title: Muslin granuloma presenting with speech disturbance diagnosed by endoscopic biopsy.
abstract: METHODS
  We report the case of a 56 year-old woman who presented with worsening speech and poor seizure control eleven years after undergoing wrapping of a middle cerebral artery aneurysm. Radiological and histological findings were consistent with a muslin granuloma with a large cystic component. The cyst was drained endoscopically and an Omaya reservoir placed. The patient's speech improved and so did their seizure control.
  
  
  CONCLUSIONS
  This is the first case in which this rare complication of aneurysm surgery has caused speech deterioration. This is also the first case in which neuroendoscopy has been successfully employed to obtain tissue for diagnosis and to treat such a lesion.
authors.affiliation: Department of Neurosurgery, Charing Cross Hospital, London, UK. jhyam25@hotmail.com
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Hyam
authors.forename: Hazem
authors.initials: H
authors.lastname: Akil
authors.forename: Federico
authors.initials: F
authors.lastname: Roncaroli
authors.forename: David
authors.initials: D
authors.lastname: Peterson