There is little evidence for an embryological origin through dysregulated vasculogenesis, whereas there is a raft of evidence to support dysregulated angiogenesis in childhood or even adulthood. Translational implications include risk stratification by biomarkers for predicting haemorrhage and novel therapeutic approaches to suppress AVM proliferation and initiate reversal.

Intradural renal cell carcinoma (RCC) metastasis is rare. We report a case of an 81-year-old female presenting with acute cauda equina syndrome (CES), secondary to intradural RCC metastasis haemorrhage. To our knowledge this is the first case of CES secondary to acute haemorrhage within an intradural RCC metastasis.

Purpose A computed tomography (CT) scan in childhood is associated with a greater incidence of brain cancer. CT scans are used in patients with ventriculo-peritoneal (VP) shunts in whom shunt dysfunction is suspected. We wanted to assess the CT scan exposure in a cohort of children with VP shunts and attempt to quantify their radiation exposure. Methods A single-centre retrospective analysis was performed recording CT head scans in children younger than 18 years with VP shunts. Hospital coding data was cross-referenced with electronic records and radiology databases both in our neurosurgery unit and in hospitals referring to it. Results One hundred and fifty-two children with VP shunts were identified. The mean time with shunt in situ was 5.4 years (± 4.61). A mean of 3.33 CT scans (range 0-20) were performed on each child, amounting to 0.65 (± 0.87) CTs per shunt year. Based on 2 msv of radiation per scan, this equates to an average exposure of 1.31 msv per child per shunt year. Conclusion Children who have multiple CT head scans for investigation of possible shunt dysfunction are at a greater risk of developing cancer. We discuss the implications of this increased risk and discuss strategies to limit radiation exposure in children with VP shunts.

Spondylodiscitis is often iatrogenic in nature. We report the case of a 69-year-old man presenting with spondylodiscitis and associated epidural abscess following transrectal ultrasonography guided prostate biopsy despite ciprofloxacin cover. To our knowledge, this is the first case of spondylodiscitis secondary to fluoroquinolone resistant Escherichia coli. Prostate cancer is the most commonly diagnosed cancer in men, accounting for approximately a quarter of all male cancers. Transrectal ultrasonography guided biopsy of the prostate (TRUBP) is a common procedure in the diagnosis of prostate cancer and has a good safety profile. However, infective complications following biopsy (including bacteriuria, bacteraemia, fever and sepsis) are well documented, occurring in 2-4% of patients despite appropriate antibiotic cover.

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