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A case of multiple brain abscess, one each in the temporal lobe, cerebellum and in the extradural space, treated successfully is reported. A careful clinical examination after drainage of the first abscess is necessary to identify and locate the subsequent ones, when they develop. The rarity of otogenic multiple in tracranial abscesses has been emphasised. [ABSTRACT FROM AUTHOR]

A seventy eight year old man sustained penetrating injury to right orbit about 15 years ago. Later he developed right orbital infection leading to phthisis bulbi. Two months before admission he developed CSF leak from the right orbit, tension pneumocephalous and meningitis. A rare case of CSF orbitorrhoea is reported here along with the discussion on mechanisms and management.

A 30 year old man presented with history suggestive of a parasellar tumour. Computerised tomography of brain revealed a hyperdense lesion on either side of sphenoid ridge having extension to floor of middle cranial fossa on the left side, enhancing homogenously with contrast and suggestive of a meningioma. Paranasal sinuses and orbit were free of tumour. He did not have any predisposing factor to harbour oppurtunistic infection. Craniotomy and total excision of the lesion was done. Histopathology was reported as aspergilloma.

A young primi-gravida with pre-eclamptic toxaemia underwent an elective caesarean at 38 weeks. On 10th day of delivery, she suddenly developed symptoms and signs of right cerebello-pontine angle lesion. On investigation a haematoma with a fluid level could be identified. Coagulation parameters were deranged and blood culture grew coagulase negative staphylococcus aureus. Possible causes of intracranial haematoma at such an unusual location are discussed.

Intratumoural bleeding into a trigeminal neurinoma is rare. The authors describe a case which had an apoplectic presentation with subsequent persistent unilateral ptosis, hemifacial pain and sensory loss. This proved to be due to a haemorrhage into a large trigeminal neurinoma.

Two adult male patients having lumbar canal stenosis with prolapsed disc, developed claudicatory priapism along with classical symptoms of claudication, are reported in this article. The first patient complained of severe claudicatory pain in anal canal along with other symptoms. The second patient had a protruded bony rim at the lower margin of L4 vertebra in addition to the prolapsed disc. All the symptoms totally subsided after relieving the compression.

A case of left cerebellar intraparenchymal schwannoma in an adult is being presented along with ten available reports in the literature, differential diagnosis and management of the condition.

Multifocal synchronous gliomas are uncommon in the absence of phakomatosis. Two cases are reported and their possible mode of spread is discussed. A guideline is proposed in the management of such lesions.

Three cases of acute spinal cord trauma developing transient diabetes insipidus are described. The level of spinal injury was cervical in one, cervicodorsal in second, and upper dorsal in the third. Two patients sustained transaction at cervical and dorsal spinal cord while the third had diffuse cordedema and partial neurological injury. In all the cases the onset of diabetes insidious was noted after 3-6 weeks following trauma and it subsided requiring no active treatment. No relevant craniocerebral injury was noted clinically or radiologically. A central medullary descending vasopressin mediated pathway, demonstrated only in experimental animals, may be involved in the spinal cord injury producing diabetes insipidus.

The spinal cord injury centre of Nizam's Institute of Medical Sciences, Andhra Pradesh, India has been functioning now for 8 months and offers its services to the population of 80 million in the state. To date, 92 patients with a spinal cord injury have been treated; 51 had a thoracolumbar spinal injury. This report presents the results of the management of these 51 patients. Preoperatively both CT and MRI were performed and the radiological findings were correlated with outcome. Twenty five had a thoracic and 26 a lumber location. Twenty nine patients underwent surgical treatment (15 thoracic and 14 lumbar) and the others were treated conservatively (10 thoracic and 12 lumbar). All these operations were carried out within 2 weeks following trauma, and methylprednisolone therapy was instituted in those who reached the hospital early. Contraindications for surgery included a delay in admission of more than 3 weeks following trauma, a focus of sepsis, bedsores, a generalised bone disorder such as osteopenia, and medical illnesses. Transpedicular screw-plate fixation was performed in 27 patients, and two patients underwent decompressive laminectomy and interlaminar bone and wire fixation. Delayed spinal decompression was offered to one patient to relieve radiculopathy. Fracture-dislocation spinal injury and those with transection of the spinal cord had the worst outcome, whilst patients with a wedge compression fracture and cord oedema fared better. Operated cases had a shorter hospital stay, and complications of immobilisation were limited. Positive psychological influence of mobilisation and early acclimatisation to the altered style of living with their disability were the most significant outcomes following surgery.

The case of an 18-year-old woman is reported who had developed progressive inability to use her left limbs since the age of 13 years. Ataxic hemiparesis was noted on the left side. A CT scan of the brain revealed a non-enhancing hypodense lesion in the cerebellopontine angle with a supratentorial extension consistent with an epidermoid. Ataxic hemiparesis has previously been reported only with intrinsic lesions of the brain, except for one case. An unusual clinical localization of this entity is reported.

Cavernous hemangioma is the most common benign intraorbital tumor in the young and middle aged, producing painless proptosis. It is common in females in whom it may enlarge during pregnancy. There have however been very few series reported on this entity.

True "multiple meningiomas" as defined by Cushing are rare. A case of multiple meningiomas without stigmata of neurofibromatosis, in a 53 year old man, treated surgically is reported. The relevant literature on multiple meningiomas has been reviewed.

Fifteen operated cases of upper lumbar disc prolapse have been reviewed. They were categorised under 4 types of clinical presentation. There was no clear correlation between the level of the prolapse, clinical presentation, and type of disc prolapse as observed at surgery. On long term follow-up 11 of the 15 (73%) cases had an excellent result and were leading a normal life. The result is poor in patients with severe paraplegia.