✓ Solitary or multiple osteochondromas, which are benign bone tumors that usually occur in the long bones, are rarely found in the vertebral column. When present in the spine, however, they have a predilection for the cervical or upper thoracic regions. The authors present the case of a solitary osteochondroma arising from the left L-5 articular process that contributed to sciatica; complete cure was achieved following its removal. It is possible to speculate that the cartilage of secondary ossification centers can be the origin of aberrant islands of cartilaginous tissue that cause the osteochondroma to form. The more rapid the ossification process of these centers, the greater the probability that aberrant cartilage will form. Therefore, the fact that osteochondromas are more frequently located in the higher segments of the vertebral column could be explained by the different durations of the ossification processes in these centers, which increase gradually below the cervical segments.

SUMMARY Two cases of chronic encapsulated intracerebral haematoma are reported. The patients presented with progressive neurological deficits. Computed tomography scan showed a roundish, intracerebral lesion, that revealed ring blush after contrast infusion, with mass effect. At operation a thick, fibrous, brownish capsule, containing clots in different stages of formation, was removed. The hypothesis of capsule formation due to an exuberant proliferation of arachnoidal fibroblasts, is discussed. Differentiation between encapsulated intracerebral haematoma and other chronic intracerebral blood collections is considered mandatory for appropriate treatment.Intracerebral haematoma (ICH) can usually be easily recognised from the clinical history, neurological examination and computed tomography (CT) findings. The natural evolution of the clots is by absorption, leaving a residual small scar or cyst.A few patients in whom a chronic encapsulated ICH developed, simulating a tumour, have been reported. We present two further cases. We assess their pathogenesis, clinical, neuroradiological and surgical features. We also suggest a classification of chronic ICH. Case reportsCase I A 33 year old man presented in November 1983 with a four month history of repeated convulsions of the arm. In the two months before admission he suffered from numbness of his right side and progressive difficulty with speech. There was no history of head injury or arterial hypertension. Neurological examination revealed mild dysphasia, dyslexia, dysgraphia, and right sided hyperreflexia.A CT scan showed a well demarcated, roundish, hyperdense lesion in the left parietal lobe with perifocal oedema and mass effect. The ring of the lesion slightly enhanced after contrast infusion (fig 1). Cerebral angiography revealed an avascular left parietal mass. At operation a well demarcated lesion with a thick, elastic, brownish capsule was found at a

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Dural arteriovenous fistulas (DAVFs) occurring simultaneously at two or more separate locations are not frequent. In fact, the incidence of multiple DAVFs is 7 to 8% of all DAVFs. Patients harboring multiple DAVFs have a higher incidence of hemorrhage, venous infarction, and neurological deficits due to a greater frequency of leptomeningeal venous drainage. To the authors' knowledge only a few cases of DAVFs involving both transverse sinuses (TSs) have been reported. These patients underwent various combined treatments (transarterial embolization, transvenous obliteration, surgical isolation, resection, and radiosurgery). Treatments performed that do not include resection of the involved sinuses do not always guarantee a cure. The authors present a patient who harbored multiple DAVFs of the TSs, both distally occluded with secondary reflux into the superior sagittal sinus (SSS), the straight sinus, the deep venous system, and the leptomeningeal veins of both hemispheres. An en bloc removal of the portions including the fistulas of the TSs, the confluence of sinuses, and the distal parts of the SSS, and straight sinus allowed for the patient to be cured. The fact is emphasized that despite the progress of endovascular treatment and radiosurgery this kind of DAVF must be surgically treated. The operation may be complex and dangerous.