Cavernous hemangiomas occur frequently in the intracranial structures but they are rare in the spine, with an incidence of 0.22 cases/million/year, which account for 5 -12% of the spinal vascular lesions, 51% of which are extradural. Most of the epidural hemangiomas are secondary extensions from the vertebral lesions. The spinal cavernous hemangiomas which do not involve the vertebrae are referred to as "pure" types. The pure epidural hemangiomas are rare, which account for only 4% of all the epidural lesions.A case of a Pure spinal epidural cavernous hemangioma in a 50 year old male, with the clinical picture of a slowly progressive compressive myelopathy, has been presented here.The imaging studies showed a well-defined, enhancing epidural lesion at the T7 -T8 level, with dorsal cordedema and myelomalacic changes. A radiological diagnosis of a meningioma was considered. Histopathologically, the lesion was diagnosed as a hemangioma. The patient improved dramatically after the excision of the lesion. CASe RepoRTA 50 year old male presented with a history of progressive weakness in both the lower limbs since 1 year. He also complained of inability in walking, lifting or appreciating sensations in the lower limbs, as well as loss of the bowel and bladder control. The general examination revealed no significant abnormalities. A detailed Central Nervous System (CNS) examination showed no neurological deficit in the upper limbs. The lower limbs were flaccid, with a reduced bulk and a power of grade 1/5. A loss of sensation was observed upto the groin crease. An examination of the spine revealed no tenderness or deformity. The systemic examination showed no abnormality. The routine haematological investigations showed mild anaemia. Magnetic Resonance Imaging (MRI) of the dorsal spine showed a well-defined, oval, enhancing lesion which measured 4.4 x 1.3 x 2.0 cm, in the posterior epidural compartment, at the T7 -T8 level, with dorsal cord oedema and early myelomalacia. The lesion was homogenously iso-intense in the T1 images and it was hyperintense in the T2 images, with effacement of the subarachnoid space posteriorly. The spinal cord showed mild extension into the neural foramina. The radiological diagnosis which was offered was meningioma [Table/ Fig-1].The patient underwent laminectomy from the T7-T8 level. Peroperatively, an epidural reddish brown mass which measured 6x2 cm at the T7-T8 level, with no dural attachment, or spinal extension or bony involvement, was observed. The excised mass was subjected to a histopathological examination.the histopathological examination findings were as follows: The gross examination of the specimen showed a single, brownish black, soft tissue mass which measured 3.5 x 1.5 x 0.5 cm. The cut section showed a brown black colour with a spongy appearance. The microscopic examination showed a benign tumour which was composed of vascular spaces of variable sizes, with fibrocollagenous walls which were lined by a single layer of flattened endothelial cells. The lumina containe...

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A 3-year-old girl presented with a history of intermittent fever of six months duration associated with respiratory symptoms consisting of recurrent cough, fever, wheeze and a suspected history of contact with tuberculosis (TB). Chest radiograph revealed pulmonary infiltrates mimicking miliary TB. She was started on anti-tuberculous treatment, but in view of clinical deterioration, a further work-up including a lung biopsy revealed non-Hodgkin's lymphoma (NHL). This case documents the extremely rare occurrence of pulmonary involvement and miliary infiltrates on the chest radiograph in NHL.

Background: The efficacy and safety of Pregabalin and Nortriptyline have been proved individually in low backache with radicular pain. However, there are limited number of studies comparing the efficacy of Pregabalin and Nortriptyline in Chronic Low Backache (CLBA) with radicular pain. Hence the present study was designed to determine the efficacy as well as tolerability of Pregabalin in comparison with that of Nortriptyline for reduction of pain in CLBA. The present study was an open label prospective observational study.Methods: Patients with CLBA, 15-60 years of age without specific cause and significant neurological deficit were included in the study. Severity of pain was assessed by Visual Analogue Scale (VAS). Patients were followed up at 2 and 4 weeks and their VAS scores and side effects were noted.Results: Both Pregabalin and Nortriptyline were effective in reducing pain, from baseline to 2 weeks and up to 4 weeks of treatment in chronic low backache with radicular pain, but there was no statistically significant difference between the two treatment groups. The incidences of side effects were less in the Nortriptyline treatment group as compared to Pregabalin.Conclusions: From the results of the present study it can be concluded that both Pregabalin and Nortriptyline were equally effective in the treatment of chronic low backache with radicular pain, but the incidence of adverse effects were more with Pregabalin as compared to Nortriptyline.