Neurochirurgie
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Orbital roof fractures after head injury is rare. Traumatic encephaloceles in the orbital cavity are even rarer, with only 24 cases published to date. ⋯ Computed tomography and magnetic resonance imaging revealed an isolated blow-in fracture of the orbital roof with herniation of the left frontal lobe into the orbit. Neurosurgery to repair the orbital defect led to full recovery.
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Review Case Reports
[The combined petrosal approach. Anatomical principles, surgical technique and indications].
Management of large petroclival tumors requires the use of extensive surgical approaches that usually jeopardize the intrapetrous neuro-otologic structures. To confirm the interest of the combined petrosal approach in this indication, we describe the relevant anatomy and the surgical steps of this procedure. After making a periauricular skin incision and muscle elevation, an occipitotemporal bone flap is shaped. ⋯ The combined petrosal approach is able to provide a wide multidirectional corridor toward the ventral surface of the pons, the basilary trunk and the ipislateral cranial nerves from the oculomotor to the lower cranial nerves. This study confirms that despite a significant extra time needed for proper achievement, the combined petrosal approach is a valuable conservative approach when the petroclival area, ventral brain stem and basilary trunk are targeted. This approach should be included in the panel of the transpetrous routes available by expert skull base teams.
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Case Reports
[Fracture luxation of the cervical spine in patients with ankylosing spondylitis: six cases].
Treatment of cervical spine fracture in patients with ankylosing spondylitis is difficult. Biomechanical changes related to ossified ankylosing spondylitis spine make cervical spine fractures highly unstable. They cover the entire width of the spine inducing multidirectional instability and the risk of neurological injuries. Treatment is more difficult that in the nonossified spine. Different treatments have been proposed including anterior stabilization, posterior stabilization, or both. ⋯ Surgical management of selected patients with ankylosing spondylitis and cervical spine fractures is challenging. Combined anterior and posterior stabilization should be considered for these fractures. A cervical brace must be associated with surgical treatment. With appropriate management, outcome can be favorable.
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We present the method and results of an original technique to implant electrodes in the subthalamic nucleus (STN) to treat Parkinson's disease, based on adaptations of the Fisher ZD stereotactic frame. ⋯ This method was efficient and safe to implant deep electrodes.
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Ventricular schwannomas are very uncommon. We report such a tumor in the right lateral ventricle of a 16-year-old young man. The various etiopathogenic hypotheses are discussed.