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Background:Choroid plexus papilloma (CPP) is a benign neoplasm that arises from the ventricular choroid plexus. The clinical features, radiological characteristics, and treatment have been discussed in this study for a pediatric population.Methods:Over an eight-year period, seven pediatric (≤12 years) CPP patients were treated. Tumors were located in the lateral ventricle (n = 4), IVth ventricle (n = 2), and in both the lateral and IIIrd ventricles (n = 1). The patients presented predominantly with features of raised intracranial pressure. Total microsurgical excision was carried out in all cases.Results:There was complete relief of symptoms at follow-up in six patients. A 2.5 year-old child with a large trigonal CPP with hydrocephalus leading to complete visual impairment, died due to postoperative hypokalemia that caused ventricular fibrillation. One of our patients required a postoperative, permanent CSF diversion procedure while another required a subduroperitoneal shunt for persisting postoperative subdural CSF collection.Conclusions:Coagulation of the tumor under constant irrigation to shrink and excise it in toto, avoids excessive bleeding during surgery. The vascular pedicle supplying the tumor should be adequately dealt with during the last part of tumor removal as retraction of a bleeding pedicle may result in ventricular hemorrhage and brain edema. Following surgery, an external ventricular drain for three days helps in preventing the development of acute hydrocephalus in lateral ventricular lesions, and the color of the drained CSF gives an estimate of the ventricular hemostasis achieved. Total excision is usually possible in these cases with excellent postoperative outcomes.

Anterior meningocele involves herniation of meninges through an abnormal defect in the anterior vertebral column. The pathogenesis, natural history, and management strategy of anterior cervical meningocele (ACM) are uncertain. We report a case of ACM with high cervical instability in a case of neurofibromatosis 1. Unlike other reported cases, torticollis and instability due to ACM were the major concerns in this case. We aim to discuss the management strategy and surgical nuances of such cases.

Intramedullary spinal cord tumors are one of the most challenging neurosurgical conditions. The compact spinal cord fiber bundles (ascending and descending tracts) and spinal cord vascularity are at a huge risk during tumor resection. Hence, the resection of such tumors always has an inherent risk of inducing neurological deficits. Thus, the determination of tumor–cord interface assumes the greatest importance. The refinement in surgical technique and intraoperative neuromonitoring has increased the safety level of modern-day results with such tumors. Management of tumor recurrence and the exact role of adjuvant therapy, however, remains to be defined. In this review, we highlight surgically relevant aspects of these tumors, the current state of adjuvant treatment choices, and a literature review.

Conversion disorder is a common somatic symptom disorder characterized by non-specific symptoms not explained by the underlying organic disease. The systemic review of patients with motor symptoms secondary to conversion disorder shows a highly variable recovery rate varying from 10% to 90%. It is not clear whether these patients use hospital care facilities transiently or have repeated admissions. The present study was performed to study the hospital revisits of all the patients discharged with the diagnosis of conversion disorder from all non-federal emergency departments and acute care hospitals in California, Florida and New York from the year January 2005 to December 2011. The revisit rate was compared between the patients diagnosed with conversion reaction to those with seizure disorder and transient global amnesia. The authors found the hospital revisit rate of patients with conversion disorder was significantly higher as compared to patients with transient global amnesia and seizure disorder. The results signify the fact that the conversion disorder is not an acute-stress induced transient event but a manifestation of chronic neuropsychiatric background with a significant hospital based burden of disease.