Intraventricular meningioma in 4 years old child: Case presentation

Meningiomas represent a rare entity in pediatric population. Also, in small children, intracranial tumors can reach giant dimensions with minimal neurological findings due to some special features of the brain and cranial vault at this age. The main diagnosis tool is the MRI. We choose to present the case of a 4 years old child with a giant intraventricular meningioma.&nbsp

Supratentorial neuroectodermal tumor in a 4 years old child presented with intratumoral hemorrhage: Case presentation and review of the literature

Brain tumors represent the most frequent solid malignancy in children and the first cause of cancer-related deaths in pediatric population. Supratentorial neuroectodermal tumor (PNET) represents one of the most aggressive brain tumors at this age. Incidence of S-PNET is 2-3% of all brain tumors in children, but reaches up to 20% of brain tumors in 0 - 3 years old children. Although in the last years the outcome has improved, the prognosis remains dismal. We choose to present the case of a 4 years old child who was at presentation in a comatose state (GCS 4 points) with anisocoria (right pupil was mydriatic). The performed head CT-scan showed a right fronto-parietal tumor with intratumoral hemorrhage, maximal dimensions of 52/75/70 mm and a midline shift of 15 mm. The surgery was performed in emergency and we made a gross total resection. Immediate postoperative CT-scan confirmed the total resection. The histopathological diagnosis was S-PNET, this result being confirmed by immunochemistry. After neuromotor rehabilitation, at the 4 month follow-up visit the GOS was MD. The patient was also referred to the oncologist and was made chemotherapy and radiotherapy of the entire craniospinal axis. The tumor showed no signs of recurrence during 12 months of follow-up

Giant asymptomatic intracranial hydatid cyst in a 3 years old child: Case report

ObjectiveAlthough hydatid cysts are known commonly to affect the liver and lung, it can also affect the brain (1-2% of cases). Brain involvement is more commonly seen in children (50-75% of intracranial hydatid cysts), and usually has intraparenchymal localization. In this paper we present a case of a 3 years old child diagnosed incidentally with a giant intracranial hydatid cyst.Case presentationThe patient was admitted in the hospital with a mild craniocerebral trauma, with an epicranial haematoma. The clinical and neurological examinations were normal. The CT scan of the brain revealed a giant solitary cystic lesion, located in the left fronto-parietal lobe, with features suggestive of hydatid cyst. The removal of the cyst, without rupture, was performed using the Dowling technique modified by Arana-Iniguez. Postoperatively the neurological exam was normal and the patient was asymptomatic at 7 months follow-up.ConclusionThe hydatid cyst usually enlarges slowly, but this is variable, the growth being higher in children, in whom it can reach giant dimensions without or with minimal symptoms. It is a benign lesion, and the removal of the cyst without rupture is very important

Growing skull fracture in a 2 months old child

A growing skull fracture, also called posttraumatic leptomeningeal cyst, is a rare complication of skull fractures - less than 1%, usually encountered in children younger than 3 years old. Although rare, this complication must be recognized early and treated to prevent permanent neurologic deficits. We present the case of a 2 months old child who had suffered a closed head trauma in a car accident 2 weeks before he was admitted in our clinic with a left parietal growing skull fracture. He was submitted to surgery and leptomeningeal cyst was evacuated, dural defect repaired and bone fragments fixed. Child was discharged 6 days postoperative without neurologic deficits. Growing skull fractures represent a rare complication of head trauma in small children. It is imperious to be recognized and treated in early phases to prevent debilitating permanent neurologic deficits in that category of population

Deontological issues - possible misdiagnosis of cerebral metastases

Authors analyses a number of 4588 (52, 24% over 50 years old) patients operated for cerebral tumors in the Clinic Emergency Hospital “Bagdasar-Arseni” from Bucharest, between 2000-2010, with peculiar attention to the concordance between the preoperative and postoperative diagnosis, related to the actual policy to evaluate a neurosurgical patient before surgery. 903 cases were cerebral metastases and 69,5% aged over 50 years old. In 9,7% of cases we recorded a preoperative misdiagnosis of a metastasis due to few main reasons: unavailable information about a present primitive cancer, treacherous MRI image with a single confusing appearance of a cerebral lesion, age less than 50 years old, clinical presentation and biological evaluation inconsistent with malignancy. Authors point that these situations can have serious consequences related to professional competence, deterioration of the patient-doctor relationship, increasing costs for completion of diagnosis and treatment, and inadequate information about patient’s prognosis