Scissoring of a Cobalt Alloy Aneurysm Clip causing Slippage during Cerebral Aneurysm Surgery : Case report and review of literature

Clip slippage is a rare occurrence, and the scissoring or torsional failure of aneurysm clips is rarer still. Titanium clips have been implicated in a few such reported cases. The authors report its occurrence while using a fenestrated cobalt alloy clip for an internal carotid artery aneurysm which was identified by intraoperative angiography and rectified by re-applying a non-fenestrated cobalt alloy clip. The possible mechanism of this complication, and measures that may prevent its occurrence, including meticulous dissection, decompression when possible, proper clip selection, and intraoperative angiogram are described. 

Fungal Granuloma following Endoscopic Third Ventriculostomy for Infantile Hydrocephalus

Endoscopic third ventriculostomy (ETV) is increasingly being used in the treatment of hydrocephalus in infancy. Infective complications rarely occur following ETV and fungal infections or granulomas have not been reported so far. The authors report the occurrence and management of a fungal granuloma incidentally detected during a repeat ventriculoscopy for a non-functioning ETV

Temporal fossa arachnoid cyst presenting with bilateral subdural hematoma following trauma: two case reports

<p>Abstract</p> <p>Introduction</p> <p>Intracranial arachnoid cysts are considered to be congenital malformations with a predilection for the temporal fossa. They are often asymptomatic but can sometimes be symptomatic due to enlargement or hemorrhage. There are multiple case reports of arachnoid cysts becoming symptomatic with hemorrhagic complications following head trauma. In such cases, the bleeding is often confined to the side ipsilateral to the arachnoid cyst. Occurrence of contralateral subdural hematomas in patients with temporal fossa arachnoid cysts has rarely been observed and is reported less frequently in the medical literature.</p> <p>Case presentation</p> <p>We report two cases of people (a 23-year-old man and a 41-year-old man) with temporal fossa arachnoid cysts complicated by a subdural hematoma following head injury. Both patients developed a subdural hematoma contralateral to the side of a temporal fossa arachnoid cyst. It is likely that lack of adequate intracranial cushioning in the presence of an intracranial arachnoid cyst may result in injury not only to ipsilateral but also to contralateral bridging veins, following head trauma.</p> <p>Conclusion</p> <p>It is important to identify and report such rare complications with intracranial arachnoid cysts, so that asymptomatic patients with an intracranial arachnoid cyst can be counseled about such possibilities following head trauma.</p

Bilateral abducens and facial nerve palsies as a localizing sign due to reduction in intracranial pressure after fourth ventriculoperitoneal shunting

A trapped fourth ventricle often requires fourth ventriculoperitoneal shunting (4VP). Complications of this procedure include shunt blockage, infection, shunt migration, and overdrainage. Cranial nerve palsies are very rare after 4VP shunting and have been described with over drainage and brainstem distortion. We present an unusual case of bilateral abducens and facial nerve palsies after 4VP shunting after normalization of 4 th ventricular parameters. Measurement of various brainstem angles presented us with a plausible hypothesis to explain the cranial nerve dysfunction

Isolated intracranial Rosai Dorfman disease

Rosai Dorfman disease (RDD), also known as sinus histiocytosis with massive lymphadenopathy, is a benign histiocytic proliferative disorder mainly affecting the lymph nodes. Although several cases of extra-nodal involvement have been reported previously, central nervous system involvement, particularly in the absence of nodal disease is extremely rare. We report a case of isolated intracranial RDD occurring in a relatively elder patient, which was shown by histological examination to have a dura-based involvement

BN20 scales.

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HADS percentages.

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QLQ-C30 symptom scales and clinically meaningful difference (CMD) to the European normative population.

QLQ-C30 symptom scales and clinically meaningful difference (CMD) to the European normative population.</p