No abstract

No abstract

A series of 10 surgically treated "spontaneous" spinal haematomas (7 cases with epidural, 3 with intramedullary location), is presented. Symptomatology was rarely acute. Clinical onset was mostly dominated by spinal or radicular pain, followed by severe motor deficit. Surgical outcome was satisfactory in the majority of cases. Age, duration of symptoms, haematoma site and size appeared to have no influence on final outcome. This was significantly correlated only with the preoperative neurological condition.

24 patients below 16 years of age with intracranial arteriovenous malformations are considered. Presenting history has been constituted mainly by intracranial hemorrhage, followed by epilepsy and hydrocephalus. The utility of angiography and CT scan is stressed, especially for preoperative evaluation. The arteriovenous malformation was located in noncritical cortical areas in 7 cases, in critical cortical areas in 6 cases, in the midline structures or in the basal ganglia in 8 cases, in the posterior fossa in 2 cases, and was only dural in 1 case. Complete surgical resection of the lesion has been carried out in 18 cases, and embolization in 1 case. The operative microscope, induced hypotension, and the ‘backward technique’ have been very useful during surgery. Following the operation, good results have been achieved in 83% of cases; mortality has been 11%. In most cases epilepsy has shown improvement after surgery. It is concluded that direct surgical extirpation of the angioma is the treatment of choice for pediatric patients, even in the presence of epilepsy alone.