Late Intramedullary Spinal Metastases from Esthesioneuroblastoma: Case Report and Prognostic Implications.

Background: Esthesioneuroblastoma (ENB) is an uncommon neuroectodermal tumor that originates from the olfactory mucosa and often recurs locally. Distant metastases of ENB have been described, but there are few reports of intramedullary metastases to the spinal cord.

Case Description: Here we report a case of a patient presenting with a progressive paraparesis and magnetic resonance imaging findings of multiple drop metastases to thoracic and lumbar regions of the spinal cord, 17 years after diagnosis and treatment for an intracranial ENB with subsequent neck nodal metastases.

Isolated intracranial myeloid sarcoma: report of a case and review of the literature.

Myeloid sarcoma is a rare malignant tumor of primitive myeloid cell origin often associated with hematologic disorders. The central nervous system is rarely involved and differentiating between myeloid sarcoma and other tumors is not possible on imaging. Here we present the rare case of an isolated intracranial myeloid sarcoma, initially misdiagnosed radiologically as a meningioma, treated with surgical total resection and subsequent chemotherapy, with no signs of any hematological disorder at follow up.

Abrupt foramen magnum syndrome due to shunt malfunction in a previously asymptomatic chiari I malformation: the hidden predictable risk in long-lasting shunted patients.

Cerebrospinal fluid overdrainage in long-lasting shunted hydrocephalus is a well recognized complication. It may lead to different clinical syndromes which may occur over time, namely cranioencephalic disproportion and hindbrain herniation. Among the latter, Chiari malformation type 1 classically refers to one of the mildest form.

Current management of central nervous system metastasis from cholangiocarcinoma: the neurosurgical perspective. Literature review.

Central nervous system (CNS) metastasis from cholangiocarcinoma (CCA) are extremely rare and associated prognosis is poor. The involvement of the CNS by metastatic CCA may discourage any further treatment; however, data from the literature are discordant, due to recent reports of exceptionally long follow-up after surgical resection of a brain metastasis. Electronic databases, such as PubMed/MEDLINE and Google Scholar, were analyzed for studies published up to October 2018 using the search term "cholangiocarcinoma and central nervous system metastasis or brain metastasis".

Repeat Bleeding 18 Years After Hemorrhagic Pilocytic Astrocytoma: Prognostic Implications of Conservative Management-Case Report and Literature Review.

Background: Acute hemorrhagic occurrence of pilocytic astrocytomas is extremely rare but has become increasingly recognized and often presents in clinically emergent situations. The precise significance of hemorrhage in these tumors and its pathogenetic mechanisms have not yet been defined. Nothing is known about the natural history of bleeding pilocytic astrocytomas.

Hypertrophic Pachymeningitis and Hydrocephalus-The Role of Neuroendoscopy: Case Report and Review of the Literature.

Background: Hypertrophic pachymeningitis (HP) is a rare primary or secondary inflammatory disorder that manifests with thickening of dura mater involving predominantly the tentorium and falx in the focal form. Hydrocephalus has not been reported in association with secondary HP.

Case Description: A 61-year-old woman presented with intracranial HP of the posterior fossa secondary to Wegener granulomatosis not responsive to corticosteroid therapy.

Brain Granuloma: Rare Complication of a Retained Catheter.

Background: Ventriculoperitoneal (VP) shunt is the most frequent treatment for hydrocephalus. VP shunt malfunction is a very common problem in neurosurgical practice, often requiring shunt revision procedures. In some cases, complete removal of a VP shunt may present difficulties, leading the surgeon to leave the ventricular catheter in situ.

Supratentorial Embryonal Tumors in the Elderly: Diagnostic Pitfalls and Clinical Prognosis.

Supratentorial embryonal tumors are very rare malignant tumors of neuroectodermal origin, characterized by an aggressive clinical behavior. They occur prevalently in children. They have been sporadically described in adults and represent an even rarer occurrence in elderly patients, raising many issues on the diagnostic pitfalls and their appropriate management.

Prolactin Secreting Pituitary Microadenoma: Results of Transsphenoidal Surgery After Medical Therapy With Dopamine Agonist.

Medical therapy with dopamine agonist is very effective in controlling prolactin serum levels and it usually represents the first therapeutic choice for prolactin secreting pituitary adenomas. However, many patients present increase of prolactinemia after withdrawal of medical therapy which consequently should be taken for long time; other present intolerance to medical therapy; women with pregnancy need to withdraw dopamine agonists with consequent potential related problems: in these patients transsphenoidal surgery can be requested. The presented study concerns the efficacy of transsphenoidal surgery in patients affected by microprolactinoma after treatment with medical therapy for different periods of time.

Isolated Oculomotor Nerve Palsy as Presenting Symptom of Bilateral Chronic Subdural Hematomas: Two Consecutive Case Report and Review of the Literature.

Background: Isolated oculomotor nerve palsy (ONP) is caused most commonly by vascular disease, posterior circulation aneurysms, and inflammatory or traumatic injury. ONP usually occurs in chronic subdural hematoma (CSDH) as a common sign of cerebral herniation that typically is associated with a deterioration of consciousness.

Case Description: We report 2 cases of bilateral CSDH who presented with ONP without deterioration of consciousness.

Paraganglioma of the cauda equina region.

Background Context: Cauda equina paragangliomas (CEPs) are rare neuroendocrine tumors. The difficulty in differential diagnosis with other tumors of this region may be misleading for surgical planning and prognostic expectations.

Purpose: To report on a rare case of CEP and review the most current information regarding the diagnosis, treatment options, and outcomes.

Lobar hemorrhages.

The lobar localization of a spontaneous intracerebral hemorrhage occurs in one third of all cases; the most frequent cause is represented by amyloid angiopathy. The clinical symptomatology depends on the dimensions of the hematic collection and of the lobe. The diagnosis is made by CT, but also MRI must performed in order to exclude any vascular malformation or neoplasms, and in young patients a cerebral angiography must be done in order to exclude small arteriovenous or dural malformations.

Occipital arteriovenous malformations and migraine.

Background: Headache has been reported to be the first clinical presentation in several patients with cerebral arteriovenous malformations (AVMs). Headache associated with AVMs often shows characteristics of migraine with and without aura. Angiographic characteristics of AVMs, such as their location, could determine the 'migraine-like' features of attacks.

An unusual growth of an intraventricular meningioma: a case report.

Intraventricular meningiomas are rare often histologically benign tumors arising most always from the trigonal region of the lateral ventricle. We report the first described case of a rapidly growing histologically benign intraventricular meningioma in a 68-year-old woman whose magnetic resonance imaging (MRI) executed 1 year before surgical operation was negative for intracranial mass lesion.

Pseudoglandular schwannoma of the cauda equina. Case report.

The authors present a case of pseudoglandular schwannoma with immunohistochemical findings consistent with epithelial metaplasia. Pseudoglandular schwannoma is a rare morphological variant of benign schwannoma characterized by the presence of glandlike structures lined with Schwann cells. To the best of the authors' knowledge, this is only the fifth case of pseudoglandular schwannoma reported in the literature.

Low-grade primary meningeal lymphoma: case report and review of the literature.

Primary meningeal lymphoma is a rare occurrence. We present a case of an immunocompetent patient operated on for a fronto-parietal lesion similar to a meningioma, which the histological examination diagnosed as a mucosa-associated lymphoid tissue (MALT)-type lymphoma. She received no further post-operative treatment and after 36 months showed no evidence of disease.

Spinal epidural abscess complicating chemotherapy in patients with leukemia.

The authors reviewed the basic facts about infections that complicate chemotherapy, and found that a difference exists between those that are medically treated, for which several standard protocols have been adopted, and infections amenable to surgical treatment, such as spinal epidural abscess, which are managed according to the experience at individual institutions. The authors believe that patients with leukemia who manifest a spinal epidural abscess should always be surgically treated when the infection occurs between the induction and remission phases, whereas medical treatment options can be considered for spinal epidural abscesses occurring at the end of the chemotherapy course.

Epidural hematoma after thoracic epidural catheter removal in the absence of risk factors.

Background And Objectives: The purpose of this report is to enhance awareness that an epidural hematoma can occur even in patients devoid of risk factors.

Case Report: A 69-year-old, 55-kg male was scheduled for video-assisted thoracoscopic resection of bilateral pulmonary metastases and received combined thoracic epidural and general anesthesia. The epidural catheter insertion was unremarkable.

Syringomyelia associated with hydrocephalus and Blake's pouch cyst: case report.

Study Design: This is a case report of a 37-year-old woman who sought treatment for a large syringomyelic cavitation extending from C3 to the entire medulla, a tetraventricular hydrocephalus, and a cystic cavitation in the posterior cranial fossa communicating with the fourth ventricle (Blake's pouch cyst). The patient underwent a decompressive craniectomy, a C1 laminectomy, and the opening of the cysts to enable communication with the subarachnoid spaces. After an initial period of symptom remission, reassured by the magnetic resonance images indicating a reduction of the syringomyelia, the patient's neurologic conditions deteriorated because of further dilation of the ventricular cavities, which was resolved by the insertion of a ventriculoperitoneal shunt.

Intrasphenoidal encephalocele associated with cerebrospinal fluid fistula and subdural hematomas: technical case report.

Objective And Importance: Intrasphenoidal encephalocele is a rare clinical entity that is often complicated by rhinorrhea, recurrent meningitis, and headache, but in no case has the association of rhinorrhea with subdural hematomas been described. A surgical procedure to stop persistent cerebrospinal fluid leakage is reported.

Clinical Presentation: A 59-year-old man sought care for intractable rhinoliquorrhea of 6 months' duration.

Calcifying pseudo-tumor of the spine: description of a case and review of the literature.

A case of calcifying pseudo-tumor of the thoracic spine, a rare lesion with tumor-like behavior and a probable inflammatory-reactive origin, is described. The clinical-pathological and neuro-radiological aspects of this lesion are discussed in relation to surgical treatment. In accordance with the other cases reported in the literature, the case observed confirmed the benign behavior of the lesion and the effectiveness of surgical treatment for achieving complete resolution of clinical symptoms without any recurrences, even when removal is only subtotal.