Lumbar discectomy is one of the most commonly performed neurosurgical procedure. Far lateral disc herniations (FLDH) make up a minor portion of the total discectomy workload for spine surgeons. Due to their lower incidence, as well as their different anatomical positioning compared to the more common para-median disc herniation, the surgical procedures involved in releasing the neural compression caused by FLDHs are often challenging and at times frustrating to most spine surgeons, resulting in suboptimal outcomes for the patient related to the higher risk of spinal instability from facet joint disruption and may even be associated with nerve root injury. We discuss here a safe and simple approach to tackle FLDH.
Subdural hematoma (SDH) is a common neurosurgical pathology, characteristically recognised on plain CT and can be treated with simple and effective surgical intervention. In contrast, dural metastatic adenocarcinoma of the prostate with SDH and malignant extension into the subdural membranes is extremely rare. We describe the case of a 62-year old Caucasian male, provide a brief review of the literature, and explore the potential role of neoangiogenesis and disseminated intravascular coagulopathy in SDH development.
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