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The authors report a series of 86 intracranial ependymomas. The origin of the tumor was supratentorial in 53 cases, infratentorial in 33. All patients underwent surgery and most of them had also radiation therapy. The operative mortality rate was 25%. Five year survival rate was 31%. Better prognosis was recorded for low grade tumors. The location of the tumor, total or incomplete surgical excision had no influence concerning long-term survival. The five year survival rate for the 28 children in the series was 42%, against 19% for adults. Local recurrence occurred in 39% of patients, and spinal metastases were recorded in only 2 cases. The authors emphasize the need for systematic radiation therapy, with different protocols according to age of patient, location and histological type of tumor.

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The authors report a case of dysplastic gangliocytoma of the cerebellum (Lhermitte-Duclos disease). This woman's first neurosurgical admission was in 1970 at the age of 15 years. Hydrocephalus related to aqueduct-stenosis was diagnosed and a ventriculo atrial shunt was inserted. Ten years later, she underwent partial resection of a third ventricle tumor which was identified as a pilocytic astrocytoma. In 1986, computerized tomography revealed a non-enhancing left cerebellar mass lesion. Surgical excision was performed, and pathological examination disclosed dysplastic gangliocytoma of the cerebellum.

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The authors report a case of choroid plexus papilloma developped in the fourth ventricle. After complete surgical resection, two local recurrences of the tumor occurred, and required new surgical procedures. Eight years after the first operation, a papilloma of the right lateral ventricle was resected. The histological examination showed benign choroid plexus papilloma after each operation. Recurrence and seeding of benign choroid plexus papillomas are infrequent in the literature. For this reason, a long-term follow-up, by clinical examination and CT scan, is necessary for those patients.

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The association of a meningioma and an arachnoid cyst is one of the many association of cyst and meningioma. The diagnosis could be difficult by CT scan. We report three cases of parameningiomal cysts and discuss their different mechanism of formation before stressing practical problems.

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A case of hemangiopericytic meningioma of the pineal region is reported. We discuss the origin of meningiomas in this region and their histological nature. The rapid recurrence in situ of the tumor in this particular case seems to confirm the need to complement surgery with radiation therapy.

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The authors report on their experience with the use of a reinforced acrylic prosthesis in cervical spine pathology. The study of their own 45 cases enables the advantages and disadvantages of the technique to be demonstrated. A discussion of possible improvements in the technique and its indication completes the report.

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Within 2 years, two sisters, aged 23 and 33, were operated on for a craniopharyngioma. With regard to this exceptional feature, relation between neuroectodermal affections and craniopharyngiomas is discussed, and genetic determination of the occurrence of those tumors is evoked.

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The authors report 10 cases of multifocal glioma of the brain. There are distinguished in multicentric tumors, when lesions develop independently in the space and time and multiples tumors when they are in connection by spreading process. They analyzed the factors that could permit to distinguish these gliomas. Multicentric tumors are histologically of low grade with gradual evolution, and from different histological nature and topography. In other hand, multiple gliomas are from malignant histology and develop simultaneously. The CT scan and biopsy in stereotaxic condition could permit to recognize these two parts which the prognosis is different.

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The roof of the third ventricle is lying on the thalamus parts. When a tumor fills and expands the third ventricle it is always possible to lift up this velotrigonal roof like the cover of a box and to access to these lesions. The authors have approached 15 tumors of the third ventricle or pineal area by this route interthalamotrigonal about 78 cases of tumors operated in the Lille's neurosurgery department during 30 years. The technical possibilities are compared and the advantages of this route emphasized with usual access. The interthalamotrigonal access gives a great convenience during operation. It make easy the complete removal of removable tumors of the pineal area and the third ventricle. It is possible with minimum during operation and after effects for the patient.

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This study, about 18 cases of AVA strictly in language areas (posterior end of the inferior frontal gyrus (Broca), posterior third of T1 and T2, supra-marginalis and angularis gyri), prepose to specify the possibilities and the legitimacy of surgical management as well as the technical parts of removal. Malformations may divided in to : 1 arterio-venous fistula, 3 medium AVAS, 8 important AVA, 6 cirsoïdum aneurysms. 15 patients presented one or several intracranial hemorrhage (ICH). 3 others were admitted before this complication : 2 epileptic seizures, 1 left hemicrania. 2 patients died because of important ICH before any surgical treatment. The 16 others were operated. Two died during post-operative course : one because of prior ICH with deep coma, the other third month after a good period. In one case upon 14, a disabling handicap concerning language is noted after an important ICH. Except an ethylic patient with post-operative acalculia, minor language handicaps were observed only in patients with hemorrhagic seizure, permissing always satisfactory life. The best results on vital and functional prognosis were obtained for patients with no prior important ICH. So we must indicate the radical removal of all known AVA or cirsoïd aneurysms. The opinion that these last malformations generally do not bleed, may produced mistakes with their weighty consequences.

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The exploration and surgical treatment of the lesions of the 3rd ventricle may be carried out without sectioning the anterior columns of the trigonum. The body of the trigonum and the choroid tissue are lifted sometimes at the cost only of the sectioning of the thalamostriated vein. The absence of mnesic trouble particularly in benign tumours of the third ventricle is the essential advantage of same. Access is very much wider particularly for the posterior part of third ventricle.

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