ABSTRACT
Haemangioblastomas are benign tumours of uncertain origin. They are composed of capillaries and/or cavernous spaces interspersed with interstitial cells. Malignant spread, distant metastases and subarachnoid seeding are very rare, and only two such cases have been reported in the English literature. We report a third such case in a 4-year-old girl. The recurrence and extensive spread were excellently demonstrated by MRI.
Subject(s)
Cerebellar Neoplasms/surgery , Hemangioblastoma/surgery , Cerebellar Neoplasms/diagnosis , Cerebellar Neoplasms/pathology , Cerebellar Neoplasms/radiotherapy , Child, Preschool , Cobalt Radioisotopes/therapeutic use , Combined Modality Therapy , Cranial Irradiation , Female , Hemangioblastoma/diagnosis , Hemangioblastoma/pathology , Hemangioblastoma/radiotherapy , Humans , Magnetic Resonance Imaging , Neoplasm Invasiveness , Neoplasm Recurrence, Local/diagnosis , Neoplasm Recurrence, Local/pathology , Neoplasm Recurrence, Local/radiotherapy , Neoplasm Recurrence, Local/surgery , Neoplasm, Residual/radiotherapy , Radioisotope Teletherapy , Radiotherapy, AdjuvantABSTRACT
Clinical features and serial cerebrospinal fluid (CSF) samples of 50 patients who underwent myelography with iophendylate were studied. Forty two patients (84%) developed one or more features suggestive of meningism lasting for 2-4 days. There was significant rise in the average (mean) CSF counts from 9.81 in the premyelogram sample to 532.6 at the end of 24 hours (p less than 0.001). Both neutrophil and lymphocyte (p less than 000) count increased. At the end of one week, there was significant decrease of total cells in the CSF to 204 (p less than 0.001). Both, neutrophils and lymphocytes decreased. There was significant rise in total proteins in the 24 hours sample, but the fall at one week was not significant statistically. The sugar and chloride values did not change significantly. All CSF samples were negative for bacterial cultures. In conclusion, a significant proportion of the patients undergoing iophendylate myelography develop clinical features suggestive of meningeal irritation and change in the CSF fractions suggestive of meningitis: however these changes are transient and do not warrant institution of chemotherapy or steroids.
Subject(s)
Cerebrospinal Fluid/drug effects , Iophendylate/adverse effects , Meningism/chemically induced , Myelography , Spinal Cord Compression/diagnostic imaging , Spinal Diseases/diagnostic imaging , Diagnosis, Differential , Female , Humans , Male , Meningism/cerebrospinal fluid , Spinal Cord Compression/cerebrospinal fluid , Spinal Diseases/cerebrospinal fluidABSTRACT
Intracranial arachnoid cysts are relatively rare; it is believed that they account for only 1% of all intracranial space-occupying lesions. When they occur in the intracranial cavity, they usually develop in relation to an arachnoid cistern as a pocket of cerebrospinal fluid within two layers of arachnoid membrane. Five cases of intradiploic arachnoid cysts have been reported, but an arachnoid cyst presenting as an extradural mass has not been described before. The authors present an unusual case of hemorrhage into a massive intracranial extradural arachnoid cyst with no intradural communication.
