Epidermoid Cyst of the IV Ventricle: Case Report

Epidermoid cysts constitute congenital, benign and rare lesions, corresponding to 0.2% to 1.8% of all intracranial tumors. Only 5% of the cases are located in the fourth ventricle. Despite their genesis in intrauterine life, they are usually diagnosed between the third and fifth decades of life due to their very slow growth pattern. The image weighted by the diffusion of the magnetic resonance is essential to establish the diagnosis. The ideal treatment consists of emptying the cystic content with complete capsule resection. In the present work, we report the case of a 31-year-old female with cerebellar syndrome that evolved with intracranial hypertension. The symptomatology was due to an obstructive hydrocephalus by an epidermoid cyst located inside the fourth ventricle, which was confirmed by the pathological anatomy.

Aneurysmal Bone Cyst of the Skull Base ­ Case Report

Introduction Aneurysmal bone cysts (ABCs) are pseudotumoral bone lesions of unknown etiology that are also hypervascularized, benign, and locally destructive. They are rare in the base of the skull. The present case report describes a case of aneurysmal bone cyst in the sella turcica. Case Report The present study was developed at the department of neurosurgery of the Hospital Universitário Professor Alberto Antunes of the Universidade Federal de Alagoas (HUPAA-AL, in the Portuguese acronym), Maceió, state of Alagoas, Brazil, and is accompanied by a review of the literature from the PubMed database. A 17-year-old female patient with bitemporal hemianopia and intense left hemicranial headache associated with symptoms from the cranial nerves contained in the cavernous sinus. Neuroimaging evidenced a large lesion in the suprasellar region with calcification foci, sellar erosion, and extension to the cavernous sinus. The patient was submitted to a partial lesion resection and the histopathological analysis showed an aneurysmal bone cyst. Conclusion A rare case of intracranial aneurysmal bone cyst, with the important differential diagnosis from pituitary adenoma.

Post-traumatic Tension Pneumoventricle: Case Report

Pneumoventricle and liquoric fistula are possible complications of traumatic brain injury (TBI), the main cause of morbimortality related to trauma in Brazil. Liquoric fistulae are more common after direct trauma with skull base fractures. However, pneumoventricle is rare and occurs due to excessive cerebrospinal fluid (CSF) drainage in the presence of a poorly compliant ventricle system, resulting in the influx of air to its interior. The pathophysiology of tension pneumoventricle remains uncertain. However, the traumatic cause is certain andmultiple bone fractures of the face and liquoric fistula may contribute to the process. If symptomatic, the tension pneumoventricle can cause rapid clinical deterioration. The authors aim to report a rare case of post-TBI tension pneumoventricle with complete resolution and without signs of recurrence of the liquoric fistula after surgical treatment.

Giant scalp arteriovenous malformation / Malformação arteriovenosa gigante de escalpo

SUMMARY Arteriovenous malformations (AVMs) of the scalp are rare lesions. The clinical picture presents with complaints of increased scalp, scalp disfigurement, pain and neurological symptoms. Its origin can be congenital or traumatic. We present a case of giant scalp AVMs and its management, followed by a brief literature review on the subject. The diagnosis of scalp AVMs is based on physical examination and confirmed by internal and external carotid angiography or computed tomographic angiography (CTA). Surgical excision is especially effective in scalp AVMs, and is the most frequently used treatment modality.

RESUMO Malformações arteriovenosas (MAV) do couro cabeludo são lesões raras. O quadro clínico apresenta-se com queixas de aumento do couro cabeludo, desfiguração do couro cabeludo, dor e sintomas neurológicos. A origem pode ser congênita ou traumática. Apresentamos um caso de MAV gigante de couro cabeludo e o tratamento adotado, seguindo-se uma breve revisão da literatura. O diagnóstico das MAV de couro cabeludo baseia-se no exame físico e é confirmado pela angiografia carótida interna e externa ou angiografia por tomografia computadorizada. A excisão cirúrgica é especialmente eficaz em MAV de couro cabeludo e é a modalidade de tratamento mais frequentemente utilizada.