Surgical management of intraventricular neurocysticercosis: Two cases treated through transcallosal interhemispheric approach.

Background: Cysticercosis, caused by the larval stage of Taenia solium, is a prevalent parasitic infection affecting the central nervous system, primarily in low-income countries. Surgical intervention becomes necessary when cysticercosis manifests within the ventricular system, with endoscopic techniques increasingly preferred over traditional microsurgical methods due to lower risks and morbidity. However, the microsurgical transcallosal approach, although effective, is infrequently used due to its associated high morbidity. Case Description: We present two cases of multiple intraventricular neurocysticercosis treated through an open microsurgical technique using a transcallosal interhemispheric approach. Patient 1, a 56-year-old male, presented with severe headaches persisting for 6 months, while Patient 2, a 54-year-old male, experienced a sudden decrease in consciousness. Both patients exhibited typical magnetic resonance imaging characteristics indicative of intraventricular neurocysticercosis, leading to the decision for surgical resection. Conclusion: Despite the transcallosal approach's decreased popularity due to associated risks, we achieved relatively good outcomes with minimal morbidity in both cases. Our experience highlights the importance of considering microsurgical approaches, particularly in facilities lacking endoscopic instrumentation, for the effective management of intraventricular neurocysticercosis. Compliance with postoperative medical therapy remains crucial to prevent recurrence.

Severe traumatic atlantoaxial dislocation and type III odontoid fracture treated with occipitocervical fixation: a case report.

The combination of atlantoaxial joint dislocation accompanied by an odontoid process fracture is exceptionally rare, with only a few cases reported. The estimated frequency of these cases is < 2% of all upper cervical spine injuries. In this report, the authors describe an unusual case of traumatic atlantoaxial dislocation with a type III odontoid fracture in a 44-year-old male patient. Before the diagnosis, the patient had a history of seeking a masseur for a neck massage. Subsequently, the patient underwent occipitocervical stabilization to address the underlying condition. This procedure aims to treat the instability between the skull and cervical spine and should be considered in the treatment planning if the patient's anatomy suits it.

Anal extrusion of a ventriculoperitoneal shunt in a 1-month-old patient: a case report.

The ventriculoperitoneal shunt procedure represents a frequently conducted neurosurgical intervention; nevertheless, it harbors inherent risks that can precipitate complications in patients. Intestinal perforation accompanied by distal shunt protrusion through the anus is an uncommon phenomenon, observed in ~0.1% to 0.7% of cases, with mortality rates reaching up to 15%. Timely identification and comprehensive management of such complications are imperative to prevent further deterioration of the patient's condition. Herein, we present a case involving a 1-month-old female infant who presented with a tube protruding from the anal orifice. Immediate surgical intervention was undertaken to remove the distal shunt and prevent further infection in the patient.

Successful reconstruction of severe traumatic scalp defect with exposed bones in a 6-year-old boy: a case report.

Full-thickness scalp defect reconstruction is considered challenging for the surgeon. The goal of this procedure is to provide coverage of the calvarium. Scalp defect needs thorough and careful planning in reconstruction, not only in choosing the best closure strategy but also in post-operative care. We report a case of successful reconstruction of traumatic severe scalp and bone loss using local scalp flap in a 6-year-old trauma patient. Free flap reconstruction should be considered in such a defect. However, limited resources prevented us to do so. In craniofacial trauma, the plastic surgeon may be involved as an attending physician in facial trauma or assisting in other trauma, especially in defect closure.

Complete resection versus functional preservation in resection of cystic vestibular schwannoma in a 56-year-old female: case report and literature review.

Surgery for vestibular schwannoma presents unique challenges to the surgeon, given that the primary objectives are achieving complete resection while preserving both facial nerve and hearing function. Consequently, a comprehensive preoperative and perioperative assessment of the tumor is essential to determine its extent, particularly in cases involving dumbbell-shaped lesions. This case report describes our experience in managing a patient with a dumbbell-shaped vestibular schwannoma, where we achieved near-total resection while successfully preserving the patient's facial nerve and hearing function. The early postoperative evaluation revealed no morbidity, and the patient experienced a significant improvement in their symptoms.

Particular Surgical Technique for Transorbital-Penetrating Craniocerebral Injury Inflicted by a Screwdriver: Technical Case Report.

Surgical techniques for non-missile penetrating brain injuries (PBI) are challenging because they require good preoperative planning. Generally, extraction is performed ipsilaterally at the entry site. In certain cases, the extraction can be performed contralaterally through the inner end of the foreign body; however, this requires special consideration. We present a case report of a patient who had a stab wound on the head via a screwdriver and underwent surgery, during which extraction was performed contralaterally through the inner end of the screwdriver without inducing any neurological deficit. Careful preoperative planning and surgical technique modification are required to minimize morbidity and mortality in patients with PBIs.

Intraparenchymal cerebellar capillary hemangioma in a 32-year-old man: a case report.

The authors present an unusual case of a 32-year-old adult male with a capillary hemangioma, which developed within the left cerebellar parenchyma. The histopathological examination reveals a mass mostly formed by the proliferation of capillaries, lined by a layer of flat-plump endothelial cells, some branching and dilating large capillaries, forming a lobulated structure separated by fibrocollagenous connective tissue. Immunohistochemistry examination with CD31 and S100 was positive on the endothelial and stromal cells, respectively, and negative S100 on the endothelial cells. Although rare, capillary hemangioma should be one of the differential diagnoses for diagnosing intra-axial lesions in the cerebellar region. Confirmation of the histopathological characteristic is necessary to determine the diagnosis of capillary hemangioma and exclude other differential diagnoses.

Management of cerebral abscess with large ventricular septal defect in rural area: a case report.

Cerebral abscess is an uncommon complication of cyanotic heart disease. However, it has a high case fatality rate, and its management requires a multidisciplinary approach. Earlier diagnosis would result in a better outcome. In this report, we presented a case of a 6-year-old boy with a cerebral abscess and a large ventricular septal defect, which was treated surgically in a rural area with a limited resources facility.

A Rare Combined Trigeminal Neuralgia with Hemifacial Spasm in a 78-year-old Male Patient.

This case reported a 78-year-old male patient presented with combined trigeminal neuralgia and hemifacial spasm, which is a rare finding and seldom addressed. Magnetic resonance imaging examination showed compression of right N.V by the right superior cerebellar artery (SCA) but did not prove any compression on the right N.VII. This patient is treated with microvascular decompression, and we found out compression of right N.V by right SCA and N.VII from the right anterior inferior cerebellar artery. Postoperatively, the symptoms were resolved with transient hypoesthesia and no recurrence after 1-year follow-up.

Primary cranial vault germinoma in a 23-year-old man: illustrative case.

BACKGROUND: Germinoma is the most common type of germ cell tumor that develops intracranially. Germinomas usually grow in the midline structures, such as the pineal and suprasellar regions, and are rarely found in other locations. To the best of the authors' knowledge, no previous research has reported on growth of this tumor in the cranial vault. OBSERVATIONS: The authors reported an unusual case of primary cranial vault germinoma in a young adult. Macroscopically, the tumor had a solid-soft consistency and grayish color with brownish spots on the surface. The histological examination revealed anaplastic cells with round, hyperchromatic, pleomorphic nuclei; prominent nucleoli; and abundant, clear cytoplasm, arranged in lobules and sheets that were infiltrated by lymphocytes and separated by fibrous connective tissue. These findings were consistent with the histopathological characteristics of germinoma. LESSONS: Primary cranial vault germinoma is a unique tumor because no previous research has reported any growth in that location. It should be considered one of the differential diagnoses of lesions located over the cranial vault. Histopathological examination is still the primary modality for diagnosing these tumors and excluding other differential diagnoses.

Bilateral frontal intracranial xanthoma associated with type II hyperlipidemia in a 42-year-old woman: illustrative case.

BACKGROUND: Xanthoma is a granulomatous lesion that develops from leakage of circulating serum lipoprotein into the surrounding tissue. An isolated intracranial xanthoma is rarely reported and usually misdiagnosed. Intracranial xanthoma is also rarely found in patients with hyperlipidemia. To the best of the authors' knowledge, no previous studies and literature have reported bilateral involvement of intracranial xanthoma in the frontal lobe. OBSERVATIONS: The authors reported an unusual case of bilateral involvement of intracranial xanthoma in the frontal lobe with associated type II hyperlipidemia in a 42-year-old woman. Macroscopically, the tumor had an appearance of greyish-yellow color with a brittle, solid consistency. Histopathological examination revealed numerous lipid-laden macrophages surrounded by a cystic, necrotic, partially hemorrhagic area, with some parts consisting of hemosiderophages and proliferative capillary blood vessels. The histopathological findings indicated the characteristics of xanthoma. LESSONS: Bilateral frontal intracranial xanthoma with associated type II hyperlipidemia is an unusual finding. Despite its rarity and wide variety of radiological presentations, it should be considered one of the differential diagnoses of lesions that develop intracranially and intraaxially. Confirmation with histopathological examination is needed to exclude from other differential diagnoses.

Congenital Midline Spinal Hamartoma in a 5-Month-Old Infant.

BACKGROUND: Congenital midline spinal hamartoma is a very rare tumor-like proliferation that mostly occurs during childhood. It consists of mature, well-differentiated ectodermal and mesodermal elements that present in an abnormal location and are mostly associated with neurofibromatosis type 1 and spinal dysraphism. CASE DESCRIPTION: A 5-month-old male patient presented with complaint of a bump over the lower back. The bump was already present since birth with the size of approximately 3 cm in diameter and slow growth. There were no other associated symptoms besides the bump on the lower back. In the physical examination, we found a subcutaneous mass with associated skin dimple located on the midline of the lower back. Computed tomography scan of the spine showed a mass that arose from inside the dura and a closed spinal dysraphism from L3 vertebra to the sacrum. A subtotal resection was performed, and the histopathology feature showed fat cells, cartilage, skeletal muscle fibers, nerve, and blood vessel. After 6 months follow-up, no symptoms or neurologic deficit were present, and no further growth was shown on the latest computed tomography scan. CONCLUSIONS: Congenital midline spinal hamartoma is very rare and seldom addressed. Most patients present with a cosmetic defect and rarely with associated symptoms. Tissue biopsy is still the best modality to definitively diagnose hamartoma and to exclude other diagnoses. Surgical excision of the tumor is still the mainstay treatment, especially for patients who are not neurologically intact and to correct the cosmetic skin defect.