A Case of Pineal Germinoma with Drop Metastasis to Cauda Equina

Pineal germinoma is one of the most radiosensitive intracranial tumors and so recently a regime of radiotherapy combined with ventricular shunting was advocated. But not infrequently seeding through the subarachnoid space and shunting system was observed. We have experienced a pineal tumor, which was treated completely by irradiation following ventriculo-atrial shunt but without evidence of intracranial recurrence spinal metastasis occurred 16 months later. After myelography total laminectomy from L1 to L3 was performed and intradural tumor was removed. Histopathological diagnosis was germinoma. After would healing spinal axis irradiation was performed with symptomatic improvement.

A Case of Malignant Meningioma Involving Frontal Bone and Frontal Lobe

Malignant Meningioma is rare and its initial clinical course tends to be short but otherwise indistinguishable from that of benign meningioma. And although it has been noted that many of them have propensities for invading the dural venous sinuses, the skull, and even extracranial tissues by direct spread, there seems little tendency for these to metastases. The changes of recurrence and eventual death are high in malignant meningioma. Recently we have experienced a case of malignant meningioma involving the right frontal bone and frontal lobe with infiltration to the adjacent structures.

A Case of Malignant Meningioma Involving Frontal Bone and Frontal Lobe

Malignant Meningioma is rare and its initial clinical course tends to be short but otherwise indistinguishable from that of benign meningioma. And although it has been noted that many of them have propensities for invading the dural venous sinuses, the skull, and even extracranial tissues by direct spread, there seems little tendency for these to metastases. The changes of recurrence and eventual death are high in malignant meningioma. Recently we have experienced a case of malignant meningioma involving the right frontal bone and frontal lobe with infiltration to the adjacent structures.

A Case of Primitive Clioma

Among the intracranial glioma, primitive glioma is very rare. We report a case of primitive glioma involving left parietofrontotemporal lobe of 8-year-old boy who had about 12 months duration of right sided hemiparesis, headache, vomiting and papilledema. CT scan showed a large, well defined round area of low density with peripheral rim of high density and high density small mass suggesting mural nodule in left frontoparietotemporal region. A left frontoparietotemporal osteoplastic craniotomy was carried out. A small nodule and cystic membrane containing pale yellowish colored proteinous cystic fluid were almost totally removed without difficulty. Postoperatively, the right hemiparesis and headache gradually cleared. Pathologic diagnosis was primitive glioma.

A Case of Intramedullary Glioblastoma Multiforme Involving Thoracic Cord in Child

Primary spinal glioblastoma multiforme is very rare, especially in childhood. 13-year-old boy was admitted to our neurosurgical department because of paraparesis, sensory loss below T10 and sphincter disturbance. Thoracic myelogram showed complete obstruction at T10 level and total laminectomy with partial removal of the intramedullary cord tumor mass was performed under the impression of spinal cord tumor. Postoperatively, his symptoms and signs unchanged. Pathological diagnosis was intramedullary glioblastoma multiforme involving thoracic cord.

Two Cases of Posttraumatic Middle Cerebral Artery Occlusion

Traumatic middle cerebral artery occlusion has rarely been discussed in the neurosurgical literature. Since Deveer and Browder reported the first case in 1942, only 24 cases of postraumatic middle cerebral artery occlusion has been reported until now. We experienced 2 cases of posttraumatic middle cerebral artery occlusion recently. One patient was 39 years old male who developed right hemiplegia, aphasia, and mental confusion after blunt head injury. Left carotid angiography was done and it revealed complete obstruction of the moddle cerebral artery in its initial portion. The other patient transfered to our Emergency Room under the semicomatous state with multiple facial laceration wounds. Simple skull X-ray revealed multiple linear skull fractures on the left frontal region. Left carotid angiogram showed complete obstruction of left middle cerebral artery in its proximal portion like as former case. During hospitalization, marked improvement was showed in both cases under the conservative treatment with steroid and low molecular weight dextran.

Intracranial Involvement of Chioroma: A Case Report

Chloroma is an unusual presenting feature of acute leukemia in childhood. These are found in relation to the periosteum of the skull, paranasal sinuses, orbits, vertebrae or ribs. Chloromas may occasionally produce central or peripheral neurologic disturbance, as this patient demonstrated. 9 year old girl entered this hospital with complaints of protrusion of left eye, headache and vomiting. A month prior to admission the parent noted slight protrusion of left eye which had progressed rapidly with development of another small mass in the scalp. On admission, the patient showed rather anemic somewhat dull mentality and moderate papilledema on right. Blood picture and biopsy of scalp mass revealed hematologic and cytologic features of leukemia. The girl has deteriorated rapidly and died on the 28th hospital day. Autopsy showed multiple chloromas in relation to the periosteum of orbital fossa, ribs, pelvis, and skull. There were four masses as large as one to two cm in diameter at the inner aspect of dura mata which were compressing the brain. It is rare in this country that the infiltration of chloroma on the dura mata was proved in autopsy.

Intracranial Involvement of Chioroma: A Case Report

Chloroma is an unusual presenting feature of acute leukemia in childhood. These are found in relation to the periosteum of the skull, paranasal sinuses, orbits, vertebrae or ribs. Chloromas may occasionally produce central or peripheral neurologic disturbance, as this patient demonstrated. 9 year old girl entered this hospital with complaints of protrusion of left eye, headache and vomiting. A month prior to admission the parent noted slight protrusion of left eye which had progressed rapidly with development of another small mass in the scalp. On admission, the patient showed rather anemic somewhat dull mentality and moderate papilledema on right. Blood picture and biopsy of scalp mass revealed hematologic and cytologic features of leukemia. The girl has deteriorated rapidly and died on the 28th hospital day. Autopsy showed multiple chloromas in relation to the periosteum of orbital fossa, ribs, pelvis, and skull. There were four masses as large as one to two cm in diameter at the inner aspect of dura mata which were compressing the brain. It is rare in this country that the infiltration of chloroma on the dura mata was proved in autopsy.