Remarkable Clinical Improvement Following Microsurgical Resection of Left Lingual Gyrus Cerebral Cavernous Malformation: A Case Report

Moyamoya disease is a chronic and unusual cerebrovascular disorder characterized by progressive stenosis and occlusion of the distal portions of internal carotid arteries and its main branches within the circle of Willis. Posterior circulation (vertebral and basilar arteries) may also be affected; however, this presentation is uncommon. As well as stenosis of the terminal portion of intracranial arteries, it is seen the development of a network of collateral vessels abnormally dilated at the base of the brain with an aspect of a "puff of smoke," whose term in Japanese is described as "moyamoya." The present study aims to report two consecutive cases of patients who presented to our service with different clinical manifestations. Further investigation with digital subtraction angiography showed a moyamoya pattern.

Brain Abscess Caused by Nocardia: Case Report and Literature Review

Nocardia brain abscess is a rare clinical entity, accounting for 2% of all brain abscesses, associated with high morbidity and amortality rate 3 times higher than brain abscesses caused by other bacteria. Proper investigation and treatment, characterized by a longterm antibiotic therapy, play an important role on the outcome of the patient. The authors describe a case of a patient without neurological comorbidities who developed clinical signs of right occipital lobe impairment and seizures, whose investigation demonstrated brain abscess caused by Nocardia spp. The patient was treated surgically followed by antibiotic therapy with a great outcome after 1 year of follow-up.

Posterior fossa extradural haematoma.

Seventeen patients with posterior fossa extradural haematoma are presented. While 7 patients had acute course, 6 had subacute and 4 had chronic course. All patients had evidence of occipital injury. Two patients did not have any fracture in the occipital bone. Concomitant lesions included cerebellar contusion in 3 cases, cerebral contusion in 4 patients, supratentorial extradural haematoma in 2 and hydrocephalus in 2 patients. All but one patient were treated surgically. None of the supratentorial lesions were operated upon. All patients with subacute and chronic course had good outcome while 43% with acute course succumbed to death. Besides the initial clinical status the co-existing lesions signifying the increased severity of injury have influenced the mortality and quality of outcome. In presence of occipital fracture a careful observation and timely intervention are warranted.

Lesoes vasculares occipitais inter-hemisféricas: acesso cirúrgico / Surgical approach to the occipital interhemispheric vascular lesions

Säo relatados 3 casos de doentes com lesöes vasculares da face medial do lobo occiptal abordados por via perietoccipital modificada, ampliando o campo operatório e minimizando a retraçäo cerebral