Peri-orbital Masson's tumor: a case report and literature review.

Masson tumor is a benign vascular lesion characterized by an intravascular papillary endothelial hyperplasia. Peri orbital locations are rare. We report a case of Masson tumor localized in the upper internal angle of the left orbit revealed by progressive ocular proptosis. Orbital computed tomography (CT) scan and magnetic resonance imaging (MRI) showed a vascular mass in the left internal canthus mimicking an arterioveinous malformation. The patient underwent total removal of the lesion with a favorable postoperative follow up. Histological examination found an intravascular papillary endothelial hyperplasia without atypical features corresponding to Masson tumor. A thorough literature review of Masson tumor is presented with a discussion of clinical findings and management.

[Ischemic stroke, an unusual complication of snake bite: case report]. / Accident vasculaire cérébral ischémique, complication inhabituelle d'une morsure de vipère: à propos d'un cas.

Snake bite is the most severe type of envenomation. Annual incidence exceeds six million, with high mortality rates. Viper bites are often responsible for coagulopathy, which causes bleeding disorders. However, ischemic complications are rare. We here report the case of a 6-year-old girl victim of a viper [genus Cerastes] bite in the left ankle. She was admitted with disorders of consciousness and disseminated intravascular coagulation 4 days after the bite. Clinical examination showed left hemiparesis and left lower limb viperin syndrome. Brain CT scan objectified right temporoparietal ischemia. The patient outcome was marked by neurological worsening, requiring mechanical ventilation. Stroke, in particular ischemic stroke secondary to severe snake envenomation, is exceptional. The physiopathological mechanism has not been clearly elucidated but it appears to be multifactorial. Then new studies are needed.

Will the high acceptance rate of coronavirus disease 2019 vaccine in Morocco accelerate the recovery of neurosurgical practice?

BACKGROUND: In developing countries, where there is a chronic shortage of neurosurgeons and medical infrastructures, the pandemic has taken a heavy toll on neurosurgical activities. In the absence of a curative treatment, reaching herd immunity through mass vaccination campaigns is the best hope we have of ending this pandemic. Therefore, the purpose of our study was first to assess the effect of coronavirus disease 2019 (COVID-19) outbreak on neurosurgical services of a Moroccan tertiary hospital. Secondarily, we aimed to describe current vaccination compliance rate in our country, and its impact on the recovery of neurosurgical practice. METHODS: To examine how COVID-19 challenged the neurosurgical delivery of care in our unit, we compared emergency and elective admissions during COVID-19 and pre-COVID-19 period using the registry of neurosurgery department. Second, after evaluating vaccine acceptance rates among 1463 healthcare workers and patients admitted to our hospital, we compared the number of surgeries performed in our department after implementation of a mass vaccination campaign. RESULTS: The overall number of procedures dropped from n = 197 (pre-COVID-19) to n = 150 during COVID-19. The number of elective surgeries declined from an average of 10.5 operations per week before COVID-19 to four surgeries per week during the COVID-19 pandemic. Conversely, an average of 3.5 emergency operations was performed each week before COVID-19 compared to 5.6 per week during the pandemic. On the other hand, our results showed that willingness to get the COVID-19 vaccine among the participants was high (81.7%) with significantly less hesitant individuals among healthcare workers (P = 0.001). This successful vaccine rollout helped resuming gradually elective surgeries in our department. CONCLUSION: Our study found a high acceptance rate of COVID-19 vaccines among Moroccans, which gives a glimmer of hope of restoring all our neurosurgical services. However, despite the high acceptance rate, the authorities must address concerns among hesitant individuals and raise awareness on the importance of COVID-19 immunization.

Total Removal of a Giant Frontal Sinus Osteoma with Orbital Extension - A Case Report.

The Rationale: Osteomas are benign tumours that are usually asymptomatic. However, giant osteomas can lead to severe complications. We report here the management of a giant frontal sinus osteoma with orbital extension. Patient Concerns: We present the case of a 17-year-old patient presenting with rapidly progressive isolated right exophthalmos. Diagnosis: A cerebral computed tomography scan was performed and showed a giant osteoma of the right frontal sinus extending to the orbit and massively eroding the anterior wall of the frontal sinus. Treatment and Outcomes: The patient underwent surgery and a complete removal of the osteoma was accomplished via an open approach, but without performing a bone flap. No recurrence was observed after 2 years of follow-up. Take-away Lessons: Although rare, giant frontal osteomas can cause severe functional impairment due to their proximity to noble structures. Therefore, open approach remains the mainstay of therapy.