An epidural hematoma of the clivus is reported in a 16-year-old boy after a motor vehicle accident. The diagnosis was made by magnetic resonance imaging. Only five similar cases have been reported in the literature. The patient was treated conservatively and recovered without neurological deficits. The mechanism of injury and formation of the hematoma in this region are discussed.

A 47-year-old man exhibited loss of libido and impotence in association with plasma hyperprolactinemia and a pituitary mass with downward extension of the tumor to the sphenoid sinus and to the suprasellar cisterns. Bromocriptine, 15 mg daily, reduced the hyperprolactinemia as well as tumor size. After 8 months on this therapy, the patient developed overt CSF liquorrhea. Five days after discontinuation of bromocriptine, the CSF rhinorrhea stopped, and when bromocriptine was given again 2 weeks later, CSF rhinorrhea returned within 3 days. We believe this phenomenon to be due to retraction of tumor by bromocriptine exposing a defect in the sella floor. Transient occurrence of CSF rhinorrhea can be considered as a consequence of tumor regression in patients on bromocriptine. The possibility of this complication, especially in patients with downward extension of tumor, should be noted.

A 25 year old patient presented with recurrent prolonged episodes of life-threatening coma varying from 3 to 10 days. The clinical recovery was slow. The history and technical examinations led to the diagnosis of basilar artery migraine (BAM). The etiology of the coma episodes is thought to be related to ischemic dysfunction of the rostral part of the brainstem due to severe spasm of the basilar artery demonstrated by arteriography. Exceptional are the recurrent prolonged coma episodes of sudden onset, the severe spasm of the basilar artery, and the suppression-burst and FIRDA pattern on the EEG examinations during the coma episodes.

No abstract

No abstract