Clivus ependymoma

Summary An 8-month-old girl had an ependymoma in the clivus, 2x6 cm in size, connected with the fourth ventricle by a cord of tissue 0.5 cm thick. There were no indications to make us suspect the origin of the tumour in the fourth ventricle, or that it was a case of ependymoma.     

Metallurgical evaluation of the compatibility of surgical clips with their appliers

Summary Five aneurysm clips and their respective appliers (Heifetz, Vari-Angle, McFadden, Scoville, and Yaargil) were tested for the production of small metal shards that could provoke a foreign body reaction or increase the risk of a stresscorrosion failure. Pivot and Vari-Angle-McFadden clips produced numerous large shards, the Scoville clip produced a few fine shards, and the Yaargil and Heifetz clips produced none. Metal shard production due to cold metal transfer is attributed to the abrasive mechanical interaction between clips and appliers made from metals with different degrees of hardness.     

A new model for non-invasive,reproducible fixation of a stereotaxic frame using an orthodontic resin plate

Summary The authors describe a new method for reproducible, non-invasive fixation of a stereotaxic localizing frame. A localizing system similar to that of Brown-Roberts-Wells for MR can be fixed at the base of the facial skeleton to the upper dental arch by an orthodontic resin plate. Results of trials with CT scan, advantages and disadvantages are discussed.The new fixture could be employed in open surgery and in fractionated radiotherapy.     

颈内动脉—后交通动脉瘤的外科治疗：附13例报告

我院自1982年～1988年共收治13例颈内动脉-后交通动脉瘤。本文就该处动脉瘤的临床诊断、手术入路以及动脉瘤破裂的预防和处理进行了讨论。     

生长抑素治疗食管静脉曲张破裂出血30例疗效分析

目的：观察生长抑素治疗食管静脉曲张破裂出血的疗效。方法：治疗组30例用生长抑素静滴维持，对照组30例用垂体后叶素及硝酸甘油静滴维持。结果：治疗组48h内止血27例，止血率为90％，对照组48h止血16例，止血率为53．3％。两组相比止血率有非常显著性差异（P＜0．01）。结论：生长抑素治疗食管静脉曲张破裂出血，具有止血速度快，止血率高及无明显副作用等优点，疗效优于垂体后叶素。     

后颅窝骨性扩大术治疗Chiari畸形合并脊髓空洞症

目的　介绍后颅窝骨性扩大术治疗Chiari畸形合并脊髓空洞症。方法　该手术分为两种亚术式 ,一种是枕颈固定扩大术 :取自体髂骨 5cm× 10cm ,打磨成“凹”字形。上端为齐头端 ,固定在后颅窝减压窗缘。缺口端为下端 ,固定在枢椎棘突上 ,将扩大的硬脑 (脊 )膜修补筋膜片固定在植骨片内面 ,使筋膜片贴附在植骨片内面 ,形成帐篷状 ;另一种是单纯骨性扩大术 :取自体髂骨 6cm× 8cm的梯形骨片 ,并利用较厚的髂骨缘打磨成弧形。植骨片固定在后颅窝减压窗上 ,弧形端构成枕骨大孔后缘。将扩大的硬脑 (脊 )膜修补筋膜片也固定在植骨片内面 ,使筋膜片贴附在植骨片内面 ,也形成帐篷状。结果　本组病例随访 2～ 7年 ,术后症状体征缓解总有效率为91.6% ,肌力比以前提高 2～ 3级。结论　该术式比其他治疗Chiari畸形合并脊髓空洞症的术式 ,治疗效果显著 ,疗效切实可靠     

Use of the KTP-532 Laser in Acoustic Neuroma Surgery

The potassium titanyl phosphate (KTP-532) laser has been applied to otologic surgery with a proven record of both safety and efficacy. The aim of this study was to demonstrate the use, safety, and advantages of laser dissection in the surgical treatment of acoustic neuromas. The authors' experience with 111 patients in whom laser surgery was used in acoustic neuroma is presented, with emphasis on surgical technique employed and facial nerve functional outcome. The method of laser dissection did not result in deleterious neurologic sequelae or laser-specific complications. In addition, laser dissection afforded certain advantages to traditional techniques, especially in larger tumors. The facial nerve functional outcome as assessed by the House-Brackmann grading system revealed that 90.2% of small tumors, 72.2% of medium tumors, and 75.0% of large tumors achieved satisfactory (grades I and II) functional results. These results compare favorably with the literature describing nonlaser dissection techniques. The observations and results reported in this article demonstrate the safety of the KTP-532 laser in the posterior cranial fossa, and specific advantages that this technology may offer to the surgical armamentarium of the neuro-otologist are outlined.     

Primary pleomorphic adenoma in posterior cranial fossa

A 35-year-old woman had an intradural tumor in the posterior fossa adjacent to the posterior wall of the left pyramidal bone, which was totally removed and histologically diagnosed as a pleomorphic adenoma. Follow-up examination for 2 years showed no recurrence of the tumor. There was no primary lesion in any other gland of the body, and therefore there is no alternative but to conclude a “migration” of some gland cells. The pathogenesis of this tumor remains unclassified.     

Incomplete hypospadiac urethral duplication with posterior urethral valves

Urethral duplication (UD) is an uncommon malformation. Obstruction rarely occurs in hypospadiac UD. We describe two children with incomplete hypospadiac UD in association with posterior urethral valves, a combination not previously recognised. The embryonic significance of this anomaly is discussed. Accepted: 30 September 1997     

MRI of the brain in cerebrotendinous xanthomatosis (van Bogaert-Scherer-Epstein disease)

The clinical, biochemical and magnetic resonance imaging findings of two patients with cerebrotendinous xanthomatosis are reported. This is a rare hereditary disease. Early recognition of this entity is important in view of the existing treatment possibilities. Magnetic resonance imaging findings typically include a bilateral and almost symmetrical increase of the signal intensity on the T2-weighted images in the cerebellar and periventricular cerebral white matter, the basal ganglia, the dentate nuclei and the brainstem as well as cerebellar and cerebral atrophy. Received: 18 January 1999; Revised: 3 June 1999; Accepted: 7 June 1999