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Background: Pineal region tumours remain challenging neurosurgical pathologies. Methods: Detailed anatomical knowledge of the posterior incisural space and its variations is critical. An opaque arachnoidal membrane seals the internal cerebral and basal veins, leading to thalamic, basal ganglia, mesencephalic/pontine infarctions if injured. Medium-size tumours can be removed en-bloc with all traction/manipulation applied on the tumour side, virtually without contact of ependymal surfaces of the pulvinars or third ventricle. Sacrifice of the cerebello-mesencephalic fissure vein may be required. Conclusions: The sitting position offers superior anatomical orientation and remains safe with experienced teams. Meticulous microsurgical techniques and detailed anatomical knowledge are likely to secure safe outcomes. [ABSTRACT FROM AUTHOR]

Percutaneous needle biopsy of lung lesions is commonly used and is usually regarded as a safe procedure with limited morbidity and extremely rare mortality. Most frequent complications are pneumothoax, pulmonary bleeding and hemoptysis. Other rare complications include systemic air embolus, tumor implantation and empyema. Systemic air emboli are extremely rare with a published incidence of 0.02' from a lung biopsy survey in the United Kingdom to 0.07' in the literature, but are serious and can be fatal. We present a case of massive air embolism occurring during lung biopsy and describe the technique used for immediate treatment.

Different parameters were measured on patients in six different positions during infratentorial surgery. One group of data served to prove that such patients were in a steady-state as far as their cardiovascular and ventilatory function was concerned. The other measured parameters concerned the intracranial pressure, the intracranial venous pressure and the cerebral perfusion pressure. It appeared from the comparison of these data, that the lateral sitting (45°) position had important advantages and that in this position the possibility of unfavourable features (such as air-embolism) was minimized. [ABSTRACT FROM AUTHOR]

Abstract: A 59-year-old female became comateuse after endocscopic retrograde cholangiopancreatography, and developed low-voltage ECG. Computed tomography revealed air emboli in the brain, the intestinal veins and in the pericardium. Low-voltage ECG most probably was due to pneumopericardium. [Copyright &y& Elsevier]