Arachnoid cysts are non-neoplastic, intracranial cerebrospinal fluid (CSF)-filled spaces lined with arachnoid membranes. Large arachnoid cysts are often symptomatic because they compress surrounding structures; therefore, they must be treated surgically. As several surgical management options exist, we explore the best approach according to each major type of arachnoid cyst: middle cranial fossa cyst, suprasellar cyst, intrahemispheric cyst, and quadrigeminal cyst.

BackgroundIntraspinal dermoid cysts are rare and benign tumors that occur primarily due to the defective closure of the neural tube, an ectodermal derivative, during the process of development. They are slow-growing tumors manifesting in the second and third decades of life.Case presentationWe present here a case of a 14-year-old Sindhi boy with a six-month history of paraparesis of the lower limbs and a progressive loss of power of grade 3/5, and hypoesthesia in the L4/L5 dermatomes of his right lower limb. A plain magnetic resonance imaging scan revealed a well-demarcated intraspinal intramedullary cyst containing an abscess at the level of T12 and L1 causing localized cord compression, which was producing the symptoms. Near total excision of the cyst was successfully performed and was sent for biopsy, which revealed keratinocytes and keratin flakes. With one month of follow-up, along with physiotherapeutic management, the patient gradually improved and was able to walk without support.ConclusionsCritical evaluation of every case with aggravating symptoms should be carried out, and neurological and radiological examinations should be conducted to ensure the well-being of patients.

Background: Cerebellar contusion accounts for 0.54% of traumatic brain injuries. They present with a variety of symptoms like ataxia, dysmetria, dysdiadokinesia, and vertigo. CT scan is the gold standard investigation for diagnosing acute cerebellar contusions. Due to the low incidence of this disease, there are no medical guidelines available for the management of cerebellar contusions. Case report: A 2-year-old child presented to the emergency department with altered level of consciousness. Computed tomography scan of the brain showed midline cerebellar contusion. He was managed conservatively with the main focus on lowering intracranial pressure. Result: Cerebellar contusion can be managed conservatively with close monitoring. However, more data is needed to study its behaviour and management. Conclusions: The patient had an excellent response to treatment and was discharged within a few days further highlighting the role of medical management in the treatment of patients with cerebellar contusions.

IntroductionIntra-medullary spinal tuberculoma is a rare form of tuberculosis, with an incidence of only two in 100,000 patients with tuberculosis. We present a case of intra-medullary tuberculoma from Pakistan, which was diagnosed by radiological findings and analysis of cerebrospinal fluid using polymerase chain reaction testing.Case presentationWe present the case of a 28-year-old Sindhi male with intra-medullary tuberculoma of the spinal cord at the C3 level. Our patient was treated solely with anti-tubercular drug therapy with no surgical intervention.ConclusionsWe discuss the possible clinical management of such rare cases, considering both chemotherapeutic and surgical options. Additionally, diagnostic procedures and findings are discussed; we suggest cerebrospinal fluid analysis via polymerase chain reaction and gadolinium-diethylenetriamine pentaacetic acid magnetic resonance imaging as important chemical and radiological tests to be performed in such cases.