Brain abscess in cyanotic congenital heart disease.

Twenty-eight patients of cyanotic congenital heart disease (CHD) complicated with brain abscess were reviewed. There were 22 males and 6 females with a mean age of 9.1 +/- 5.5 years. Tetralogy of Fallot was the commonest cyanotic CHD observed. Transposition of great arteries (PS), tricuspid atresia with VSD, PS and double outlet right ventricle with VSD comprised 25% of the cardiac lesions. Febrile illness was the commonest mode of presentation (42.86%). Frontal lobe was the commonest site of abscess localization (37.5%) followed by parietal lobe (32.5%). Multiple abscess were seen in 32.14% and in 35.7% the pus was sterile on culture. Twelve patients died (mortality -42.8%), and autopsy reports were available in 6. Infective endocarditis was suspected in 7 on clinical grounds, while at autopsy, out of 6 only 2 had evidence of right-sided endocarditis. There was no correlation of mortality with age, sex, type of micro-organism, site of abscess localization and the nature of heart disease. Multiple abscesses, features of raised intracranial tension and associated meningitis/ventriculitis predicted a grim outcome.

Esthesioneuroblastoma : neurosurgical implications.

Six histologically confirmed cases of esthesioneuroblastoma re reported. Two case had presented with primarily an intracranial mass, two had intracranial extension of a nasal tumour and the remaining two had only nasal growth. Local recurrence in the form of a swelling at the root of nose and metastases to the cervical vertebra, dorsal extradural space and lumbar subarachnoid space were seen in one case each. Aggressive treatment with surgery, radiation therapy and chemotherapy improved the qualityof life in locally recurrent and metastatic disease. CT scan findings and the role of chemotherapy in the primary metastatic esthesioneuroblastoma are discussed.

Thymolipoma--a rare mediastinal tumour--report of two cases and review of literature.

Thymolipoma is a rare mediastinal tumour. We report two cases of thymolipoma. Our first case, a woman of 60 years, presented with an extremely rare association of myasthenia gravis with thymolipoma. Second case presented with dyspnoea productive cough in a male of 62 years. The relevant literature is briefly reviewed.