The TLICS score treatment recommendation matched surgical treatment in 47 of 49 patients (96%). The TLICS was found to correlate to the AO classification. This suggests that the TLICS can be used to classify thoracolumbar trauma and can accurately predict surgical management.

-Eighteen patients (mean age of 66.5 years) with normal pressure hydrocephalus (NPH) underwent a ventriculo-peritoneal shunt surgery. Prior to operation a cerebrospinal fluid tap-test (CSF-TT) was performed with measurements of gait pattern and psychometric functions (memory, visuo-motor speed and visuo-constructive skills) before and after the removal of 50 ml CSFby lumbar puncture (LP). Fifteen patients improved and 3 were unchanged after surgery. Short duration of disease, gait disturbance preceding mental deterioration, wide temporal horns and small sulci on CT-scan were associated with good outcome after shunting. There was a good correlation between the results of CSF-TT and shunt surgery (X 2 = 4,11 ,phi = 0.48, p < 0.05), with gait test showing highest correlation (r = 0.99, p = 0.01). In conclusion, this version of CSF-TT proved to be an effective test to predict improvement after shunting in patients with NPH.KEY WORDS: normal pressure hydrocephalus, lumbar puncture, shunt surgery. Valor preditivo da punção liquórica ("tap test") na hidrocefalia de pressão normalRESUMO -Este estudo visa melhorar o valor diagnóstico e preditivo da punção liquórica ("tap test", TT) na hidrocefalia de pressão normal (HPN), particularmente nos casos em que os dados clinicos e de neuroimagem são inconclusivos e não permitem uma decisão cirúrgica segura. Dezoito pacientes (média de idade = 66.5 anos) com HPN foram submetidos a derivação ("shunt") ventriculo-peritoneal. O TT era realizado antes da cirurgia, consistindo na análise quantitativa da marcha e funções cognitivas (memória, rapidez perceptivo-motora e habilidade vísuo-construtiva) antes e depois da retirada de 50 ml de liquor via punção lombar. Quinze pacientes melhoraram e 3 permaneceram inalterados após a cirurgia. Curta duração da doença, distúrbio da marcha precedendo a deterioração mental, dilatação dos cornos temporais e apagamento (ou redução) dos sulcos corticais na tomografia computadorizada cerebral estavam associados a bons resultados pós-operatórios. Houve boa correlação entre os resultados do TT e os do "shunt" (X 2 = 4.11, phi = 0.48, p < 0.05), principalmente no teste da marcha (r = 0.99, p = 0.01). Esta versão do TT liquórico mostrou-se efetiva na prediçâo da melhora pós-operatória em pacientes com HPN. PALAVRAS-CHAVE: hidrocefalia de pressão normal, punção lombar, cirurgia de "shunt".Normal pressure hydrocephalus (NPH) is characterized by gait disturbance, progressive mental deterioration and urinary incontinence associated with enlargement of the ventricular system and normal cerebrospinal fluid (CSF) pressure. In typical cases, gait disturbance is the first and most salient sign, followed by forgetfullness or mild dementia, psychomotor retardation, apathy (with parkinsonian or depressive appearance) and, later on, urinary urgency or incontinence. These cases present minor diagnostic difficulties and they are the most likely to improve after shunting"" 11 .Differential diagnostic problems may, however, arise in some patients with atypical o...

The extent of hippocampal resection is associated with outcome. Incomplete resection of atrophic hippocampus may explain most surgical failures in patients with TLE due to unilateral hippocampal sclerosis.

Low-grade gliomas arising in dorsal midbrain in children and young patients usually present few neurological symptoms and findings, and patients management is controversial. Some authors propose only clinical observation until the patient present signs of increased intracranial pressure when a shunt with or without biopsy, is inserted; others recommend radiotherapy after stereotactic or open biopsy. Microsurgical total removal of tumor may be curative. We present a retrospective analysis of eight patients (mean age 16.6 +/- 11.5 years-old) with low-grade astrocytoma of the tectal region operated on using an infratentorial/supracerebellar approach between 1981 and 2002. All patients presented hydrocephalus and had a shunt insertion before surgical resection of the lesion. The tumour could be totally resected in seven patients. In one case radical removal was not possible due to infiltrative pattern of the lesion. Postoperative radiotherapy was performed in two cases, one patient at the beginning of this series and in the case with infiltrative tumor. This patient presented progressive tumor growth and died five years after surgery. No recurrence occurred after total removal. Post-surgical follow-up time ranged from 2 1/2 to 22 1/2 years (mean 9.9 +/- 5.9 years). Radical microsurgical removal of non invasive tumors is possible without mortality or significant morbidity. It may be curative and should remain as an alternative to be discussed with the patient.

Whole-body vibration contributed little to improve the functional levels of stroke patients.