[2 cases of coexistence of meningioma and glioma]. / Dwa przypadki wspólistnienia oponiaka i glejaka mózgu.

The authors present two cases of a rare coexistence of cerebral meningioma and glioma. In one case meningioma was situated closely to malignant glioma. In the second case in a patient operated on for cerebral glioma a meningioma was removed 20 years later. The meningioma was situated far from the first tumour.

[Spontaneous intracranial epidural accumulation of air in a patient with excessive skull pneumatization]. / Samoistna nadtwardówkowa odma wewnatrzczaszkowa u pacjenta z nadmierna pneumatyzacja czaszki.

We report a rare case of spontaneous epidural accumulation of air in the occipital region resulting from an unusual hyperpneumatization of the cranium in a 37-year-old miner. For suspected subarachnoid haemorrhage the patient was admitted to neurological department. Performed computed tomography (CT) revealed extensive hyperpneumatization of the cranium, involving also the upper part of the cervical vertebral column, and epidural pneumocephalus. To the authors knowledge, so much pneumatization of the cranium seems to be very rare and when present, however, can cause spontaneous pneumocephalus. Based on the two years follow-up of this patient, conservative therapy showed to be sufficient for him, despite this, we have suggested him periodically perform CT of the head.

[Selected problems of neurofibromatosis with presentation of a case of multiple intracranial and intramedullary tumors]. / Przypadek nerwiakowlókniakowatosci typu II z mnogimi guzami wewnatrzczaszkowymi i sródrdzeniowymi.

A case of neurofibromatosis type II in a 19-year-old man is described with clinical and neuroimaging (MRI) findings. The diagnostic criteria of neurofibromatosis type I (NF1) and type II (NF2) and the optimal management options are still controversial. The authors suggest that this patient fulfills criteria of neurofibromatosis type II as well as partially neurofibromatosis type I. At present, without molecular analysis of DNA, this assumption can not be verified.

Surgery or conservative treatment in children with traumatic intracerebral haematoma.

In contrast to the case of extracerebral haematomas, the criteria for operative treatment of traumatic intracerebral haematoma (TIH) are not clear. The purpose of this study was to find factors that would be helpful in reaching a decision for surgical or conservative treatment of TIH. We performed a retrospective analysis of 31 consecutive cases of TIH treated in our department. The following factors were estimated: age, mechanism of injury, initial GCS or CCS score, neurological deficits, coexistence of arterial hypotension and respiratory disturbances, and localisation and size of the haematoma. The outcome was evaluated according to a modified GOS. Treatment was surgical for 20 patients and conservative for 11. Patients with GCS or CCS scores of 3-8 were treated surgically significantly more often than those with higher scores. The other factors did not correlate with type of treatment. It seems, then, that the clinical status of the patient, especially the level of consciousness according to the GCS or CCS score, is the most important predictor of the need for surgery in children with TIH.