Neurocutaneous melanosis is considered to follow from neurulation disorders which could account for associated developmental malformations as the so-called Dandy-Walker complex. Cutaneous lesions are usually recognized at birth whereas neurological manifestations develop later. Numerous neurological symptoms have been reported according to extent of leptomeningeal and parenchymal infiltration. Whether magnetic resonance imaging of the neuroaxis represents the choice radiological exam, definite diagnosis relies upon the histological data obtained by mean of biopsy. Once symptomatic, surgical and medical measures remain palliative since death occurs within 3 years.

Background:Massive ischemic cerebellar infarct (MICI) is a main source of stroke, which can lead to severe morbidity and mortality. There is no consensus in medical literature for the management of MICI. The choice is made between placing an external ventricular drainage, suboccipital decompressive craniectomy, and removal of necrotic tissue or conservative treatment. There are not many prospective studies, done on this subject.Methods:We retrospectively analyzed the clinical features, and imaging studies of 53 patients with MICI who had been treated by surgery or conservative treatment between January 2000 and December 2008 at the Department of Neurosurgery of the general hospital of Fort de France in Martinique. A total of 25 patients underwent surgery and 28 were treated medically.Results:The results show significantly better outcomes in the operated patients compared with the patients treated medically; Operated comatose patients demonstrated significant improvement in their Glasgow coma score (GCS) score with only two deaths. Whereas, nonoperated comatose patients lost points in their GCS with four deaths.Conclusion:The results of our study suggest that surgery may be an effective procedure and quite helpful for MICI in majority of cases.

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The discrepancy between clinical radiculopathy and disc herniation level on MRI or on CT scan is not rare. Management of this discrepancy requires further investigation to avoid missing diagnosis and treatment failure.

Although not as frequent as sciatica, cruralgia remains one of the most frequent reasons why people consult a neurosurgeon. It should be kept in mind, however, that every anterior leg pain is not cruralgia and thus several diagnoses must be discarded, such as of musculoskeletal diseases of hip, pelvis and femur. In the last years of the 19th century, André Léri, a French neurologist, described Leri's sign as it is used widely even today in everyday clinical practice. We studied retrospectively files of those patients who were seen in Neurosurgery by the authors for L3 and L4 nerve root compression to evaluate the reliability and accuracy of this sign. Between October 1998 and September 2017, 38,654 patients were examined in our department of Neurosurgery. Among them, 1698 patients presented pain as cruralgia and meralgia. In total, 1545 patients were included in the study. The data analysis showed that the sensitivity of LS was 0.9333 and the specificity 0.7974. The results of the study show a reliable diagnostic accuracy of Leri's sign.