Chikao Nagashima

Malignant change in an intradiploic epidermoid: report of a case and review of the literature

An unusual case of intradiploic epidermoid tumor is reported. In this case, a soft mass located over the parietal bone was noted shortly after birth. The mass gradually enlarged. The tumor underwent malignant change after several excisions and repeated inflammations. The patient was successfully treated with extensive excision, radiotherapy, and chemotherapy. Compiling a summary of reported cases with a tabulation of pertinent information, we discuss the incidence, pathogenesis, prognosis, and therapy of malignant intradiploic epidermoid.

Foramen magnum syndrome caused by a dolichoodontoid process

A 21-year-old Japanese man with basilar impression with an anomalous configuration of the odontoid process and many other vertebral anomalies is reported. We thought that posterior decompression alone would be hazardous; therefore, in one session, the odontoid tip and anterior arch of the atlas were removed transorally, and posterior fixation between the occipital squama and the lamina of C-3 using acrylic plastic was performed. This treatment resulted in marked clinical improvement and required only a short hospital stay.

Symmetrical thalamic low densities in descending transtentorial herniation

In a case with descending transtentorial herniation due to an acute subdural hematoma, symmetrical round low densities located bilaterally in the anterior thalamus are reported in addition to a diffuse low density in the territory of one posterior cerebral artery. The possible mechanism involved is discussed.

Craniocervical abnormalities. Modern diagnosis and a comprehensive surgical approach.

SummaryA retrospective study of 41 patients operated on between 1975 and 1983 is presented including guidelines for surgical management with some alternative technique both in anterior and posterior approaches and modern diagnostic procedures. A proposed base-line inclined — 10° from Reids base-line proved to be adequate to obtain the true shape and size of the foramen magnum on CT-scan. The normal range of the clivo-axial angle in adults is reported and its clinical significance is stressed.