Spontaneous cervical epidural haematoma.

Spontaneous spinal epidural haematoma can occur in the elderly and is a reversible cause of neurological deficit if treated promptly. The diagnosis can be made from a careful history and a simple neurological examination, but it can be confused with myocardial infarct, musculoskeletal pain, vasculitis and acute dissection of an aortic aneurysm. For a favourable outcome, early decompressive laminectomy and evacuation of the haematoma are necessary. We report an unusual case of acute quadriplegia in which prompt diagnosis and early intervention led to almost complete functional recovery with minimal disability.

Frontal lobe tumours.

The diagnosis of frontal lobe tumours can easily be missed. Subtle mood or personality changes may be evident only after questioning of close family, friends or carers. Neurological signs may be absent.