Neurosurgery
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Aggressive fibromatoses are proliferations of fibrous tissue that infiltrate surrounding tissues and tend to recur after surgical resection. We report a series of five children with aggressive fibromatosis involving the cranial base. ⋯ Fibromatoses of the cranial base are rare and seem to be most common in the pediatric age group. Gross total resection, preferably in the first attempt, should be the goal. Radiotherapy and hormonal therapy are useful adjunctive methods for the treatment of aggressive fibromatosis. Fibromatoses that involve the cranial base are most likely to require a multidisciplinary treatment approach.
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Although an autogenous saphenous vein is frequently used as a bypass graft, an aneurysm of a venous graft is a rare complication, especially in the case of cerebrovascular revascularization. We report a case of a successfully treated aneurysmal change in a venous graft after short vein bypass grafting. ⋯ The aneurysm seemed to have developed in a curved segment because of hemodynamic stress.
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This study was conducted to determine whether a ventriculoperitoneal shunt alone was effective in treating subdural effusion with hydrocephalus. ⋯ Ventriculoperitoneal shunting alone is an effective and satisfactory procedure; no subdural peritoneal shunt is needed for patients with subdural effusion accompanied by hydrocephalus. To-and-fro communication between the subdural effusion and ventricles is considered to be present in these patients. When selecting the treatment for subdural effusion, it is important to consider whether hydrocephalus (disturbance of cerebrospinal fluid circulation) is present.
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To evaluate the surgical findings and subsequent therapeutic implications of posterior fossa reexploration for persistent or recurrent trigeminal neuralgia (TN) or hemifacial spasm (HFS) after failed microvascular decompression (MVD). ⋯ Recurrent vascular compression was seldom identified during posterior fossa reexploration for failed MVD in patients with persistent or recurrent TN or HFS. The previously placed Ivalon sponge or Teflon implant was consistently found to be in good position. Partial sensory trigeminal rhizotomy is an often effective alternative in cases of recurrent TN when neurovascular compression is not identified. However, because of the relatively high incidence of complications associated with reexploration, we recommend other ablative or medical treatments for most patients after failed MVD for TN or HFS.