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Introduction and importance: Intracranial dermoid cysts (IDC) are defined as rare, slow-growing cystic congenital neoplasms. Rupture of an intracranial dermoid cyst occurs rarely and most often spontaneously and results in potentially serious symptoms. Case presentation: A39-year-old female, with mechanical prosthetic heart valve presented with history of headache for 10 months and generalized tonicoclonic seizures. On the admission, the patient had a normal neurological and cranial nerve exam. The authors performed a computed tomography of the brain, The MRI could not be performed because of the presence of the prosthetic valve, revealed rupture of the dermoid cyst in the bilateral subarachnoid spaces. The patient underwent a large temporal craniotomy and the tumour was well exposed and completely removed without incident, the histopathological examination concludes to dermoid cyst, the patient recovered well from surgery. Clinical discussion: Rupture is a very rare phenomenon. there are about 60 cases reported in the literature. the contents of the cyst disseminate into the subarachnoid and ventricular spaces in the event of rupture. A variety of clinical symptoms is usually caused. The mechanism of spontaneous rupture of the dermoid cyst is unclear. Among the proposed mechanisms is a rapid expansion of the cyst. Complete surgical resection of dermoid cysts is the only effective treatment for the prevention of recurrences and/or complications. Conclusion: Rupture of an intracranial dermoid cyst is associated with significant morbidity and mortality, although it remains a rare phenomenon. Surgical excision should be considered as soon as the diagnosis is made in order to prevent more severe intracranial complication.
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Cavernous hemangiomas are vascular malformations that can affect any part of the central nervous system. In general, epidural hemangiomas are secondary extensions of spinal lesions. These tumors grow slowly and are expressed as slow spinal cord compression syndromes, radiculopathy, or both. History, clinical examination, routine radiographs, MRI, and histopathologic studies are aids to a definitive diagnosis. This is a 61-year-old chronic smoker with a history of cholecystectomy in 2017. History of the disease: dates to 1 month by a progressive installation of heaviness of the left lower limb, then of the right one 15 days later. The state was complicated one week before his admission by sphincter disorders such as urinary leakage. Clinically, the patient walked with assistance, with a paraparesis of the two lower limbs at 4/5 on muscle testing, with a posterior cord syndrome, a D6 sensory level and normal osteotendinous reflexes. Spinal cord MRI showed a tissue-like process at D6-D7 extra-medullary extradural. Spinal cavernous extradural hemangioma is a frequent lesion, represented by a malformation of the microcirculation, whose diagnosis has become easier with the advent of MRI, revealed essentially by a spinal cord compression syndrome, whose evolution is favorable if treated in time.
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Osteoblastoma is an uncommon primary bone tumor. Its occurrence in the cranial vault is extremely rare. We here report our first case of right parietal bone osteoblastoma in a 46-year old woman with a history of benign cranial traumas. She reported progressive painful, non-inflammatory right parietal bone swelling. Craniocerebral CT scan showed hyperdense bone lesion with sparing of the internal table of the right parietal bone. The patient first underwent biopsy, then complete resection of the bone lesion with methyl-methacrylic cement cranioplasty. The postoperative course was uneventful. Anatomopathological examination showed osteoblastoma with no sign of malignancy. This study and literature review highlight the clinical manifestation, the radiological and anatomopathological features as well as the management of osteoblastoma of the parietal bone of the cranial vault.
