Tuberculous meningo-encephalitis complicated by hydrocephalus in HIV patient

Hydrocephalus is a serious complication of tuberculous meningoencephalitis in HIV patients. The disease can affect vital and functional prognosis of patients. A 20 years-old woman was admitted for deterioration of her consciousness. She has a history of HIV infection since 3 months. Cerebral imagery showed signs of tuberculous meningoencephalitis. The paient was treated by antituberculous therapy with a good evolution. At the third months of treatment the patient presented roughly alteration of her consciousness and intracranial hypertension. Cerebral scan showed active ventricle hydrocephalous. The patient had ventricle extern derivation and then ventricle peritoneal derivation. Antituberculous and antiretroviral therapies were maintained. The outcome was favourable [follow up of one year]. central nervous system involvement in HIV patient can be observed at any stage of the disease with a consequent mortality and morbidity. central nervous system tuberculosis is observed in 10% of patients who presented an association of HIV-tuberculosis and only in 2% to 5% of tuberculous immunocompetent patients. Hydrocephalous is observed in 32% to 51% of HIV patients associated with tuberculosis meningoencephalitis. Hydrocephalous is a common complication of tuberculous meningoencephalitis witch can worsened the neurological statue of HIV infected patient. An early surgical and medical management was associated with a good prognosis

[Spinal metastases: About 70 cases]

From 70 cases of vertebral metastasis of various origins, the authors discusss the indications of the surgical treatment. The mean age of patients is 48 years old. The mole sex predominates [64.5%]. The primitive cancer is dominated by the bronchogenic carcinoma and the breast cancer. 70% patients were admitted for neurological deficiency. This reflects the delay in diagnosis and consequently in the management of this affection. The dorsal spine is the first area of localisation, with 52.6% of cases, and the lumbar spine the second one. Surgical decompression is effective in relieving neurological symptoms of spinal metastasis [44 cases]

Exophthalmos as a presenting sign of extradural haematoma

A conscious 14-year old boy admitted to hospital with progressive right exophthalmos, decreased visual acuity and headache 9 days after head trauma, with neurological deficit. Computerized tomography [CT] scan demonstrated intracranial and intraorbital cystic mass. At craniotomy, a subacute extradural haematoma was found which communicated with an orbital subperiosteal haematoma through an orbital roof fracture. Postoperative outcome was marked by complete recovery of exophthalmos and visual acuity. This case demonstrated the rare diagnosis of epidural and subperiosteal orbital haematoma. The literature is reviewed and surgical management is discussed