Massive ischemic cerebellar infarct (MICI) is a main source of stroke, which can lead to severe morbidity and mortality. There is no consensus in medical literature for the management of MICI. The choice is made between placing an external ventricular drainage, suboccipital decompressive craniectomy, and removal of necrotic tissue or conservative treatment. There are not many prospective studies, done on this subject. We retrospectively analyzed the clinical features, and imaging studies of 53 patients with MICI who had been treated by surgery or conservative treatment between January 2000 and December 2008 at the Department of Neurosurgery of the general hospital of Fort de France in Martinique. A total of 25 patients underwent surgery and 28 were treated medically. The results show significantly better outcomes in the operated patients compared with the patients treated medically; Operated comatose patients demonstrated significant improvement in their Glasgow coma score (GCS) score with only two deaths. Whereas, nonoperated comatose patients lost points in their GCS with four deaths. The results of our study suggest that surgery may be an effective procedure and quite helpful for MICI in majority of cases.

As a result of solicited muscles, strong friction, and tensile force on cutaneous tissue, the difference in closure procedure and management strategies and complications of surgical incision healing is a real challenge in lumbar spine surgery. We performed a retrospective study to compare different types of wound closure in lumbar spine surgery. 4383 patients were included in this study. Wound dehiscence was more common in the intracutaneous suture group than in the far‐ near‐near‐far suture group. Delayed wound healing occurred more in the far‐near near‐far suture group than intracutaneous suture group. Also, the far‐near near‐far interrupted point suture group showed a higher ratio of delayed wound healing compared with crossover suture. The superficial wound infection rate was roughly the same in all types of sutures with an average value of 0.79% with 0.81% SD. This is a preliminary study to compare different types of operative wounds showing the pros and cons related to each option.

External ventricular drainage (EVD) is an emergency process intended to reduce intracranial hypertension resulting from the obstruction of cerebrospinal fluid (CSF) flow. This creates a temporary situation to extract CSF that cannot pass through normally. Knowing the surface anatomy for EVD implantation is important to prevent its inadvertent complications. The external landmarks have been designed in this anatomic study to review the classical landmarks and come up with new landmarks to improve this simple but lifesaving procedure. From November 1998 to October 2012, we implanted 439 EVDs. In the first years, we employed usual landmarks to implant 97 EVDs. Since 2002, we used modified anatomical landmarks to implant 342 EVDs directly in the third ventricle. Using effective landmarks for EVD implementation allows the catheter to be inserted in the third ventricle. In addition, it permits more precise accuracy to ensure a safer procedure with fewer complications.

Lumber disc arthroplasty is a technological advancement that has occurred in the last decade to treat lumbar degenerative disk diseases. The aim of this retrospective study was to establish the impact and outcomes of managing patients with lumbar degenerative disk disease who have been treated with lumbar total disc arthroplasty (TDA). Several studies have shown promising results following this surgery. We reviewed the files of 104 patients at the Department of Neurosurgery in Colmar (France) who had been operated on by lumbar spine arthroplasty (Prodisc) between April 2002 and October 2008. Among the 104 patients, 67 were female and 37 were male with an average age of 33.1 years. We followed the cases for a mean of 20 months. The most frequent level of discopathy was L4-L5 with 62 patients (59.6%) followed by L5-S1 level with 52 patients (50%). Eighty-three patients suffered from low back pain, 21 of which were associated with radiculopathy. The status of 82 patients improved after surgery according to the Oswestry Disability Index score, and 92 patients returned to work. The results indicate that TDA is a good alternative treatment for lumbar spine disk disease, particularly for patients with disabling and chronic low back pain. This technique contributes to improve living conditions with correct patient selection for surgery.