Porencephalic Cyst Associated with Shunt Malfunction

When hydrocephalus develops, excessive cerebrospinal fluid accumulation usually occurs within the ventricular system, leading to a ventriculomegaly caused by increased intracranial pressure. Shunt malfunction, a common complication after a shunt operation, usually occurs, together with recurring ventricular dilatation. The authors report a case of shunt malfunction which manifested as a porencephalic cyst along the proximal catheter. The cyst subsided after the replacement of the shunt system, and this led to the patient's clinical improvement. We postulate that although the region around a catheter is an unusual site for cerebrospinal fluid collection, this finding should be considered as a shunt obstruction. The possible mechanism of reversible porencephaly is discussed and the literature is briefly reviewed.

Cranio-orbital Zygomatic Approach for Skull Base Lesion

Radical removal of extensive tumors in the parasellar region, interpeduncular fossa and cavernous sinus, or the clipping of the distal posterior circulation is very difficult via conventional approach. Seven patients with tumors in the parasella, cavernous sinus and subtemporal area, and six patients with aneurysms of distal posterior circulation were treated by using cranio-orbital zygomatic approach, with good results. The advantages of this approach are minimal brain retraction, exposure of lesion in shortest distance, multidirectional viewing of the lesion and a single cranial bone flap with relative good cosmetic result. Our cases treated via this approach are yet insufficient to compare this approach with other conventional operative approach in definitive advantages but we suggest that this approach is one of the best suitable approach for deep large lesions in the anterior and middle cranial fossae.