Symptomatic multiple extradural arachnoid cysts of the spine are extremely uncommon in children and have only rarely been reported. The authors report a case of multiple extradural spinal arachnoid cysts in a 14-year-old child who presented with signs of spinal cord compression. The disease affected the thoracic spine and extended from T-5 to T-10 with an underlying defect in the dura of the spinal canal that was predisposed to the formation of cysts. The authors describe the imaging examination, surgical planning, and surgical technique, and they review the literature. They also discuss the possible mechanisms of cyst formation.

Objective:Surgical management of giant skull osteomas Osteomas are benign, generally slow growing, bone forming tumors limited to the craniofacial and jaw bones.Materials and Methods:A retrospective review of all cases of osteoma diagnosed from 2009 to 2013 treated in our hospital. The data collected included age at diagnosis, gender, lesion location, size, presenting and duration of symptoms, treatment, complication and outcome.Results:During our study period there were 15 cases that were treated surgically. Their mean age was 42 years (range: 15–65 years) and all of our patients were female. The average duration of symptoms was 3 years and size varying from 4 cm to 12 cm. Eight patients complained of headache, whereas 6 patients complained about esthetics, and 1 patient presented with proptosis. The tumor was excised by cutting the base of the tumor and then residual tumor was grinded using a round head cutting bar. Osteoma was removed with esthetically acceptable appearance.Conclusion:There were no major complications during operative and postoperative period. Although osteomas are usually slow growing but surgery is usually performed due to esthetic reasons. It is important to plan an appropriate surgical approach that minimizes any damage to the adjacent structures.

This study has shown that, with a neurosurgery nurse delegated to the role, it is feasible to conduct follow-up telephone interviews with patients after discharge from a neurosurgery ward and that in fact such follow-up was appreciated by patients.

A large proportion of patients are being discharged with considerable levels of difficulty in four of the five EQ-5D dimensions. This stresses the importance of providing good follow-up and support of patients and their families.

Introduction:Tuberculum Sellae Meningioma is one of the most challenging surgeries among neurosurgeons. Many approaches have been established in the effort of removing the tumor and some of them are supported by an advanced neurosurgical technology. In this study, we aim to compare the efficacy of the two most common approaches, the pterional and the unilateral frontal.Materials and Methods:This was a restrospective study that aimed to observe the efficacy of the two most common approaches used in our center, the pterional and the unilateral frontal, in resecting the tuberculum sellae meningioma, which was held in Dr. Hasan Sadikin General Hospital, Bandung, from July 2007-July 2010. Twenty patients were enrolled with half of them operated by the pterional approach and the rest by unilateral frontal approach. We evaluated six parameters: tumor size, degree of tumor removal, surgery duration, post-operative cerebral edema, patients' outcome, and length of stay, which were evaluated to take measure of the efficacy of each procedure.Results:We found that the pterional approach gave more advantages than the unilateral frontal. Total tumor removal, especially in tumor size ≥ 3 cm was achieved in a greater number of subjects in the pterional (P<0.023). Other advantages of the pterional compared to the unilateral frontal were a shorter surgical duration (P=0.024), shorter length of stay (P=0.009) and less frequency of post-operative cerebral edema incidence (P=0.023).Conclusion:According to our facilities and conditions, it seems that the pterional approach have more advantages than the unilateral frontal approach in tuberculum sellae meningioma surgery.

Microsurgery techniques are useful innovations towards minimizing the insult of canal stenosis. Here, we describe the trumpet laminectomy microdecompression (TLM) technique, advantages and disadvantages. Sixty-two TLM patients with lumbar disc herniation, facet hypertrophy or yellow ligament or intracanal granulation tissue. The symptoms are low back pain, dysesthesia and severe pain on both legs. Spine levels operated Th11-S1; the patients who had trumpet-type fenestration, 62.9% had hypertrophy of the facet joint, 11.3% had intracanal granulation tissue, 79.1% had hypertrophy of the yellow ligament and 64.5% had disc herniation. The average of procedure duration was 68.9 min and intraoperative blood loss was 47.4 mL. Intraoperative complications were found in 3.2% of patients, with dural damage but without cerebrospinal fluid leakage. The TLM can be performed for all ages and all levels of spinal canal stenosis, without the complication of spondilolistesis. The TLM has a shorter duration, with minimal intraoperative blood loss.

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✓Symptomatic multiple extradural arachnoid cysts of the spine are extremely uncommon in children and have only rarely been reported. The authors report a case of multiple extradural spinal arachnoid cysts in a 14-year-old child who presented with signs of spinal cord compression. The disease affected the thoracic spine and extended from T-5 to T-10 with an underlying defect in the dura of the spinal canal that was predisposed to the formation of cysts. The authors describe the imaging examination, surgical planning, and surgical technique, and they review the literature. They also discuss the possible mechanisms of cyst formation.