Intramedullary lipoma of the cervicodorsal spinal cord with intracranial extension: case report

BACKGROUND: An unusual case of an extensive intramedullary lipoma of the cervicodorsal spinal cord with intracranial extension causing compression of spinal cord and brainstem is described. CASE DESCRIPTION: A 3-year-old child with lack of limb movement since birth, the cause of which had remained obscure, developed opisthotonos and episodes of severe respiratory difficulty with brief periods of apnea. Craniospinal computed tomography and magnetic resonance imaging (MRI) were diagnostic of lipoma. Urgent occipitocervical decompression and subtotal removal of the posterior fossa and cervical spinal cord lipoma resulted in lasting resolution of symptoms. CONCLUSIONS: Extensive spinal cord lipomas with intracranial extension can present with alarming spinal cord/medullary compression and respiratory symptoms. Computed tomographic scan and MRI are diagnostic. Total removal is not feasible, or necessary, because subtotal removal and decompression give long-lasting resolution of symptoms.     

Chronic subdural hematoma: correlation of computerized tomography with colour

Summary The computerized tomographic and operative findings in 10 patients with chronic subdural hematoma (SDH) are reviewed. A constant correlation was found between the CT density and the colour of the hematoma evacuated thus enabling an accurate prediction of the colour of fluid one would expect to find at operation. Certain clinical features and CT appearances are highlighted to prevent the likelihood of misdiagnoses.     

Fatal brain abscesses caused by Ramichloridium obovoideum: Report of three cases

Summary Three cases of brain abscesses caused by Ramichloridium obovoideum are reported. Inspite of adequate antifungal chemotherapy and multiple surgical procedures, all the three patients died of the rupture of a recurrant abscess into the ventricles. Ramichloridium obovoideum was identified as the causative fungus of these brain abscesses. Clinical, histological and mycological features of these cases are described. To our knowledge this is the first time that this fungus is isolated from a brain abscess in Saudi Arabia. The possibility that this life threatening cerebral mycosis may be endemic in this part of the world is considered.