Post traumatic bilateral facial palsy causing severe psychosocial impairment

Bilateral facial palsy is a relatively uncommon condition and its early identification after head injury can be particularly challenging. It is often not realized that it can be also extremely debilitating in terms of psychosocial functioning. We report a 35-year-old male who fell down while trying to alight from a moving train and lost consciousness for 30 minutes. It was later during the course of his hospitalization for observation that his bilateral facial palsy was recognized. Due to poor feeding because of compromised oral function and inability in expressing emotions, he had significant impairment of psychosocial functioning. He was particularly concerned about his complete inability to smile and as a result, was reluctant to go back to work and socialize with friends

Arachnoiditis mimicking recurrent spinal ependymoma

Spinal arachnoiditis is a cause of persistent symptoms or recurrence of symptoms in 6-16% of postoperative patient. Spinal arachnoiditis mimicking ependymoma tumour recurrence in a young child is reported here. A 9-year-old child was operated 3 years back for extensive lumbar and sacral ependymoma. He presented with short history of rapidly progressive paraparesis and radiology was stongly suggestive of recurrent tumour in lumbar spinal canal. However, surgery revealed only CSF loculation in the spinal canal. No tumour was seen. The patient improved after adhesiolysis. Postoperative spinal arachnoiditis can mimic tumour recurrence in ependymomas. This is an interesting case observed by us and we advise that the possibility of spinal arachnoiditis should be kept in mind in the differential diagnosis of causes of neurological deterioration in previously operated cases of ependymoma

Acute epidural haematoma following ventriculoperitoneal shunt in an adult

The authors report a 50-year-old patient of pituitary macroadenoma with hydrocephalus, who developed a large left parieto-occipital epidural haematoma following placement of a ventriculoperitoneal shunt. This is the first case report describing this complication in an adult patient, and it is hypothesised that coagulation of the dura along with rapid lowering of intracranial pressure, may lead to its stripping from the bone with attendant tear in the emissary vein [s] resulting in the possibility of epidural haematoma formation in adults. Judicious dural coagulation should therefore avoid this uncommon and potentially life-threatening condition