Introduction: Primary deposition of amyloid can take several forms including amyloidoma organ restricted among which is brain. Brain amyloidoma can mimic several lesions and offers a diagnostic challenge to the physician. The present work reports an additional case and summarizes the salient characteristics of previously published cases. Case Report: A 61-year-old, woman experienced paroxystic auditory hallucinations followed at times by generalized tonico-clonic seizures. Examination revealed a mild left pyramidal weakness. Head CT scan and MRI revealed a lobular lesion of the right atrium with contrast enhancement. The diagnosis of amyloidoma Lambda light chain (λLC) type was performed by means of a stereotactic biopsy. The patient was treated by 3 cures of high dose methotrexate (15 mg/m 2 ). At 24 months follow up the patient remains stable clinically and biologically. The 2 years follow-up MRI showed the same findings. Conclusion: No guidelines can be suggested for brain amyloidoma treatment; the "wait and see" was the mind-set in the literature. However, a non-tumour like pattern of a cerebral mass developing near the ventricle with a fine, irregular radiating margin enhancement and lack of oedema, and mass effect are important MRI clues for brain amyloidoma diagnosis. The diagnosis is histological after biopsy or excision.

Intracranial hematomas, whatever its causes, represent an important disabling, and dreaded adult's lesion. This brain's condition has not well been studied in developing countries. The aim of our study is to overview the management of intracaranial hematomas in Abidjan. It is a retrospective analytical and descriptive study, involving patients who had been admitted and monitored by neurosurgeons for intracranial hematomas, documented in brain CT scan and had been operated on from 1 January 2007 to December 31, 2009 in Abidjan. These 30 patients were 23 men and 7 women. The average age was 58.6 years old. 90% of the patients were admitted with wakefulness issues. Half had a Glasgow score of less than 8. The brain scanner allowed identification of an intraparenchymal hematoma associated or not with a cerebral ventricle contamination in 28 patients. There were 18 external ventricle derivations with or without decompressive craniectomy and 12 independent decompressive craniectomy. The evolution was marked by 20 deaths. 10 patients (33.3%) survived. Among the survivors, the first attack and arterial hypertension were the only illness before the attack. None had blood in the membranes and all had Glasgow scores greater than or equal to 9 at admission. Around 7 out of 10 patients were operated on during the first 48 hours. The operative indications of intracranial hematomas are still the subject of controversy. By basing itself on criteria and rigorous clinical and neuroimaging selection, surgery could eventually contribute to the management of this How to cite this paper:

Introduction: Intra-dural and extramedullary ependymomas are rare lesions. We report a clinical case confirmed by the histology supported by the neurosurgery department of Martinique University Hospital. Clinical, paraclinical and therapeutic data will be compared to a literature review. Observation: A 38-year-old patient was admitted for tetraparesthesia evolving since 3 months, associated with a left hemiparesis. The clinical examination revealed deterioration of the general condition and a tetrapyramidal syndrome. MRI of the cervical spine revealed extensive cervical extra-medullary intradural lesion of C3 to C5. The treatment had been an excisional surgery that had been subtotal in two stages, supplemented by craniospinal radiotherapy because the pathological examination had found a grade III anaplasic ependymoma. Conclusion: Because of their rarity, the treatment of these forms of ependymoma is not yet well codified.