W. Craig Clark

Bilateral occipital epidural hematomas

Two cases of bilateral occipital epidural hematoma are presented. Clinical findings, results of angiography and computed tomography, and operative management are discussed.

Tumors of the Posterior Fossa and Skull Base in Adults

Posterior fossa tumors in adults may be subdivided into those related to the cerebellum and those in the cerebellopontine angle (CPA). The most common cerebellar tumors are astrocytomas and hemangioblastomas, followed by meningiomas. Because both astrocytomas and hemangioblastoma are best resected using techniques other than the laser, this portion of the discussion will necessarily concentrate on meningiomas. Medulloblastomas are primarily a pediatric tumor and are discussed in Chapter 8.

The Use of the Laser in the Operative Management of Intraspinal Tumors

In adults, the ratio between intraspinal and intracranial tumors is roughly one to four [37]. For purposes of discussion, we have divided these tumors into three major categories: (1) those extradural in location; (2) those inside the dura, but outside the spinal cord (intradural-extramedullary); and (3) those inside the spinal cord (intramedullary).

Benign Supratentorial Tumors

In adults, 60% of brain tumors are supratentorial. A little less than half of these are benign tumors. Meningiomas and pituitary adenomas are the most common, but since the majority of pituitary tumors are removed with suction and the laser is not routinely used, this discussion will concentrate on the meningiomas. A few other interesting entities are included, but these occur far more infrequently than the meningiomas.