Craniosynostosis with Marfan syndrome, hand and foot anomalies.

We report a patient with various connective tissue abnormalities suggesting a distinctive connective tissue disorder combining some features of the Marfan syndrome with craniosynostosis and hand and feet anomalies.

Transoral plate and screw fixation of the craniovertebral region--a preliminary report.

A transoral plate and screw fixation of the clivus to the body of the cervical vertebra is described. The procedure was successfully performed in a patient with congenital basilar invagination after odontoidectomy.

Rapid enlargement of subdural haematoma.

A case of subdural haematoma (SDH) having atypical features (headache, vomiting, drowsiness but normal haematological and metabolic parameters and no localising neurological signs) is reported. The SDH rapidly enlarged and liquefied in five days as evident on computerised tomographic (CT) scan and operative findings. Rapid improvement was observed following this. Abnormally excessive fibrinolytic activity in the SDH is a possible cause.

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.

Cladosporium bantianum (trichoides) infection of the brain.

A 32 yr old male patient with history of convulsion and bitemporal headache was diagnosed as suffering from tuberculoma based on CT Scan. He worsened after anti-tuberculous therapy. The patient underwent parieto-occipital craniotomy with drainage of abscess. The histopathological examination of brain abscess revealed the infection with cladosporium bantianum. The details of this rare case of opportunist fungal cerebral lesions in healthy individual are reported.

Hemorrhage into an intradiploic arachnoid cyst. Case report.

Intracranial arachnoid cysts are relatively rare; it is believed that they account for only 1% of all intracranial space-occupying lesions. When they occur in the intracranial cavity, they usually develop in relation to an arachnoid cistern as a pocket of cerebrospinal fluid within two layers of arachnoid membrane. Five cases of intradiploic arachnoid cysts have been reported, but an arachnoid cyst presenting as an extradural mass has not been described before. The authors present an unusual case of hemorrhage into a massive intracranial extradural arachnoid cyst with no intradural communication.

Neurosurgery in India.

This is a brief account of Neurosurgery in India. Prior to 1949, Neurosurgery was being practised by General Surgeons. With the return of Professor Jacob Chandy to the Christian Medical College, Vellore in 1949 modern neurosurgery was born and progressed, and today there are more than 180 neurosurgeons in India. Even so, the ratio works out to one neurosurgeon for every 3,600,000 individuals! Conditions commonly encountered such as hydrocephalus, craniovertebral anomalies, pyogenic, fungal and tuberculous infections of the central nervous system, and fluorosis are being discussed. Stereotaxic surgery for pain, epilepsy, behaviour disorders and involuntary movements is being practised at several centres especially at Madras. Following the workshops conducted by Professor Pia and his co-worker Professor Grote , enthusiasm for microneurosurgery has waxed.

Radiation induced sarcoma.

A case of radiation induced sarcoma presenting seven years after radiotherapy for a conus cauda equina astrocytoma is reported.