Intracranial leptomeningeal CNS ganglioneuroblastoma. First report and review of the literature.

BACKGROUND: CNS ganglioneuroblastoma in an extremely rare embryonal tumour, specifically in the pediatric population. Bad prognosis is documented due to aggressiveness and absence of protocolized treatment at the moment. CLINICAL DESCRIPTION: We present the case of a 5-year-old boy who presented with sudden loss of consciousness. CT scan was performed showing a large posterior fossa lesion with several intraventricular focal lesions, suggesting metastases, the largest one located inside the III ventricle. The patient underwent a posterior fossa resection of the lesion and a subtotal resection of the III ventricle lesion, with adjuvant chemotherapy. The evolution was poor and the patient finally died 3 months after diagnosis. CONCLUSION: Ganglioneuroblastoma is extremely likely to recur quickly and extensively. There is little knowledge about treatment options but is documented that gross total resection followed by adjuvant radiotherapy and chemotherapy is the best management in these patients.

Doble derivación ventrículo y cisto biliar en el tratamiento de quiste aracnoideo gigante supraselar con hidrocefalia secundaria / Double ventriculo-gallbladder shunt in the treatment of giant suprasellar arachnoid cyst with secondary hydrocephalus

La derivación ventrículo biliar se describe como un procedimiento alternativo eficaz en el tratamiento de la hidrocefalia. Presentamos el caso de un paciente de 19 años de edad diagnosticado de quiste aracnoideo supraselar e hidrocefalia, portador de doble sistema valvular de derivación ventrículo peritoneal y cisto peritoneal desde la infancia. Tras varios recambios por fallo peritoneal, fue sometido a derivación ventriculoauricular, con complicaciones asociadas y posterior recolocación a peritoneo. Tras nueva disfunción valvular por complicaciones peritoneales, se planteó la derivación ventriculobiliar como tratamiento alternativo para este paciente, que resultó segura y eficaz en la resolución de la clínica del paciente, siendo dado de alta, manteniendo estabilidad clínica durante más de 2 años de seguimiento. (AU)

Ventriculo-gallbladder shunt is described as an effective alternative procedure in the treatment of hydrocephalus. We present the case of a 19-year-old patient diagnosed with suprasellar arachnoid cyst since his childhood and hydrocephalus, with a double shunt; ventriculoperitoneal and peritoneal cyst shunt. After several replacements due to peritoneal failure, he underwent ventriculoatrial shunt, with associated complications and subsequent repositioning to the peritoneum. After new valve dysfunction due to peritoneal complications, ventriculo-gallbladder shunt was proposed as an alternative treatment for this patient, which was safe and effective in resolving the patient's symptoms, and the patient was discharged, maintaining clinical stability in the follow-up more than 2 years later. (AU)

Double ventriculo-gallbladder shunt in the treatment of giant suprasellar arachnoid cyst with secondary hydrocephalus.

Ventriculo-gallbladder shunt is described as an effective alternative procedure in the treatment of hydrocephalus. We present the case of a 19-year-old patient diagnosed with suprasellar arachnoid cyst since his childhood and hydrocephalus, with a double shunt; ventriculo peritoneal and peritoneal cyst shunt. After several replacements due to peritoneal failure, he underwent ventriculoatrial shunt, with associated complications and subsequent repositioning to the peritoneum. After new valve dysfunction due to peritoneal complications, ventriculo-gallbladder shunt was proposed as an alternative treatment for this patient, which was safe and effective in resolving the patient's symptoms, and the patient was discharged, maintaining clinical stability in the follow-up more than 2 years later.

Intracranial hypertension caused by superior sagittal sinus stenosis secondary to a depressed skull fracture: Case report and review of the literature / Hipertensión intracraneal causada por estenosis del seno sagital superior secundaria a fractura por hundimiento craneal: caso clínico y revisión de la literatura

Depressed fractures that occur on the superior sagittal sinus (SSS) cause stenosis or thrombosis of the sinus in 11.5% of cases. Despite this, the appearance of signs and symptoms derived from high intracranial pressure is an infrequent event. So far, only 17 cases of venous sinus injury causing intracranial hypertension have been documented. It is necessary to establish treatment immediately before clinical suspicion. Surgical treatment by craniectomy is a fast, effective and safe alternative according to the series. However, it is necessary to anticipate the possibility of haemorrhage in the operating room. The case of a 7-year-old girl admitted for traumatic brain injury (TBI) with the diagnosis of a left parasagittal occipital sinus fracture that stenosed the posterior third of the superior sagittal sinus is presented. Upon arrival, she was asymptomatic, and conservative management was selected. Subsequently, the patient began to present with headache, nausea, vomiting and diplopia associated with bradycardia and apnoea pauses of central origin. She underwent surgery with a craniectomy with satisfactory clinical and radiological evolution and normalization of the intracranial pressure (ICP) registry

Las fracturas por hundimiento que acontecen sobre el seno sagital superior (SSS) ocasionan estenosis o trombosis del seno en el 11,5% de los casos. Sin embargo, en raras ocasiones ocasionan hipertensión intracraneal. La revisión de la literatura aporta únicamente 17 casos de fractura sobre senos venosos provocando cuadro de hipertensión intracraneal, aunque posiblemente se trata de una entidad más frecuente de lo que cabría esperar sobre lo publicado. Es necesario establecer un tratamiento de forma inmediata ante la sospecha clínica. El tratamiento quirúrgico mediante craniectomía es una alternativa rápida, eficaz y segura según las series. Sin embargo, es necesario estar anticipado en el quirófano ante la posibilidad de sufrir hemorragia. Se presenta el caso de una niña de 7 años que ingresa por traumatismo craneoencefálico con el diagnóstico de fractura por hundimiento occipital parasagital izquierda que estenosa el tercio posterior del SSS. A su llegada se encuentra asintomática y se decide manejo conservador. Posteriormente comienza con cefalea, náuseas, vómitos y diplopía asociado a bradicardia y pausas de apnea de origen central. Es intervenida mediante craniectomía con posterior evolución clínica y radiológica satisfactoria, y normalización de la presión intracraneal

Intracranial hypertension caused by superior sagittal sinus stenosis secondary to a depressed skull fracture: Case report and review of the literature.

Depressed fractures that occur on the superior sagittal sinus (SSS) cause stenosis or thrombosis of the sinus in 11.5% of cases. Despite this, the appearance of signs and symptoms derived from high intracranial pressure is an infrequent event. So far, only 17 cases of venous sinus injury causing intracranial hypertension have been documented. It is necessary to establish treatment immediately before clinical suspicion. Surgical treatment by craniectomy is a fast, effective and safe alternative according to the series. However, it is necessary to anticipate the possibility of haemorrhage in the operating room. The case of a 7-year-old girl admitted for traumatic brain injury (TBI) with the diagnosis of a left parasagittal occipital sinus fracture that stenosed the posterior third of the superior sagittal sinus is presented. Upon arrival, she was asymptomatic, and conservative management was selected. Subsequently, the patient began to present with headache, nausea, vomiting and diplopia associated with bradycardia and apnoea pauses of central origin. She underwent surgery with a craniectomy with satisfactory clinical and radiological evolution and normalization of the intracranial pressure (ICP) registry.