Intracranial abscess in Ectopia Cordis.

We present a case of intracranial abscess in a young female with Ectopia Cordis, an exceptionally rare cardiac condition. The neurosurgical implication is the predisposition to intracranial abscess formation. A heightened awareness of this association will aid diagnosis in similar clinical scenarios.

Symptomatic delayed trans-dural herniation and strangulation of cauda equinae following resection of Myxopapillary ependymoma.

Pseudomeningocoele is a recognised complication of spinal surgery. It could be either asymptomatic or symptomatic. We present a 63-year-old male who developed a delayed pseudomeningocoele and symptomatic transdural herniation and strangulation of the cauda equinae following resection of a Myxopapillary ependymoma. He underwent successful operative re-exploration, un-tethering of the cauda equinae and re-closure of the dural defect with resolution of his symptoms. We discuss the clinical features, operative technical factors involved and the essential importance of neuroimaging with critical analysis of the imaging findings and correlation of the clinical symptoms, when such a diagnosis is being considered.

Metastasis of breast cancer to a lumbar spinal nerve root ganglion.

STUDY DESIGN: A case report of a surgically treated metastasis of breast cancer to the L2 nerve root ganglion. OBJECTIVES: To report of an uncommon site of metastasis as the first manifestation of distant hematogenous spread of breast cancer mimicking a benign lesion. SUMMARY OF BACKGROUND DATA: Although metastatic disease is a common condition there are limited reports of metastases to the spinal nerve root ganglion. To our knowledge this is the fourth reported case and the first report of a metastasis of a breast carcinoma. METHODS: A 46-year-old female patient was admitted with severe right sided radicular pain and moderate weakness of hip flexion and knee extension. Magnetic resonance imaging revealed a small lesion of the L2 nerve root. Intraoperatively an intradural tumor was encountered and debulked. The procedure was followed by radiation therapy. RESULTS: The operative procedure resulted in complete pain resolution with improved motor function. The histologic examination confirmed the tumor to be a metastasis of breast cancer as determined by immunohistological staining. The patient remained recurrence free at 6 month follow-up. CONCLUSION: Although very rare, metastasis to the spinal nerve root ganglion can be the first manifestation of distant hematogenous metastases of breast cancer. The clinical course is characterized by increasing radicular symptoms-especially intractable pain. The radiologic appearance might mimic a benign lesion. Surgical intervention with tumor debulking followed by radiotherapy provides local tumor control and palliation from pain.

Post-clipping cerebrovascular compliance in an infant with bilateral anterior circulation aneurysms

We present an uncommon case of an infant 12 months, presenting with a seizure due to subarachnoid hemorrhage secondary to an anterior circulation aneurysm. Following angiography, a right A1/A2 junction aneurysm was clipped by a right pterional approach. Angiography 5 months after clipping revealed loss of flow in the right anterior cerebral artery and a de novo L A1/A2 aneurysm, which was electively clipped by a left pterional approach. Follow angiography 5 monthslater showed loss left anterior cerebral artery flow and the anterior cerebral artery territory perfused by posterior cerebral arteries. Cerebral angiography 8 months later did not show further aneurysms and demostrated the posterior circulation vessels perfusing the anterior circulation vascular territory The child remains neurologically intact (AU)

Post-clipping cerebrovascular compliance in an infant with bilateral anterior circulation aneurysms

We present an uncommon case of an infant 12 months, presenting with a seizure due to subarachnoid hemorrhage secondary to an anterior circulation aneurysm. Following angiography, a right A1/A2 junction aneurysm was clipped by a right pterional approach. Angiography 5 months after clipping revealed loss of flow in the right anterior cerebral artery and a de novo L A1/A2 aneurysm, which was electively clipped by a left pterional approach. Follow angiography 5 monthslater showed loss left anterior cerebral artery flow and the anterior cerebral artery territory perfused by posterior cerebral arteries. Cerebral angiography 8 months later did not show further aneurysms and demostrated the posterior circulation vessels perfusing the anterior circulation vascular territory The child remains neurologically intact