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Object As one of the aspects of the International Surgical Trial in Intracerebral Haemorrhage (STICH), prerandomization computerized tomography (CT) scans were collected. In the present study the authors determined the inter-and intraobserver variability of various parameters pertinent to CT scans obtained in patients with intracerebral hematomas (ICHs). Methods A protocol was devised to analyze CT scans in a uniform and systematic manner. Each observer evaluated the same set of scans twice, with a minimum 2-month interval between assessments. In addition to noting the side and the sites of involvement, the observers measured the scale present on the scan itself and the length, breadth, height, and depth of the spontaneous ICH as well as the midline shift. The intraclass correlation was very high (κ 0.8–1) for the measurements of volume, depth, and midline shift. Good interobserver agreement (κ 0.8–1) was demonstrated with regard to involvement of basal ganglia or thalamus, presence of intraventricular extension, and the side of the hematoma. Agreement was substantial (κ 0.61–0.8) with regard to identifying primary involvement of particular lobes. Agreement was moderate (κ 0.41–0.6) on the presence or absence of hydrocephalus. When comparing the first and the second sets of readings, the intraobserver agreement was good (80–100%). Conclusions The study quantifies the degree of inter- and intraobserver agreement regarding evaluation of CT scans in patients with ICH when conducted in accordance with a set protocol.

We present a case of anterior migration of prosthesis that presented acutely several weeks following cervical arthroplasty. The implant was subsequently removed and the level fused. The cause of this unusual complication is speculated.

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The purpose of this paper is to serve as a reference to aid in the management of this poorly understood intracranial malignancy. The authors report their experience treating the eighth ostensible case of a primary intracranial alveolar soft part sarcoma (ASPS). A 21-year-old man presented to hospital after collapsing. He gave a 1-year history of headache, a 2-month history of reduced visual acuity and on examination had left facial paraesthesia with left-sided incoordination. MRI of the brain revealed a large left posterior fossa mass. The patient underwent resection of the tumour with good recovery in function. Immunohistochemical analysis of the tumour specimen confirmed an ASPS, and multimodal imaging in search of an extra-cranial disease primary was negative. A review of the literature yielded only seven other cases of primary intracranial ASPS. A variety of diagnostic imaging modalities were employed in search of a disease primary, as were various combinations of surgical resection, chemotherapy and radiotherapy as treatment. Half of the cases documented delayed disease recurrence. The authors discuss t h e f o l l o w i n g : t h e u n i q u e r a d i o l o g i c a l a n d immunohistological characteristics of this disease including the potential for its misdiagnosis; the investigations required to diagnose a primary intracranial ASPS; the efficacy of current medical and surgical treatment options and the factors that will aid in prognostication. This is the first review of this new primary intracranial malignancy. From our analysis, we offer a joint radiological and immunohistochemical algorithm for the diagnosis of primary intracranial ASPS and specific operative considerations prior to resection.