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Primary spinal cord tumors in children are uncommon and account for approximately 5% of all pediatric central nervous system tumors. Intracranial metastases from primary spinal cord tumors have rarely been reported. Spinal cord glioblastoma in children mainly involves the thoracic region, whereas involvement of the medullaris conus with intracranial dissemination has been described in six cases. This paper describes a pediatric case of thoracic glioblastoma multiforme with intracranial dissemination in the early stage of the clinical course and discuss the clinical and neuroradiological manifestations, the possible patterns of dissemination and finally to consider the therapeutic implications.

Gli autori descrivono i principali aspetti TC della loro casistica di 21 EED dell'infanzia e dell'adolescenza, tutti sottoposti a verifica chirurgica, osservati nella Divisione di Neurochirurgia II dell'Ospedale Bellaria di Bologna dal 1985 al 1990. Gli EED sono risultati più frequenti rispetto agli ematomi sottodurali acuti e cronici (8 casi).La possibile presenza di un EED in assenza di fratture craniche è più alta in età pediatrica rispetto a quella adulta: in 4/21 (20%) dei nostri casi non erano riscontrabili fratture all'esame diretto del cranio. La localizzazione esclusivamente frontale, ritenuta rara in passato, era dimostrabile con discreta frequenza (in 3 casi su 21) (14%). in 3/5 (60%) pazienti con lesioni intradurali associate e complicanze neurologiche si osservarono frequentemente falde ematiche di notevole spessore (= 3 cm) e aspetti di disomogenità della falda stessa. Peraltro EED di rilevanti proporzioni sono stati ben tollerati in un numero elevato di casi (2/5 40% della nostra serie) senza lesioni intradurali associate; tale dato dipende da fattori anatomici (pervietà della fontanella anteriore, distensibilità delle suture, presenza di ampi spazi extracerebrali e cisternali) e fisiologici (reversibilità del danno cerebrale plasticità) propri dell'encefalo infantile.Infine è importante sottoporre i pazienti a TC successivi all'intervento: aspetti ipodensi esito di processi edematosi e/o lacero-contusivi e atrofia corticale localizzata e/o diffusa) furono riscontrati in 6 pazienti su 21 (20%). Tali dati rivestono particolare importanza per la prognosi del paziente pediatrico.

Summary The authors report a family in which two members had multiple intracranial aneurysms. This is the third reported family with more than one member affected by multiple cerebral aneurysms. The congenital nature and the patterns of inheritance of the disease are discussed. The indications for elective investigation of the asymptomatic relatives and surgical prophylaxis on asymptomatic aneurysms are also briefly discussed.

In order to verify the value of serum thyroglobulin (hTg) determination to detect cancer recurrence, 104 patients previously treated with surgical and 131I total thyroid ablation for differentiated thyroid cancer were studied. Comparison of serum hTg results and 131I total body scans (131I TBS) was attempted. In 87 patients with negative 131I TBS, serum hTg was undetectable in 80% of the patients whereas in 20% detectable amounts of hTg were measured. In 57 patients with positive 131I TBS, serum hTg was measurable in 72% of the patients whereas in 20% was undetectable. These contrasting results of serum hTg measurement and 131I TBS suggest to us the usefulness to use both tests in the detection of thyroid cancer recurrence.

Summary Fifty-eight patients suffering from intractable pain in the trigeminal distribution due to neoplasms of the intracranial or facial regions underwent controlled percutaneous coagulation of the Gasserian ganglion (trigeminal thermorhizotomy). Of them, 35 were evaluated at varying time intervals from the intervention (mean: 7 months). While pain was completely relieved in 71 per cent of cases at discharge, the follow-up examination was consistent with 49 per cent of analgesias.