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Aneurysmal bone cysts (ABCs) are benign, nonneoplastic, hemorrhagic, and expansile osseous lesions that present most frequently at age younger than 20 years. Aneurysmal bone cysts typically involve long bones of extremities, thorax, pelvis, or spinal column. Skull base involvement is very rare. The authors report the case of a 23-year-old woman with ABC of the skull base and total removal of lesion with pure endoscopic endonasal approach. The patient had presented with nasal obstruction for 6 months. Physical and neurological examination findings were normal except for bilateral anosmia. Cranial magnetic resonance imaging (MRI) revealed a tumor occupying ethmoid sinuses anterior skull base that extended into bilateral frontal lobes. The patient underwent pure endoscopic endonasal surgery, and the tumor was resected gross-totally. Histologic examination revealed ABC. Consequently, ABC should be considered in differential diagnosis of skull base pathologies. Endoscopic endonasal surgical approach is a safe, minimally invasive, and effective way in the treatment of these tumors.

Sphenoidal sinus foreign bodies are very rare entities that are often associated with a cranial and/or orbital trauma. In this paper, a case of a metallic foreign body that pierced the sphenoid sinus and penetrated into the intracranial space due to a work accident is presented. A 29-year-old male was referred to our clinic due to a right orbital penetrating trauma. Skull X-ray and computed tomography (CT) scans demonstrated a foreign body inside the sphenoidal sinus, extending to the left temporal fossa. The foreign body was removed using an endoscopic endonasal technique, and the skull base was reconstructed with a multilayer closure technique. There were no complications during or after the operation. Postoperative result was perfect after three months of follow up.

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AIm: Deep venous thrombosis (DVT) and pulmonary embolism (PE) are the most frequent surgical problems and associated with high morbidity and mortality. Neurosurgical patients constitute a unique group where prophylaxis with anticoagulant and antiaggregant agents are relatively contraindicated due to the natural course of vascular problems such as aneurysms, hemorrhagic tumors or hematomas or increased vulnerability to complex spinal surgeries and trauma. mAterIAl and methOds: We included 67 patients predicted to be immobilized for 2 or more months in this retrospective analysis. A vena cava filter was inserted between the first and seventh postoperative day in 40 patients in a prophylactic manner whereas 27 patients received low dose heparin for the same purpose. The patients were evaluated for symptomatic DVT or PE.results: Percutaneous insertion was performed for all filters without any complication. DVT occurred in two patients of the filter group and 1 patient of the heparin group. There was no PE recorded in any patient of either group. Patients were followed up for 22 months in the filter and 16 months in the heparin group. COnClusIOn:We conclude that prophylactic filter use in high risk neurosurgical patients is not beneficial and not superior to low-molecularweight heparin use. Nevertheless, it is reasonable to prevent PE in patients with proven DVT who have no contraindication for anticoagulant drugs.KeywOrds: Deep venous thrombosis, Venous thromboembolism, Vena cava filter, Low molecular weight heparin, Pulmoner embolism prophylaxis, Neurosurgical patients ÖZ AmAÇ: Derin ven trombozu ve pulmoner embolizm yüksek morbidite ve mortaliteyle seyreden en sık cerrahi problemler arasında yer alır. Anevrizma gibi vasküler problemler, hemorajik tümörler, hematom, kompleks spinal cerrahi ve travma gibi nöroşirürjiye ait hastalıklar antiagregan ve antikoagülan tedavinin göreceli olarak kontrendike olduğu özel bir grubu oluşturmaktadır. yÖntem ve GereÇler: Bu retrospektif çalışmada, 2 ay veya daha uzun süre immobilize olması beklenen 67 hastanın analizi yapılmıştır. Vena kava filtreleri 40 hastada postoperatif bir ile yedinci günde proflaktik amaçla yerleştirildi. 27 hastada ise aynı amaçla düşük moleküler ağırlıklı heparin kullanıldı. Hastalar yattıkları süreçte ve izlemde semptomatik derin ven trombozu (DVT) ve pulmoner emboli (PE) açısından takip edildi.BulGulAr: Bütün filtreler perkütan yolla yerleştirildi ve işleme ait herhangi bir komplikasyon gelişmedi. Filtre grubunda 2, heparin grubunda 1 hastada DVT gelişti. Her iki grupta PE saptanmadı. Hastalar filtre grubunda ortalama 22 ay, heparin grubunda 16 ay süreyle takip edildi. sOnuÇ: Yüksek riskli nöroşirürji hastalarında prolaktik filtre kullanımının düşük moleküler ağırlıklı heparin kullanımına üstün olmadığı düşünüldü. Buna rağmen DVT'si kanıtlanmış ve antikoagülan ilaçların kontrendike olduğu durumlarda PE'yi önlemede etkin olduğu açıktır.