Lumbar spine epidural meningioma: report of a rare case.

INTRODUCTION AND IMPORTANCE: Spinal meningiomas are typically intradural lesions. Some may infiltrate the dura mater, thus exhibit direct extradural extension. Pure spinal epidural meningiomas are very rare. Here we present a 64 year-old-male with a purely extradural meningioma, and reviewed 15 previously reported cases from the literature. CASE PRESENTATION AND CLINICAL DISCUSSION: A 64-year-old male presented with a progressive cauda equine syndrome. When Lumbar spine MRI showed two extradural lesions regarding the L3-L4 level, one was fully removed (i.e., the posterolateral lesion), while the other anterior lesion was left alone (i.e., to avoid potential neurologic sequelae). Pathologically, the lesion was a benign meningioma. CONCLUSIONS: Spinal epidural meningiomas are rare and should optimally be fully excised at the index surgery.

Asymmetric Bilateral Traumatic Epidural Hematoma: A Report of a Rare Traumatic Lesion.

Bilateral epidural hematoma is a rare presentation in head trauma injuries, accounting for only 1%-2% of all epidural hematomas, but with a higher mortality rate than the unilateral form. Herein, we report the case of a 27-year-old man admitted to our department following a road traffic accident. On admission,his Glasgow Coma Scale (GCS) score was 13/15. After a few minutes, he became comatose (GCS 6/15) with right anisocoria. CT scan revealed a bilateral asymmetric epidural hematoma with a left extralabyrinthic linear fracture. Surgical evacuation was subsequently performed, starting with the voluminous right hematoma. The patient was discharged on the 23rd postoperative day with a right third-nerve palsy. Conclusions: In this case report, we discuss the etiology, mechanism, and management of bilateral epidural hematoma. Early diagnosis and a judicious surgical approach for bilateral epidural hematoma are necessary to minimize mortality and morbidity. Prevention is key to reducing traumatic brain injuries.