É relatado um caso de traumatismo frontobasal com lesão isolada do seio esfenoidal esquerdo, cujas complicações foram meningite e fistula liquórica. Ocorreram 3 surtos de meningite, respectivamente 5, 8 e 11 anos após o traumatismo. A fistula liquórica foi observada pela primeira vez 8 anos após o traumatismo, permanecendo intermitente durante 6 anos. O tratamento consistiu na obliteração do pertuito fistuloso mediante craniotomia bifrontal.

A case of fronto-basal traumatism with isolated fracture of the left sphenoidal sinus is reported. Meningitis occured 5, 8 and 11 years, respectively, after injury. Cerebrospinal fluid cranio-nasal fistula was observed at the first time 8 years after injury and remained intermitent in the last 6 years. The surgical technic was accomphished according to the procedure devised by Dietz and consisted of plastics of the anterior floor of the skull accompanied by galea-periosteal junction taken out from the scalp.

São relatados 4 casos de ataxia telangiectasia, analisando aspectos clínicos, imunológicos e radiológicos, em confronto com dados da literatura. Os autores justificam a publicação do trabalho pela raridade da doença e sua ocorrência em 3 irmãos no grupo estudado. Finalizam, lembrando a facilidade diagnostica, tendo por base o aparecimento precoce da ataxia e das manifestações cutâneo-vasculares.

The clinical, immunologic and radiologic aspects of 4 cases of ataxia telangiectasia are reported. Comparing with a large revision of literature, the authors justify the publication of the report by the scarse occurrence of the disease and by its incidency in 3 brothers of one same family.

Os autores empregaram detalhes técnicos pessoais para descompressão da fossa posterior em casos de impressão basilar e/ou maliormação de Arnold-Chiari, consistente em intuoação endotraqueal sem retroflexão da cabeça do paciente, sendo o mesmo operado em posição sentada e com a cabeça ereta. Foi realizada plástica da paquimeninge da fossa posterior com dura-mater de cadáver conservada em glicerina.

The surgical technic for decompression of the posterior fossa in cases of basilar impression and malformation of Arnold-Chiari mainly based in (1) endotracheal intubation without any flexion of the head, (2) position of the head without anterior flexion during the surgery, (3) plastic of the posterior fossa with dura-mater of cadaver conserved in glicerina, was emploied in 13 patients. The plastic was made to create space at the craniocervical joint in order to avoid cerebrospinal fluid fistula and to restore the integrity of the dura. Infection was not observed.

Craniotomia descompressiva uni ou bilateral foi empregada como tratamento paliativo em 30 casos de edema cerebral grave de etiologia predominantemente traumática. Coma, midríase e descerebração caracterizaram o quadro clínico na maioria dos casos. A sobrevida foi de 46,6%.

Uni or bilateral decompressive craniotomy was carried out in 30 patients bearing severe cerebral edema of etiology predominantly traumatic. Coma, midriasis and decerebrate state were the mostly commonly clinical features presented. The average survival in the series was 46.6%.

Sixty-seven cases of non-communicating hydrocephalus treated according to the Torkildsen's procedure are reported. The spinal fluid blockage was caused in 55 cases by supratentorial and in 10 cases by infratentorial tumors; in the remaining cases the spinal fluid interruption was due to non-tumoral causes. Ventriculography was the most important examination performed as far as the local diagnosis was concerned. 15 patients in this series disclosed lethal complications with signs of brain stem lesions. Patient survival was 3.9 years with variation ranging from 1 to 9 years. The following conclusions were drawn: 1) Ventriculocisternostomy is a valious method for the treatment of non-communicating hidrocephalus for it allows a more physiological drainage of the spinal fluid besides favouring the exploration of the posterior fossa in cases of doudtful pre-operative diagnosis. This procedure is of low cost and involves a relatively simple tecnique as compared with other procedures which demand the use of special valves. 2) According to the review of the pertinent literature the best results have been accomplished in cases where there is a non-tumoral aqueduct stenosis as well as in inoperable tumors of the third ventricle. 3) Bilateral drainage is mandatory in cases of bilateral obstruction of Monro's foramina. It has also been indicated in all cases as a precaution due to the possibility of occlusion of one catheter. 4) Ventriculocisternostomy should also be indicated as a prophylactic treatment of non-communicating hydrocephalus in cases of inoperable tumors of the sela or the basal ganglia with compression of the third ventricle but without completly blockage of the ventricle system. 5) Ventriculocisternostomy should be indicated with some reserve in cases of infratentorial tumors as well as in great supratentorial space-occupying lesions. It is however contra-indicated in cases of large tumors and in the inflammatory process involving the posterior fossa. 6) In the present series the obstruction of the draining-system was very uncommon being observed in only three patients. 7) No cases of spinal fluid fistula or meningitis were observed in the present study.