in comatose patients, if the lesion is in such a site that it can be radically removed.

The occurence of haemangioblastoma in three brothers of one family.

The occurence of haemangioblastomas in three brothers is reported. From a review of the literature it becomes evident that only a few of such cases have been confirmed histologically. The interesting features of our three haemangioblastoma cases, which have all been confirmed histologically, are discussed.

Intradural spinal echinococcus simulating lumbar disc protrusion.

A case of intradural hydatid cyst, simulating disc protrusion is described. It is emphasized, that in countries like Greece, the possibility of hydatid cyst compressing the spinal cord, should always be considered.

Observations on the pathogenesis of low pressure hydrocephalus. Analysis of 25 cases.

Over a period of three and a half years 25 cases of L.P.H. were observed. An analysis was attempted on thirteen of these, which did show a particular interest, from pathogenetic point of view. All thirteen had been operated upon with very good results.

"Benign" acute subdural haematomas. Analysis of 12 cases.

Twelve cases of acute subdural haematomas, who had a benign course, were studied. During the same period of 8 years, 132 patients with acute subdural haematomas were treated in our unit, an incidence of 9%. From our study it becomes evident that the fate of the patients is determined by the type of injury and especially the conscious level of the patients on admission and their evolution. It also becomes evident from the world literature, that the term "acute" was used in an arbitrary way in most papers and more strict criteria should be used for using this term and for evaluating the ultimate course of these patients.