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Retinal involvement in tuberous sclerosis.

In two infants hospitalized at the ages of three and one-half months and 11 months because of epileptic seizures, the diagnosis of tuberous sclerosis was reached upon the basis of retinal astrocytomas found in the fundus examination. It is recommended that indirect ophthalmoscopy be performed in all infants and young children referred with signs possibly related to this disease.

Astrocytoma↗

[Ota's nevus].

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Adolescent↗

Grand rounds.

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Aged↗

[Headache affecting the pigmented zones of Ota's naevus: clinical study in four cases (author's transl)].

Four women, aged between 23 and 69 years, who had developed Ota's naevi either during the menarche (3 cases) or the first pregnancy (1 case), complained of headache in the frontal and orbital zones affected by the naevi. These headaches bore no relationship to those normally described as occurring in this region. They increased in severity, at the same time as the intensity of the pigmentation of the naevus, in each patient during the menstrual periods, and did not respond to conventional analgesics.

Adult↗

[Malignant blue nevus in Ota's nevus].

A 21-year-old Caucasian woman with congenital nevus of Ota developed a subcutaneous tumor below the lacrimal sack within the area of discoloration. The tumor, located subcutaneously, has been present for 4 years. Histologically, parts of the tumor showed neuroid structures as well as those like cellular blue nevus. In one part, however, malignant transformation features could be found.

Adult↗

Surgical reconstruction after extensive skull base surgery.

Skull base surgery is a rapidly expanding surgical subspecialty bringing together the sophisticated surgical skills of the neurotologist-head and neck surgeon and the neurosurgeon. Newly described surgical approaches to the skull base have made possible greater surgical ablation of the skull base region, resulting in large defects and thus heightening the need for reconstructing these regions. Prevention of cerebrospinal fluid leaks is the most important aspect of reconstruction and is achieved most readily when possible by dural patch grafts of fascia lata, coverage of the dura with soft tissue, and preservation of the soft tissue utilizing skin or split thickness skin grafts. Soft tissue may be in the form of free fascia lata grafts, pedicled galeal flaps, or local or regional skin flaps. Defects of the skull base larger than a few square centimeters are best reconstructed with local or regional skin flaps or musculocutaneous flaps. These flaps lend sufficient structural support so that bone support is not usually required. Subsequent cranioplasty, when necessary, can provide protection to those regions of the brain that are more susceptible to blunt trauma.

Cranial Fossa, Posterior↗