Unusual case of temporal dermoid cyst presenting as oculomotor nerve palsy.

Dermoid cysts are choristomas resulting from the inclusion of ectodermal tissue during closure of the neural tube and occur along the epithelial lines of fusion. Frontotemporal dermoids are the most common type and generally present as an asymptomatic mass. We present an unusual case of frontotemporal dermoid presenting as sudden onset oculomotor nerve palsy in young male patient and describe the neurosurgical approach in its management.

Recurrent venous thrombosis with factor V Leiden mutation.

A patient who presented with recurrent venous thrombosis is reported. Following an episode of spontaneous deep vein thrombosis of the lower limb he was started on oral anticoagulant therapy, which he discontinued. He presented with cerebral venous thrombosis and improved partially with anticoagulant therapy. Evaluation for hypercoagulable states revealed factor V Leiden mutation by polymerized chain reaction method. Long-term anticoagulation has been planned. Evaluation for factor V Leiden mutation is always warranted in patients presenting with spontaneous thrombosis, especially if there is recurrent thrombosis.

High cervical and lumbar canal stenosis of varied etiology: a case report.

Developmental stenosis without any significant spondylotic changes frequently occurs at C3 vertebra or below, and typically extends to C6-C7. However, high cervical focal canal stenosis is unusual. A case of cervical canal segmental stenosis at C2-3 level in addition to a developmental stenosis of the lumbar region, in a 45 year old male, has been presented in this article. The dynamics of the spinal canal in relation to the likely pathology of such conditions are reviewed. We speculate that focal segmental stenosis in the high cervical region may be due to a possible premature fusion of the neurocentral synchondrosis of the cartilage, or due to an abnormal rotary biomechanics which can result in facetal hypertrophy.

Intrasellar tuberculoma presenting as pituitary apoplexy.

The combination of apoplectic symptoms and a sellar mass most often points to a diagnosis of a pituitary adenoma. Sellar tuberculomas are not considered as a cause of 'pituitary apoplexy' and there has been no radiological documentation of haemorrhage associated with them. We report a 27 years old man who presented with 3 previous episodes of pituitary apoplexy. CT scan showed evidence of a sellar mass with haemorrhage. Transsphenoidal biopsy of the intrasellar mass was reported as 'tuberculoma'. The patient had marked reduction in the size of the lesion following antituberculous therapy with no recurrence of symptoms. Intrasellar tuberculomas must be considered as one of the differential diagnosis when patients present with a pituitary apoplexy.

Motor and somatosensory evoked potentials in a primate model of experimental spinal cord injury.

Motor and somatosensory evoked potentials (MEP and SSEP) were compared after experimental spinal cord injury in Bonnet monkeys (macaca radiata). The MEP and SSEP changes following graded injuries were related to clinical outcome. Eight healthy mature monkeys with a mean weight of 4.2 + 0.9 Kg were chosen for the study. Graded spinal cord injury was caused using 50, 100, 200, 300 gm-cm force by modified Allens' weight drop device. MEP and SSEP recordings were done before injury and at 0, 2, 4 and 6 hours after injury and on the 7th postoperative day. Neurological assessment was done at 24 hours and on the 7th day following injury. 50, 100, 200 gm-cm force caused partial injuries and 300 gm-cm force caused severe spinal cord injury. The predictive value of MEP and SSEP following partial injuries was 80% and 66.67% respectively. Both MEP and SSEP were 100% predictive in severe injury. MEP and SSEP monitoring can therefore be complementary to each other in predicting the neurological outcome in partial injuries to the spinal cord.

Sacral nerve root cysts: A review on pathophysiology.

Nerve root cysts of the sacral region are generally asymptomatic but are known to cause neurogenic claudication. In this paper we present an elderly lady who presented with claudication, whose MR imaging showed a sacral cyst. She underwent lumbo-sacral laminectomy, partial excision of the cyst wall with plication. A review of the possible pathophysiology of such a lesion is discussed.

Medullomyoblastoma: A case report.

Medullomyoblastoma is a rare tumour seen in childhood. We report a medullomyoblastoma occurring in the cerebellar vermis of a 4 year old boy. The light microscopic features, immunohistochemistry and histogenesis are described.