Maternal hydrocephalus in pregnancy and delivery: a report of two cases

We present two cases of maternal hydrocephalus in pregnancy. In one case, the patient had no medical problems and had a spontaneous vaginal delivery of a normal neonate at term. In the second case, the patient had an uneventful pregnancy until 36 weeks when she presented to the labour ward with drowsiness and decreasing consciousness. She only recovered after emergency Caesarean section and revision of her ventriculo-peritoneal shunt. Her neonate although preterm had no anomalies and was sent home soon after birth with the mother.

Presentamos dos casos de hidrocefalia en el embarazo. En uno de los casos, la paciente no presentaba problemas médicos y tuvo un parto vaginal espontáneo de un neonato a término. En el segundo caso, la paciente tuvo un embarazo sin incidentes hasta la semana 36 en que se presentó a la sala de partos con somnolencia y pérdida gradual de la conciencia. Sólo se recuperó luego de una cesárea deemergencia y la revisión de su derivación ventrículo-peritoneal. Su neonato, aunque pre-término, nopresentó anomalías, y fue enviado a casa junto con su madre, poco después de su nacimiento.

Brain Abscess at the University Hospital of the West Indies

Surgical infections of the central nervous system are still attended by high rates of morbidity and mortality, although substantial progress has been made since the advent of computed tomography (CT) scanning technology. In this retrospective review of 25 surgically treated patients with either brain abscess of subdural empyema at the University Hospital of the West Indies, the majority of patients were male and between the ages of 10 and 30 years with a mean age of 16.9 years. Almost half the patients had a hemiparesis on presentation while 60 percent had fever. Subdural empyema was more common than a localised intracerebral abscess which was most frequently located in the frontal lobe. The most common predisposing factors were sinusitis and congenital heart disease. Streptococci spp and Staphylococci spp were the most frequently isolated organisms. All patients underwent CT scanning and surgical intervention. The mortality rate was 20 percent, and 21 percent of the survivors had late seizures. There must be a high index of clinical suspicion and early referral to specialist centres where neuroradiological investigation and prompt neurosurgical intervention can be carried out to minimise morbidity and mortality.

Orbital psuedotumour with intracranial extension: a case report

Inflammatory pseudotumour of the orbit is an unusual condition of unknown aetiology which rarely extends beyond the orbit. To our knowledge 19 cases with intracranial extension have been reported, none of which involved the pituitary fossa or sphenoid sinus. Most required cytotoxic agents, surgery or radiotherapy in addition to corticosteroids. We present a case of orbital pseudotumour with extension into the pituitary fossa, sphenoid sinus and cavernous sinuses with vascular compression. Marked clinical improvement occurred on steroid therapy alone.