Spinal arachnoid cysts - 10 cases

The authors report their experience of 10 patients with spinal arachnoid cyst at the Hopital des specialties in Rabat. There were 5 females and 5males. The mean age was 27 years [range 6 to 70 years]. Eight patients had sings of spinal cord compression and the other two were admitted with severe sciatica. All patients had computed tomography-myelography or magnetic resonance imaging. The lesion involved the thoracic spine in 7, lumbar in 2 and cervical in 1 patient. The cysts were intradural in 6 an extradural in 4 patients. Treatment consisted of complete removal in 5 patients, marsupalisation in 3 and perforation aspiration in 2 patients. Follow-up ranging between 2-7 years, showed total improvement in 6 patients, partial recovery in 3 patients and 1 patient remained unchanged. Recurrence of the cyst was seen in 2 patients. The authors discuss the aetiology, pathogenesis, clinical, radiological and therapeutic aspects of this benign condition

Parinaud syndrome from tuberculoma of pineal area

Computerised tomography and magnetic resonance imaging [MRI] revealed obstructive hydrocephalus and a pineal mass in a 44-year-old woman who presented with headaches and Parinaud's syndrome. Although there was no major evidence of extracranial tuberculosis, and cerebrospinal fluid obtained during third ventriculostomy contained no leukocytes, stereotactic biopsy of the lesion revealed it to be a tuberculoma. MRI showed resolution of the lesion following antituberculous therapy. The implications of this case with regard to difficulties in the diagnosis of cerebral tuberculoma and the management of pineal region tumours are discussed

Lumbar spontaneous spinal epidural haematoma

Spinal epidural haematoma can be secondary to congential acquired coagulation disorder or rupture of a vascular malformation. However, sometimes none of these aetilogies are present, as in the case of our patient. The authors report a case of lumbar spontaneous epidural haematoma causing complications of a malignant systemic arterial hypertension in a 48-year-old patient, who had not presented signs of arterial hypertension previously. In this study, we discuss the clinical aspects, pathogenesis and exploration methods of this rare disease. Its characteristics are that it appears suddenly and constitutes a therapeutic emergency