Primary bone non-Hodgkin lymphoma of the cervical spine: case report and review.

Primary bone lymphomas (PBL) account for approximately 3% of all malignant tumors and are commonly found in the femur or pelvis. Only 1.7% of the PBLs are found in the spine. We report the case of a 73-year-old male complaining of cervical pain with progressive loss of strength and frequent falls. The MRI showed invasion of the fourth cervical vertebra and an infiltrating prevertebral mass. A C4 corpectomy was performed. The pathology exam revealed a diffuse large B-cell lymphoma. Due to the previous condition of the patient only radiotherapy treatment was applied. PBL arising from the cervical spine is an exceptional event. The low incidence of this condition and its unspecific radiological features make the diagnosis challenging for the clinician. When neurological deficit appears, early surgery for decompression is indicated, followed by local radiotherapy and systemic chemotherapy.

Bilateral traumatic facial paralysis. Case report.

Although traumatic injury of the facial nerve is a relatively common condition in neurosurgical practice, bilateral lesions related to fracture of temporal bones are seldom seen. We report the case of a 38-year-old patient admitted to Intensive Care Unit after severe head trauma requiring ventilatory support (Glasgow Coma Scale of 7 on admission). A computed tomography (CT) scan confirmed a longitudinal fracture of the right temporal bone and a transversal fracture of the left. After successful weaning from respirator, bilateral facial paralysis was observed. The possible aetiologies for facial diplegia differ from those of unilateral injury. Due to the lack of facial asymmetry, it can be easily missed in critically ill patients, and both the high resolution CT scan and electromyographic studies can be helpful for correct diagnosis.