Spinal intradural arachnoid cyst associated with diastematomyelia in an adult: a case report and review of literature.

We report a case of a spinal intradural arachnoid cyst in a thirty year old female with a previously undiagnosed and untreated diastematomyelia. The cyst was located exactly between the two hemi-cords of the split cord malformation. The patient was treated successfully by laminoplasty and total removal of the cyst. Additionally, sectioning of the filium terminale was done in the same sitting by a separate incision. This case posed a diagnostic dilemma. Though the clinical findings favoured an extramedullary lesion, the possibility of cystic degeneration in the spinal cord due to the tethered cord syndrome could not be completely negated. Spinal intradural arachnoid cysts have been reported in association with various neural tube defects, mainly in the paediatric age group. However, such a lesion associated with diastematomyelia in an adult, to the best of our knowledge, has not been reported previously.

Vertebro-basilar stroke due to Bow-Hunter syndrome: an unusual presentation of rotatory atlanto-axial subluxation in a fourteen year old.

Bow Hunter's syndrome is a rare disorder usually producing transient ischemic symptoms as a result of dynamic compression of the vertebral artery during head turning. We report a case of a 14 year old male presenting with stroke due to occlusion of vertebral artery due to rotatory atlanto-axial subluxation. The patient presented with sudden onset vertigo and ataxia. History revealed led mild torticollis since childhood which was never investigated. MRI and MRA showed infarcts in the bilateral cerebellar hemispheres and the occipital lobes with a hypoplastic left vertebral artery and kinking of the right vertebral artery at the cranio-vertebral junction due to rotatory atlanto-axial subluxation. The patient was successfully treated by C1 lateral mass and C2 sub-facetal screw with rod fixation. Bow-Hunter's syndrome producing transient ischemia is well reported but stroke in the vertebro-basilar territory in a 14 year old due to rotatory atlanto-axial subluxation is uncommon, and to the best of our knowledge, this is the eighth such reported case.

Diffuse Leptomeningeal Glioneuronal Tumor: A Rare Case Report with Review of Literature.

Diffuse leptomeningeal glioneuronal tumor (DLGNT) is a rare tumor that was defined as a separate entity in the 2016 World Health Organization classification of brain tumors. It is most common in the pediatric age group. The diagnosis of this tumor can be made preoperatively by its characteristic imaging findings of diffuse intracranial and intraspinal nodular leptomeningeal thickening and enhancement associated with small cyst-like nonenhancing lesions in the brain and spinal cord. We report a case of DLGNT in a 7-year-old male presenting with hydrocephalus. The patient was treated successfully by cerebrospinal fluid (CSF) diversion followed by biopsy of the lesion from the cerebellum. Histopathology and immunohistochemistry confirmed the diagnosis of DLGNT. Our case would hopefully increase the awareness regarding this rare tumor and facilitate an early diagnosis and management of the affected patients with atypical radiological features.

Endolymphatic Sac Tumour: A Case Report and Review of the Literature

Introduction Endolymphatic sac tumor (ELST) is a slow-growing, low-grade, locallyinfiltrative tumor arising from the endolymphatic sac/duct, which is located in the posterior part of the petrous temporal bone. It may be sporadic in origin, or may be associated with Von-Hippel Lindau (VHL) syndrome. Case description A 40-year-old female patient with an ELST without VHL syndrome who was treated successfully by microsurgical extirpation of the tumor. Discussion We discuss the radiological features and the histopathology of this rare tumor and review the relevant literature. Conclusion The case herein reported adds to the previously-reported cases of this rare tumor.

Untreated tension pneumoventricle leading to progressive encephalomalacia: a rare case report with review of literature.

Tension pneumoventricle is a rare but potentially life threatening condition affecting the central nervous system.The majority of the reported cases are iatrogenic, seen after surgery for posterior fossa tumours, particularly in sitting position and pituitary and skull base tumours.Tension pneumoventricle following head injury is very rare with only seven reported cases till date. We report a case of untreated tension pneumoventricle, resulting from head injury due to road traffic accident leading to encephalomalacia of both the frontal lobes.

Tuberculosis of spine: An experience of 30 cases over two years.

OBJECTIVE: Tuberculosis of spine is still a very common condition in India. Here, the results of 30 cases of tuberculosis of spine treated in SSG Hospital, Vadodara, Gujarat, in the last two years, are reviewed. MATERIALS AND METHODS: A total of 30 patients with tuberculosis of spine were treated in SSG Hospital in the last two years. They were classified into three groups, based on the GATA, GATA = Gulhane Askeri Tip Akademisi (Gulhane Military Medical Academy) classification for spinal tuberculosis, with few modifications. Their neurologic status was evaluated by the Frankel's grading. All the patients were started on four drug anti-tuberculosis medication given every alternate day as per the DOTS and RNTCP program of the Government of India for 6 months. Patients in group 1 were treated by bed rest, analgesics, and antituberculous drugs after confirmation of the diagnosis by CT-guided biopsy. Patients in group 2 were treated by surgical of USG-guided aspiration of abscesses followed by full course of antituberculous drugs. Twenty-one patients in group 3 underwent surgery. A single-stage anterior decompression and anterior fixation was done in all the cases. RESULTS: All the nine patients in group I and 2 responded well to medical management and were cured of the disease. Out of the 21 operated patients, 19 had significant improvement in neurological status and return to their normal activities. The first operated patient died. The neurological status of one patient did not improve till 1 month after surgery and was lost to follow-up. Thus, 100% of group 1 and 2 patients were cured of the disease and 90% of group 3 patients had good neurological recovery. CONCLUSIONS: If treated timely and adequately, the outcome for tuberculosis of spine is relatively good. Anterolateral approach to the spine with decompression and fixation gives good result with respect to neurological function.