unique case of an epidural cavernous haemangioma presenting with lumbar radiculopathy in a child

Spinal cavernous haemangioma [CH] is a pathological entity that is commonly diagnosed in adults. It is usually located in the thoracic spine and involves the vertebral body. Epidural CH without bone involvement is a rare variant with only 75 cases reported in the literature, most of whom were adults. We report a unique case of a child with a pure lumbar epidural CH, who presented with a radiculopathy. The lesion was diagnosed by magnetic resonance imaging [MRI] and treated by total excision. All children with a radiculopathy should undergo an MRI and pure epidural CH should be considered in the differential diagnosis of the pathology in these patients

Giant cerebral cavernous malformation

Cerebral cavernous malformations [CCMs] that are 6 cm or more in size have been loosely labeled as "giant" in the literature. Lesions of such size are rare with only 21 cases reported in the literature to date. We report a 27-year-old female patient who presented with raised intracranial pressure and focal neurological deficits which were related to a giant CCM. The pathology was documented by a preoperative MRI and confirmed by histopathological examination after the lesion was excised completely. A review of all the reported giant CCMs is carried out and it is hoped that the presentation will draw neurosurgeons attention to the clinical, radiological and histological features of giant CCMs and encourage a wider acceptance of giant CCMs as the subgroup of CCMs that are 6 cm or more in size

Intracranial extraskeletal mesenchymal chondrosarcoma

Intracranial extraskeletal mesenchymal chondrosarcoma is a rare malignant variant of chondrosarcomas. We present a 5-year-old Saudi male child who was brought to the Emergency Department with the complaints of headache, irritability, vomiting, and unsteadiness of gait with right hemiparesis. Radiological studies confirmed the presence of a space-occupying lesion in the left cerebral hemisphere of the brain. Through a left temporoparietal craniotomy a total macroscopic excision of the tumor was carried out, and the tumor was found attached to the dura at the base of the temporal fossa. The tumor was well circumscribed, extra axial in location, and was easily dissected from the other part of the brain. The histopathological examination revealed the tumor to be a mesenchymal chondrosarcoma. This rare tumor of the pediatric age group should be included in the differential diagnosis of all intracranial tumors with aggressive characteristics

Enterococcus avium-An unusual cause of cerebral abscess

Enterococci are responsible for an increasing number of human infections. They are normally part of the flora of the human gastrointestinal tract, buccal cavity, perineal skin, vagina, urethra and gallbladder, but may occur as pathogens in several sites causing urinary tract infections, intra-abdominal infections, fatal bacteremia, meningitis and endocarditis. Enterococcus avium is a rare cause of infection in humans. Here, we report a 19-year-old Saudi girl diagnosed as a case of astrocytoma grade II arising from the right thalamus. She underwent treatment with radiotherapy followed by 5 chemotherapy sessions. She subsequently developed a cerebral abscess, and we performed mini craniotomy of the left parietal region with drainage of the brain abscess. The pus obtained from the abscess grew Enterococcus avium. We successfully treated her with antibiotics and discharged her home. The rarity of the organism causing cerebral abscess has motivated the documentation of this case and the pathogenesis of Enterococcus avium