This is the second case of adjacent occurrence of an acoustic schwannoma and epidermoid cyst in the cerebellopontine angle. This case of a 70-year-old woman is presented with a history of her illness, neuroradiologic data, and photographs during the operation. We compare this case with the first of its kind.

With the help of modem computer-assisted imaging techniques, direct evidence of intracerebral lesions can be provided earlier and in more detail. often before the patient begins to exhibit symptoms. In asymptomatic cases, however, it is often difficult to establish an indication for a certain therapy. The choice of treatment chiefly depends on the histological nature of the lesion. Even in the age of computer-assisted imaging techniques, the specific diagnosis can only be made under the microscope. CT-guided stereotactic biopsy is a valuable and safe diagnostic tool for classifying intracranial lesions. It provides the basis for selecting the appropriate therapy, whether it be surgery, radiotherapy, or conservative treatment. We present a series of 250 stereotactic biopsies. The indications, technique, complications and limits of the method are discussed, as well as the diagnostic yield which achieved 97.6% in our series.

The diagnostic validity of stereotactic intracranial biopsies was investigated in 70 patients retrospectively. In 56 cases (80%) the presence of a neoplastic lesion as well as its grade of malignancy was proved by cytological, histological and immunohistochemical techniques. An inflammatory or vascular lesion was found in 8 patients (11.4%). In 6 patients (8.6%) the nature of the lesion remained unclear because of nonspecific histological findings. In 27 cases a correlation was found between the biopsy specimens and corresponding material obtained during open surgery or autopsy. 24 concordant results were found (88.9%). In one case a malignant tumour was classified only according to the findings obtained at operation. In two cases subsequently diagnosed as glioblastoma biopsy reported a higher differentiated astrocytoma and a non-neoplastic lesion, respectively. These results confirm stereotactic biopsy of intracranial lesions as a method with low complication rate and high diagnostic validity.

The management of patients with a brain tumour is essentially dependent on the knowledge of the histology. Because of its high accuracy and low complication rate stereotactic tumour biopsy has proven to be an important diagnostic procedure, especially in deep-seated lesions. Stereotactic tumour biopsy was carried out in 18 patients with target calculation either from computerized tomography (CT) or magnetic resonance imaging (MR).

Color atlas of microneurosurgery , Color atlas of microneurosurgery , کتابخانه دیجیتال جندی شاپور اهواز

Within a period of 13 months a 24-year-old male student experienced four attacks of subarachnoid haemorrhage. An intradural-extramedullary haemangioma at the level of the second thoracic segment was found to be the cause of the repeated bleeding.

Shunting and radiotherapy should no longer be the treatment of choice in cases of tumours of the pineal region. Microsurgical extirpation by the infratentorial supracerebellar approach according in 7 consecutive cases in the pediatric age group of a total of 17 processes of the pineal region and even within the mesencephalon is presented. The various other approaches are compared with anatomical studies and the advantages and hazards are discussed. The more aggressive surgical approach to tumours of the pineal region is stressed.

In the department of Neurosurgery, University of Vienna, about 700 patients with intracranial arterial aneurysms have been operated since autumn of 1964. The distributions of age, sex and the localization of the aneurysms correspond exactly to the international statistics.

Treatment of intracranial abscesses has become somewhat more successful since the introduction of antibiotic therapy, although surgery of acute brain abscesses still has a high rate of mortality. On the basis of experience gained with 167 intracranial abscesses, the method of choice in the surgical approach to the various stages of development in brain abscesses is to be demonstrated.