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We report the unusual case of a patient with neurofibromatosis type I, who was irradiated 16 years previously for a mesencephalic glioma causing hydrocephalus, and who developed a cerebellar haemorrhage caused by a histologically confirmed cavernous angioma, that was invisible on several earlier MRI scans. The different hypotheses concerning the de novo formation of cavernous angiomas (venous obstructive disease and genetic abnormalities) are succinctly reviewed.

In a retrospective study of 62 cases of syringomyelia, spanning thirteen years, we investigated the diagnostic value of the different imaging techniques, and the outcome of the several forms of therapy. Magnetic resonance imaging appears to be the examination of choice, being most informative and least invasive. When surgical treatment is indicated, syringoperitoneal shunting will stabilize or improve the condition in a substantial number of cases. Indications for the other surgical procedures are discussed.

Thanks to the more systematical use of CT scan, more and more foraminal and extraforaminal disk herniations are discovered. Some symptoms and signs can be suggestive. Association of negative myelography with important radicular signs should receive special attention. The extremely lateral herniation can be managed easiest and safest by a combined approach, both interlaminar paramedian and lateral to the facet joint, which should be preserved.

We performed a retrospective study of 62 patients with syringomyelia. Most noteworthy among the clinical features in our patient population are the following: segmental sensory disturbances are usually less restrictive than the classical thermoanalgesia, pain is a presenting symptom in almost 50% of cases, and skeletal abnormalities of the "status dysraphicus" are very common. The different hypotheses about the pathogenesis are also discussed.