Primary cerebral gliosarcoma: report of 17 cases.

A retrospective study of 17 cases of primary cerebral gliosarcoma is presented. These uncommon highly aggressive intracranial neoplasms were seen at the Royal Preston Hospital, between 1973 and 1992. The patients' ages ranged from 21 to 73 years (mean 52), nine were males and eight were females. They presented with signs and symptoms of a rapidly expanding brain tumour. The diagnosis was suspected on radiological findings and confirmed by histological examination. Treatment involved surgical excision in 15 cases and biopsy in two followed by radiotherapy. Chemotherapy was given in three cases. Despite active management, median survival was only 9 months. The clinical, radiological and pathological features of these lesions are highlighted with emphasis on combined histochemistry and immunohistochemistry. The features of gliosarcoma and glioblastoma are compared and contrasted.

De novo development of saccular aneurysms: report of two cases.

The development of de novo aneurysms after previous successfully treated aneurysms is uncommon. If risk factors are not present the patient may be reassured that the risk of developing a further aneurysm following successful treatment is minimal. Two cases of second aneurysms developing six and eighteen years after successful treatment of a first aneurysm are reported. The risk factors associated with the formation of second aneurysms are emphasized.

Optochiasmal arachnoiditis induced by muslin wrapping of intracranial aneurysms. A report of two cases and a review of the literature.

Muslin wrapping of intracranial aneurysms has been used for many years, but muslin-induced optochiasmal arachnoiditis was first reported only in 1978, as a complication with catastrophic loss of vision. In this study of 54 cases wrapped with muslin over the last six years, two cases of optochiasmal arachnoiditis occurred. Three patients had early rebleeding among the 27 who had wrapping as the only treatment of the aneurysm.

Intracranial meningeal melanocytoma: a report of two cases and a review of the literature.

Two rare cases of intracranial meningeal melanocytoma are reported with clinical, radiologic, and pathologic findings. In one of these the diagnosis was established by ultrastructural studies that showed premelanosomes and melanosomes in nonarachnoid-derived tumor cells. The other case was diagnosed retrospectively after a very long survival and is still alive 35 years after total excision and radiotherapy. The occurrence of these tumors in the cerebellopontine angle is rare as seen in our case.

Multifocal giant cell glioblastoma: case report.

Glioblastoma multiforme (GM) of the cerebellum is a rare tumour. A variant of GM, a multifocal giant cell glioblastoma, initially presenting in the cerebellum, has not previously been reported. A giant cell glioblastoma occurring in a 46-year-old man who presented initially with a cerebellar tumour is described. One month after excision of the tumour, the patient had a grand mal seizure. Computed tomography (CT) showed a low-density lesion in the left temporal lobe. Four months later he developed dysphasia and right-sided hemiparesis. Repeat CT scan revealed a large temporal lobe tumour which was excised, and histologically found to be a giant-cell glioblastoma with histopathological similarities to the original cerebellar tumour. The clinical course, computed tomographic and pathological features of this tumour are described and discussed.

Primary malignant non-Hodgkin's lymphoma of cranial vault: a case report.

Primary cranial vault non-Hodgkin's lymphomas are rare and only four such cases are described in the literature. A 65-year-old woman presented with focal neurological deficits and a subcutaneous scalp lump. Computed tomography (CT) scan showed a left parietal cranial vault lesion with soft tissue scalp swelling and underlying intracranial extra axial mass mimicking a meningioma. Histology showed features of a typical B-cell non-Hodgkin's lymphoma, there was no systemic involvement. The characteristic CT findings of this lesion are described and relevant literature is reviewed. We are reporting this case because of its rare occurrence. A diagnosis of primary lymphoma of the skull vault should always be considered in the differential diagnosis when such a lesion is encountered.

Compression of the C-2 root by a rare anomalous ectatic vertebral artery. Case report.

The authors report a symptomatic congenitally anomalous ectatic vertebral artery not passing through the transverse foramen of the atlas (C-1), but instead piercing the dura mater below the posterior arch of the C-1 in the atlantoaxial (C1-2) interlaminar space. This occurrence is exceptionally rare, but in this case it was uniquely associated with occipital neuralgia due to vascular compression of the C-2 root. Microvascular decompression was curative. Neuroradiological and surgical findings are presented and their implications discussed.

Ossification of the ligamentum flavum in a Caucasian: case report.

Ossification of the ligamenta flava (OLF) and posterior longitudinal ligament (OPLL) of the spine causing spinal cord compression is described mainly in Japanese patients and is often termed as 'Japanese disease'. We are reporting a case of OLF of the thoracic spine seen in a male Caucasian who presented with an intractable intercostal pain. This is the first case report of OLF in a Caucasian.

Intraparenchymatous schwannoma of the cerebellum.

Intraparenchymatous schwannomas of the central nervous system are rare. In decreasing order of frequency they are found in the spinal cord, cerebral hemispheres, brainstem and cerebellum. So far, only six such tumours have been reported in the cerebellum. A male predominance and early onset of symptoms are salient features. A case of a 73-year-old Caucasian female with an intraparenchymatous schwannoma of the right cerebellar hemisphere which extended into the brainstem is reported. A complete cure followed surgical removal of the tumour. The preoperative clinical and radiological diagnosis was that of a cerebellar astrocytoma.

Cerebral berry aneurysms in identical twins: a case report.

A pair of identical twins in whom cerebral berry aneurysms were found is reported. One presented with epilepsy, and the aneurysm was discovered incidentally. The other presented with a spontaneous bleed, which was fatal.

Primary cerebral lymphoma: report of 24 patients and review of the literature.

A retrospective study of 24 patients with primary non-Hodgkin's cerebral lymphoma (non-immunocompromised) is presented. All patients were seen at the Royal Preston Hospital, Lancashire between 1976 and 1991. Fifteen patients were over the age of 50 years (range 27-84). The commonest clinical presentation, seen in 16 patients was of an expanding space-occupying lesion. The diagnosis was suspected from the radiological findings but confirmation in every case was by histological examination of biopsy or necropsy material. The tumours were treated either by surgical excision or by biopsy and radiotherapy. Chemotherapy was given in two patients. Despite these measures the mean survival time was 3.6 months. The clinical radiological and pathological features of these tumours are highlighted with particular emphasis on the use of stereotactic biopsy, immunohistochemistry and chemotherapy in diagnosis and treatment.