Kak Vk

Craniovertebral Anomalies: a study of 82 cases

Eighty-two cases of craniovertebral anomalies have been analysed. Fifty of these were operated upon. Congenital atlanto-axial dislocation was the commonest anomaly encountered (56.1%). Multiple anomalies were frequently seen (48.8%). Common combinations were atlanto-axial dislocation with occipitalisation of atlas, basilar invagination with Arnold-Chiari malformation and basilar invagination with occipitalisation of atlas. There was a high incidence (50%) of neck deformity and/or a low hairline which provided a good clue to the diagnosis. Precipitating factors, paroxysmal symptoms and an acute onset were common in cases of atlanto-axial dislocation. Cranial nerve and cerebellar dysfunction were common in cases with multiple anomalies. Thirty-six (72%) patients improved following surgery, and three died.

Congenital intramedullary spinal ependymal cyst

A rare case of congenital intramedullary ependymal cyst of the dorsal cord in a 7-year-old boy associated with kyphoscoliosis and rachidian malformations of the dorsal spine is reported. Myelography suggested an intramedullary lesion. The posterior location and presence of a clear plane of cleavage from the medullary tissue enabled total enucleation of the cyst. Histological differentiation from other similar intradural cysts is discussed and the relevant literature is reviewed. This is the fifth such case reported in the literature.

Aneurysmal bone cysts of the spine

Aneurysmal bone cysts are uncommon bony lesions of the spine. Two such patients are reported in the study. The first patient had involvement of first and second thoracic vertebrae, and a preoperative diagnosis was made possible due to the typical magnetic resonance imaging appearances. A total removal was achieved in two stages. In the second patient the C2 spinous process was involved, and this patient presented as atantoaxial dislocation. Removal of the abnormal tissue and posterior fusion was done. Both the patients showed neurologic improvement. The relevant literature is reviewed.

Hemibase syndrome: An unusual presentation of intracranial paraganglioma

A case of paraganglioma of parasellar origin in a 7-year-old girl is described. She presented with hemibase syndrome with involvement of a majority of the left cranial nerves. Three times in the past 2 years she had recurrent ophthalmoplegia with complete recovery. She was treated surgically and with postoperative radiotherapy. The site of origin of this paraganglioma as well as the clinical presentation are uncommon features in this case.

Epidural spinal tuberculoma presenting as ‘spinal tumour syndrome’

Abstract A case of epidural spinal tuberculoma presenting as ‘spinal tumour syndrome’ is described. Published instances in the literature are reviewed. A brief account of pathology, diagnosis and therapy is included.

Brain metastasis from urachal carcinoma: case report.

A rare case of metastasis to the brain from an urachal carcinoma is reported. Metastasis in the brain developed 7 months after partial cystectomy and radiation therapy. Cranial computed tomography showed a ring-enhancing mass lesion that was excised. A month later, the patient died of distant metastasis.

Cysticercosis of filum terminale

922 Neurology India | Nov-Dec 2011 | Vol 59 | Issue 6 was done. Brisk extradural bleeding was noted from the region of the skull base even as the bone flap was being removed. The MMA was cauterized and the foramen spinosum occluded with bone wax to stop the bleeding. A fracture line along the greater wing of sphenoid was noted, along with an overlying 1.5 × 1.5 cm dural tear through which the inferior part of the intracerebral hematoma was visualized. After formal dural opening, a cortical incision was made in the middle temporal gyrus to reach the temporal hematoma, which was then evacuated. No well-formed aneurysm wall was encountered at the time of surgery. The dural tear was repaired with a pericranial graft. After surgery, the patient made a steady recovery. His GCS score improved to 14 over the next few days and he was discharged.