Granular cell tumors (GCTs) in the spine are uncommon. They are mostly located in the intradural extramedullary space and rarely, in an intramedullary (IM) location. Complete resection is the treatment of choice. Recurrences are rare in intradural-intramedullary (IDEM) GCTs. Recurrent and incompletely excised cases are subjected to adjuvant radiation therapy. We report such a recurrence in a 13-year-old girl who was re-operated and subjected to radiotherapy.
Herpes Simplex Encephalitis is the commonest form of sporadic encephalitis. Availability of effective antiviral therapy viz Acyclovir has significantly reduced the mortality of Herpes Simplex Encephalitis. Elevated intracranial pressure resulting in herniation syndromes continues to be an important cause of mortality. Antiviral therapy and medical measures for managing raised intracranial pressure including osmotic diuretics, careful usage of steroids and controlled hyperventilation continue to be the cornerstones in management of these patients. Authors present a 38-year-old male patient with Cerebrospinal fluid Meningo-encephalitic panel positivity for herpes simplex virus 1 and bilateral temporal lobe lesions with secondary decline due to impending herniation syndrome despite osmotic diuretics and steroids with patient survival and complete recovery following decompressive hemicraniectomy.
Solitary fibrous tumor (SFT) is a spindle cell lesion, classified under mesothelial tumors. Involvement of the nasal cavity, paranasal sinuses, and nasopharynx is rare. We present an extremely rare case of SFT of nasal origin eroding the anterior skull base. Complete local excision is the treatment of choice in the head and neck SFT, and we successfully excised the tumor by endoscopic approach only. The patient followed an uneventful course without any evidence of recurrence on 8-months follow-up.
Pesudotumor cerebri is a syndrome which causes intracranial hypertension with no associated mass lesion. It is managed both medically as well as surgically. Cerebral spinal fluid diversion using theco-peritoneal shunt is commonly performed to decrease intracranial tension. We present a case of a middle age lady who had severe low pressure headaches following theco-peritoneal shunt for pesudotumor cerebri. She was managed by attaching pressure gradient chamber to the pre-existing theco-peritoneal shunt. Patient had marked improvement in headache, which gradually subsided. Attaching pressure gradient chamber to the pre-existing theco-peritoneal shunt helps to improve low pressures headaches in pseudotumor cerebri. It is an alternative procedure considering other extensive surgical options.
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