Yuekang Zhang

Intracranial clear-cell meningioma

Intracranial clear-cell meningioma (CCM) is rarely reported in the literature since it has to be distinguished from other subtypes of meningioma. Most of the CCMs are intraspinal, according to the related literature. We report a case of occipital parietal CCM in a 6-year-old child, review all the 35 intracranial CCMs that have been reported since 1995 to present and discuss their clinical, radiological and histopathologic characteristics.

Intracranial extraaxial ependymoma in children: a rare case report and review of the literature.

Intracranial extraaxial ependymomas (IEAEs) are extremely rare. We present a pediatric patient with IEAE misdiagnosed as a meningioma preoperatively, successfully treated surgically with a favorite outcome. The literature about IEAEs was briefly reviewed. Thereafter we discuss the clinical characteristics of the disease.

An Echinococcosis multilocularis presenting as a giant anterior cranial basilar tumor

AbstrtactCerebral alveolar hydatid disease is a rare subtype of Echinococcus, and prevalent in northern China and Tibetan area. In this report, we presented a giant lesion of Echinococcus multilocularis which located in anterior cranial fossa, and discussed its clinicopathological and radiological features, and strategy of treatment.

Atypical meningioma of sylvian fissure with a 20-year history: a rare case report

Atypical meningiomas of sylvian fissure are extremely rare. We reported a case of sylvian fissure atypical meningioma with a 20-year history. The tumor was excised subtotally, thereafter a postoperative radiation therapy was done. The patient had a favorable outcome during the two-year follow-up. The possible pathogenesis of this case was hypothesized and analyzed in this article.

Meningeal melanocytoma of the middle cranial fossa (the Meckel's cave)

Neurology India / March 2015 / Volume 63 / Issue 2 nerve. Since the afferent fibers of the lingual nerve travel in the hypoglossal nerve,[3] there is a possibility that they may also possess connections with the C2 spinal nerve roots. The greater and lesser occipital nerve also arise from the second spinal nerve. The steroid block for the occipital neuralgia stabilized the transmission of impulses within the related interconnected nerves including the occipital nerve, the C2 spinal nerve root, the hypoglossal and the lingual nerve (the latter containing the afferent fibers from the chorda tympani nerve that carry taste sensations from the anterior two‐thirds of the tongue) leading to improvement in dysgeusia.[3,8] Post‐traumatic misdirectional regeneration of facial nerve fibers can result in a cross‐talk between the facial nerve and the cervical plexus (and the occipital nerve in particular).[8] Suppression of these direct interneural connections by an occipital block could have resulted in the recovery of the dysgeusia.

A giant cholesteatoma of the mastoid extending into the foramen magnum: A case report and review of literature

Cholesteatomas are very rare benign, progressive lesions that have embryologic derivation and usually result in progressive exfoliation and confinement of squamous epithelium behind an intact or preciously infected tympanic membrane. To the best of our understanding no reports demonstrates the extension of cholesteatoma from the temporal bone into the foramen magnum. We therefore present a case of cholesteatoma extending down into the foramen magnum. We report a case of 67- year-old man with a giant cholesteatoma extending into the foramen magnum without substantial destruction of the mastoid and petrous temporal bones. The patient’s major symptoms were recurrent tinnitus in the left ear and dizziness with unilateral conductive hearing loss. A working diagnosis of cholesteatomas was made combining the symptoms and magnetic resonance imaging findings. He was then successfully operated on with very minimal postoperative complications. Cholesteatomas originating from the mastoid bone often linger with the patients for many years in a subclinical state and progress into a massive size before causing symptoms. Patients with unilateral conductive hearing loss who are otherwise asymptomatic and have a normal tympanic membrane should be suspected with a progressive cholesteatoma. Cholesteatoma should be one of the working diagnosis when an elderly patient present with unilateral conductive hearing loss that is associated with tinnitus and dizziness.

Efficacy of Closed Continuous Lumbar Drainage on the Treatment of Postcraniotomy Meningitis: A Retrospective Analysis of 1062 Cases

BACKGROUND Postcraniotomy meningitis is a severe complication in neurosurgery, and can result in high morbidity and mortality. Closed continuous lumbar drainage (CCLD) as an adjuvant method for treating postcraniotomy meningitis in adults is rarely assessed. This study aimed to evaluate the efficacy of CCLD in the treatment of postcraniotomy meningitis. METHODS A total of 1062 patients older than 16 years with postcraniotomy meningitis were included, between January 2000 and December 2015. Of these, 474 received intravenous antibiotic therapy, steroid administration and adjuvant CCLD (experimental Group). The remaining 588 patients only received intravenous antibiotic and steroid therapies (control Group). Data were extracted from medical records. RESULTS In the experimental group, meningitis-related mortality was 2.7%, and 77.4% individuals achieved a Glasgow Outcome Scale of 4-5. In the control group, meningitis-related mortality reached 11.6%, with only 61.1% of patients achieving a GOS of 4-5. The time to negative cerebrospinal fluid laboratory test and the duration of meningitis-related symptoms were significantly shorter in the experimental group compared with controls (P < 0.05). CONCLUSIONS Intravenous antibiotic and steroid therapies, assisted by CCLD, can lead to lower mortality and improved Glasgow Outcome Scale score in patients with meningitis after craniotomy. Laboratory results negative for cerebrospinal fluid leak and meningitis-related symptom relief occurred faster in the experimental group. Intravenous antibiotic and steroid therapies combined with CCLD appear to be an effective and safe treatment for postcraniotomy meningitis.