John Liddell

Isolated unilateral hypoglossal nerve paralysis caused by an atlanto-occipital joint synovial cyst

An isolated unilateral hypoglossal nerve lesion is an uncommon cranial nerve palsy. We report a case of isolated hypoglossal nerve paralysis caused by an intra-dural synovial cyst. To our knowledge, this is the first reported case of a twelfth nerve paralysis caused by a synovial cyst. The anatomy of the hypoglossal nerve, its blood supply and the relationship of the nerve to the atlanto-occipital joint are reviewed, along with the common causes of isolated hypoglossal nerve paralysis.

Non-neoplastic demyelinating process mimicking a disseminated malignant brain tumour.

Non-neoplastic demyelinating processes of the brain with ring enhancing lesions and mass effect on MRI imaging, mimicking malignant brain tumours, are rare phenomena. We document the case of a 32 year old male with clinical, radiological and initial histological findings, suggestive of a malignant brain tumour. Additional investigations confirmed the diagnosis of multiple sclerosis. This case is significant as the lesion could not be easily distinguished from a malignant brain tumour on imaging alone. Cases such as this illustrate the importance of considering a demyelinating process in the differential diagnosis of tumour-like brain lesions.

Adult polycystic kidney disease and arachnoid cyst formation: Case report.

A 34 year old man is reported with adult polycystic kidney disease with an associated extensive arachnoid cyst occupyingmost of his left hemicranium. The aetiology of arachnoid cyst formation is discussed.

P4-134: Ventriculo-peritoneal shunting for normal pressure hydrocephalus: A prospective study

uation of memory, attention, language, praxias, orientation and executive function; neuropsychiatric exam; functional evaluation using Pfeffer’s scale of daily living activities and neuroimaging evaluation (cranial computerized tomography CT and/or magnetic resonance imaging MRI). Conclusions: All of the patients presented with cognitive and behavioral alterations, but in different degrees, dependent upon the following variables: intensity of the structural abnormalities in neuroimage exams; latency until the beginning of specific treatment with aciclovir, and others. Memory deficit pattern found in herpetic encephalitis resembles that observed in Korsakoff syndrome and in Alzheimer’s disease. Behavioral symptoms were compatible with Kluver-Bucy syndrome and resembled that observed in frontotemporal dementia. Neuroimaging exams showed asymmetric mesial temporal pathology in most of the cases with extension to the orbitofrontal areas in some cases.