Shenoy Sn

Cystic trochlear nerve neurinoma mimicking intrinsic brainstem tumour.

Trochlear nerve neurinomas are very rare with less than 20 surgically proved cases reported in the literature. A case of histologically proved cystic trochlear nerve neurinoma, which was mimicking an intrinsic brainstem tumour is reported here. The tumour was totally excised. The clinical features and surgical management are described and the literature reviewed.

High dose radiation induced meningioma

Radiation therapy has played an important integral part in the management of various intracranial tumours. However, radiation has been implicated in the development of intracranial tumours. We describe three cases of radiation-induced meningiomas following high dose cranial irradiation. All these patients developed tumours within the previous radiation field and satisfied the criteria used for the definition of radiation-induced neoplasm. The interval between the irradiation and the onset of meningioma was significantly less in the younger patient. All the cases had several unique features of radiation-induced meningioma including features of atypical meningioma. Two patients developed multiple site meningiomas and one patient developed early recurrence of the tumour. This report confirms that patients exposed to cranial irradiation are at lifelong risk of developing radiation-induced tumours such as meningiomas. Hence these patients require long-term clinical and radiological surveillance to detect occurrence as early as possible.

Cystic cervical intramedullary schwannoma with syringomyelia.

We report a case of cervical intramedullary cystic schwannoma associated with segmental syrinx in a young adult without evidence of neurofibromatosis. The relevant literature is reviewed.

Spontaneous transdural spread of glioblastoma with atypical presentation.

The dura provides an excellent protection against infiltration by malignant tumours. It is extremely rare for glial tumour cells to infiltrate the dura and subsequently invade adjacent structures. We report an interesting case of glioblastoma of the temporal lobe with spontaneous transdural spread to the skull base and infratemporal fossa. This is the first radiologically documented case of transdural spread of glioblastoma before and after the spread without previous craniotomy.