Raghvendra Ramdasi

Cavernoma of the septum pellucidum in the region of foramen of Monro

A rare case of cavernoma in the region of the septum pellucidum is reported. A 35-year-old female patient presented with chronic headaches. Her neurological exam was normal. Her magnetic resonance (MR) imaging showed a lesion within the inferior aspect of the septum pellucidum extending into the anterior third ventricular region, blocking the foramen of Monro, resulting in moderate supratentorial asymmetrical hydrocephalus. A central neurocytoma or subependymoma was suspected on imaging. Complete excision of the septum pellucidum cavernoma was performed using microneurosurgical techniques through an interhemispheric transcallosal route. The patient had an excellent outcome and is cured. Although rare, septum pellucidum cavernomas should be considered in the differential diagnosis of anterior third ventricular lesions in the region of foramen of Monro. The unusual location, atypical radiological features, differential diagnosis as well as surgical nuances in the management of a cavernoma in the septum pellucidum and anterior third ventricular region are discussed in the light of current literature.

Spinal angiolipoma manifesting with apoplexy

We report a 58-year-old man presenting with acute paraplegia. MRI showed a haematoma within a well-defined epidural lesion at C7-D1. Intraoperatively, organised epidural haematoma surrounded by tumour tissue was found. The final histopathology report was angiolipoma. The patient had dramatic recovery. Angiolipomas should be considered in the differential diagnosis of acute paraplegia when imaging shows well-circumscribed haematoma.

Lower motor neuron facial palsy after ventriculoperitoneal shunt surgery

A 40-year-old woman underwent marsupialisation of a symptomatic retrocerebellar cyst. She developed pseudomeningocoele after the procedure. CT of the brain showed hydrocephalus. Therefore, a right-sided ventriculoperitoneal shunt procedure was performed. Unfortunately, the patient developed lower motor neuron-type facial paralysis immediately after the surgery. We localised the site of injury in the distal fallopian canal probably during tunnelling of the subcutaneous tract for passage of the shunt. We discuss the steps to be followed to avoid such mishaps with a brief review of the literature.

Malignant fibrous histiocytoma of the skull base: A neurosurgical nuance

A 69-year-old male, treated for colonic carcinoma 15 years back, presented to our services with status epilepticus. He had complaints of headache and vomiting for 7 days prior to presentation. Computed tomography and magnetic resonance imaging of the brain revealed heterogeneous, lobulated and osteolytic tumor involving middle and posterior cranial fossa. Excision of the tumor was planned in two stages. Middle fossa component was removed through right temporobasal approach. Histopathology was suggestive of malignant fibrous histiocytoma. Patient succumbed to pneumonia and septicemia in the postoperative period. Pathology, clinical features and therapeutic challenges of this clinical entity have been briefly reviewed.

Migrated Disc at Cervicothoracic Junction Presenting as Acute Paraplegia.

Herein, we report on an inferior migration of an intervertebral disc C6-7 to the cervicothoracic junction manifesting as acute paraplegia. The patient showed a remarkable recovery after the surgery. The diagnostic dilemma and management difficulties of such an entity are briefly discussed.

Solitary thoracic osteochondroma presenting as Brown-Séquard syndrome.

We discuss a rare case of solitary osteochondroma arising from D2–D3 vertebrae presenting as Brown-Séquard syndrome (BSS) in a 28-year-old man following a fall. MRI revealed cord compression by an extradural ventrolateral tumour projecting into the spinal canal at D2–D3 level. Intraoperatively, it was found to be a bony tumour arising from the left of the D2 and D3 vertebral bodies, left pedicles and adjacent articular facets. The neurological deficits of the patient improved after the surgery.

Vestibular schwannoma and tuberculoma occurring In collision in the posterior fossa: A case report

Highlights • We report a case of a 46 years female found to have vestibular schwannoma and tuberculoma in collision.• Such association of vestibular schwannoma and tuberculomas never been reported.• It must be kept in mind if two different tumors are detected radiologically in patients residing in endemic regions of tuberculosis.

An unusual variant of anlage tumor of pineal region in an infant.

A 9-month-old male child was brought with complaints of increasing head size for 2 months, increasing lethargy and vomiting for the last 2 days. Radiology revealed a heterogeneously enhancing, globular lesion in the pineal region with hydrocephalus. Near total excision of the tumor was carried out. The histopathological examination of the lesion showed heterogenous elements in the form of mature neuroepithelial and ectomesenchymal tissue. The pathology and radiology of this unusual lesion is discussed with relevant review of literature.

Intraconal optic sheath schwannoma: report of two cases

Abstract Optic sheath schwannoma is extremely rare. We discuss two cases of intraorbital intraconal optic sheath schwannoma. Vision significantly improved in both patients following the surgery. We have briefly described the surgical technique & discussed the relevant literature

Meningioma of Foramen Magnum Causing Drop Attacks

A 52-year-old female presented with frequent episodes of falls without loss of consciousness. These episodes lasted for brief period followed by full neurological recovery. Magnetic resonance imaging (MRI) of the brain showed foramen magnum meningioma encasing left vertebral artery. The patient had dramatic improvement after excision of the tumor.