]]> Description. Magnetic resonance imaging demonstrated a large mass involving the hypothalamus, infundibulum, optic nerves, and chiasm.
Intervention. At surgery the optic pathways were found to be grossly involved within the inflammatory mass. Histological examination demonstrated a nonspecífic, mixed inflammatory infiltrate, composed predominantly of lymphocytes and plasma cells. She responded dramatically to dexamethasone, with mass reduction on serial imaging studies and vision improvement. In addition, she received hormone replacement therapy. Conclusion. Infundibulohypophisitis is a rare disease. Surgical bíopsy and dexametasone were an effective treatment.]]>
2. Pestell RG, Best JD, Alford FP. Lymphocytic hypophysitis. The clinical spectrum of the disorder and evidence for an autoimmune pathogenesis. Clin Endoc 1990; 33: 457-66.

3. Goudie RB, Pinkerton PH. Anterior hypophysitis and Hashimoto's disease in a young woman. Journ Pathol Bact 1962; 83: 584-5.

4. Lee JH, Laws ER, Guthrie BL, Dina TS, Nochomovitz LE. Lymphocytic hypophysitis: ocurrence in two men. Neurosurgery 1994; 34: 159-63.

5. Cebelin MS, Velasco ME, De Las Mulas JM, Druet RL. Galactorrhoea associated with lymphocytic adenohypophysitis. Brit Journ Obstet Gynae 1981; 88: 675-80.

6. Godart J, Jacquet G, Angonin PH, Klofenstein A, Bonneville JF, Czorny A. Adenohypophysite lymphocytaire: a propos d-un nouveau cas. Neurochirurgie 1994; 40 : 372-8.

7. Venneste JAL, Kemphorst W. Lymphocytic hypophysitis. Surg Neurol 1987; 28: 145-9.

8. Nishioka H, Akada K, Miki T, Ito H. A case of lymphocytic hypophysitis with massive fibrosis and the role of surgical intervention. Surg Neurol 1994; 42: 72-8.

9. Hoshimaru M, Hashimoto N, Kikuchi H. Central diabetes insipidous resulting from a non-neoplastic tiny mass lesion localized in the neurohypophyseal system. Surg Neurol 1992; 38: 1-6.

10. Tmura H, Nakao K, Shimatsu A, Ogawa Y, Sando T, Fujisawa I, Yamabe H. Lymphocytic infundibulo-neurohypophysitis as a cause of central diabetes insipidus. N Engl J Med 1993; 329: 683-9.

11. Kojima H, Nojima T, Nagashima K, Ono Y, Kudo M, Ishikura M. Diabetes insipidus caused by lymphocytic infundibulo-neurohhypophysitis. Arch Pathol Lab Med 1989; 113: 1399-402.]]> Description. A 50 years old female patient presented progressive headaches and left exoftalmus during the last year. MRI showed a tumoral lesion that involved the etmoidorbitalmaxilary region.
Intervention. The lesion was resected through the subfrontal approach after performíng a bifrontal craniotomy with a supraorbital osteotomy. Pathology informed meningioma. Postoperatively the patient showed transient left ptosis, diplopia and CSF fistula. After 18 months the patient was asymptomatic and control MRI showed no tumor. Conclusion. The craniofacial meningioma was totally resected usíng a combined approach with low morbidity at 18 month.]]>
2. Origitano T, Petruzzelli G, Vandevender D. Management of malignant tumours of the anterior y anterolateral skull base. Neurosurgical Focus 2002; 12: 7-10.

3. Sekhar LN, Nanda A, Sen Ch, Snyderman CN, Janecka IP. The extended frontal approach to tumours of the anterior , middle and posterior skull base. J Neurosurg 1992; 76: 198-206.]]> Description: Cystic meningiomas account for about 2-4% of intracranial meningiomas and their clinical presentation is similar to that of noncystic meningiomas; but in some cases, quick neurological deterioration may occur, perhaps due to rapid intratumoral cyst expansion among other causes. These lesions have been mistaken for astrocytomas, hemangioblastomas, neuroblastomas and metastasis. A thorough radiographic examination allows us to make the diagnosis of meningiomas in a high percentage of cases; however, even with CAT scanning, MRI and cerebral arteriography, diagnosis of cystic meningiomas is difficult. Tumor cells may be present in the cyst wall, so that resection of the solid portion alone carries the chance of tumor recurrence. Because of that, a total cyst excision in some cases is the goal to present tumor recurrence.
Intervention: In the last three years, we have operated three cases of cystic meningiomas, two females and one male patient among 35-43 years old, all of them went to gross total surgical removal (Simpson II) of the solid and cystic portion; the pathological examination revealed a "meningothelial type" in two of them and a "sincitial type" in the other.
Conclusion: Proper surgical management depends on early recognition so that curative excision is not replaced by palliative surgery.]]>
2. El Filki M, El Henamy Y, Abdel Rahman N Cystic meningioma. Acta Neurochir (Wien) 1996; 138 (7): 811-7.

3. Wasenko J, Hochhauser L, Stopa EG, Winfield JA. Cystic meningioma: characteristics and surgical correlations. En: Osborn A, Eskridge J, Grossman R, Hudgins PA, Ross J Editores: Year Book of Neuroradiology. Chicago: Mosby, 1995, pp. 159-63

4. Chen C T, Zee C, Miller AC, Weiss HM, Tang G, Chin L, et al. Magnetic resonance imaging and pathological correlates of meningioma. Neurosurgery 1992; 31: 1015-9.

5. Watanaba A, Ishii R, Taka K, Suzuki Y, Himno K, Okamura H et al. Magnetic resonance imaging and histology of a large cystic meningioma- case report. Neurol Med Chir (Tokyo) 1995; 35: 87-91.

6. Guthrie BL, M, Ebersold MJ, Scheithauer BW, Shaw EG. Meningeal hemangiopericytoma. Histopathological features, treatment, and long-term follow-up of 44 cases. Neurosurgery 1989; 25: 514-22.]]> Conclusion: surgical removal of a chloroma reduced its mas effect and the patient improved neurologically, but the process could hardly be controlled definitively. ]]>
2. Meiss JM, Butler JJ. Granulocytic sarcoma in nonleukemic patients. Cancer 1986; 58: 2697-709.

3. Byrd JC, Weiss RB. Recurrent granulocytic sarcoma. An inusual variation of acute myelogenous leukemia associated with 8,21 chromosomal translocation and blast expression of the neural cell adhesion molecule. Cancer 1994; 73: 2107-12.

4. Krishnamurthy M, Nusbacher N. Granulocytic sarcoma of the brain. Cancer. 1977; 39: 1542-6.

5. Fukui K, Iguchi I, Kito A, Ohba M. Intracerebral leukemic mass in acute myelogenous leukemia. J Neuro Oncol 1992; 12: 121-4.

6. Kao SCS, Yuh WTC. Intracranial granulocytic sarcoma (chloroma): MR findíngs. J Comput Assist Tomogr 1987; 11: 938-41.]]> Description. A 56 years oldfemale presented actúe amaurosis, headaches, nausea and vomiting. Vision returned 15 days later. TAC and MRI showed a tumoral lesion that involved the sphenoid sinus and sellar region. Prolactin Level was 47.66 ng / ml. Onx-rays the sella turcica size was increased. Computerized visual fields were pathologic. Intervention. A transsphenoidal approach was perfomed. A mucoid tumor with calcified pseudocapsule was completely resected. Pathology informed osteoid osteoma. Postoperative outcome was good. Visual fields normalized and control MRI showed no tumor.
Conclusion. For all sellar pathology, including osteoid osteoma, the transsphenoidal surgery is the treatment of choice.]]>
2. Neff S, Hansen K, Domanowsk GF, Wu JL. Cryptic osteoid osteoma of the cranium: case report. Neurosurgery 1990; 27: 820-1.

3. Shibata Y, Yoshii Y, Tsukada A, Nose T. Radioluscent osteoma of the skull : case report. Neurosurgery 1991; 29: 776-8.

4. Fu YS, Perzin KH. Non-epithelial tumors of the nasal cavity, paranasal sinuses and nasopharynx. A clinicopathologic study. II. Osseus and fibroosseus lesions, including osteoma, fibrous dysplasia, ossifying fibroma, osteoblastoma, giant cell tumor, and osteosarcoma. Cancer 1974; 33: 1289-305.

5. Assoun J, Richardi G, Railhac JJ, Baunin C, Fajadet P, Giron J, et al. Osteoid osteoma: MR imaging versus CT. Radiology 1994; 191: 217-23.

6. Davies M, Cassar-Pullicino VN, Davies AM, McCall IW, Tyrrell PN. The diagnostic accuracy of MR imaging in osteoid osteoma. Skeletal Radiol 2002; 31: 559-69.

7. Kneisl JS, Simon MA. Medical management compared with operative treatment for osteoma osteoid. J Bone Joint Surg 1992; 74A: 179-85.

8. Rosenthal DI, Hornicek FJ, Wolfe MW, Jennings LC, Gebhardt MC, Mankin HJ. Percutaneous radiofrequency coagulation of osteoid osteoma compared with operative treatment. J Bone Joint Surg Am 1998; 80A: 815-21]]> Description. A 23 years old female patient presented with headache, vomiting, dizzines, ataxia, amenorrhea and galactorrhea, progressive during the iast 5 years. MRI showed a fourth ventricle tumoral lesion that involved the medulla oblongata with hydrocephalus.
Intervention. First a ventriculo-peritoneal shunting was performed. One week later through a midline approach a microsurgical complete removal was done. Postoperative outcome was good. MRI 6 months later was free of tumor. After one year the neurological examination was normal.
Conclusion. Teratomas of the medulla oblongata are rare lesions. Surgery is the treatment of choice.]]>
2. Youmans, J. Editor. Neurological Surgery 4a. ed, WB Saunders. 1996; Vol 4, cap. 115.

3. Tsuzuki N, Kato H, Ishihara S, Miyazawa T, Nawashuro H, Shima K. Malgnant teratoma of the medulla oblongata in an adult male. Acta Neurochir (Wien) 2001; 143: 1303-4]]> Methods. 112 patients with 120 sacular aneurysms were treated by endovascular coiling approach. Technical complications related were observed in 8 patientes (7.1% ). The complications were mainly hemorraghic and tromboembolic.
Tromboembolic events were morefrequent than hemorraghic events. We described some
of our complications: isquemic and aneurysmal ruptures.
Results. Patients with tromboembolic complications liad 0% mortality and 0.8% morbidity. The mortality in patients with hemorraghic complications was 1.8% and morbidity 0%.
Conclusion. Our experience in endovascular approach to sacular aneurysms indicates that the morbi-mortality is aceptable. This surgical technique is notfree of complications ]]>
2. Byrne-Guglielmi. Endovascular Treatment of Intracranial Aneurysms. Berlin: Springer 1998; 157-63.

3. Berenstein - Lasjaunias P. Surgical Neuroangiography 4 Endovascular Treatment of cerebral Lesions. Berlin: Springer-Verlag 1992; 253-60.

4. Connors-Wojak. Interventional Neuroradiology New York W.B Saunders 1999; 768-77.

5. Gurian JH, Martín N, King WA, Duckwiler GR, Guglielmi G, Vinuela F. Neurosurgical Management of cerebral aneurysms following unsuccesfull or incomplete endovascular embolization. J Neurosurg 1995; 83: 843-53.]]> Results: A total of 12 lesions were included in this presentation. Out of these, 8 were supraclavicular lesions, wich required neurorraphy in 4 nerves or trunks, neurotization in 11, and neurolisis in one. There were 4 infraclavicular lesions: 4 required neurolisis, and 2 neurorraphy
Conclusion: Each group of TBPL required a different surgical reconstruction technique.]]>
2. Narakas AO. Thoughts on neurotization or nerve transfers for irreparable nerve lesions. Clin Plastic Surg 1984; 11: 153-9.

3. Kline D. Perspectives concerning brachial plexus injury and repair. Neurosurg Clin N Am 1991; 2: 151-64.

4. Oberlin C, Béal D, Leechavengvongs S, Salon A, Dauge MC, Sarcy JJ. Nerve transfer to the biceps muscle using a part of the ulnar nerve for C5-C6 avulsion of the brachial plexus: anatomical study
and report of four cases. J Hand Surg 1994; 19A: 232-7.

5. Socolovsky M. Conceptos actuales en la cirugía de los nervios periféricos. Parte I: Lesiones del plexo braquial (artículo de revisión). Rey Argent Neuroc 2003; 17: 71-8.

6. Merrell GA, Barrie K, Katz DL, Wolfe SW. Results of nerve transfer techniques for restoration of shoulder and elbow function in the context of a metaanalysis of the English literature. J Hand Surg 2001; 26A: 303-14.]]> Description: a 34 year-old male patient had during the last 5 years a progressive Brown-Sequard syndrome. MRI showed ventral displacement f the spinal cord at 77T8 and widening f the posterior subarachnoíd space.
Intervention: a laminectomy was performed with reduction of the hemiated cord and closure of the dural defect with a graft. Postoperative outcome was uneventful and the patient improved neurologically. Control MRI showed hyperintense cord signals at the level of the previous herniated leveL
Conclusion: surgery with reduction f the hernia and dura closure provided symptomatic improvement. Postoperatíve MRI cord hyperintense signals may correspond to syringomyelia.]]>
2. Marshman LA, Hardwidge C, Ford-Dunn SC, 01- ney JS. Idiopathic spinal cord herniation: case report and review of the literature. Neurosurgery 1999; 44: 1129-33.

3. Kumar R, Taha J, Greiner AL. Herniation of the spinal cord. Case report. J Neurosurg 1995; 82: 131-6.

4. Hausmann ON, Moseley IF. Idiopathic dural herniation of the thoracic spinal cord. Neuroradiology 1996; 38: 503-10.

5. Watanabe M, Chiba K, Matsumoto M, Maruiwa H, Fujimura Y, Toyama Y Surgical management of idiopathic spinal cord herniation: a review of nine cases treated by the enlargement of the dural defect. J Neurosug 2001; 95 (Suppl 2): 169-72.

6. Maggiora P, Morales JC, Turjanski L. Hernia medular espontánea: relato de un caso y revisión de la literatura. Neurorraquis 2004, junio 27-28, 2004, Mar del Plata.]]> Description: A patient (30 years, female) who refers eight-months history of radicular pain and progressive right leg weakness, with exacerbations and remissions. On examination the patient had right hemihypesthesia with T-10 sensitive level and right leg 4/5 palsy. Magnetic resonance imaging showed an extradural cystic lesion in T11- T12 hypointense in T1 and hyperintense en T2, without contrast enhancement. The cyst contained fluid that demonstrated the same signal as cerebrospinalfluid.
Intervention: After laminectomy of T-10 and T-11 the cystic lesion was exposed. The cyst was filled with CSF- fluid like. A surgical resection of the cyst wall was made. A small dural defect that allowed communication between the cyst and the subarachnoid space was revealed during the surgery, and a closure was made with a suture. Histopathological examination confirmed a cystic lesion with a single-cell lining of meningothelial cells, that contained no neural tissue neither ganglion cells.
Conclusion: Extradural arachnoid cysts showed characteristic images in the MRI in the preoperative stage. There was no need to use other invasive methods such as myelography or mielotomography to decide the indication for surgery or the surgical technique. Definitive diagnosis is based on the free comunication with the subarachnoidal space and the lack of neural tissue in the histopathological examination, which allowed us to distinguish between extradural arachnoid cysts and Tarlov cysts. ]]>
2. Nabors MW, Pait GT, Byrd EB, Karim NO, Davis DO, Kobrine Al et al. Update assessment and current classification of spinal meningeal cysts. J Neurosurg 1988; 68: 366-77.

3. Uemura K, Yoshizawa T, Matsumura A, Asakawa H, Nakamagoe K, Nose T. Spinal extradural meningeal cyst. Case report. J Neurosurg 1996; 85: 354-6.

4. Krings T, Lukas R, Reul J, Spetzger U, Reinges MHT, Gilsbach JM et al. Diagnostic and therapeutic management of spinal arachnoid cysts. Acta Neurochir (Wien) 2001; 143: 227-35.

5. Voyadzis JM, Bhargava P, Henderson FC. Tarlov cysts: a study of 10 cases with review of the literature. J Neurosurg 2001; 95: 25-32.

6. Rimmelin A, Clouet PL, Salatino S, Kehrli P, Maitrot D, Stephan M et al. Imaging of thoracic and lumbar spinal extradural arachnoid cysts: report of two cases. Neuroradiology 1997; 39: 203-6.]]> Intervention: An anterior transabdominal approach with wall cyst dissection, excision
of the sac and simple ligation of the neck was performed.
Conclusion: We presented an uncommon case of ASM in an adult woman, with the transabdominal surgical approachwas the treatment of choice ín anterior sacral meningocele.]]>
2. Currarino G, Coln D, Votteler T. Triad of anorectal, sacral, and presacral anomalies. AJR 1981; 137: 395-8.

3. Gegg C, Vollme R ,Tullous M, Kagan-Hallet K. An Unusual Case of the Complete Currarino Triad: Case Report, Discussion of the Literature and the Embryogenic Implications. Neurosurgery 1999; 44: 658-62.

4. Byung-Chan J, Do-Heon K, Ki-Young K. Anterior endoscopic treatment of a huge anterior sacral meningocele: technical case report. Neurosurgery 2003; 52: 1231-4.

5. Clatterbuck R, Jackman S, Kavoussi L, Long D. Laparoscopic treatment of an anterior sacral meningocele: Case illustration. J Neurosurg 2000; 92: 246.

6. Kurosaki M, Kamitani H. Anno Y, Watanabe T, Hori T, Yamasaki T. Complete familial Currarino triad: Report of three cases in one family. J Neurosurg 2001; 94: 158-61.

7. McGuire IRA Jr, Metcalf JC, Amundson GM, McGillicudy GT. Anterior sacral meningocele: Case report and review of literature. Spine 1990; 15: 612-4.

8. Dyck P, Wilson CB. Anterior sacral meningocele. Case report. J Neurosurg 1980; 53: 548-52.

9. Smith HP, Davis CH Jr. Anterior sacral meningocele: two case reports and discussion of surgical approach. Neurosurgery 1980; 7: 61-7.

10. Wilkins RH, Rossitch E. Anterior and Lateral Spinal Meningoceles. En Datchling P, editor. Disorders of the Pediatric sSpine. New York: Rayen Press pp 265-76.]]> Description: case 1 (60 years, female) liad a chronic cervical myelopathy; case 2 (56 years, male) had and acute transitory postraumatic cervical myelopathy and case 3 had local cervical pain.
Intervention: in case 1 we resected the anterior arc of C 1, the pannus and the odontoid. The subluxation was reduced and a posterior occipitocervical fixation (POC) was performed. In case 2 the resection included the anterior arc of C 1 , the pannus and the odontoid partially because the dura was opened accidentally with the drill. In spite of it the subluxation was reduced anda POC was done. In case 3 the resection was limited to the anterior arc of the atlas and the pannus. The subluxation was reduced and a POC was performed.
Conclusion: in cases of MS with superior migration of the odontoid or retro-odontoid pannus, odontoidectomy must be performed but in cases with pre-odontoid pannus, odointoidectomy can be avoided.]]>
2. Dickman CA, Crawford NR, BrantleyAGV, Sonntag VK. Biomechanical effects of transoral odontoidectomy. Neurosurgery 1995; 36: 1146-53.

3. Sammi M, Knosp E, editores. Approaches to the clivus. Berlín: Springer-Verlag.1992; pp 7-19.

4. Crockard HA, Calder L, Ransford AO. One-stage transoral decompression and posterior fixation in rheumatoid atlanto-axial subluxation. J Bone Joint Surg 1990; 72B: 682-5.

5. Crockard HA, Pozo JL, Ransford AO, Stevens JM, Kendall BE, Essigman WK. Transoral decompression and posterior fusion for rheumatoid ailanto-axial subluxation. J Bone Joint Surg 1986; 68B: 350-6.

6. Fang HSY, Ong GB. Direct anterior approach to the upper cervical spine. J Bone Joint Surg 1962; 1: 1588-604.]]> Description: We report a case of a patient suffering posterior cervical pain, left brachíalgia , lip numbness and paresthesias in the tip of the tongue. A compressive "os odontoideum" was found which was treated by a posterior approach. The patient did well showing symptoms relief.
Intervention: 'The patient was operated through a posterior approach and an occipitocervical (C2 ) fixation and arthrodesis with iliac bone graft were reformed.
Conclusion: Patients harboring compressive "os odontoideum" and/or C1-C2 instability associated or not to neurological symptoms should be surgically treated. The occipitocervical fixation and fusion through a posterior approach offered stability and allowed symptoms improvement in some cases.]]>
2. Singh SK, Rickards L, Apfelbaum RI, Hurlbert RJ, Maiman, D, Fehlings MG. Occipitocervical reconstruction with the Ohio Medical Instruments Loop: results of a multicenter evaluation in 30 cases. J Neurosurg (Spine 3) 2003; 98: 241-8.

3. Menezes A.H Congenital and acquired abnormalities of the craniovertebral junction. En: Youmans JR, Editor. Neurological Surgery. 4a. edicion. Philadelphia: W.B Saunders Company, 1996. Vol 2. pp 1035-89.

4. Van Gilder JC, Menezes AH. Craniovertebral abnormalities and their neurosurgical management. In Schmidek HH, Sweet WH, editores. Operative neurosurgical techniques. 3 ° edición. Philadelphia: W.B Saunders Company, 1995. Vol 2. pp 1719-29.

5. No Authors listed. Os Odontoideum. Neurosurgery 2002; 30 (Suppl): S148-S55.]]> Methods: Trials concerning administration of corticosteroids to patients sustaining acute head injury were identified by means of electronic searches of MEDLINE. Articles related to pharmacology of corticosteroids, with special emphasis on potential neuroprotective activities were reviewed.
Results: Nineteen trials were identified, showing, except for a few, no statistical difference in outcome or mortality between patients receiving corticosteroids or placebo. Nevertheless, a tendency was noticed towards a small number of deaths in the treated group. There was no statistical difference between groups concerning gastrointestinal bleeding or other major complications. The analysis of the available literature on corticosteroids pharmacology provided a wide range of potentially beneficial effects through direct (receptor independent) and indirect actions, including among others, anti-inflammatory, membrane stabilizing, anti-oxidant and energetic metabolism protecting activities.
Conclusion: Corticosteroids given acutely to patients sustaining severe head injury resulted in a small but statistically insignificant reduction in mortality. There was no significant difference between corticosteroid and control groups in mortality, nor in the rates of gastrointestinal bleeding or infection. Because of the relatively small number of patients previously enrolled in corticosteroids versus placebo trials, small reductions in mortality or deleterious effects associated with corticosteroid administration cannot be excluded.]]>
2. Teasdale GM. Current status of neuroprotection trials for traumatic brain injury: lessons from animal models and clinical studies. Neurosurgery 1999; 45: 207-20,

3. Marmarou A. Pathophysiology of traumatic brain edema: current concepts. Acta Neurochir (Wien) (Suppl.) 2003; 86: 7-10

4. Alderson P, Roberts I. Corticosteroids in acute traumatic brain injury: a systematic review of randomised trials. BMJ 1997; 314: 1855-9.

5. Falkenstein E, Tillmann H, Feuring M, Wehling M. Multiple Actions of Steroid Hormones: A Focus on Rapid, Nongenomic Effects. Pharmacol Rev 2000; 52: 513-56.

6. MRC CRASH Trial National Coordinators. Update on progress in the international multicenter, randomized, controlled trial of corticosteroids after significant head injury (Medical Research Councill CASH Trial) Curr Open Crit Care 2003; 9: 92-7.]]> Description. A 18 years old mole patient arrived to the hospital with a knife stabbed tato the lett temporal cranial region. He presented a Glasgow coma scale of 9/ 15 and a right hemiplegia. He was studied with x-rays and a CT scan.
Intervention. He was taken to surgery and the knife was removed. Pos toperative outcome was uneventful. He made rehabilitation,for a right hemiparesis.
Conclusion. Good results can be obtained with removal at surgery of a stabbed knife tato the cranium..]]>
2. Nathoo N, Boodhoo H, Nadvi SS, Naidoo SR, Gouws E. Transcranial brainstem stab njuries: a retrospective analysis of 17 patients. Neurosurgery 2000; 47: 1117-22.

3. Taylor AG, Peter Jc: Patients with retained transcranial knife blades: a highrisk group. J Neurosurg 1997; 87: 512-5.]]> Method. Twenty dry heads and four formalin-fixed adults heads injected with silicon were examined. We performed measurements of the jugular foramen in the dry heads and the operative approaches in a stepwise manner in the formalin-fixed heads. Results. The jugular foramen is divided into three compartments: the petrosal (inferior petrosal sinus), the intrajugular (glossopharyngeal, vagus, and accessory nerues) and the sigmoid (sigmoid sinus) parts. In 65% dry heads the right foramen was larger than the left, in 5% equal, and in 30% smaller than the left. The length of the jugular foramen was 14,29 mm from the endocranial view and 15,10 mm from the exocranial view. The approaches to the jugular foramen are the retrosigmoid , the far-lateral paracondylar, the transmastoid infralabyrinthine and the preauricular infratemporal.
Conclusion. The operative approaches to the jugular foramen can be categorized into three groups: 1) a posterior group directed through the posterior cranial fossa, 2) a lateral group directed through the mastoid bone , and 3) an anterior group directed through the tympanic bone.]]>
2. Katsuta T, Rhoton AL Jr, Matsushima T. The jugular foramen: Microsurgical anatomy and operative approaches. Neurosurgery 1997; 41: 149202.

3. Rhoton AL Jr, Buza R: Microsurgical anatomy of the jugular foramen. J Neurosurg 1975; 42: 54150.

4. Wen HT, Rhoton AL Jr, Katsuta T, de Oliveira E. Microsurgical anatomy of the transcondilar, supracondylar, and paracondylar extensions of the far-lateral approach. J Neurosurg 1997; 87: 555-85.

5. Tedeschi H, Rhoton AL Jr. Lateral approaches to the petroclival region. Surg Neurol 1994; 41: 180-216.

6. Fish U. Infratemporal fossa approach to tumours of the temporal bone and base of the skull. J Laryngol Otolaryngol 1978; 92: 949-67.]]> Methods: Between July 2003 to June 2004, 7 patients were operated through this approach. Diagnosis included 1 pituitary macroadenoma, 1 craniopharyngioma, 1 clinoidal meningioma, 1 olfactory tract meningioma, 2 ApCom aneurysms and 1 carotidophthalmic aneurysm. In all patients the surgical technique was similar.
Results: Many factors demonstrate the advantage of this technique: minimal brain exposure, and cerebral retraction, shortened surgical time and early hospital discharge. There were no approach-related complications. All the lesions were of less than 35 mm of diameter and under the medial third of the third ventricle.
Conclusion: The supraorbital transciliar keyhole approach, endoscope assisted, is a safe way to reach sellar and parasellar lesions when the lesion is of less than 30 mm, without extension to posterior fossa.]]>
2. van Lindert E, Perneczky A, Fries A, Pierangeli E. The supraorbital keyhole approach to supratentorial aneurysms: Concept and Technique. Surg Neurol 1998; 49: 481-90.

3. Al-Mefty O. Supraorbital-pterional approach to skull base lesions. Neurosurgery 1987; 21:474-7.

4. Brock M, Dietz H. The small frontolateral approach for the microsurgical treatment of intracranial aneurisms. Neurchirugia (Stuttg) 1978; 21:185-91.

5. Fries G, Perneczki A. Endoscope-assisted Brain Surgery: Part 2 - Analysis of 380 procedures. Neurosurgery 1998; 42 :226-32.]]> Methods. Hospital records from (he last 3 years were retrospectively reviewed. Five formalin-fixed adults heads were examined using X 6 to X 40 magnification. A correlation belween clinical findings, anatomical studies and MRI images was performed.
Results. Medical records from 382 patients operated on al our department were reviewed. Of these, 16 patients underwent complete oculomotor palsy before brain surgery. Two patients hada mesencephalic tumor, 6 patients underwent uncal herniation dueto afast-growing intracranial mass, one patient had a superior cerebellar artery aneurysm, 3 patients had a posterior communicating artery aneurysm, one patient had an anterior choroidal artery aneurysm, 2 patients hada pituitary tumor and one patient hada cavernous sinus meningioma, An analysis of the clinical, anaomical and MRI/ angiography data of 5 cases are presented in this study.
Conclusion. Oculomoor palsy is a relatively commonfinding in neurosurgical practice. The fact that it can be caused by different etiologies should be considered in order to arrive o the appropriate diagnosis and treatment. Anatomical knowledge of third nerve is very important when dealing with oculomotor palsy.]]>
2. Williams PL, Warwick R: Nervio motor ocular común. En: Williams PL, Warwick R, editores: Gray Anatomía, Tomo II, Edimburgo: Churchill Livingstone, 1992, pp 1160-2.

3. Patten J: The pupils and their reactions. En: Patten J, editores: Neurological Differential Diagnosis, London: Springer,„ 1996, pp 6-15.

4. Santiago ME, Corbett JJ: Nervio oculomotor. En: Micheli F, Nogués MA, Asconapé JJ, Fernández Pardal MM, Biller J, editores: Tratado de Neurología Clínica, Buenos Aires: Panamericana, 2002, pp 154-5.]]>