The records of 488 patients who underwent neurosurgical procedures in the sitting position were reviewed with special attention to the development of complications related to this operative position. The complications encountered included air embolus, pneumocephalus, subdural hematoma, compressive peripheral neuropathy, and orthopedic and dermatological problems. The 30-day operative mortality was 2.5%. These complications and methods of prevention, diagnosis, and treatment are discussed in detail, and the literature concerning the sitting position in neurosurgery is reviewed.

A case of chondromyxoid fibroma arising from the C-7 vertebral body and involving the epidural space and paraspinal soft tissues is presented. The surgical treatment of this tumor is described, and the pertinent literature is reviewed.

The authors describe a patient who suffered from tic douloureux associated with atypical facial pain and tinnitus. All preoperative neurodiagnostic findings were normal. Posterior fossa exploration disclosed a tentorial ossification compressing the sensory root of the trigeminal nerve. Ossification within the tentorium and the implications of unusual symptoms associated with trigeminal neuralgia are discussed.

The retinal circulation of 35 patients (age, 30 to 71 years) with symptomatic internal carotid occlusion (22 cases) or severe inaccessible stenosis (13 cases) was studied both before and after superficial temporal to middle cerebral artery (STA-MCA) bypass surgery using ophthalmodynamometry (ODM) and intravenous fundus fluorescein angiography (IVFA). Ninety-four per cent of the patients were found preoperatively to have funduscopic findings or symptoms indicative of ocular ischemia. ODM values were abnormal preoperatively in 32 of 35 patients (91%), and improvement in ODM values for the ipsilateral eye was noted postoperatively in 25 patients (71%). ODM values obtained during the early (less than 3 months) and late (greater than 3 months) postoperative periods were significantly improved when compared to the preoperative values. IVFA values were abnormal in 25 of 29 patients (86%) preoperatively, and significant improvement was noted in 22 of 25 patients (88%) postoperatively. Preoperative patients with normal fundus examinations (10 cases) had significantly better values for IVFA and ODM than patients with venous stasis retinopathy. The findings of the study showed that STA-MCA anastomosis is beneficial in treating retinal ischemia secondary to ipsilateral severe inaccessible carotid artery stenosis or occlusion.

The retinal circulation of 35 patients (age, 30 to 71 years) with symptomatic internal carotid occlusion (22 cases) or severe inaccessible stenosis (13 cases) was studied both before and after superficial temporal to middle cerebral artery (STA-MCA) bypass surgery using ophthalmodynamometry (ODM) and intravenous fundus fluorescein angiography (IVFA). Ninety-four per cent of the patients were found preoperatively to have funduscopic findings or symptoms indicative of ocular ischemia. ODM values were abnormal preoperatively in 32 of 35 patients (91%), and improvement in ODM values for the ipsilateral eye was noted postoperatively in 25 patients (71%). ODM values obtained during the early (less than 3 months) and late (greater than 3 months) postoperative periods were significantly improved when compared to the preoperative values. IVFA values were abnormal in 25 of 29 patients (86%) preoperatively, and significant improvement was noted in 22 of 25 patients (88%) postoperatively. Preoperative patients with normal fundus examinations (10 cases) had significantly better values for IVFA and ODM than patients with venous stasis retinopathy. The findings of the study showed that STA-MCA anastomosis is beneficial in treating retinal ischemia secondary to ipsilateral severe inaccessible carotid artery stenosis or occlusion.