Hemorrhagic complications after endoscopic third ventriculostomy are rare. The formation of a traumatic basilar tip aneurysm after this procedure has not been reported in the literature. Laser fenestration of the third ventricular floor may increase the risk of this event.

The hemorrhage rate of a patient with venous malformations is similar to the rates presented in previous reports for patients with cavernous malformations without previous symptomatic hemorrhage. We think that hemorrhage in a patient with venous malformations may be related to an underlying but not yet documented cavernous malformation. Because of the low risk for new neurological events, we advocate conservative management. The risks associated with surgical intervention greatly exceed the low risk of morbidity related to venous malformation hemorrhage.

In this article the authors describe the management of Type II odontoid fractures with special attention to operative technique and avoidance of complication. Anterior odontoid screw fixation is a procedure the authors have performed over the last 8 years in cases with acute Type II and rostral Type III odontoid fractures. In cases of Chronic Type II odontoid fractures and in patients with transverse ligament disruption, the authors prefer to undertake posterior transarticular facet screw fixation supplemented by bone graft and interspinous C1–2 wiring. The technical aspects of these procedures are described with a focus on operative nuances. Selection criteria and techniques that the authors have refined over the years have helped them to optimize success rates and minimize complications.