Huge calcified epidural abscess--case report

A 76-year-old female with an intracranial epidural abscess having a long history of about 30 years is presented. Craniogram, carotid angiogram, and computed tomographic scan showed a huge calcified lesion with hyperostosis at the right parietal region. The abscess appeared to have granulated and calcified due to long-lasting stagnation of the pus.

Bimaxillary hyperplasia: the facial expression of homozygous beta-thalassemia

A boy born in Curaçoa, who was 6 years old at his initial visit and known to have homozygous beta-thalassemia, is described. Emphasis is directed to the typical facial expression. The possibility of surgical treatment of the maxillary hypertrophy is discussed. However, in view of the limited life expectancy of these patients, correction should not be performed before adolescence.

Total decompression of the spinal cord for combined ossification of posterior longitudinal ligament and yellow ligament in the thoracic spine

One of the causes of hyperostosis in the spinal canal, ossification of the posterior longitudinal ligament (OPLL) combined with ossification of the yellow ligament (OYL) in the thoracic spine, can result in serious myelopathy, leading to sandwich-type compression of the spinal cord from anterior and posterior. For such cases we devised a treatment of total decompression of the spinal cord and intervertebral body fusion. This operation consists of two steps. The first step is designed for posterior and lateral decompression of the spinal cord by removal of the OYL following wide laminectomy. The second step is removal of the OPLL anteriorly for anterior decompression, followed by interbody fusion. As the final procedure of the first step, two deep parallel gutters, covering the extent of the OPLL to be removed anteriorly, are drilled down from the rear into the vertebral body along both sides of the dura. This pre-treatment makes removal of the OPLL anteriorly during the second stage much easier, faster, and safer. This operation is lengthy and demanding. However, based on our experience so far, it appears to be a promising surgical procedure.