Intracranial fibromuscular dysplasia. Report of two cases and review of literature.

Intracranial fibromuscular dysplasia (IFMD) is a rare angiopathy of unknown origin primarily affecting children and young women. We report here on two cases of IFMD; the patients, two females, aging 29 and 25 years, suffered from acute, complete stroke. In one of them emergency extra-intracranial by-pass was attempted without evidence of positive influence on the patient's outcome. In both patients angiography showed the pathognomonic sign of "string of bead" at the level of intracerebral arteries. Cases of IFMD previously reported in the literature are then reviewed and etiology, clinical presentation, pathology, diagnosis and possible treatment of this rare disease are discussed.

[Study of 4 cases of chronic subdural hematoma with unusual symptomatology]. / Osservazioni su quattro casi di ematoma subdurale cronico a sintomatologia inconsueta

Some cases of chronic subdural haematomas (in patients aged from 17 to 27 years) with unusual symptomatology and difficult diagnosis are presented. The usefulness of cerebral scintigraphy which can clarify any diagnostic doubt and lead to a right neuroradiological behaviour is underlined.

[Cystic meningioma simulating glioblastoma in x-ray computed tomography]. / Les méningiomes kystiques simulateurs de glioblastomes en tomodensitométrie.

Seven cases of supratentorial meningiomas are reported. CT-Scan showed irregular hypo-hyperdense zones and features of intratumoral cysts. At surgery a well circumscribed tumor has always been found and easily removed "en bloc". In two cases stereotaxic biopsy was performed previously. CT-Scan findings of meningiomas with microcystic structure and/or necrotic areas may mimic a malignant glioma and lead to an incorrect presumptive diagnosis: then, both therapy and prognosis will be very different. It comes that stereotaxic biopsy is mandatory in all suspected cases of cerebral tumors, in the absence of classical angiographic patterns.

Course of intracranial pressure after extirpation of posterior fossa tumours.

Forty-seven patients with posterior fossa tumours underwent continuous monitoring of intracranial pressure (ICP) in the early postoperative period by means of an intraventricular catheter. ICP values were very low on the day of operation and subsequently became normal in 37 patients. ICP values were raised in 10 patients. The relationship between the ICP and the clinical course was investigated. Patients were subdivided according to the clinical postoperative course into three groups: good, temporarily deteriorated, poor clinical course. The two first groups showed lower values in the ICP than he third one, nevertheless the relationship between the ICP and the postoperative clinical course is marked but not strict. Our data may have some clinical relevance for the treatment of hydrocephalus before extirpation of posterior fossa tumours.