The likelihood of rupture of unruptured intracranial aneurysms that were less than 10 mm in diameter was exceedingly low among patients in group 1 and was substantially higher among those in group 2. The risk of morbidity and mortality related to surgery greatly exceeded the 7.5-year risk of rupture among patients in group 1 with unruptured intracranial aneurysms smaller than 10 mm in diameter.

We review 40 epidermoids and 4 dermoids of the skull and brain treated surgically in our Department between 1976 and 1987. Fourteen were extradural and 30 intradural. The mean duration of symptoms was 3 years for extradural and 10 years for intradural tumours. Symptoms varied with tumour site, in some sites being helpful in differential diagnosis. Skull X-rays and CT were the key diagnostic investigations in extradural and CT in intradural lesions, the latter, with few exceptions, presenting a characteristic CT scan. In 7 cases MRI supplied important details on the tumour boundaries. All the diploic and orbital lesions were removed totally, with a good outcome. Twelve of the intradural lesions were removed totally, 9 subtotally and 9 partially, with a good outcome in 21 patients and a poor outcome in 4; 5 patients died. Outcome was unrelated to degree of removal.

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A 32-year-old previously healthy man presented with headache that progressively worsened during the day. He denied any previous history of headache and trauma. There was no family history of neurological diseases. Examination revealed nuchal rigidity. Cranial computed tomography disclosed a left frontal hemorrhage. Brain magnetic resonance imaging revealed multiple cerebral cavernous malformations (CCM). The patient received conservative treatment. Cerebral cav-ernous malformations are commonly described in the famil-ial form and are frequently asymptomatic. When symptoms do occur, seizures are the most common followed by focal deficits and headache 1. Several mutations in CCM genes have already been identified in patients with sporadic disease 2. Figure 1. Axial cranial CT scan: an oval-shaped hyperdense lesion in the left frontal lobe with perilesional vasogenic edema and a small focus of blood in the contralateral frontal lobe. Figure 2. Brain MRI in axial T1 (A), Axial-susceptibility-weighted (B) and multiplanar reconstruction (C) showing an heterogeneous lesion with a hyperintense signal associated with perilesional vasogenic edema suggestive of acute hematoma. Additionally, there are multiple nodules with hypointense signal throughout the parenchyma and a subarachnoid hemorrhage in the left Sylvian fissure.