A rare case of childhood hemiparesis

Abstract

A 14-year-old boy with no history of trauma complained of left-side weakness and ataxia during the previous 24 h. The symptoms first appeared while playing the trumpet in the school orchestra. Neurologic examination on admission showed left hemiparesis (grade 3/5) with brisk reflexes. The remainder of the neurological and general examinations was normal. Lateral skull radiograph showed air in the frontal lobe (Fig.1a). Computed tomography (CT) scan revealed an ethmoid sinus osseous lesion and large right frontal pneumatocele (Fig. 1b–d).The patient underwent a right frontal craniotomy, which revealed an ethmoid roof bony mass that had eroded the upper sinus wall and breached the dura (Fig. 2). The tumor had also encroached into the frontal lobe. After complete removal of the ossifying tumoral tissue, the dura was repaired and covered with a fascia graft. Osteoma was confirmed by pathological examination. The postoperative course was uneventful, and the symptoms progressively improved. He was discharged 1 week after surgery and the 2year follow-up revealed no neurologic sequelae. Discussion