Vertebral artery dissection and posterior stroke in a child.

Vertebral artery dissection is a relatively rare disease. Its symptoms and signs can be misleading, making the diagnosis, even with imaging assistance, difficult. We describe an 8-year-old boy in whom a brain tumor was suspected because of neurological signs and findings on computerized tomography of the brain. The differential diagnosis was broadened with further imaging evaluation. Magnetic resonance angiography demonstrated vertebral artery dissection, which was attributed to a trivial trauma the child had experienced 1 week before presentation. During the follow-up period, the child recovered, except for residual right hemianopsia.

Dermoids of the posterior fossa. Case reports and review.

Three children are presented with dermoid cysts of the posterior fossa, one of the most common locations of dermoid. They were initially diagnosed as having abscesses. Clinical presentations included hydrocephalus and recurrent meningitis. A helpful clue for identification is a bony defect of the skull on plain film or on a bone-window at Computed Tomography (CT).

Cord compression as the presenting symptom of extradural malignant lymphoma.

Six patients with spinal cord compression as the presenting symptom of malignant lymphoma are described. These patients suffered from back pain for several months and were diagnosed after sudden paraparesis appeared. Five patients were treated by operative decompression followed by local irradiation, and all regained their motor function. A sixth patient presented with a more insidious paraparesis. A bone marrow aspiration established the diagnosis of malignant lymphoma, and this patient recovered with radiation and steroids alone. Thus, we recommend considering malignant lymphoma as a possible cause of acute cord compression, attempting to establish the diagnosis on an emergency basis within several hours, and attempting to achieve decompression with local radiotherapy and intravenous dexamethasone.

Central neurogenic hyperventilation in a patient with medulloblastoma.

Central neurogenic hyperventilation is a rare but important cause of the frequently observed phenomenon of hyperventilation. Its diagnosis demands that primary respiratory or metabolic causes, as well as cerebrospinal fluid abnormalities, be ruled out. We hereby describe a patient whose attacks of hyperventilation were the presenting sign of her disease and might be consistent with the central neurogenic mechanism. This patient suffered from a medulloblastoma which compressed the pons. After removal of the tumor the hyperventilation attacks ceased.

Conus ganglioglioma in a 2 1/2-year-old boy. Case report.

Gangliogliomas are rare tumors, primarily seen in patients under the age of 30 years. They occur least commonly in the spinal cord. This report presents a 2 1/2-year-old boy who harbored an intramedullary conus tumor with the light microscopic appearance of a ganglioglioma. The neurobiological behavior of this tumor is yet to be determined.