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Omar M. Salazar, Hernan Castro-Vita, Paul VanHoutte, Philip Rubin and Cengiz Aygun

estimates, patterns of tumor spread and failure, autopsy findings, and long-term radiation effects in more than 50 patients with intracranial ependymomas treated with postoperative radiation therapy. This recent update of our experience constitutes the subject of the present report. Clinical Material and Methods From 1959 through 1979, 51 patients with pathologically confirmed intracranial ependymomas received postoperative radiation therapy in the Division of Radiation Oncology, University of Rochester Cancer Center. The tumors were histologically graded from Grade

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James Tait Goodrich

I read with interest this follow-up study by Dr. Jimenez and Dr. Barone on their surgical treatment of coronal synostosis. 1 The study reviews a 16-year experience with 115 patients who were surgically treated with an endoscopy-assisted craniectomy supplemented with postoperative cranial orthosis therapy (helmet-assisted recontouring of the skull deformity). I have been familiar with this work since its beginning and have participated in a number of panel discussions with Dr. Jimenez at national and international meetings over the years. As a result I am

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Neurosurgical Forum: Letters to the Editor To The Editor Philip Littman , M.D. Luis Schut , M.D. Roger Packer , M.D. Derek Bruce , M.D. Leslie Sutton , M.D. Philadelphia, Pennsylvania 658 660 In the article by Salazar, et al. (Salazar OM, Castro-Vita H, VanHoutte P, et al: Improved survival in cases of intracranial ependymoma after radiation therapy. Late report and recommendations. J Neurosurg 59: 652–659, October, 1983), the authors

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Randall T. Higashida, Van V. Halbach, Leslie D. Cahan, Grant B. Hieshima and Yoshifumi Konishi

I ntravascular detachable balloon embolization therapy for neurovascular lesions was first described by Serbinenko in 1974. 26 At that time, occlusion of vessels was utilized diagnostically to assess collateral blood flow and also to treat certain vascular malformations. With the further development of intravascular detachable balloon technology, permanent solidification agents, and high-resolution real-time digital subtraction angiography, it is possible to treat complex intracranial aneurysms from a transvascular approach in selected cases. The procedure is

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Rachel Pruitt, Alexander Gamble, Karen Black, Michael Schulder and Ashesh D. Mehta

H yperthermia as a tool in operative neurosurgery has a history going back several decades. 21 , 36 Lack of precision and uncertainty regarding the volumes and actual temperatures delivered has prevented this method from being widely accepted. Laser interstitial thermal therapy (LITT), first proposed in the 1980s, 1 has generated excitement recently in the neurosurgical community. It has been proposed as an ablative tool for patients with lesions when minimal invasiveness is desired. LITT uses MRI-compatible fibers that transmit laser energy and are

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Cesare Arienta

L ong-term survival in patients operated on for craniopharyngioma is rare. 1, 3–12, 14, 15 We report a patient with a craniopharyngioma who was operated on but not given radiation therapy. Thirty-six years after surgery, he was readmitted for a meningioma of the falx. Case Report This 55-year-old man entered the Neurosurgical Clinic of the University of Milan in December, 1981, for evaluation of a partial motor seizure in the left leg. First Admission . At the age of 19 years, he was admitted to our clinic with a history of headache, impaired vision

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Raheel Ahmed, Meryl A. Severson III and Vincent C. Traynelis

tuberculous infections. 4 , 16 The management of spinal osteomyelitis consists of aggressive antimicrobial therapy. Surgical intervention is indicated in patients with symptomatic neural compression and/or spinal instability. 15 Eradication of the infection is often hampered by local hypoxia and/ or ischemia, which delays wound healing and impedes the oxidative bactericidal function of neutrophils. 5 Initially used to treat decompression sickness, HBO therapy is now recommended as a primary and/or adjunctive treatment for a wide range of clinical disorders. 17

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Erin C. Peterson, Kamlesh B. Patel, Gary B. Skolnick, Kristin D. Pfeifauf, Katelyn N. Davidson, Matthew D. Smyth and Sybill D. Naidoo

plagiocephaly and/or brachycephaly (DPB) involves active repositioning or orthotic helmeting. 7 , 12 , 16 , 22 Recent systematic analyses found helmeting often reduces cranial asymmetry faster than positioning. 25 , 32 , 34 Positioning therapy involves laying the child down in a way that avoids pressure on the flattened area and additional supervised time on their stomach. 24 , 25 Helmeting is started between 4 and 6 months of age, is worn for 22–23 hours per day for a duration of 3–6 months, and is used for moderate to severe deformations. 12 , 13 , 23 Known risks of

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A. Leland Albright and Susan S. Ferson

✓ Since its introduction in the late 1980s, intrathecal baclofen (ITB) therapy has become the standard treatment for severe generalized spasticity and dystonia in children. Treatment with ITB decreases spasticity in the upper and lower extremities and has been associated with improved function and decreased musculoskeletal contractures. In addition, ITB decreases generalized secondary dystonia and has been associated with improved comfort and ease of care in approximately 85% and with improved function in approximately 33% of patients. Continued effectiveness of ITB in treating spasticity has been observed for up to 17 years, and its effectiveness in treating dystonia has been observed for up to 10 years. Although ITB therapy is frequently associated with complications such as infections, catheter malfunctions, and cerebrospinal fluid leaks, the benefits of therapy appear to outweigh the risks. Additional investigation is needed to determine the effects of ITB on other movement disorders such as athetosis and chorea.

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Mahmoud G. Naguib, Shelley N. Chou and Angeline Mastri

C horoid plexus papillomas are generally believed not to be sensitive to radiation therapy. A case is presented in which a large left cerebellopontine angle tumor was found associated with bone destruction. On histological examination, it was identified as a choroid plexus papilloma. Due to its extreme vascularity and its location, gross resection was not possible. A course of radiation therapy was given, with excellent results. Case Report This 29-year-old man was brought to the neurosurgical service for evaluation of recent x-ray evidence of petrous