Gorham's disease, also called massive osteolysis or vanishing bone disease, is an enigmatic condition caused by endothelial proliferation occurring in bone and soft tissue. Death is frequent when there is spinal or visceral involvement. We present a case of spinal and skull base Gorham's disease that was reversed by radiation therapy administered while the spine was supported by a halo vest. The literature is reviewed.

The authors report three cases of cerebral vascular spasm following transfrontal removal of large pituitary neoplasms. One patient awakened from surgery hemiparetic, but has since recovered. A second patient developed hemiparesis with confusion on the fifth postoperative day and eventually died. The third patient developed hemiplegia on the tenth postoperative day, but recovered completely. Vascular spasm was documented angiographically in all three cases. Possible mechanisms underlying this unusual complication are discussed.

A variety of lesions of ectodermal, mesodermal, (rarely) endodermal, or mixed-cell layer origin involve the region of the conus medullaris. Some of these abnormalities produce cord tethering and others, such as lipoma, frequently present as masses. In the present case, an infant was discovered to have a lesion most closely resembling a capillary hemangioma involving the skin of the midline and right buttock, the deep soft tissues of the right buttock, the dura, and the conus medullaris. The origin of this congenital spinal tumor from primitive mesoderm is proposed in light of its metameric pattern of distribution.

Herniation of a lumbar disc in the pediatric age group is rare. A 12-year-old female twin developed backache and left sciatica after a mild lifting injury. Magnetic resonance imaging of the spine showed multilevel lumbar disc herniation. The patient was managed conservatively and her symptoms subsided within 6 weeks. Magnetic resonance imaging of her asymptomatic twin sister revealed a similar pattern of disc degeneration and multilevel herniation. This report emphasizes the hereditary nature of juvenile lumbar disc degeneration.

Experience with endocurietherapy of skull base tumors is reviewed. We present our cases of recurrent pituitary hemangiopericytoma, radiation-induced recurrent meningioma, recurrent clival chordoma, recurrent nasopharyngeal cancer involving the cavernous sinus, and recurrent parotid carcinoma of the skull base which were all successfully retreated with high-activity 125iodine (I-125) permanent implantation.