Cervical spine diastematomyelia in adulthood

Adult cervical diastematomyelia is a rare malformation and is usually associated with posterior element anomalies. A case of isolated cervical diastematomyelia, which was initially thought to be a herniated cervical disc, is described. Diagnosis and surgical management are discussed.     

Cervical diastematomyelia: a case report with operative management

A case of midcervical diastematomyelia presenting as acute traumatic hemiplegia in an adult is discussed, with emphasis upon features reflecting this particular location. Advantages of metrizamide computed tomographic imaging in the diagnosis of this entity are presented, and a method of operative management is outlined.     

Cervical spine chordoid meningioma. Case report

Chordoid meningiomas are a rare but increasingly recognized subtype of meningioma. Although some cases have been associated with systemic symptoms, in many instances the clinical features are indistinguishable from those associated with other subtypes of meningioma. Given the prognostic significance of the diagnosis of chordoid meningioma, careful consideration should be given to the diagnosis during histological assessment. The authors describe a rare case of chordoid meningioma in the cervical spinal region.     

Cervical spondylolysis with spondylolisthesis. Case report.

The authors describe as case in which cervical spondylolysis was found at multiple levels with spondylolisthesis and associated neurological deficits. Radiographic findings with the absence of history of trauma suggest a congenital etiology.     

Cervical spinal intramedullary myxoma in childhood. Case report

A unique case is reported of a cervical intramedullary myxoma in an 18-month-old boy who presented with torticollis and monoparesis. Radical removal of the tumor by a planned two-stage procedure was curative.     

Eosinophilic gastroenteritis presenting as ascites. Case report.

A 46 year old man presented with a four week history of ascites and loss of weight. The diagnosis of eosinophilic gastroenteritis was made only after histological examination of a biopsy specimen taken at laparotomy. All other investigations had been unhelpful. He made a good recovery and was given no treatment.     

Cervical spinal cord intramedullary abscess. Case report

A case of progressive symptoms and signs of cervical spinal cord damage due to intramedullary abscess is reported. The literature is reviewed and the radiological features, particularly magnetic resonance image, are analyzed.     

Lymphocytic adenohypophysitis presenting as infertility. Case report

The authors report a nulliparous patient presenting with infertility and hyperprolactinemia. She underwent transsphenoidal surgery after radiological investigation disclosed an enlarged pituitary gland which did not respond to bromocriptine therapy. The removed tissue had histological features consistent with adenohypophysitis including a diffuse lymphocytic infiltrate. The lymphocyte subsets present in the infiltrate were characterized by immunohistochemical methods to establish the contribution of different elements of the cellular immune response. Lymphocytes bearing CD4 antigen (helper-inducer cells) were most prominent and appeared to bear the majority of the interleukin-2 receptor (expressed during lymphocytic activation) present in the pituitary gland. A few B lymphocytes were also observed. The location of the major histocompatibility antigen (classes I and II) and interleukin-2 receptor correlated with the lymphocytes and macrophages rather than with the stromal or parenchymal elements of the pituitary. Lymphocytic adenohypophysitis is an unusual cause of pituitary enlargement which can mimic a pituitary tumor, and is sometimes associated with hyperprolactinemia. In women of child-bearing age, it almost always occurs during pregnancy or the postpartum stage. The autoimmune disorder reported here has not previously been associated with infertility nor has the lymphocytic infiltrate of the pituitary previously been analyzed in detail by modern immunological methods.     

Cervical myelopathy in diffuse idiopathic skeletal hyperostosis. Case report

The case of a rapidly progressive cervical myelopathy in a 64-year-old man is presented. Radiological studies revealed a partial extradural block, which at surgery was found to be a focal fibrous, calcified mass associated with the ligamentum flavum. On the basis of the underlying disorder of diffuse idiopathic skeletal hyperostosis (DISH), the etiology of this compression was concluded to be focal fibrous proliferation and dystrophic calcification. The neurological complications of DISH are reviewed. The authors are not aware of any other reports of this cause of myelopathy associated with DISH.     

Intraventricular subependymoma presenting as subarachnoid hemorrhage. Case report.

The Authors describe the case of an intraventricular subependymoma presenting as subarachnoid hemorrhage in a 42-year-old woman. The preoperative and postoperative CT-scans and Magnetic Resonance Images of this rare benign neoplasm are presented. The pathology, the clinical findings and the prognosis of this tumour are discussed.     

Congenital astrocytoma presenting with intracerebral hematoma. Case report.

A massive left intracerebral hematoma was surgically evacuated from a 2-week-old infant. Pathological examination showed that the hemorrhage had developed within a fibrillary astrocytoma. Neonatal intracerebral hemorrhage should raise the question of congenital tumor because such a hemorrhage in this age group is rarely the result of trauma, bleeding diathesis, or vascular malformation.     

Cervical spine infection with Streptococcus anginosus. Case report

A case of cervical spine infection due to Streptococcus anginosus is reported. Streptococcus milleri is encountered in the mouth, gastro-intestinal tract, vagina and nasopharynx. It is an uncommon pathogen responsible of suppurative infections such as brain liver or spleen abscesses, intra-abdominal or soft tissue abscesses and pleural empyema. In rare cases it can cause spondylodiscitis and osteomyelitis. Based on the review of eight cases of spondylodiscitis or osteomyelitis, diagnosis and treatment are discussed.     

Prostate carcinoma presenting as intracranial hemorrhage. Case report

The authors report a case of subdural metastasis from a prostatic carcinoma presenting as an acute intracranial subdural and intracerebral hemorrhage. The pertinent literature is reviewed.