Detailed (1)H and (13)C NMR spectroscopy of lipid extracts from 12 human intracranial tuberculomas and two control brain tissue samples was performed to assess the role of lipids in the disease process. One-dimensional and two-dimensional NMR techniques were used to resolve the mixture of lipid components and make resonance assignments. The lipid components that could be identified in tuberculoma lipid extracts and not in control samples were: cholesterol ester, plasmalogen and phenolic glycolipids. It is proposed that the combined occurrence of these lipid components can be used as 'fingerprint markers' for the differentiation of intracranial tuberculoma from healthy brain tissue. Furthermore, phenolic glycolipids present in intracranial tuberculomas may have diagnostic significance in differentiating them from other disease conditions of the central nervous system such as malignant tumors.

ABSTRACT:We report a case of a 47 year old man who presented with head injury due to road traffic accident, with CT scan suggestive of large left sided acute SDH with comminuted fracture of occipital bone. Within a few hours, patient showed significant neurological improvement. Follow-up CT scan revealed rapid spontaneous resolution and redistribution of the acute SDH. The proposed hypothesis explaining this rare phenomenon suggests intracranial and extra cranial redistribution as the cause of spontaneous resolution of acute SDH. The intracranial phenomenon is more common of the two. To our knowledge, this is the first case in the literature where both intracranial and extracranial phenomenon played a role in the same patient leading to rapid spontaneous resolution of acute SDH. KEY WORDS: • acute subdural hematoma • spontaneous resolution • intracranial redistribution • extracranial redistribution. INTRODUCTION:Acute subdural hematoma (SDH) is a common entity after traumatic brain injury. Acute SDH, more than 10mm in thickness, require immediate surgical evacuation in vast majority of the cases. Though a very rare phenomenon, rapid spontaneous resolution of acute SDH does occur 1,2,3,4,5,6,7 . Two possible hypotheses have been suggested: (1) the hematoma is diluted by cerebrospinal fluid (CSF) due to tearing of the arachnoid membrane and then is washed out. (2) The hematoma is compressed by the pressure produced by acute brain swelling and is redistributed 4 . In our current communication, we present a case of spontaneous resolution of acute SDH, the proposed theories explaining spontaneous resolution of acute SDH, as well as, the clinical parameters and imaging characteristics that might predict such a phenomenon are also reviewed. The possibility of spontaneous resolution of an acute SDH, although remote, may affect the decision making process regarding the management of these patients under certain conditions 1 .

Tuberous sclerosis complex (TSC) is a neurocutaneous syndrome, inherited as an autosomal dominant trait with a high incidence of sporadic cases and protean clinical expression, with a incidence of prevalence between 1 in 10,000 and 1 in 170,000. The cardinal features of TSC are skin lesions, convulsive seizures, and mental retardation. We report a sporadically occurring case of definite TSC in a young female who presented with oral and cutaneous manifestations without mental retardation or history of convulsive seizures, which to the best of our knowledge has not been reported so far.

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