Pilomyxoid astrocytomas (PMAs) are low-grade (WHO Grade II) tumors for which the imaging features are similar to pilocytic astrocytomas (PAs), but for which histological features and the clinical course differ. They are classified as a variant of PA. They have only been recently recognized, and they behave more aggressively than PAs. Most cases occur in the hypothalamic-chiasmatic area, although they may be located in any part of the neuraxis. Posterior fossa PMAs are very rare. The authors report a case of a 2-year-old girl with cerebellar PMA.

A 63-year old Yemeni male, known case of endstage renal disease (ESRD), hypertension and diabetes mellitus, underwent craniotomy and endoscopic removal of an intraventricular mass. Peri-operatively he was started on cefazolin, a normal diet and regular hemodialysis without heparin. The international normalising ratio (INR) increased rapidly, reaching 4.2 on day five but responded equally rapidly to parenteral Vitamin K and withdrawal of cefazolin. Cefazolin is an antibiotic commonly used in clinical practice because of its long half-life, narrow spectrum and its ability for dose adjustment in renal failure patients. We review the literature, discuss the risk factors of its use and suggest possible mechanisms causing the prolonged coagulation.

Distal cortical middle cerebral artery (MCA) aneurysm is a rare entity. Despite the challenging procedure, the role of endovascular treatment is emerging due to its safety and efficacy in obliterating the microaneurysm. We report a 25-year-old male, who presented with a history of dizziness and headache for almost 2 weeks. Computed tomography scan showed a right front parietal subdural hematoma (SDH). We could not identify any underlying defining etiology of SDH neither head injury nor coagulopathy disorder. Therefore, diagnostic cerebral angiogram was performed, which showed a microaneurysm in the distal right MCA cortical branch. Hence, complete obliteration of this microaneurysm was performed using Onyx for endovascular embolization. Therefore, this case report demonstrates the efficacy of this modality in the treatment of microaneurysms with SDH.

No abstract