The coincidence of a lumbar disk herniation L4-5 and a neurinoma at the L5 nerve root in a 52-year-old male is reported. The clinical course revealed typical signs of a herniated disk, whereas the tumour was accidentally found by myelography initially performed for the suspected prolapse. Both lesions were removed without complications. The clinical and neuroradiologic aspects of this rare condition are discussed, with special regard to the problems of differential diagnosis. A review of the literature is added.
A method is described in which a combined endovascular and microneurosurgical approach is used for clipping aneurysms of the proximal paraclinoidal segment of the internal carotid artery. By temporary occlusion of the cervical carotid artery and continuously retrograde sucking of blood from the distal vessel via a double lumen ballon catheter, clip application to large and critically located aneurysms is facilitated applying decompression to the trapped arterial segment under intraoperative somatosensory-evoked potential (SEP) monitoring.
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