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Background Atopic dermatitis is a chronic inflammatory skin disease associated with pruritus. Skin affected by atopic dermatitis not only shows a high percentage of Staphylococcus aureus colonization, but corneal barrier dysfunction is also known to occur. It is considered a risk factor for bacterial infections in various areas of the body. However, the relationship between atopic dermatitis and bacterial infection following neurological surgery has not yet been reported. Here, we present a case of atopic dermatitis in which the surgical site became infected twice and finally resolved only after the atopic dermatitis was treated. Case presentation A 50-year-old Japanese woman with atopic dermatitis underwent cerebral aneurysm clipping to prevent impending rupture. Postoperatively, she developed repeated epidural empyema following titanium cranioplasty. As a result of atopic dermatitis treatment with oral antiallergy medicines and external heparinoids, postoperative infection was suppressed by using an absorbable plastic plate for cranioplasty. The patient’s postoperative course was uneventful for 16 months. Conclusions Atopic dermatitis is likely to cause surgical-site infection in neurosurgical procedures, and the use of a metal implant could promote the development of surgical-site infection in patients with dermatitis.

Intracranial teratoma is a rare disease that frequently occurs in children and young adults. It comprises of approximately 0.1% of the brain tumors. We report a case of a large mature teratoma in the third ventricle with Holmes tremor. A 5-year-old boy presented with tremors 2 years ago. CT showed a 56×48 mm tumor in the third ventricle and hydrocephalus. The tumor was well demarcated from the surrounding brain tissue and contained calcification. MRI indicated a partially high-intensity signal on T1-weighted and T2-weighted images. The preoperative diagnosis was teratoma. Initially, the tumor was biopsied using neuroendoscopy and the Ommaya reservoir was set. The pathological results showed fat-like tissues and fibroblasts. Subsequently, the tumor was completely removed using the interhemispheric transcallosal transchoroidal approach. The tumor included fat and hair tissues. It also included calcification similar to that observed in a tooth. It was strongly adhered near the pineal gland. Pathologically, the diagnosis was a mature teratoma. Postoperatively, the tremor disappeared and the patient was discharged from the hospital without neurological deficits. We believe that compression of the Guillain-Mollaret triangle was relieved by removal of the tumor. Hence, the tremor disappeared after the operation.

Brain metastases from esophageal cancer is rare and the incidence has been reported at approximately 5%. We report a case of brain metastases with repeated bleeding from Esophageal carcinoma. The case is a 76-year-old man. Three years ago he was diagnosed with small cell carcinoma of the esophagus by endoscopic biopsy. Metastasis was found only in the cervical lymph node, but the condition was stable by chemoradiotherapy and no metastases were found throughout the body before 1 month. He was admitted to the hospital because of a sudden convulsion, and CT scan revealed cerebral hemorrhage in the right frontal lobe. We performed conservative treatment, but rebleeding was observed from the same site repeatedly after 1 month and 2 months. Due to the influence of bleeding, it was difficult to distinguish cerebral hemorrhage from brain tumor by contrast MRI. After surgery, the cause of bleeding was diagnosed as metastatic brain tumor of esophageal small cell carcinoma. Postoperative radiation therapy was performed in another hospital, but rebleeding was observed 3 months after the operation. A reoperation was performed at another hospital, and a recurrence of metastatic brain tumor was diagnosed. In the case of highly malignant metastatic brain tumors, it was considered necessary to frequently follow the images.

INTRODUCTION Cystosis is the most common parasitic disease of the central nervous system. Especially in developing countries, it is one of the differential diagnosis of diseases that cause seizures. We report a case of a foreigner suspected of having neurocysticercosis. CASE A 36-year-old Nepalese visiting Japan for 2 years. Two days ago, she lost consciousness for a few seconds and was transferred to our hospital complaint of convulsions for about 1 minute. Head Computed Tomography (CT) revealed a mass lesion with a ring enhancement effect of about 10 mm in the right frontal lobe, with edema around it. Magnetic Resonance Imaging (MRI) shows T1WI low signal, T2WI high signal, and diffusion-weighted image with a light high signal. The ring-shaped enhancement effect was exhibited. Whole body CT showed no obvious lesions and blood tumor markers were negative. Various infections were negative, and cerebrospinal fluid cytology and culture were negative. POSTOPERATIVE COURSE From the surgical findings, brain abscesses such as cerebral tuberculoma were suspected, but various tests were negative. As a pathological result, the tumor had a capsule, and the inside showed necrotic tissue and fibrous granulation tissue reaction. There were no insects, and no obvious cells were identified by special staining. From the origin area, symptoms, and pathological findings, neurocysticercosis was most suspected. CONCLUSION We experienced a case of suspected neurocysticercosis that was difficult to diagnose from images and pathological findings. In neurocysticercosis, when the worm body dies, contrast-enhanced MRI shows a ring-like enhancement effect, and it is accompanied by surrounding edema, which may require differentiation from brain tumors.

INTRODUCTION In the case of the differentiate between olfactory groove schwannomas(OGS) and olfactory ensheathing cell (OEC) tumors, CD57 which is the marker which is specific for Schwann cell is useful. We experienced a case of OGS that was negative for CD57. CASE PRESENTATION This case was a 13-year-old girl. Medical history: She visited the pediatric department with a chief complaint of headache. On the magnetic resonance image (MRI), a tumorous lesion was found in the anterior skull base and was referred to our department. No dysosmia, visual impairment, or cafe au lait spots were observed. Past history: As a medical history, she has developed acute lymphocytic leukemia at the age of 1 and has achieved complete remission after chemotherapy. At that time, radiation treatment to the head was not performed. Neuroradiological findings: The tumor was strongly enhanced heterogeneously in Gadolinium (Gd) enhanced MRI and the angiography showed hypovascular. Progress after hospitalization: The tumor was clearly demarcated from the surrounding brain surface and adhered strongly to the cribriform plate. Eventually, all tumors were removed and the patient was discharged on the 10th postoperative day. Five years have passed since the operation, and no recurrence of the tumor has been confirmed by MRI. Pathological findings: Antoni A and Antoni B were seen by Hematoxylin & Eosin (H & E) staining. Immunostaining showed S-100 strong positive, Schwann / 2E and Sox10 positive, and CD57 negative. Discussion: In our case, CD57 (Leu7) was negative, but Schwann / 2E and Sox10 were positive, so OGS was diagnosed. CONCLUSION We experienced a case of OGS that was negative for CD57 (Leu7) but positive for Schwann / 2E and Sox10. For pathological differentiation between OGS and the OEC tumor, Schwann / 2E and Sox10 immunostaining would also be necessary in addition to H & E stain and CD57 (Leu7).