Search

The new vaccines are emergently authorized and currently approved for use to protect against the coronavirus disease 2019 (COVID-19) pandemic and serious adverse events are uncommon. Moyamoya disease (MMD) with autoimmune disease is a rare entity and usually presents with intracranial hemorrhage in adults.We reported a 40-year-old female patient with Sjogren disease and autoimmune thyroiditis, who had received the second dose of Moderna (mRNA-1273) vaccination. Three days later, she presented with left intraventricular and intracerebral hemorrhage as a complication.After a series of diagnostic workups, left intracranial hemorrhage was associated with MMD.Emergent external ventricular drainage and subsequent stereotactic evacuation of hematoma with insertion of intracranial pressure monitoring were performed.Under the care of the neurocritical care team, her physical condition improved gradually. The neurological sequelae was noted by defects of cognitive function, apraxia, agnosia, and impaired executive function. She was discharged after eight weeks with a follow-up in the vascular neurology clinic planning for performing revascularization.To the best of our knowledge, no similar case has been reported before, and this is the first case of MMD complicated with intracerebral and intraventricular hemorrhage after mRNA-1273 vaccination. It is noticeable to assess the vaccine safety surveillance and raise the alertness about moyamoya in patients with autoimmune diseases during the COVID-19 pandemic. Further studies for risk evaluation of COVID-19 vaccines in patients with autoimmune diseases might be required in the future.

Summary A case of 65-year-old female with intrasellar mass was operated on under the diagnosis of pituitary adenoma. The final diagnosis of plasmacytoma was made by immunocytochemical stain of IgG and electron microscopical findings. Postoperatively, the radiological studies of systemic skeletal bone and cytology of bone marrow were normal. However, the serum IgG was high, and the urinary Bence-Jones protein (kappa type) was positive. Although these laboratory data normalized after operation and irradiation, the patient converted to severe multiple myeloma and expired one and half year after operation.

✓ A case of focal cerebral syphilitic gumma of the right temporal lobe is reported. Angiography showed moderate focal hypervascularity with stretched vessels, and irregularity of the vessel walls. Plain computerized tomography revealed an area of low density that enhanced strongly after intravenous administration of contrast medium.

If meningeal hemangiopericytoma could be diagnosed prior to operation, the neurosurgeon might be better prepared to deal with excessive bleeding during the operation. This type of tumor should be completely excised because of the high risk of recurrence and remote metastasis. Computed tomography as well as cerebral angiography would aid in the preoperative diagnosis of hemangiopericytoma. Early detection and periodic observation by computed tomography may minimize the morbidity and mortality associated with late detection.

We report the case of a woman with ossifying fibroma of the right frontoethmoid sinus. Computed tomography and hypocycloidal tomography were useful in identifying the lesion and its extension into the intracranial and intraorbital cavity.

Duplication or fenestration of the vertebral artery is an unusual vascular variation previously described as present either at the extracranial segment (atlantoaxial level) or at the intracranial segment of the artery. This report describes such a duplication that extended from the extracranial to the intracranial segment and was revealed by angiography. The embryologic genesis and potential clinical significance of this condition are discussed.