Sarcoidosis of the Skull: A Systematic Review.

BACKGROUND: Lesions of the skull make up a small but important part of neurosurgical practice. Several systemic disorders may involve the cranial vault including neoplastic and non-neoplastic conditions. Sarcoidosis of the skull is a little-known cause of calvarial involvement that has been rarely reported in the literature. The available information about skull sarcoidosis (SS) is sparse and is not well described; for this reason, we consider that a detailed description of this uncommon condition is necessary. METHODS: An illustrative case of SS is presented; in addition, a PubMed and Scopus search adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed to include studies reporting patients with SS. Different information was analyzed in these cases to describe the characteristics of this condition. Also, different sources of literature were analyzed to complete the description of this clinical entity. RESULTS: The search yielded 22 cases of patients with SS showing a variety of clinical manifestations. All studies were case reports. Most patients diagnosed with SS had no previous history of systemic sarcoidosis. Different characteristics of SS are analyzed and described in this paper. CONCLUSIONS: The information collected from this review shows that SS is a rare condition that frequently is observed in patients without previous diagnosis of sarcoidosis. SS may manifest in different ways, and even may be found incidentally in some patients. The diagnosis of SS should be considered when multiple lytic skull lesions are observed, especially in cases of patients without a previous history of malignancy.

Brain Stem Ischemic Stroke Associated with Anaphylaxis.

Anaphylaxis is a serious allergic reaction that may have different manifestations including hypotension. It is reported that vertebral artery hypoplasia (VAH) may be present in up to 20% of the general population. Previous studies have demonstrated that patients with VAH have a higher risk of developing an ischemic stroke in the area supplied by this hypoplastic artery. This paper describes the case of a patient with preexistent VAH who presented with lateral medullary syndrome associated with a hypotensive episode secondary to anaphylaxis. To the best of the authors' knowledge, this association has not previously reported.