Intradiploic meningioma of the orbit: a case report.

We report a case of a 12-year-old male child who presented with a gradual onset exopthalmos involving the left eye. The plain radiographs of the skull showed hyperostosis of the left orbital roof. The computerized tomography (CT) scan revealed an intradiploic orbital roof tumor with expansion of both the tables of the orbital roof. The tumor was completely excised by an extradural route using a basal frontal craniotomy. The histopathological diagnosis of the tumor was a psammomatous meningioma. A split calvarial frontal bone graft was used to reconstruct the orbital roof. The pathogenesis, radiological features and surgical technique involved in the management of intradiploic orbital roof meningioma are discussed and the relevant literature is reviewed.

Sinus pericranii in the frontal region: a case report.

Sinus pericranii is a rare vascular anomaly. A case of sinus pericranii at the nasion with an orbital extension is presented. The drainage was into the superior sagittal sinus. The pathogenesis is discussed and the literature is reviewed.

Cost-effectiveness of two types of dysphagia care in head and neck cancer: a preliminary report.

We conducted a prospective, preliminary study to compare the cost-effectiveness of two different instrument-based techniques for diagnosing and managing dysphagia in 30 consecutive hospitalized patients with head and neck cancer. The two techniques are videofluoroscopy via modified barium swallow (MBS) and videoendoscopy via flexible endoscopic evaluation of swallowing with sensory testing (FEESST). Medicare was the primary insurer of all patients. Fifteen of these patients had their dysphagia diagnosed and managed by MBS and the other 15 by FEESST. Cost-effectiveness was assessed by determining the average Medicare reimbursement for each procedure. We found that the mean reimbursements were $451.01 (+/- $50.55) for MBS and $321.23 (+/- $3.01) for FEESST. The mean reimbursement for FEESST was significantly lower than that for MBS (p < 0.0001; Mann-Whitney U test). We conclude that FEESST appears to be more cost-effective than MBS for the inpatient management of dysphagia in patients with head and neck cancer.

Occipital falcine meningioma presenting with ipsilateral hemifacial spasm: a case report.

We report a large right occipital falcine meningioma, the main presenting feature of which was ipsilateral hemifacial spasm. The patient was relieved of the hemifacial spasm after the supratentorial tumour was resected. The pathogenesis of hemifacial spasm is reviewed in light of this unusual case and the treatment of hemifacial spasm secondary to a tumour is discussed.

Unattached intracranial extra-axial schwannoma.

We describe an intracranial extra-axial petroclival schwannoma which did not arise from any cranial nerve, nor was it attached to brain parenchyma or dura. The possible pathogenesis is discussed.

Multiple intramedullary schwannomas--case report.

A 15-year-old boy with von Recklinghausen's disease presented with two very rare symptomatic cervical intramedullary schwannomas manifesting as slowly progressive weakness. The tumors were totally resected and he made a complete recovery.

Extensive extraaxial blastomycosis granuloma at the skull base--case report.

A 37-year-old female presented with a rare case of intradural, extraaxial Blastomyces dermatitidis granuloma involving a large part of the skull base. She had the principal complaint of worsening vision, but was otherwise healthy. The lesion mimicked an en-plaque meningioma on radiological examination and in gross appearance during surgery. This is a very unusual presentation for a blasto-mycosis granuloma.

Massive benign osteoblastoma of the clivus and atlas.

A case of massive benign osteoblastoma involving the clivus and atlas is reported. Usually, these tumours involve the posterior elements of a vertebra and are detected when small as a result of the usual presenting symptom of pain. The unusual site, massive size and presentation with neurological deficits are rare for benign osteoblastomas. The problems encountered in the surgical management of the patient are discussed.

Technique of extended transcranial approach for massive nasopharyngeal angiofibroma.

Various surgical approaches have been described to deal with extensive nasopharyngeal angiofibromas. These lesions, particularly those with a large intracranial extension and involving the cavernous sinus, pose a formidable surgical challenge. An extended transcranial approach was employed to resect successfully 2 such lesions.

Cerebrospinal fluid rhinorrhoea: unusual presentation of acoustic neurinoma.

A 40-year-old male presenting with spontaneous cerebrospinal fluid (CSF) rhinorrhoea was found to have raised intracranial pressure due to an acoustic tumour. This report adds to the scant literature on an intracranial tumour causing markedly raised intracranial pressure leading to a non-traumatic CSF rhinorrhoea. After a ventricular shunt and resection of the tumour the CSF leak stopped.

Bilateral otogenic cerebellar abscesses.

An unusual presentation of bilateral otogenic cerebellar abscesses observed in two of our patients is reported. Both gave a history of otorrhoea, fever, headache, vomiting and had bilateral cerebellar signs and conductive hearing loss. The abscesses were detected on computerised tomography. X-rays revealed bilateral mastoiditis. The therapy followed was excision of abscesses, mastoidectomy and antibiotic therapy.