Symptomatic subdural hygroma as a complication of foramen magnum decompression for hindbrain herniation (Arnold-Chiari deformity).

Pseudomeningocele is a well known complication of foramen magnum decompression. Symptomatic subdural hygroma has not previously been described. We discuss a case of Arnold Chiari malformation type 1 in a 55-year-old Caucasian woman who underwent foramen magnum and upper cervical decompression and who developed a symptomatic subdural hygroma 2 weeks following surgery. This complication was most likely due to a technical error during surgery. It responded favourably to conservative therapy.

Supratentorial haemangioblastoma not associated with Von Hippel Lindau complex or polycythaemia: case report and literature review.

Solitary or multiple supratentorial haemangioblastomas are rare and may be associated with Von Hippel Lindau complex (VHLC), polycythaemia or a family history of VHLC. An extensive review of the literature (1902-1992) has revealed 112 cases. They account for 2-8% of all haemangioblastomas and are commonly intraparenchymatous (86.8%) and infrequently intraventricular (6.6%). However, a meningeal location 5.6%) is extremely rare. Only one case of a solitary leptomeningeal haemangioblastoma has previously been reported and this was associated with a family and personal history of VHLC, cerebellar haemangioblastoma and renal carcinoma. We report a solitary solid left parietal leptomeningeal haemangioblastoma mimicking a meningioma or a secondary deposit on computed tomography in a 72-year-old male. There were no manifestations of or a family history of VHLC or polycythaemia.

Extradural application of bismuth iodoform paraffin paste causing relapsing bismuth encephalopathy: a case report with CT and MRI studies.

Bismuth iodoform paraffin paste (BIPP) is used in dressings in ear, nose, and throat, dental, and neurosurgical practice. Neurotoxicity due to absorption of bismuth from the BIPP pack is rare. It is preventable and reversible but likely to be fatal if unrecognised. A case of relapsing but reversible toxic encephalopathy due to a large extradural BIPP pack is reported in a 57 year old Caucasian woman, operated on for a huge basal cell carcinoma of the vertex invading the skull and extradural space. Clinical, neuroradiological (CT and MRI), and biochemical studies are presented and discussed in the light of the available literature.

Spinal extradural arteriovenous malformation presenting with recurrent hemorrhage and intermittent paraplegia: case report and review of the literature.

Symptomatic spinal extradural arteriovenous malformations (AVMs) are uncommon. They usually present with slowly progressive myelopathy and/or radiculopathy and only rarely with spinal extradural hemorrhage (SEH). Histopathologic features of a true spinal extradural AVM causing an overt SEH have only previously been described in four cases. A further case of a histologically confirmed spinal extradural AVM causing SEH in a 50-year-old otherwise medically normal Caucasian woman is presented. Recurrent hemorrhage resulted in intermittent paraplegia and acute chest/shoulder pain--diagnosed initially as hysteria. Interesting sequential myelographic, computed tomographic, and magnetic resonance imaging studies are presented, and the literature on spinal extradural AVMs presenting with SEH is reviewed.

Subdural haematoma caused by metastatic dural carcinomatosis.

A case of subdural haematoma caused by metastatic dural carcinomatosis is reported. The condition is a rare but distinct entity. It is usually due to vascular obstruction of the dural vessels by tumour cells. If diagnosed early, patients may benefit from neurological surgery.