Classically meningiomas present and evolve with a progressive course. Meningiomas manifest themselves mainly in middle and old age when the incidence of strokes is higher. The authors report three instances of meningioma with acute haemorrhagic onset. The clinical picture of our cases consisted of subarachnoid bleeding, subdural hematoma and intracerebral haemorrhage respectively. The diagnostic difficulties encountered when assessing these patients are discussed. The current literature regarding meningioma associated with haemorrhage is reviewed. One of our cases seems to be the first reported case of subarachnoid haemorrhage originating from a meningioma of the petrous bone.

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The case of a 5-month-old boy with sagittal synostosis secondary to a calcified cephalohematoma of the cranial vault is reported. Although birth trauma has been suggested as a cause of craniosynostosis, a review of the current literature failed to show a similar case. Surgical treatment to remove the calcified hematoma produced good cosmetic and functional results.

A 16-month-old male infant presented with paraparesis and a high thoracic skin dimple. After myelography the child underwent complete surgical removal of the dermal sinus and of an abscessed tumor located within the cervicothoracic cord. Histological study showed that the lesion was an intramedullary epidermoid cyst. Only four descriptions have previously been published of dermal sinuses associated with intramedullary epidermoids, three of them complicated by intramedullary abscesses. This appears to be the first report in the current literature of the association of a dermal sinus and an infected intramedullary epidermoid occurring out of the confines of the lumbosacral region.

Complications of valve reservoirs or flushing devices are seldom reported as a cause of shunt malfunction. The authors document their experience in six cases of mechanical complications of shunting devices. Two cases presented with collapse and intracranial migration of the valve reservoir, a complication that has not been reported previously. In two cases, the plastic dome became disconnected from the metallic base of the reservoir. A fifth patient, with an integral shunt system, showed a fracture in the soldered join of the distal tube to the reservoir dome. The last patient had the valve reservoir partially collapsed by bone growth at the time of shunt revision.