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Hideo Terao and Seitaro Sato

✓ A ventriculo-orbital fistula developing as a result of closed head injury produced intraorbital compression symptoms including downward deviation of the globe and inability of upward gaze. Percutaneous injection of Conray clearly demonstrated the fistula, which was successfully closed by frontal craniotomy.

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Hideo Terao and Isao Muraoka

✓ An enormous globoid aneurysm arising from the right middle cerebral artery is reported. A functioning blood channel ran through the laminated thrombus within the aneurysm, and operative injury to this blood channel caused serious cerebral infarction.

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Kentaro Shimizu, Norio Nakamura and Hideo Terao

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Hideo Terao, Seitaro Sato and Shiin Kim

✓ An isolated case of Gardner's syndrome with characteristic multiple osteomas in the skull is presented. Neurosurgical intervention was required for an intracerebral metastasis from colonic carcinoma. Postoperatively, abnormal hyperplasia of the dura developed.

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Hideo Terao, Shu Kobayashi, Akira Teraoka and Riki Okeda

✓ Bilateral xanthogranulomas arising from both choroid plexuses were found in a 6-year-old child with epileptic seizures and psychomotor retardation. Both masses were surgically removed without adding any neurological deficits. The xanthogranulomas were fairly large, and the posterior part of both lateral ventricles were slightly dilated, but clinical symptoms and the location of the xanthogranulomas could not be clearly correlated in this case.

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Tomokatsu Hori, Hideo Terao, Tsuneyoshi Eguchi and Masao Matsutani

✓ A case of a huge, rapidly enlarging, intraoral carotid aneurysm, presenting with dysphagia and dyspnea, was successfully treated by a combination of extracranial-intracranial bypass and internal carotid artery ligation. This case is unusual in that a tendency to bleed was observed for about 3 weeks after the operation. This is thought to be related to a consumption coagulopathy associated with the aneurysm.

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Hideo Terao, Tomokatsu Hori, Masao Matsutani and Riki Okeda

✓ Two cases of cryptic vascular malformation that were not demonstrated by cerebral angiography were detected by computerized tomography. One of these patients had a cavernous angioma in the fourth ventricle with recurrent subarachnoid hemorrhages, and the other harbored a small arteriovenous malformation and intracerebral hematoma. The usefulness and limitations of computerized tomography in the identification of cryptic vascular malformations are discussed.

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Tomokatsu Hori, Takanori Fukushima, Hideo Terao, Kintomo Takakura and Keiji Sano

✓ The authors have developed a fluoroscopy-assisted technique of percutaneous radiofrequency facial nerve coagulation at or near the stylomastoid foramen for management of facial spasm. The details of the procedure and the operative results in the initial series of 27 cases of facial spasm are described. The series included six men and 21 women, aged from 16 to 73 years. Twenty-four patients had classical, intractable, persistent hemifacial spasm, one had an unusual bilateral facial spasm, and one a postparalytic facial spasm. The age of onset varied from 16 years to 70 years. The duration of the symptoms ranged from 3 months to 11 years. Ten patients had undergone previous blunt-needle compression of the facial nerve from one to 10 times. The operative results in the 27 patients have so far been excellent. The longest follow-up has been 1½ years. Although partial facial weakness was present in 60% of the cases, it invariably disappeared within 1 to 4 months. Only three patients experienced recurrence of spasm. In two of them, recurrence followed lowtemperature coagulation. The procedure is simple, easy to perform, and extremely effective. It can be performed under local anesthesia in the outpatient clinic.