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Meningioma

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Sagittal T2 (image 1), sagittal T1 post contrast (image 2), axial FLAIR (image 3), and axial T1 post contrast (image 4) MRI images and child with diffuse leptomeningeal glialneuronal tumor shows lobular abnormal signal (arrows) extending from the ependymal surface of the ventricular system into the surrounding parenchyma. There is only minimal enhancement of the tumor. Diffuse leptomeningeal glial neuronal tumor is a rare neoplasm that most commonly occurs in boys. Characteristically, the tumor appears with diffuse leptomeningeal thickening. Multifocal cystic lesions may appear in both the brain and spinal cord.

Dura in patient after multiple episodes of meningitis. S/p mvc patient was undergoing bifrontal crani for cranialization of frontal sinus after CSF leak found to be cause of meningitis.

Female, 46 years old, repeated attacks of epilepsy and convulsions

Non-shunt Management of Communicating Hydrocephalus in an Immunocompetent Host With Disseminated Central Nervous System Coccidioidomycosis
Disseminated coccidioidomycosis is associated with significant morbidity and mortality. Involvement of the meninges is often fatal if untreated, typically requiring lifelong antifungal therapy and neurosurgical intervention. We present the case of a young male without any known immunocompromising conditions who opted exclusively for medical management of newly diagnosed coccidioidomycosis meningitis with communicating hydrocephalus and discuss the controversy associated with this approach. This case highlights the importance of shared decision-making between patient and clinician, even if the plan diverges from available guidelines. Furthermore, we discuss clinical considerations in approaching the close outpatient monitoring of patients with central nervous system coccidioidomycosis with hydrocephalus.