[Spontaneous extradural spinal hematoma. Case report]. / Hematoma extradural intrarraquidiano espontâneo. Relato de caso.

We report a case of a 55-year-old woman, that has a mild hypertension, in use of a betablocker drugs, who had a sudden spinal cord compression syndrome with intense cervical pain, tetraplegia and sensitivity level in C4. Extradural spinal hematoma of the cervical spine was diagnosed by magnetic resonance. The patient underwent a laminectomy and aspiration of the hematoma. The patient is on physiotherapy and presents progressive motor and sensitivity improvement.

[Spontaneous epidural hematoma. Report of two cases]. / Hematoma epidural espontâneo. Relato de dois casos.

Spontaneous epidural hematomas are rarely described in literature. They are associated with infectious diseases of the skull, coagulation disorders, vascular malformations of the dura-mater and metastasis to the skull. The authors report two cases of spontaneous epidural hematoma of different etiologies, and study parameters of hemostasis.

[Intraspinal enterogenous cyst. Case report]. / Cisto enterógeno intrarraquiano. Relato de caso.

The authors report the case of a 7 years old boy with cervical pain and tetraparesis progressing by two months. He presented an intraspinal cystic lesion from C4 to C6. Exeresis of the lesion was undergone by anterior way through a corpectomy of C5-C6 followed by reconstruction with bone graft of the iliac crest and metallic plaque. Anatomic diagnosis of the lesion was enterogenous cyst. Aspects of clinical presentation, embryology and treatment of these cysts are discussed.

[Unusual association of Kallmann syndrome and arachnoid cyst of the middle fossa. Report of a case]. / Associação singular de síndrome de Kallmann e cisto aracnóide da fossa média. Relato de caso.

Hypogonadotrophic hypogonadism can result from different abnormalities in the central nervous system. The clinical picture depends upon the time of onset the deficiency, the magnitude of the gonadotropins deficiency and whether there are other pituitary hormone deficiencies as well. We report on a 18-year-old boy, who was investigated because of pubertal and growth delay. He also had learning disabilities. On physical examination he exhibited mild eunuchoid aspect, 162 cm height (z score = 2.17), pubertal development on stage G II, P II, and 4 cm3 testis. Laboratory investigation revealed pre-pubertal levels of testosterone and normal results of the combined test of anterior pituitary function, except for in GnRH acute and prolonged test. Brain CT showed an arachnoid cyst on left middle fossa with expansion to suprasellar cisterna. He was diagnosed as having hypogonadotrophic hypogonadism secondary to compression by the cyst, and a cyst-peritoneal derivation was performed. After surgery there was no improvement of the pubertal state and bilateral anosmia was discovered, so Kallmann's syndrome was then diagnosed and was confirmed by MRI, even though the hormonal results are not totally matched with the referred syndrome. We did not find in the literature any description of the association between Kallmann's syndrome and arachnoid cyst and we believe that in this case the results of the hormonal measurement may be due to such association that provoked an additional hypophysis dysfunction.

[Intratumor hemorrhage in tuberous sclerosis. A case report]. / Hemorragia intratumoral em esclerose tuberosa. Relato de caso.

The authors report the case of 19 year-old patient with features of tuberous sclerosis that developed a massive hemorrhage in a subependymal giant-cell astrocytoma causing sudden death. Aspects of the pathophysiological bleeding are discussed.