accessory middle cerebral artery associated with an aneurysm

An accessory middle cerebral artery [MCA] usually originates between the A1 and proximal A2 segment of the anterior cerebral artery, reaches the Sylvian fissure, and supplies the territory of the MCA. This anomaly has been associated with cerebral aneurysms and Moyamoya disease. These associations are rare. We report a case of an accessory MCA associated with an aneurysm. Knowledge and recognition of such anomalies are useful and important in the interpretation of cerebral images and during neurosurgical procedures

Cervical Ewing's sarcoma presenting as neurinoma

Considering their usual bone localisation, Ewing's sarcomas of soft tissues are rare. We report a case of a 19-year-old patient who had been suffering from cervico-brachial neuralgia followed by symptoms of progressive spinal cord compression. Magnetic resonance imaging detected a tumour at the C [7] level in the antero-lateral part of the spinal canal with an intracanal extension via an enlarged inter vertebral foramen, mimicking a neurinoma. The patient underwent an incomplete tumoural exeresis. The pathological examination yielded typical findings of Ewing's sarcoma. The patient underwent chemotherapy followed by complementary tumoural exeresis and radiotherapy. Literature review denotes the exceptional feature of the presentation. Correct and definitive diagnosis is made by pathological examination. Management of Ewing's sarcoma with the three main modalities: surgery, radiotherapy and chemotherapy increase the patient's survival