Mediastinal dumbbell angiolipoma.

Nonneurogenic dumbbell tumors are rare. This report describes the case of a 46-year-old woman with a symptomatic mediastinal dumbbell angiolipoma. The tumor was successfully resected using a single-stage procedure, combining a posterior microneurosurgical and thoracoscopic approach. The patient made an uneventful recovery and the neurologic symptoms improved immediately.

Dorsal meningioma developed between two sheets of the spinal dura mater. Case report.

A case of meningioma developing between two sheets of the spinal dura mater is reported. The genesis of this neoplasm, arising from arachnoidal villi included into the dura is discussed. The authors suggest to distinguish the term 'intradural' from 'subdural'.

Glial cyst of the pineal gland: case report and considerations about surgical management.

Symptomatic glial cyst of the pineal gland are rare lesions. Origin, natural history and factors leading to cyst enlargement are not completely clear; thus management remain uncertain in some cases. We report a case of symptomatic glial cyst and analyze the implication for surgery. Surgical management is indicated in patients presenting hydrocephalus, mass effect or symptoms related to mesencephalic dysfunction. The infratentorial supracerebellar approach represent the first choice for this condition allowing easy orientation with wide exposure of the tumor and good visibility of deep venous systems that may be preserved. Size of the tumor is a key element in evaluation of the treatment and the appropriate course for asymptomatic cyst less than 1 cm in size consist of conservative management. Periodic follow up is always indicated.

Fatal carotid dissection after blunt head trauma.

Occurrence of internal carotid artery injuries associated with skull base fracture has been reported. A. report a case of fatal intracranial carotid dissection related to petrous fracture involving the carotid canal. Identification of carotid lesions may be difficult and generally related to appearance of unexpected neurological deficit. Skull base fractures may be considered an indirect sign for detection of vascular injury. Patterns of the fracture are of paramount importance; routine CT scan may fail to detect basilar fractures and high definition fine-cut CT scan should be executed to carefully identify and evaluate fractures. Temporal and sphenoid bone fractures are common in head trauma and involvement of the course of the carotid artery is frequent. The involvement of the intracranial carotid artery course represents a direct risk factor for lesions of the petrous, lacerum and cavernous segments of the carotid artery. Early diagnosis of post-traumatic vascular injury may lead to prognosis improvement because of effectiveness of heparin anticoagulant therapy. Then vascular screening is recommendable in cases with complex fractures of the skull base and particularly fracturing along the course of the carotid artery. Magnetic resonance angiography may be considered the first line diagnostic tools for vascular screening. Angiography may be reserved for patients with a proven lesion or rapid neurological deterioration taking into account the possibility of interventional treatment.

Multiple diverse intracranial and intramedullary spinal tumors. Report of a case.

A case of spinal ependymoma diagnosed 26 years after the removal of an acoustic neurinoma in a patient free of von Recklinghausen's disease is described. The extreme rarity of such a finding and the pathogenetic hypotheses regarding multiple primary tumors of the nervous system are discussed at the light of the literature.

[Epidural spinal meningiomas. Review of the literature and presentation of a clinical case]. / I meningiomi epidurali spinali. Revisione della letteratura e presentazione di un caso clinico.

A rare case of spinal epidural meningioma is reported. The possible origin of the neoplasm is discussed with a review of the literature on the subject.