A case of eosinophilic granuloma of the cervical spine in a ten year-old white boy is reported. The patient complained of posterior cervical pain at the level of C5-C6 and right hemiparesis that progressed to mixed tetraparesis (lower motor neuron in upper limbs and upper motor neuron in lower limbs). Examination of the cerebrospinal fluid (CSF) disclosed an inflammatory reaction; radiologic studies of the cervical spine showed an irregular aspect with demineralization at the base of spinous process of C6. The patient was treatet intermitently with corticosteriods (prednisone); there was an improvement of neurologic symptoms and the examination of the CSF was normal within a few days, each time he took the drug. Neurologic symptons and abnormalities of the CSF recurred after discontinuation of corticotherapy. Examination of a fragment of the spinous process and neighboring tissues of C6, taken by biopsy, disclosed eosinophilic granuloma. Radiotherapy was then indicated, plus corticosteroids. There was remission of all neurologic symptoms and signs. The unusual features of the case are discussed in relation to others reported in the literature.

Case report of a 7 1/2-year-old girl considered as being normal until the age of 2 years. From then on she progressed with gait disturbance, mental deterioration, dystonic movements, convulsions and dysarthria. She died of bronchopneumonia one year later. CT scan showed hyperdensity at the putamen, with no signs of cerebral atrophy. Pathological examination disclosed an intense red coloration of the putamen and axonal "spheroids" at electron microscopy.

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Our aim is to present the results obtained from the evaluation of the neurological examination as well as chemical and cytologic data from the CSF obtained at the admission and discharge of 255 children aged between zero and 12 years with a diagnosis of serogroup A meningococcal meningitis made at the Hospital Emilio Ribas in São Paulo, Brasil, in the years of 1976 and 1977. By the time of their admission, 27 patients (10,59%) showed positive neurologic findings besides meningeal signs. Seizures were the most common ones, with higher incidence in children under 13 months; ataxia, deafness, motor deficits, neuro-psychomotor involution, subdural effusions and disturbed behavior followed in that order. Subdural effusions were found only in those under 13 months. A fatal outcome was registered in eleven (4,31%) patients, of which nine died in the first 24 hours after admission. By the time of hospital discharge 14 patients (5,49%) had neurological abnormalities, deafness and ataxia being the most common ones, in the older patients. Under 13 months, developmental involution predominated. There is no need of CSF evaluation for antibiotic therapy interruption in patients with meningococcal meningitis.

The diagnosis of primary spinal meningioma is rare in children with an annual incidence of 8 cases per 1000000 people 1 . Meningiomas are largely benign in nature and their recurrence is most associated to histologic type. The current treatment of choice is surgical resection.The aim of this report is to present a case of a ten year-old boy diagnosed with a psammomatous meningioma in the topography of the thoracic column (T4), and to review some epidemiological, pathophysiological, clinical and prognostic features.Case A ten year-old male patient with no relevant past medical history suddenly showed progressive spastic paraparesis of lower limbs with reduced sensitivity to pain, 40 days prior to hospital admission. Moreover, no infections had been observed prior to symptoms, nor relevant epidemiological antecedents or previous exposure to ionising radiation. Clinical examination revealed bilateral reduction in muscular strenght of the legs and thighs (both power grade II) with normal bilateral deep tendon reflexes while no changes in sensitivity to heat, pain or proprioception were observed. The results of dermatologic examination were normal. Fundoscopy was normal. The child also had normal CSF tests. Brain CT scan showed no signs of schwannomas or other tumors. A neuroaxis MR (Fig 1) showed a posterior intradural expansive mass at the level of T4 and T5 vertebrae, in an apparent extra-medullary, well delimited, homogenous, lobulated topography. The tumor measured around 1.8 × 1.2 × 0.9 cm and was characterized by T1 iso-signal, T2 hypersignal, and homogenous accentuated enhancement following contrast injection, and exerted a local expansive effect creating medullar dorsal compression with signs of local edema/trauma signs characterized by T2 hypersignal. The patient underwent laminectomy, and opening up of the dura exposed a whitish tumor compressing the adjacent medulla. The tumor presented a hard consistency, with little bleeding, a clear cleavage plane with the dura mater and weak adherences to the adjacent arachnoid. The tumor was fully resected. Anatomopathologic study revealed a psammomatous meningioma (Fig 2). Post-operative evolution was satisfactory, with recovery of muscular strength to power grade 4 in three days. He is currently undergoing motor rehabilitation with good clinical evolution. DisCussionMeningiomas are rare tumors in children, accounting for less than 5% of brain tumors in children and less than 2% of all