Spontaneous regression of a cyst of the cavum septi pellucidi

A 20-year-old woman with secondary amenorrhoea and an empty sella turcica was found to have a cyst of the cavum septi pellucidi (CSP) on MRI. The cyst had regressed spontaneously on follow-up MRI.

Neuroimaging findings of four patients with Sandhoff disease

Sandhoff disease is a severe form of GM2 gangliosidosis that is caused by the deficiency of both hexosaminidase A and B. Startle reaction, hypotonia, psychomotor retardation, and blindness are the main clinical features. Presented are computed tomography and magnetic resonance imaging findings of four patients with Sandhoff disease diagnosed by enzymatic analyses. Bilateral homogeneous thalamic hyperdensity was evident on computed tomography. Magnetic resonance imaging scans revealed mild cortical atrophy, a thin corpus callosum, and abnormal signal intensities in the caudate nucleus, globus pallidum, putamen, cerebellum, and brainstem. No correlation was evident between the severity of the central nervous system imaging findings and the clinical pictures. In this article the neuroimaging findings of four patients with Sandhoff disease are discussed.

Extradural balloon obliteration of the empty sella report of three cases (intrasellar balloon obliteration)

Empty sella syndrome is an anatomical and clinical entity composed of intrasellar reposition of the CSF and compression of the pituitary tissue, resulting in a clinical picture of headache, visual field defect, CSF rhinorrhea and some mild endocrinological disturbances. While some cases are primary with no appreciable aetiology, secondary cases are associated with prior operation or radiotherapy of the region. In our series, 3 patients with primary empty sella syndrome were treated by the current approach of extradural filling of the sellar cavity. This technique was first described by Guiot and widely accepted thereafter. We used a detachable silicon balloon filled with HEMA or liquid silicone for obliteration of the sellar cavity and obtained clinically satisfactory results without complications. Visual symptoms regressed and headache disappeared. But at long term follow-up all the balloons were found to be deflated. Despite the facility and efficacy of the technique we do not recommend it in the treatment of the empty sella because the filling of the sella is only transient and relapses may occur.

Cerebral candidiasis presenting as a mass lesion

The authors report of a case of pseudotumour caused by Candida species without evidence of any underlying disease. No portal of entry of the infection was found. Total removal followed by treatment with flucanazole resulted in a favorable outcome. We discuss the differential diagnosis of a huge calcified intracranial mass lesion without any soft tissue component.

Posttraumatic high-flow priapism treated by N-butyl-cyanoacrylate embolization

A patient with high-flow priapism was treated by transcatheter embolization of a posttraumatic left cavernosal arteriovenous fistula using N-butyl-cyanoacrylate (NBCA), resulting in complete detumescence. Erectile function has been preserved during a 3-month follow-up. Only two patients with NBCA embolization for high-flow priapism have been reported previously.

Intramedullary tuberculous abscess: a case report

STUDY DESIGN

This case report shows an intramedullary thoracic spinal cord abscess secondary to Mycobacterium tuberculosis in a 7-year-old boy with chronic progressive paraparesis and hypesthesia below T10.

OBJECTIVES

The treatment of this patient involved drainage of pus followed by appropriate chemotherapy.

SUMMARY OF BACKGROUND DATA

Abscess and tuberculomas of the spinal cord are rare entities. They are indistinguishable from neoplasms. The possibility of tubercular abscess or granuloma should be kept in mind when an intraspinal mass is found, provided that the clinical history is unusual for tumor.

METHODS

A left T7-T8 hemilaminectomy was performed. A quantity of pus was drained through a small myelotomy. A small specimen was taken, and antituberculosis treatment was given after surgery.

RESULTS

Excellent clinical outcome was obtained with a combination of medical and surgical management.

CONCLUSION

The treatment of intramedullary abscess consists of surgical evacuation of the pus. Appropriate treatment offers a favorable prognosis even in cases with severe deficits.

Oesophageal perforation subsequent to anterior cervical spine screw/plate fixation

We report three cases of oesophageal complications due to pressure necrosis secondary to screws post anterior plate fixation of the cervical spine. Two of the patients were treated using primary closure; and the third by conservative treatment, which consisted of wound drainage and an external orthotic device application. We recommend the early surgical closure and removal of the metallic implant with debridement as the first option of treatment. In the event that this option is not suitable, we suggest that wound drainage, tube feeding and parenteral antibiotics may be an appropriate alternative.