SCSDH should be included in the differential diagnosis of progressive spinal cord and nerve root compression in patients receiving anticoagulant therapy. Prompt diagnosis and early surgical decompression lead to a good outcome.

Most arteriovenous malformations (AVMs) associated with the meningeal artery in the anterior cranial fossa are the pure dural type, and mixed pial-dural AVMs are rare. Two types of mixed pial-dural AVM occur in the anterior cranial fossa according to the shunting point: one with the nidus in the brain parenchyma of the frontal lobe, and the other with the shunting point in the dura mater. We describe two patients with AVMs fed by the anterior ethmoidal arteries and the persistent primitive olfactory artery, with the nidus located in the pure brain parenchyma of the inferior aspect of frontal lobe, and drained via an abnormal cortical vein into the cavernous and superior sagittal sinuses. The importance of occluding the venous outflow to obliterate intracranial dural arteriovenous fistula (AVF) is emphasized. However, removal of the nidus in the brain parenchyma is required. The presence of a pial feeder should be considered before diagnosis of dural AVF of the anterior cranial fossa, and preoperative detailed evaluation for the pial supply and shunting point is mandatory.

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Sumatriptan has direct scavenging activity on free radicals and NO. Acute migraine drugs with antioxidant properties may provide heretofore unheralded benefits via this mechanism.

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An 86-year-old man presented with intermittent claudication caused by a cyst of the ligamentum flavum. Lumbar magnetic resonance imaging demonstrated an extradural cystic mass at the L5-S1 intervertebral space and canal stenosis at the L4-5 space. L-5 laminectomy and flavectomy at the L4-5 and L5-S1 spaces were performed, and the cystic mass was excised. The histological features were consistent with cyst of the ligamentum flavum. The histological diagnosis was ganglion cyst of the ligamentum flavum. After surgery, claudication completely disappeared and the patient made a good recovery.

Although the tumors extending to the deep parapharyngeal space are difficult to completely remove via a single approach, a combined approach is useful in these huge extracranial extensions.

Cancers of the paranasal sinuses and nasal cavity are the most common malignant tumors of the anterior and anterolateral skull base. The treatment of these tumors affecting the skull base is complex due to the significant anatomical features. We examined 25 patients, 17 males and 8 females with mean age 61 ± 2 years. En bloc resections using anterior skull base resection, orbital resection, middle fossa resection, and combined procedures of these three resections were performed. Using a combination of adjuvant radiation and chemotherapy, we have achieved a 2-year disease-free survival rate of 90% in these cases. However, potential complications include cerebrospinal fluid leakage, meningitis, abscess formation, pneumocephalus, frontal brain contusion, trismus, and dysphagia as a functional complication. We believe that the optimal management of such malignant tumors involves a multimodal and multidisciplinary team approach. Here we present our recent institutional experience and treatment policy employed during the past 3 years.