Collision tumor comprised of chronic lymphocytic leukemia and myxopapillary ependymoma.

Background: Collision tumors involving the co-occurrence of two morphologically and genomically distinct neoplasms in the same anatomical site are exceptionally rare in the central nervous system (CNS).

Case Description: We report a unique case of a CNS collision tumor comprising chronic lymphocytic leukemia and myxopapillary ependymoma in a 77-year-old male with acute neurological decline. Presumed to represent leukemic infiltration, urgent laminectomy was pursued for tissue diagnosis and spinal cord decompression, revealing the unexpected ependymal component.

A benchtop brain injury model using resected donor tissue from patients with Chiari malformation.

The use of live animal models for testing new therapies for brain and spinal cord repair is a controversial area. Live animal models have associated ethical issues and scientific concerns regarding the predictability of human responses. Alternative models that replicate the 3D architecture of the central nervous system have prompted the development of organotypic neural injury models.

Spontaneous resolution of a Chiari malformation with syringomyelia.

The Chiari I malformation (CM-I) is characterised by overcrowding of the posterior fossa and descent of the cerebellar tonsils and is associated with syringomyelia. With the increasing availability of magnetic resonance imaging, CM-I is placing a growing burden on neurosurgical services. However, its natural history remains poorly understood, and the timing and nature of surgical intervention is controversial.

Regression of a spinal schwannoma after Pomalidomide.

A 77-year old female with a history of neurofibromatosis type 2 (NF2) was diagnosed with a spinal schwannoma that was managed conservatively over a decade. During this time, follow up imaging revealed this lesion had been growing and the patient had become symptomatic from it necessitating surgical decompression. However, the patient had been diagnosed with multiple myeloma and underwent treatment with Pomalidomide chemotherapy which delayed surgery for the spinal schwannoma.

Colonic perforation by an intrathecal baclofen pump catheter causing delayed meningitis.

Intrathecal baclofen (ITB) delivery via an implanted pump is frequently used for the treatment of spasticity. This is an effective and safe neurosurgical and pharmacological intervention associated with an improvement in patient quality of life. There is, however, a risk of device-related infection.

Unusual placement of intrathecal baclofen pumps: report of two cases.

Intrathecal baclofen delivery via implantable pump represents an important modality for symptomatic relief in patients with chronic spasticity. Pumps are routinely implanted subcutaneously in the anterior abdominal wall. We describe two unusual cases where skin-related complications necessitated revision surgery in order to relocate the pump to alternative sites.

Adult tethered cord syndrome resembling plantar fasciitis and peripheral neuropathy.

Adult tethered cord syndrome without spinal dysraphism is rare, and can present with subtle symptoms that could mimic other pathologies. As a result, timely diagnosis of this condition has proved to be a significant challenge. It is crucial for clinicians to be aware of adult tethered cord syndrome and its presenting symptoms in order to achieve early diagnosis and subsequent management.

Cranial meningioma co-localised with Langerhans cell histiocytosis.

We present a case in which a patient was initially diagnosed and treated for a para-cavernous meningioma with radiotherapy. An accompanying lesion overlying the left frontal convexity was surgically removed several months later to provide a histological diagnosis. Surprisingly, meningioma and Langherhans cell histiocytosis were found in the same lesion.

Nasoethmoid schwannoma with intracranial extension. Case report and review of literature.

A 27-year-old woman presented with a six-month history of intermittent headache and a 2-week history of blurring of vision. Subsequently a 4 cm large enhancing lesion in the left frontal parafalcine region with a small extension into the nasoethmoid sinus was found. This was thought to be either an anterior cranial fossa meningioma or an esthesioblastoma.

Spontaneous extra-axial intracranial hemorrhage followed by thrombosis in congenital afibrinogenemia: perioperative management of this rare combination.

Background: Although congenital afibrinogenemia can commonly present with hemorrhage from the umbilical cord at birth, or with spontaneous mucosal or intracranial hemorrhage in the neonatal period, life-threatening intracerebral hemorrhage in adults is infrequent.

Case Description: We report a 32-year-old woman with congenital afibrinogenemia. Postoperatively, she developed bilateral pulmonary emboli despite the fact that her INR was elevated to 2.