Over a 3-year period in our clinic, surgeons operated on 32 persons over 65 years old with lumbar spinal stenosis. This article presents the retrospective analysis of the clinical, radiological, and short-term surgical outcomes. The stenosis seen most commonly among the elderly develops focally at the intervertebral junctions as a result of a complex process of disc degeneration, facet arthropathy, ligamentum flavum hypertrophy, spondylosis, and sometimes spondylolisthesis. All patients underwent a midline decompressive laminectomy with foraminotomies at the affected levels, and discectomy was performed in persons with lumbar disc hernia. Average age was 71.15 +/- 5.09 (65-80); 50% (16) were women, and 50% (16) were men. The most frequent symptoms were pain (96.9%) and neurological claudication (90.6%). The average preoperative duration of the symptoms was 139.87 +/- 115.03 weeks. The most frequent neurological symptoms were reflex disturbances (62.5%), Lasèques's sign (SLR) (+)(53%), and motor deficit (50%). The anteroposterior diameter of the spinal canal was less than 11.5 mm in 71.9% of the cases. In 62.5% of the patients, partial recovery was observed in the short term; 68.8% of the patients underwent laminectomy. Of those, 87.5% had total and 12.5% had partial laminectomies. In addition to laminectomy, discectomy was performed in 31.3% of the patients. Total laminectomy was more likely to be performed on patients older than 65 years, because the anteroposterior diameter was more likely to be below 11.5 mm in this cohort of patients. In lumbar stenosis, surgical treatment-decompression-is an effective method. Surgery has been demonstrated to be effective even in patients over the age of 75 years.

In this paper, a brief information on factors taking role in intracranial air formation and tension pneumocephalus because of two cases epidural air formation and tension pneumocephalus following transsphenoidal operation is presented. Two cases were treated conservatively.

Decompressive laminectomy can be performed safely and effectively in patients of with lumbar stenosis.

Conclusión. Los abscesos epidurales constituyen el 5-25% de todas las infecciones intracraneales localizadas. La colonización del microorganismo se puede producir por contigüidad, por vía hematógena, por traumatismo craneal abierto o a consecuencia de una intervención quirúrgica. La sinusitis es una de las causas más relevantes de los abscesos epidurales, sobre todo en la región frontal. La aparición bilateral es rara. En este trabajo, se presenta un caso de absceso epidural bilateral y se revisan los criterios diagnósticos y de tratamiento.PALABRAS CLAVE: Bilateral. Absceso epidural cerebral. Sinusitis.

Description.A 19-year-old male with periorbital painful swelling, headache and vomiting was admitted to our clinic. Because of the diagnosis of sinusitis he had received medical treatment in another center two months before, consisting of antibiotics and analgesics. However as a result of valid persistence of the patients' complaints, brain CT and MR imaging were required; showing bilateral epidural abscess. The patient was operated upon through a coronal incision and bifrontal craniotomy, draining both abscesses and removing their membranes.Conclusion. Epidural abscess constitute 5-25% of all the localized intracranial infections. Microorganism colonization may be produced by contiguous infection, hematogenous spread, open cranial trauma or as a consequence of neurosurgical intervention. Sinusitis is one of the most relevant causes of epidural abscesses, mostly in the frontal region. Bilateral occurence is rare. In this paper a case of bilateral epidural abscess is present. Diagnosis criteria and treatment approaches are reviewed.KEY WORDS: Bilateral. Epidural brain abscess. Sinusitis Absceso frontal bilateral epidural Resumen Descripción. Un joven de 19 años ingresó en nuestra clínica con inflamación dolorosa periorbitaria, cefalea y vómitos. Debido al diagnóstico de sinusitis, dos meses antes había recibido un tratamiento con antibióticos y analgésicos en otro centro. Al persistir el dolor se solicitó una TAC y una RM craneal, que mostraron abscesos epidurales bilaterales. El paciente fue intervenida mediante una incisión coronaria y craneotomía bifrontal, con drenaje de los dos abscesos y extirpación de sus membranas.Conclusión. Los abscesos epidurales constituyen el 5-25% de todas las infecciones intracraneales localizadas. La colonización del microorganismo se puede producir por contigüidad, por vía hematógena, por traumatismo craneal abierto o a consecuencia de una intervención quirúrgica. La sinusitis es una de las causas más relevantes de los abscesos epidurales, sobre todo en la región frontal. La aparición bilateral es rara. En este trabajo, se presenta un caso de absceso epidural bilateral y se revisan los criterios diagnósticos y de tratamiento.PALABRAS CLAVE: Bilateral. Absceso epidural cerebral. Sinusitis.