Giant Subgaleal cerebrospinal fluid leakage: An unusual complication of chronic subdural hematoma surgery

We report a rare case of chronic subdural hematoma complicated with a Giant subgaleal cerebrospinal fluid leakage. Physical examination was performed with no alteration in mental status and no focal neurological disorder. The subdural hematoma was drained and two weeks later, patient was admitted to our hospital with a giant scalp swelling. Physical examination revealed a left parietal subcutaneous collection. The patient was reoperated with a correction in the fistula, he presented a satisfactory postoperative evolution. To our knowledge, this is the first report in literature of a chronic subdural hematoma with a complicated giant subgaleal cerebrospinal fluid leakage

Post-traumatic cerebellar infarction due to vertebral artery foramina fracture: Case report

Posttraumatic cerebral infarction is an uncommon cause of morbidity and mortality and many studies have highlighted that trauma needs to considered as causative factor for cerebellar infarction. We present a case of cerebellar infarction in a 35 year old young patient secondary to vertebral fracture involving the vertebral foramen and vertebral artery injury. CT scan cervical spine showed C2-3 fracture on left side with fracture extending into the left vertebral foramen. A CT scan angiogram could not be performed because of poor neurological status. Possibly the infarction was due to left vertebral artery injury. Without surgical intervention prognosis of these patients remain poor. Prognosis of patients with traumatic cerebellar infarction depends on the neurological status of the patient, intrinsic parenchymal damage and more importantly extrinsic compression of the brainstem by the edematous cerebellar hemispheres

Acute spontaneous subdural hematomaas unusual complication after tooth extraction

Background: Intracranial bleeding has been reported in the literature associated with tooth extraction. Coagulation disorders are often associated with complications after dental extraction. In this case report, we describe a case of spontaneously intracranial subdural hematoma possible after tooth extraction.Case description: The patient was a 26-y-old female without any underlying diseases. A computerized tomography scan showed a subdural hematoma 48 hours after the dental extraction. She was managed with a burr hole, good postoperative evolution and discharged to home.Conclusion: Although rare, the presence of headache with signs of alarm after the extraction of a tooth, we must discard intracranial abnormalities. To the best of our knowledge this is the first report in the literature of a spontaneously intracranial subdural hematoma possible after tooth extraction

Unilateral traumatic hemorrhage of the basal ganglion and bihemisferic cerebral infarction

Among the various injuries caused by the cerebral tramatic lesion are trau- matic brain contusions. Hemorrhagic contusions of the basal ganglia are unusual. Different injuries such as cranial fractures, epidural hemorrhage, subdural hematoma, subarachnoid hemorrhage among others may be associated with brain contusions. In some cases traumatic brain injury arises. We present a case of a patient with unilateral cerebral contusion associated with bihemispheric cerebral infarction

Extracranial internal carotid artery aneurysm: Case illustration

Extracranial internal carotid artery aneurysms (EICAA) are uncommon lesion. These aneurysms can be classified as true or false aneurysms, atherosclerotic, dysplastic, infectious, posttraumatic and iatrogenic aneurysms. The most common presentation is central neurologic dysfunction, either a stroke or a transient ischemic attack. The rupture of these aneurysms can lead to severely impairment and can affect the quality of life of the patients or even may lead to death. Management of these lesions is required in most cases to prevent complications, however there is no treatment guideline or expert consensus for the management. We present a case of an unusual EICAA, associated with kinking of the affected vessel and review the literature

An international based survey about preferences in neurosurgical irrigation fluids in neurotrauma procedures

Background: Traumatic brain injury surgery is the most frequently performed by neurosurgeons. The use of 0.9% saline solution (normal saline) irrigation and other solutions during neurosurgical procedures has been considered a cause of neural tissue injury. The normal saline has been used for many years, but at cellular level it may cause harmful changes. The emergence of new solutions, such as artificial cerebrospinal fluid and Ringer's lactate, seem to produce less damage effects on brain tissue. The aim of this study is to evaluate the trends in use of irrigation solutions in traumatic brain injury surgeries.Materials and Methods: This study was conducted through a web-based survey sent to 40 neurosurgeons worldwide.Results: Over the period of the study data was collected from the 40 physicians and the 100% of the respondents used any type of irrigation solution during neurosurgery.Conclusion: The use of normal saline in brain surgery is a widespread practice worldwide, despite the negative effects on neural tissue as it may contribute to further damage. The conception of new irrigation solutions for neurosurgery, especially in traumatic brain injury, may be a useful alternative for future studies and to expand our knowledge on this topic

What the Neurosurgeon needs to know about Cerebral Developmental Venous anomalies

Venous Angiomas or Developmental venous anomalies (DVA) are extreme variations of normal transmedullary veins that are necessary for the drainage of white and gray matter, also are one type of cerebrovascular malformation (CVM), sharing category with capillary telangiectesias, cavernous malformations (CM), and arteriovenous malformations (AVM), each of which may also be associated with a DVA. DVA are the most commonly encountered CVM, accounting for up to 60% of all CVM. We present a review of the literatura

Transoral osteosynthesis for C1 fractures: two cases report

The upper cervical spine fractures are rare and often fatal injuries so immediately with the traumatic event. Due to the amplitude of the spinal canal in the upper cervical region, only 16% of the survivors exhibit neurological compromise, so they can go unnoticed for emergency care. CI injuries are rare. We report two cases in relation to our experience in the management of this injury through transoral

Solitary plasmocytoma of the skull: Case report and review of the literature

Solitary plasmacytoma and extramedullary plasmocytoma are tumors of malignant character composed of plasma cells, with a mean age of onset at 60 years. They can appear anywhere where the reticuloendothelial system is present. Usually these tumors lead to the development of multiple myeloma in a period of time ranging from 3 to 5 years. We present a rare case handled in our neurosurgery service associated with an unusually long period of evolution

Association of abnormal metopic suture causing hypertelorism, interfrontal encephalocele with craniofacial cosmetic deformity associated with myelomeningocele: Management literature review

Myelomeningocele may be associated with other neural and extraneural anomalies. Authors present association of metopic suture abnormality, an interfrontal encephalocele with widening of metopic suture and abnormal shape frontal bones in the forehead in those associated with hydrocephalus. Authors describes two neonates with interfrontal encephalocele, representing first series reporting in neonate. Management and pertinent literature is briefly discussed