First described by Weisenburg in 1910, glossopharyngeal neuralgia is paroxysmal, lighting, excruciating pain referred to the posterior lingual region, tonsillar pillar, throat, external auditory canal and pinna. It is much less frequently encountered than trigeminal neuralgia with a reported relative frequency of the order of 1%. It is often secondary to neoplastic processes of the oropharyngeal region but can also be caused by mechanical compression of abnormal vessels on the nerve root. Less frequently it is of essential or idiophatic origin. Between 1990 and 2000, operations were performed at our Institute on 3 patients, all women ranging in age from 61 to 80 years, with glossopharyngeal neuralgia. All the patients had been taking caramazepine with only temporary initial improvement and in 2 cases parenteral feeding had been necessary before admission. The first 2 patients were submitted to percutaneous thermocoagulation rhizotomy of the inferior petrous ganglion of Andersch at the jugular foramen, the third to open procedure consisting in vascular decompression of the ninth nerve in posterior fossa. The follow‐up ranges from 2 to 10 years. The results were excellent or very good in all cases at the time of evaluation.The authors emphasize the role of surgical therapy in glossopharyngeal neuralgia when medical therapy fails.

At the time of this report, 80 patients have been operated upon for typical trigeminal neuralgia by the percutaneous rhizotomy approach. Through follow‐up evaluation extending over a period of 1 to 20 years, it has been completed for 65 of these patients. The average age was 63 years and 60% of patients were female. In 60% of patients pain was located on the right, and the second and third division of the trigeminal nerve were commonly involved. Isolated pain in the first or third division was less frequent than the second division. The disease had been present for an average of 8 years and was characterized by increasingly severe episodes of paroxismal pain and shortening period of remission. Nearly all patients had been treated with either diphenylhydantoin or carbamazepine, as well as other forms of medical and physical remedies. Response to follow‐up was obtained for all 65 patients. All were contacted by questionnaire on phone and a family member was contacted if the patient had died. At the time of evaluation, 94% of patients reported excellent to good results from the procedure. The remaining patients obtained only fair results because of undesirable side‐effects or recurrence of pain. The authors emphasize the importance of surgical therapy in trigeminal neuralgia when medical therapy fails.

BACKGROUNDThe incidence of tuberculous spondylitis, which had declined steadily for over 40 years in our countries, started increasing again in the eighties, paralleling the resurgence of pulmonary tuberculosis. Therefore it has become a matter of discussion in contemporary literature, because it can be a diagnostic challenge and, in spite of its severe neurological complications, it is a potentially curable illness.METHODSIn this retrospective study the authors report their experience concerning 12 patients operated on in a 25-year period because of serious cord compression from thoracic (9 cases) and cervical (1 case) tuberculous spondylitis or from thoracic tubercular epidural lesion (2 cases). Surgical techniques were selected on the basis of the cause of cord compression. Fusion with autologous bone and metallic osteosynthesis was performed in the cervical case (1986); no other patient received spinal instrumentation, and this can be explained with the consideration that all but one cases of Pott's paraplegia were treated in the years 1968-1977. In all of these cases fusion was achieved by means of plaster jackets and prolonged bed rest. Prolonged chemotherapy was systematically administered.RESULTSFollow-up data collected in 1995 show good and long-lasting results.CONCLUSIONSThey conclude that surgical treatment is required in case of cord compression and results can be excellent even in presence of severe neurological impairment; spinal instrumentation available in our era should be now considered in order to make rehabilitation earlier and morphologic results more satisfactory.

100 consecutive patients admitted for SAH from aneurysm rupture were treated in a 2 year period employing GDC embolization as the primary therapeutical choice. 78 cases were embolized and 22 submitted to microsurgical aneurysmal exclusion. Overall mortality has been 6 patients (6%, 4 of GDC group, 2 of surgery group); overall morbidity has been 8%. GDC embolization significantly decreased the incidence of posthemorrhagic spasm. One patient with partial sack embolization (50%) rebled; but no rebleeding has been observed among patients with sack occlusion exceeding 70%. The very low mortality and morbidity of these 100 patients suggests that endovascular treatment has indeed ameliorated the outcome of patients presenting with ruptured intracranial aneurysm.

Bilateral traumatic abducens nerve palsy after head injury is a rare event. We present a case associated with skull fractures and intracranial hematoma, with complete recovery of abducens nerve palsy after six months. The mechanism of the lesion, the clinical conditions and the radiological findings are presented.