Acute spontaneous subdural hematoma of arterial origin, a neurosurgical emergency resulting from rupture of the perisylvian cortical artery, is a rare occurrence. We report four such patients who presented with progressive neurological deterioration. All the patients were operated and perisylvian cortical artery was identified as the source of bleeding in all the patients. Three of the patients had associated hypertension. We reviewed the clinical characteristics, etiology, and outcome of the reported cases in the literature. A high index of suspicion is necessary even in young patients in view of the phenomenon of re-rupture mimicking stroke. Early diagnosis and a wide craniotomy over the sylvian fissure to obtain hemostasis of bleeding points results in good outcome.
Multicentric gliomas are among the rarest of multiple intracranial neoplasms. Two biopsy proven cases are described with a review of the literature. Both cases had supratentorial and posterior fossa lesions. Computed tomography was performed in both cases, open and stereotaxic biopsy was done in one case and open biopsy of both lesions in the other case. The major problem in multicentric gliomas is the management. The two cases were managed differently based on the clinical condition and the location of the lesions.
Tuberculomas of the brain can now be diagnosed readily with computerised axial tomography. A rare, biopsy proven case of a third ventricular tuberculoma is presented. Typical CT scan findings are discussed and management with drugs and minimal surgical intervention when necessary is stressed.
Two cases of primary tuberculous osteomyelitis of skull confirmed by appropriate laboratory investigations are described here. Primary tuberculous osteomyelitis of skull is rare. Only two cases of chronic granulomatous osteomyelitis have been described so far in the literature.
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