Gamma knife surgery (GKS) is a well-established modality for controlling the progression of vestibular schwannomas. Adverse effects of this treatment are extremely rare but include cyst formation and malignant transformation. We report a case of anterior inferior cerebellar artery (AICA) pseudoaneurysm development rupture presenting as a poor WFNS grade subarachnoid haemorrhage. This is only the fourth case of aneurysm development (AICA aneurysm) following GKS reported but due to its serious nature we believe this potential complication warrants awareness in those offering this treatment.

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SummaryBenign intracranial hypertension is a clinical diagnosis linked to a number of medical and surgical disorders. A common aetiology has not yet been established. It would seem, however, that many, if not all, of these cases can be related to some degree of cerebral venous outflow obstruction. We present here a series of patients with extraluminal compression of the cerebral venous sinuses that has been amenable to surgical resection.These 'surgical' causes of BIH illustrate an important subset of the disease and inform us about the possible pathophysiological principles underlying the disorder.

Intradural disc herniation is a rare entity reported at 0.04–1.1% that occurs most commonly in the lumbar spine particularly at L4–L5 region. There is a paucity of literature due to the rarity of this condition. Intradural disc herniations must be considered in the differential diagnosis of prolapsed intervertebral disc disease especially with recent worsening of symptoms and mismatch of unenhanced magnetic resonance induction (MRI) findings. The confirmation is made with intraoperative findings. An intradural disc herniation is most often diagnosed intraoperatively. Contrast enhanced MRI scan is mandatory for pre-operative diagnosis. We report on two cases presenting to our unit in the form of recurrent intradural disc disease following previous lumbar surgery occurring within 3 months of the index procedure in both cases.

We report the case of an adolescent with a thoracic spine astrocytoma whose initial presentation was communicating hydrocephalus. We speculate that the mechanism may be reduced meningeal compliance due to meningeal spread of the tumour. Craniospinal MR imaging should be considered as part of the routine work up for patients presenting with unexplained hydrocephalus, elevated CSF protein and/or long tract symptoms/signs.