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Abstract: Ewing''s sarcomas (ES) account for approximately 10% of primary malignant bone tumors. Primary Ewing''s sarcoma of the skull is a very rare entity. We report a case of Ewing''s sarcoma of the sphenoid bone in a 5-year-old boy. CT scan showed heterogeneously enhancing mass with associated spiculated new bone formation along the posterolateral wall of the orbit. Magnetic resonance (MR) imaging showed markedly heterogeneously signal intensity mass lesion containing areas of hemorrhage and fluid–fluid levels. Spiculated new bone formation and fluid–fluid levels had not been reported previously in skull Ewing''s sarcomas and may be helpful features for preoperative diagnosis. [Copyright &y& Elsevier]

Abstract: Gliofibromas are rare glio-mesenchymal tumors composed of astrocytic and benign mesenchymal components, which commonly occur in the first two decades of life. They are not listed as a distinct entity in the current WHO classification of CNS tumors. Their biological behaviour is unknown, and histogenesis is debatable. We describe a case of histopathologically proven gliofibroma in the region of the left quadrigeminal plate in a 15-year-old child that mimicked a tentorial meningioma both at imaging and surgery. Post-operatively, the residual tumor regrew to a size similar to the initial mass (4cm×3.6cm×3.5cm), within one and a half years after the first surgery. The histopathology of the tumor was similar on both occasions. Although a poor prognosis has been characteristically noted in gliofibromas with high-grade glial component, but the present case had recurrence despite being of low-grade, thus highlighting the uncertain behaviour of this rare tumor. [Copyright &y& Elsevier]

Abstract: Objective: Since it was first described, normal pressure hydrocephalus (NPH) and its treatment by means of cerebrospinal fluid (CSF) shunting have been the focus of much investigation. Whatever be the cause of NPH, it has been hypothesized that in this disease there occurs decreased arterial expansion and an increased brain expansion leading to increased transmantle pressure. We cannot measure the latter, but fortunately the effect of these changes (increased peak flow velocity through the aqueduct) can be quantified with cine phase-contrast magnetic resonance imaging (MRI). This investigation was thus undertaken to characterize and measure CSF peak flow velocity at the level of the aqueduct, before and after lumbar CSF drainage, by means of a phase-contrast cine MRI and determine its role in selecting cases for shunt surgery. Patients and methods: 37 patients with clinically suspected NPH were included in the study. Changes in the hyperdynamic peak CSF flow velocity with 50ml lumbar CSF drainage (mimicking shunt) were evaluated in them for considering shunt surgery. Results: 14 out of 15 patients who were recommended for shunt surgery, based on changes peak flow velocity after lumbar CSF drainage, improved after shunt surgery. None of the cases which were not recommended for shunt surgery, based on changes in CSF peak flow velocity after lumbar CSF drainage, improved after shunt surgery (2 out of 22 cases). Conclusion: The study concluded that the phase-contrast MR imaging, done before and after CSF drainage, is a sensitive method to support the clinical diagnosis of normal pressure hydrocephalus, selecting patients of NPH who are likely to benefit from shunt surgery, and to select patients of NPH who are not likely to benefit from shunt surgery. [Copyright &y& Elsevier]

Abstract: The occurrence of intradural spinal teratomas in association with spinal dysraphism is uncommon and even rarer is renal differentiation in a teratoma. We report two rare cases of patients with spinal dysraphism, split cord malformation and intraspinal teratomas with renal differentiation in a boy of 1 year and a girl of 3 years of age. Surgical excision of the mass, detethering of the cord and repair of the lipomyelomeningocele was done. Pathologic examination in both the cases revealed features of a mature teratoma with nephrogenic differentiation in the form of elements of mature renal tissue. To the best of our knowledge, spinal teratoma with renal component has not been described previously. [Copyright &y& Elsevier]

Abstract: Primary intracranial squamous cell carcinoma is extremely rare, with most of the cases arising from malignant transformation of an epidermoid or a dermoid cyst. We report here a case of a 45-year-old male patient who presented with 1-month history of intermittent headache and recent onset of altered sensorium. Imaging revealed a midline posterior fossa mass lesion compressing the fourth ventricle and causing hydrocephalus. A provisional diagnosis of dermoid cyst was considered. Histopathological examination revealed a squamous cell carcinoma possibly arising from an underlying epidermoid cyst. This entity is being reported for its rarity. [Copyright &y& Elsevier]

Abstract: Eumycetoma in the cerebellopontine angle region is extremely uncommon with no case being reported as per an extensive review of the literature by the authors. The authors report a case of cerebellopontine angle eumycetoma in a young female managed by subtotal decompression and antifungal treatment. The pre-operative diagnosis of eumycetoma in this location is extremely difficult and the role of histopathology is very important to characterize this uncommon lesion. The prognosis of this bizarre pathology is dismal despite all treatment modalities as compared to the usual tumors of the cerebellopontine angle that generally have a favorable outcome. [Copyright &y& Elsevier]