Pediatric sellar-suprasellar tuberculosis: A case report and review of the literature.

Background: Pediatric sellar-suprasellar tuberculosis is a rare form of tuberculosis that affects the pituitary gland and surrounding areas in the brain. It can be difficult to diagnose based on clinical and radiological signs alone, as they can be similar to other pituitary masses. A combination of biological, hormonal, and imaging examinations can aid in making an accurate diagnosis. It is important to consider tuberculosis in the differential diagnosis of sellar-suprasellar masses in the pediatric population, especially in areas with a high prevalence of tuberculosis. Case Description: A 17-year-old male with no history of illness showed up with a series of symptoms, including headaches and vision problems. A sellar-suprasellar lesion was seen on imaging, along with several minor lesions. The diagnosis of tuberculosis meningitis with cerebral and pituitary tuberculoma was made after cerebrospinal fluid analysis revealed the presence of tuberculosis. Treatment with anti-tuberculosis drugs led to clinical improvement and lesion resolution. Conclusion: Children's sellar tuberculomas can be difficult to diagnose since they resemble other pituitary tumors. It is essential to take them into account in the differential diagnosis, especially in regions with a high incidence of tuberculosis. Long-term chemotherapy is the recommended course of treatment, and monthly follow-up visits are necessary to check hormone levels and evaluate whether a permanent hormone replacement is necessary.

Atypical radiological aspect of meningioma: Web-like enhancement.

Meningiomas are the most common extra-axial neoplasmof the central nervous system (CNS). There are a number of characteristic imaging features of meningiomas on magnetic resonance imaging (MRI) that allow an accurate diagnosis, however there are a number of atypical features that may be diagnostically challenging. Furthermore, a number of other neoplastic and non-neoplastic conditions may mimic meningiomas. This case highlights the importance of careful analysis of imaging findings and the need for consideration of all possible diagnoses, including rare or atypical presentations of common neoplasms such as meningiomas. Early detection and accurate diagnosis are crucial in determining the appropriate management and improving the outcomes for patients with intracranial tumors.

Spinal mesenchymal chondrosarcoma: A case report of a rare malignant tumor.

Background: Mesenchymal chondrosarcoma is an uncommon malignant variant of chondrosarcoma that mainly affects the bones and cartilaginous tissues, but may rarely involve the spine. Careful preoperative planning for surgical tumor removal and spine reconstruction is mandatory and must be based on oncologic and surgical staging. Case Description: Over 1 month, a 16-year-old female became paraplegic with a T9 sensory level and urinary dysfunction. The magnetic resonance imaging revealed an intraspinal extradural T7-T9 mass that was isointense in T1W1 and markedly enhanced with gadolinium. The patient underwent gross-total tumor resection followed by an osteoplastic laminectomy with fusion. The histological examination was consistent with a mesenchymal chondrosarcoma. She had received radiation and chemotherapy. One year later, she was readmitted for tumor recurrence with multiple metastases involving L1, the lung, and peritoneum. Despite full course of radiotherapy and chemotherapy, she died after 6 months of the second surgery. Conclusion: Total resection of mesenchymal chondrosarcomas is the gold standard for treatment and is typically followed by radiation and/or chemotherapy. However, the status of residual tumor, local extension, and or metastases best determine the overall survival which may prove extremely limited.

Bobble head doll syndrome (BHDS): Case report.

The bobble head doll syndrome is a rare neurological disorder characterized by repetitive and involuntary movement of the head that typically appear in childhood. It is usually associated with the dilatation of the third ventricle and one or more cystic lesions that can be treated surgically. We present the case of a 7-year-old girl with a history of autism, who has experiencing repetitive up and down head movements for 2 years, which were initially thought to be stereotypies. However, 2 months prior to admission, the movements worsened and were accompanied by symptoms of intracranial hypertension. The neurological examination revealed a coordination disorder, specifically a tremor, along with impairment of thermo-algic sensitivity. Ophthalmological examination was unremarkable, but the MRI indicated a colloid cyst of the third ventricle. A minimally invasive neuro-endoscopy procedure was chosen as the treatment of choice for our patient. The bobble head doll syndrome is a complex neurological disorder, and imaging is crucial in the diagnosis and treatment of any movement disorder to enable an early diagnosis and treatment.

Spontaneous regression of solid-cystic vestibular schwannoma: A case report.

Background: Vestibular schwannomas (VSs) are one of the most common tumors of the cerebellopontine angle and internal meatus, the evolution of this type of tumors is defined as unpredictable, it can enlarge or present a spontaneous regression as described in rare cases. Case Description: We report the case of a 50-year-old woman who presented with a large right full cystic VS revealed by a balance disorder associated with deafness in the right ear which spontaneously regressed. The patient was lost to follow-up for 3 years, the symptomatology improved, and the tumor clearly regressed without any surgical treatment. Conclusion: Spontaneous regression of solid-cystic VS is possible but rare, it can be part of conservative treatment, which requires regular follow-up.

The white cerebellum sign with good prognosis: A case report.

The white cerebellum sign is a radiologic sign rarely described resulting from diffuse cerebral edema, reported especially in children with hypoxic brain lesions, it is usually associated with poor prognosis leading to irreversible brain damage. We report the case of a child who presented this sign after a severe head injury and differently from most of previous cases, our patient has recovered very successfully. The white cerebellum sign is a radiologic sign that is not frequently described, which when present carries a poor prognosis, one third of the patients die and the others have severe deficits, its identification is necessary for a better patient management.

Giant Arachnoid Cyst Associated with an Orbital Meningocele: A Case Report and Cystoperitoneal Shunt Management.

INTRODUCTION: Intracranial arachnoid cysts (ACs) are space-occupying lesions that typically remain stable in size and clinically silent over time. CASE REPORT: We describe an unusual pediatric case of enlarged AC impressive by its compressive phenomena. An 11-month-old girl presented with remarkable macrocephaly associated with a cystic orbital tumor. CT scan and MRI studies revealed a large intracranial ACs extending in the orbit with an orbital meningocele (OM). The intracranial cyst did communicate with the orbital one into a bony defect in the right inner region of the orbital roof and represses the globe outward. A cystoperitoneal shunting procedure was performed to remove the mass effect as soon as possible and facilitate normal development. DISCUSSION/CONCLUSION: Cysts in infants younger than 1 year of age are remarkably different from those in older children and adults in terms of cyst localization and enlargement. Classically described complications result from compression of adjacent structures and include focal neurologic involvement, headaches and seizures and developmental deficits, or macrocephaly in younger children. There are few cases of ACs with ophthalmic manifestations reported in the literature. The paucity of literature prompted us to analyze the case. To the best of our knowledge, an AC accompanying OM has not been reported. The pathogenesis and management of the case will be discussed.

Neurosyphilis revealed by compressive cervical spine syphilitic gumma: a case report.

INTRODUCTION: Neurosyphilis is a sexually transmitted disease secondary to the invasion of the central nervous system by the Treponema pallidum. The spinal syphilitic gumma is rare. CASE PRESENTATION: We report a case of extradural cervical spinal syphilitic gumma revealed by spinal cord compression in a 58-year-old male. The epidural lesion was removed via a posterior approach. Histological examination revealed syphilis. Syphilis serologies were positive. Brain MRI showed an associated cerebro-meningeal syphilitic gumma. Antibiotic regime based on aqueous penicillin G was introduced for 14 days. DISCUSSION: Currently, there is an increase in the frequency of syphilis and changes in its clinical manifestations. Neurosyphilis can take atypical forms. Spinal syphilitic gumma is a rare manifestation and its association with cerebral involvement is exceptional. Diagnosis is based on serologies in the blood and cerebrospinal fluid. The place of imagery, especially magnetic resonance imaging, is essential. Neurosyphilis should be discussed as a possible differential diagnosis in evaluation of spinal and cerebral lesions.

[Surgical treatment of sacral Tarlov cysts: about 20 cases]. / Traitement chirurgical des kystes de Tarlov sacrés: à propos de 20 cas.

Tarlov cyst or perineural cyst is a local dilation of the subarachnoid space formed within the nerve root and filled with cerebrospinal fluid. There is no consensus on the best treatment of syntomatic sacral perinervous cysts. Many methods have been used to treat these symptomatic lesions, with variable results. We report a case series including 20 patients undergoing surgery for sacral Tarlov cyst. Our results were satisfactory; 80% of patients improved without neurological worsening in the post-operative period. Our surgical technique (sacral laminectomy+cyst puncture+establishment of dural sheat) described for the first time in this study seems to have been effective in the 20 cases reported in our study.

Tumeurs du cône médullaire et de la queue de cheval associées à l'hydrocéphalie chronique: à propos de 2 cas: Tumors of the conus medullaris and of the cauda equina associated with chronic hydrocephalus: about 2 cases.

Chronic hydrocephalus associated with a tumor of the conus medullaris and/or of the cauda equina is extremely rare. We here report two cases of medullary tumor revealed by the triad: dementia, difficulty walking and urinary incontinence. Magnetic resonance imaging (MRI) of the cerebrospinal fluid showed communicating hydrocephalus and intradural spinal tumors at the level of the conus medullaris and of the cauda equina. Surgical resection of a benign schwannoma and of an ependymoma allowed the resolution of the clinical symptomatology due to hydrocephalus without implantation of ventricular shunt. A dozen cases of dementia and hydrocephalus associated to spinal tumor have been reported. A variety of approaches have been proposed to explain this association but the exact pathophysiology is not accurately known.

[Meningeal melanocytoma: aggressive evolution of a benign tumor: about 2 cases]. / Mélanocytome méningé: évolution agressive d'une tumeur bénigne: à propos de 2 cas.

Meningeal melanocytomas are rare pigmented tumors affecting the central nervous system and developing in the cerebrospinal leptomeninges. We report two cases of meningeal melanocytomas showing very marked disparity in their evolution: a very long-term development of meningocerebral lesion, with malignant transformation resulting in the death of the first patient after 32 years and intramedullary ectopic location with very fast massive meningeal diffusion in the second patient. These two cases show the uncertain evolutive profile of meningeal melanocytomas. These lesions may become aggressive with poor prognosis despite an intensive therapeutic strategy.