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Akio Noguchi, Vijayabalan Balasingam, Yoshiaki Shiokawa, Sean O. McMenomey, and Johnny B. Delashaw Jr.

) early decompression and mobilization of the optic nerve; and 3) improved surgical exposure as evidenced by Evans and colleagues 7 in a cadaveric study whose results revealed a twofold increase in the exposed length of the optic nerve and the opticocarotid triangle as well as a three- to fourfold increase in the maximum width of the opticocarotid triangle. The extradural anterior clinoidectomy procedure coupled with the opening of the optic sheath was introduced into the neurosurgical armamentarium in 1985 by Dolenc. 3 The procedure allows for the complete removal of

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Luis A. Castillejo, José de Jesús Julian, Pedro González, and Rafael Román

Plasmacytoma is a myelomatous mass that may be solitary, may be seen in combination with multiple myeloma (MM), or may progress to a generalized disease. 1 The diagnosis of solitary plasmacytoma requires exclusion of MM based on bone marrow aspiration, electrophoresis of serum and urine protein, and no other lesion on the complete skeletal survey. 2 Solitary extradural plasmacytoma of the skull (SEPS) is a rare finding with 35 cases reported in the English-language literature. It may involve the cranial vault, skull base, and orbit. Distinction between SEPS

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Risheng Xu, Lydia Gregg, Sheng-fu Larry Lo, and Philippe Gailloud

L ow-flow spinal arteriovenous fistulas include spinal dural arteriovenous fistulas (SDAVFs), low-flow perimedullary arteriovenous fistulas, and low-flow spinal extradural arteriovenous fistulas (SEAVFs). 1 Low-flow SEAVFs were described by Merland and colleagues in 1980. 2 Although relatively common, they are frequently misdiagnosed as SDAVFs and their true prevalence underestimated. The principal feature distinguishing low-flow SEAVFs from SDAVFs is the location of the shunt, which involves a pouch of the internal vertebral venous plexus in SEAVFs and

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Extradural aerocele

Case report with 20-year follow-up results

Eben Alexander Jr., Courtland H. Davis Jr., and Charas Suwanwela

I n 1962, we reported two patients with extradural aerocele. 3 There had been little in the literature on that rare lesion before that time, and the cases that had been reported did not appear to be definitely extradural. Case Report The first of our reported cases was that of a 37-year-old man who complained of headaches, and had had an episode of meningitis several years before admission. Nineteen years before we first saw him, he had sustained a head injury in an automobile accident. Roentgenograms of the skull showed a remarkable amount of air

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Tsutomu Iwakuma and Carl V. Brunngraber

R eports of ossification are rare since most extradural hematomas are removed surgically before ossification can occur. 6 We are reporting such a case with extradural bone formation demonstrable in skull films. Case Report This 33-year-old man was admitted on January 2, 1973, for treatment of a calcified mass in the left frontal region and progressive disorientation since he suffered a fracture in the same region on November 2, 1972. Since October, 1971, he had had three generalized epileptic seizures with unconsciousness, urinary incontinence, and

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Ahmad Hanieh

T he term “chronic extradural hematoma” was applied by Sparacio, et al., 4 to cases in which 48 to 72 hours elapse between trauma and the evacuation of the hematoma. Intervals of up to 36 days have been reported. 2 Aerocele is a not uncommon complication of head injury, and the risk of meningitis in these cases has been stressed by North. 3 Dinning, et al., 1 have discussed the indications for dural repair in cases of aerocele. The following is a case in which both an extradural hematoma and an extradural aerocele were found at the same site. Case

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Sangham R. Soni

E xtradural hemorrhage is a serious complication of head injury, and the fact that the condition may be bilateral is not widely known. A case is reported in which bilateral extradural clots in asymmetrical positions presented at different times. This occurrence has not been recorded before to the author's knowledge. Case Report A 23-year-old man was admitted to the casualty department of the Cardiff Royal Infirmary at 12:05 a.m. on March 14, 1970. An hour earlier while working on a building site he had been hit on the left side of the forehead by a crane

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Sidney M. Marks and Malcolm D.M. Shaw

S pontaneous intracranial extradural hematoma, although an unusual phenomenon, is a recognized complication of several conditions. These include sinus, middle ear, and orbital infections, vascular malformations of the dura mater, and disorders of blood coagulation occurring either spontaneously or iatrogenically. 1–3 Only six cases of extradural hematomas complicating infections have been recorded to date. 3 Three were cases of chronic otitis media, two of frontal sinusitis, and one of orbital cellulitis. Arteritis and progressive detachment of the dura

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Naoya Kuwayama, Shinichiro Takahashi, Makoto Sonobe, and Kyoichi Sugita

S pontaneous extradural hematomas (EDH's) are rare. They may be caused by pericranial inflammatory diseases, hemorrhagic tendencies due to coagulopathies of the blood, and vascular disorders of the dura mater. Recently, we experienced a case of spontaneous bilateral EDH's assumed to be caused by hypofibrinogenemia. Case Report This 21-year-old woman came to our attention on April 17, 1983. Family history was unremarkable and there was no record of coagulopathy. She had fractured her limbs twice in childhood, but they both recovered well after

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Extradural guinea-worm abscess

Report of two cases

Mohammed S. Khwaja, Jonathan F. B. Dossetor, and James H. Lawrie

I nfection by Dracunculus medinensis is a major cause of morbidity in certain parts of tropical Africa and Asia. An extremely high incidence of infection in both children and adults has been reported from various parts of West Africa. 2, 5, 6 However, despite the prevalence of this infection in endemic areas only six cases of extradural guinea-worm abscess have been reported between 1961 and 1970. 1, 3, 4, 7 Clinical diagnosis of this complication is rarely possible and the prognosis is unpredictable. Early surgical intervention may be rewarding, but the