No abstract

Symptomatic spinal osteochondromas are rare occurrences in an individual surgeon's experience. Computed tomography or magnetic resonance imaging are the imaging procedures of choice. In the majority of patients with myelopathy or radiculopathy, surgery results in complete relief of symptoms as demonstrated in this case.

Between the years 1970 and 1997, 112 patients with tumors of the lateral ventricle were operated on at the University of Ankara, School of Medicine, Department of Neurosurgery. Seventy-one patients (63.4%) were male and 41 patients (36.6%) female. Headache (35.7%), nausea and vomiting (22.3%) were the most common presenting complaints. Papilloedema (42.9%), motor and sensory loss (25%) were the most common findings at neurological examination. Complete tumor removal was accomplished in 38.4% of the patients. Histopathologically, the most commonly seen types of the tumor were ependymoma (25%) and astrocytoma (21.4%). Among the various approach, the anterior transcortical (53.6%) and the posterior transcortical (16%) were the most commonly used. Eleven patients were reoperated for tumor recurrence. After surgery, radiation therapy was also performed on fourty-two patients. The morbidity and mortality rates were considerably higher before 1976 when the use of microneurosurgical techniques was introduced. After this, our morbidity and mortality rates decreased dramatically. The overall surgical mortality rate was 7.1% before 1976; during the last 10 years (n:46), it was 6.5%. In this report, our choice of operative approaches and the results will be discussed.

A case is presented of a woman who was shot in the left occipital area with a .32 caliber automatic pistol. She was neurologically intact on admission, and skull x-ray films revealed the bullet in the right suboccipital area. On the 2nd day of the admission she developed Lhermitte's sign. Repeat films showed that the bullet had migrated to the C-4 vertebral level. The bullet was subsequently removed via a total laminectomy at C3-4.

A series of 88 consecutive patients operated on for tuberculum sellae meningioma at the Neurosurgery Department of the University of Ankara Medical School was reviewed. Visual impairment was the most common initial complaint. All but 9 patients had visual symptoms. All patients underwent craniotomy, with an operating microscope being used in 62 cases. Use of the operating microscope appeared to increase the total removal rate while lowering the mortality. In our series visual function improved in 53.5%, was unchanged in 27.5%, and worsened in 19% of the patients.