Posterior interosseous nerve paralysis due to vascular compression

A rare case of posterior interosseous nerve paralysis due to vascular conflict with the arcade of vessels arising from the recurrent radial artery is reported. This is one of the most unusual causes of nerve compression in the radial tunnel region. Section of the compressing arterial vessels and the external neurolysis led to the complete recovery of the motor deficit within 12 months. The surgical exploration is advisable on the basis of the clinical findings of posterior interosseous nerve deficit; the vascular nerve compression is a surgical surprise and cannot be predicted preoperatively. The outcome of the motor deficit is good, up to a complete recovery, when the nerve decompression is early and satisfactory

Meningiomas associated with brain metastases.

The authors report a series of 6 patients with simultaneous occurrence of meningioma and single brain metastasis, who underwent surgical removal with histological verification of both lesions. The site of the primary tumor was the breast in 3 cases, the ovary in one, the lung in one, and was unknown in one. Among the six patients, two had a carcinomatous metastasis accidentally found into a meningioma after histological examination of the meningiomatous mass. Two others had a brain metastasis in the cerebral parenchyma surrounding the meningioma; both lesions were removed in an one-stage operation. Finally, two patients, whose lesions were distant, first underwent removal of the brain metastasis, whereas the meningioma was excised 10 and 13 months later. The pathogenetic relationships between meningiomas and tumors of the female reproductive system are discussed. The occurrence of a metastasis into a meningioma is a rather unusual event, which has been described in 50 previously reported cases. The correct differential diagnosis between meningioma and metastasis is very important in these patients. An intracranial mass lesion occurring in patients with known malignant tumors elsewhere in the body (mainly females with breast cancers) has a small but real chance of being a meningioma

Malignant intracerebellar schwannoma

The authors report an exceptional case of malignant cerebellar schwannoma in a 29-year-old woman, explored by computed tomography and angiography; a solid and vascular vermian tumor was removed at operation. The histological diagnosis of malignant schwannoma with epithelioid areas was confirmed by immunohistological staining (positive S-100 protein, Leu 7 and vimentin, negative glial fibrillary acid protein, cytokeratin, desmin and HMB45). The patient died 8 months after surgery for tumor recurrence. The literature reviewhas shown 44 cases of schwannomas occurring in the cerebral hemispheres, 9 within the brainstem and 14 in the cerebellum. All but one reported cerebellar schwannomas were benign, with prevalence of young patients and vermian localization. The present case is the second reported malignant intracerebellar schwannoma