Craniopharyngioma
September 2014 A 7 year old boy was admitted by the local team after previously being investigated for short stature and long history of vomiting over the previous couple of years. The height at admission was 104cm. There were no reported subjective visual problems. He was also getting headaches up to 3-4 times a day […]
Blunt trauma and intracranial vascular injury
September 2013 This month has a selection of 3 cases with a similar theme – that of vascular trauma after blunt intracranial injury. Given the relative rarity of the condition, it is not an area that many of us know much about, so diagnosis is often delayed and management is uncertain. The consequences, however, can […]
A rare case of delayed SAH after Chiari decompression
June 2013 A 7 year-old twin presented to the general paediatric clinic with persistent and longstanding torticollis and concerns that the right side of his body was smaller than the left. He tilted his head to the right and this was initially ascribed to a squint. Clinical examination The examination confirmed right torticollis, mild weakness […]
An unsual vascular tumor of the Sylvian fissure
April 2013 Presenting complaint A 2-year old previously healthy female patient presented after having seizures for the previous 6 days. Her seizures occurred during the night and the early morning hours. Semiology is stereotyped and as follows: she wakes up from sleep, sits up, eyes roll up and she stares. The duration of each seizure […]
An eloquent area ganglioglioma
October 2012 Presenting complaint The patient is a 3 year boy who presented with a complex partial seizure. Background The boy was born by normal delivery at term. Development has been normal and the parents have had no concerns thus far. Current symptoms Apart from this presenting seizure, the child is asymptomatic. Clinical examination General […]
A bad case of Chiari
March 2012 The case for this month is slightly different – a clinical problem presented for some discussion. This is the information we have: Presenting complaint The patient is a 13 year old wheelchair-bound girl born with a thoracolumbar myelomeningocele. She was managed elsewhere but presented to us with progressive deterioration in bulbar and upper […]
A case of an endovascularly treated aneurysm
January 2012 An unusual vascular association with tuberous sclerosis in a young child, and the value of endovascular techniques in paediatric neurosurgery. Clinical Presentation A 9 month old boy with the clinical hallmarks of tuberous sclerosis presented to the ophthalmology clinic for evaluation of a lazy right eye. Examination revealed a right third nerve palsy. […]
A case of focal and diffuse brainstem glioma
An unusual case of a mixed focal and diffuse brainstem glioma. A lesson in unusual pathology, challenging surgery, and operative technique. Clinical Presentation A 4 year old girl presented with a relatively long history of progressive left-sided weakness and regression of developmental milestones. The symptoms extended over a year and may have been subtly present […]
A case of Achondroplasia – ‘Position, position, position’
March 2011 This case illustrates the hazards of operative positioning in children with compression at the craniocervical junction and the potential value of intraoperative neurophysiological monitoring. Clinical Presentation A 4-year old boy with achondroplasia presented to his pediatrician with slowly worsening stiffness of his legs. His symptoms were mild and his gait was minimally affected; […]
A three-month old boy with a spinal lesion
February 2011 A female Caucasian infant was born with a congenital hydrocephalus diagnosed antenatally by ultrasound screening at 20 weeks gestation. There was a history of a previous male newborn being diagnosed with hydrocephalus requiring a VP shunt. No maternal history or pregnancy concerns were reported. The child was born at 38 weeks of gestation […]
