Intracranial epidermoid--a 10-year study.

Twenty-eight cases of intracranial epidermoids were operated over a period of 10 years at the Bangur Institute of Neurology, Kolkata; 17 of them were male and 11 were female with an age range of 11 to 55 (mean 28.21) years. Their locations include--cerebellopontine angle region (n = 15), fourth ventricle (n = 6), lateral ventricle (n = 3), corpus callosum (n = 2), pineal region (n = 1) and basal cistern near temporal lobe (n = l). Hearing loss and vertigo were commonest features of cerebellopontine angle epidermoids. Fourth ventricular tumours presented with gait disturbances and cerebellar signs. Symptomatology of other lesions were varied. CT scan was diagnostic in 23 cases. Sixteen patients had ventriculomegaly and 10 of them required ventriculoperitoneal shunt. Total removal was achieved in 6, near total in 14 and partial in 8 cases. Five patients died. Postoperative complications included chemical meningitis in 7, worsening of cerebellar functions in 3 and aggravation of cranial nerve deficits in 2 patients. All of them except one case of cranial nerve deficit resolved with time. Nineteen patients were followed up over a mean duration of 5 years and 10 months. Reoperation was required in one. Rest had satisfactory outcome.

Bone flap preservation after decompressive craniectomy--experience with 55 cases.

We describe our experience with the previously described technique of preservation of the bone flap in a subgaleal pocket created over the intact side of the calvaria, discuss our experience of this method and review the literature to compare this method with other alternative techniques.