A case of idiopathic basal ganglia calcification in a 56-year-old woman with parkinsonism and cognitive impairment is described. The nigrostriatal dopaminergic pathway and regional cerebral blood flow were evaluated using dopamine transporter (DAT) brain single photon emission tomography combined with a low-dose x-ray computerized tomography transmission (hybrid SPECT/CT) and Tc-99m HMPAO brain perfusion SPECT study, respectively. DAT SPECT/CT imaging revealed a reduction in DAT binding in both striatum regions coinciding with bilateral calcifications in the basal ganglia. Brain perfusion scan showed hypoperfusion in basal ganglia regions, posterior parietal cortex bilaterally, left frontopolar and dorsolateral prefrontal cortex, and left temporal lobe. These findings correlated well with the clinical condition of the patient. Mineralization may play a critical role in the pathogenesis of neuronal degeneration. Cortical perfusion changes in patients may better explain the patient's altered cognitive and motor functions.

Objective. Percutaneous balloon compression (PBC) is an effective and safe management for medically refractory trigeminal neuralgia; however, technical failure to cannulate the foramen ovale (FO) using only fluoroscopy is a significant problem in some cases. In this paper, we suggest the use of intraoperative navigation, in cases of reoperation due to prior technical failure to cannulate the FO under fluoroscopy. Methods. A total of 174 patients underwent PBC for TN since 2003. In 9 cases the penetration of the FO was not accomplished. Five of those patients were reoperated on for PBC using navigation from March 2012 to September 2012. Surgical technique: preoperatively, a head Computed Tomography (CT) scan is performed and the acquired images are imported into the navigation system. Intraoperatively, a small reference frame is strapped firmly to the patient’s forehead, the CT images are registered, and cannulation is performed under the guidance of the navigation system. Results. In all patients, the operation overall was completed successfully. Moreover, all patients reported complete pain relief immediately postoperatively and no complications were recorded overall. Conclusions. We suggest the use of neuronavigation in cases of technical failure of PBC. That technique involves technology with significant advantages helping the successful cannulation of the FO and seems more efficient and safer.

Aims: The main purpose of this study is to underline the factors which are likely to increase the risk of a sixth nerve injury after percutaneous balloon compression of the gasserian ganglion. Methods: Medical records and intraoperative radiological images of 79 consecutive patients, who underwent percutaneous balloon compression for treating drugresistant trigeminal neuralgia, were analyzed. Results: Post-operatively, transient palsy of the sixth nerve developed in 2 patients. According to their intraoperative radiographs, the side effect resulted from irregular balloon shape and inflation of the balloon towards the sellar floor. Conclusion: The anatomic position and the shape of the inflated balloon represent key factors in determining the procedure’s benefit or risk of complications.

The case is described of a fatal injury to a young amateur boxer. The number of deaths from boxing have decreased in recent years. However, new rules devised to promote safety, such as limitation of the number of rounds, mandatory use of safety head guards, and better medical control during the match, seem to be of limited value in preventing severe head injuries from boxing.