Rosai-Dorfman Disease  is a rare disorder of unknown etiology. Intracranial presentation is even rarer and often mimics the appearance of a meningioma on neuroimaging. Here we present the case of a 38-year-old male patient admitted for an intracranial, extra-axial, supratentorial tumor associated with mild neurological deficit; the presumptive diagnosis was convexity meningioma. After surgery, the definitive histological diagnosis was informed as intracranial Rosai-Dorfman Disease.The differential diagnosis of any extra-axial intracranial lesion suggestive of a meningioma should include intracranial Rosai-Dorfman Disease due to the similarities on clinical presentation and neuroimaging.

Arterial vasculitis or cerebellar vasculitis in systemic lupus erythematosus (SLE) are extremely infrequent, and these might be included within cases of neuropsychiatric SLE (NPSLE), cerebellar stroke in SLE, and within the group of central nervous system vasculitis due to SLE. The addition of surgical management to this condition has been reported in few publications. We present the case of a 18- year old female patient with SLE, NPSLE, and cerebellar stroke, highly suspicious of inflammatory vasculitis affecting cerebellar arteries, in whom, in spite of medical management, suboccipital decompression was performed. Inflammatory vasculitis of cerebellar arteries in SLE is an infrequent cause of cerebellar stroke, and it has elevated mortality rates. There is limited scientific evidence with respect to suboccipital decompression for the management of this condition.