Ventriculoperitoneal shunt extrusion in pediatric patients, clinical patterns and therapeutic strategies: A scoping review.

Background: Ventriculoperitoneal shunts (VPSs) are frequently employed in neurosurgery to treat hydrocephalus, with a particular focus on pediatric patients. Although VPSs are commonly utilized, they are not exempt from difficulties, such as shunt extrusion. The main aim of this study is to enhance comprehension regarding the occurrence, causes contributing to, and consequences of VPS extrusion in pediatric patients. Methods: A comprehensive search approach was implemented, including electronic databases, including PubMed, Google Scholar, and Scopus, to locate pertinent articles published between January 1950 and May 2023. The utilization of keywords such as "ventriculoperitoneal shunt" and "extrusion," "ventriculoperitoneal shunt" and "migration," and "ventriculoperitoneal shunt" and "perforation" was employed. Data on patient demographics, underlying diseases, origin of extrusion, presenting symptoms, treatment, and follow-up were gathered. Statistical studies were conducted to identify potential risk factors connected with the occurrence of shunt extrusion. Results: A study analyzed 80 studies on 120 individuals with extruded VPS catheters. The majority of patients (55.8%) had symptoms such as cerebrospinal fluid leakage and irritation. Hydrocephalus was categorized into congenital (40%), obstructive (36.7%), and communicating (11.7%) groups. Catheter extrusion sites varied, with most from the anal or rectal site. Preoperative meningitis or peritonitis was present in 20% of patients. Treatments ranged from shunt removal to endoscopic third ventriculostomy, resulting in a 90% recovery rate, 1.7% mortality, and 5% follow-up loss. Conclusion: Extrusion of the distal catheter in VPSs is a critical medical situation that necessitates urgent surgical intervention. The presence of an infection raises the likelihood of complications; hence, it is vital to promptly address the issue through the administration of antibiotics and the replacement of the shunt. Timely intervention enhances results.

The role of precentral cerebellar vein in neurosurgery: An in-depth review of anatomy, implications, and risks.

Background: The Precentral Cerebellar Vein (PCV) plays a crucial role as an anatomical landmark in neurosurgery, and the possibility of its safe sacrifice is controversial. Understanding its anatomical nuances and clinical implications is fundamental in enhancing neurosurgical practice. Methods: A systematic review following PRISMA guidelines was conducted to consolidate literature on the PCV. PubMed, Scopus, and Web of Science were systematically searched using predefined criteria. Studies providing complete research texts in English, focusing on the PCV's surgical anatomy and neurosurgical implications were included. Results: Fourteen articles met inclusion criteria, exploring the PCV's anatomical variations, trajectory, dimensions, and connections. The PCV's utility in localizing posterior fossa tumors was underscored, aiding in surgical precision. However, sacrifices of the PCV or minor veins for access to quadrigeminal areas posed postoperative risks, emphasizing the need for careful preoperative planning. Additionally, the PCV's diagnostic value in venous malformations and developmental anomalies was highlighted. Conclusions: This comprehensive review accentuates the pivotal role of the PCV in neurosurgery. While serving as a vital guide in procedures, it poses potential risks when manipulated. Understanding its multifaceted significance, from anatomy to clinical implications, is paramount for informed decision-making and minimizing complications in neurosurgical interventions.

Retropharyngeal abscess with mediastinal extension - A mausoleum of mumps: A case report.

Introduction: Retropharyngeal abscess is a fatal infection that is uncommon, yet serious, especially in young children below 5 years. Oropharyngeal infections, in particular, can cause it as a complication of upper respiratory infections. They can also lead to respiratory depression and acute upper airway blockage and other complications. Case presentation: The unusual case of large retropharyngeal abscess in a 2-year-old child, secondary to mumps infection who presented to us with impending airway compromise is reported. Discussion: Retropharyngeal abscess secondary to mumps is a rare occurrence.The child initially had a bilateral parotid enlargement with fever and upper respiratory tract infection, which was diagnosed clinically as mumps by primary care physician and later confirmed by IgM antibody testing. The child was initially treated conservatively as the symptoms were mild at the beginning, however, the child worsened progressively and presented o our institute with acute retropharyngeal abscess in stridor. Emergency tracheostomy and intraoral abscess drainage were done under general anesthesia followed by appropriate intravenous antibiotics therapy. Conclusion: A dramatic recovery was observed following the treatment approach. Although it is rare to see such a large RPA in this antibiotic era, it is imperative to maintain a high index of suspicion.

Unusual giant plunging sublingual epidermoid cyst: A case report and review of literature.

Key Clinical Message: When treating a painless or asymptomatic mass in the submental or floor of the mouth, sublingual epidermoid cyst should be considered. Despite its irregularity, preventing malignant transformation is essential for a successful outcome. Abstract: Dermoid and epidermoid cysts are rarely found in the head and neck region. They account for less than 0.01% of all oral cavity cysts. This is a rare case of a sublingual epidermoid cyst of the oral cavity in a 25-year-old male. The patient presented with a painless sublingual swelling for a duration of 1 month. The clinical examination revealed a non-tender swelling in the sublingual region extending to the submental triangle. Magnetic resonance imaging confirmed a 6.2 × 7.7 × 3.2 cm cystic lesion in the sublingual space. Fine needle aspiration cytology confirmed dermoid cyst contents. Intra-oral surgical excision under general anesthesia was performed successfully. Histopathological analysis revealed that the cyst wall was lined by stratified squamous epithelium. The presence of a prominent granular layer and keratin flakes confirmed the diagnosis of an epidermoid cyst. Postoperative recovery was good, and no recurrence was observed during follow-up. This case emphasizes the infrequent and unusual presentation of a case of a giant plunging sublingual epidermoid cyst and promotes awareness and potential studies in the enhancement of patient care in this area.

Intracerebral haemorrhage in multiple sclerosis: assessing the impact of disease-modifying medications.

Multiple Sclerosis (MS) is a complex autoimmune disorder that significantly impacts the central nervous system, leading to a range of complications. While intracranial haemorrhage (ICH) is a rare but highly morbid complication, more common CNS complications include progressive multifocal leukoencephalopathy (PML) and other CNS infections. This severe form of stroke, known for its high morbidity and mortality rates, presents a critical challenge in the management of MS. The use of disease-modifying drugs (DMDs) in treating MS introduces a nuanced aspect to patient care, with certain medications like Dimethyl Fumarate and Fingolimod showing potential in reducing the risk of ICH, while others such as Alemtuzumab and Mitoxantrone are associated with an increased risk. Understanding the intricate relationship between these DMDs, the pathophysiological mechanisms of ICH, and the individualised aspects of each patient's condition is paramount. Factors such as genetic predispositions, existing comorbidities, and lifestyle choices play a crucial role in tailoring treatment approaches, emphasising the importance of a personalised, vigilant therapeutic strategy. The necessity for ongoing and detailed research cannot be overstated. It is crucial to explore the long-term effects of DMDs on ICH occurrence and prognosis in MS patients, aiming to refine clinical practices and promote patient-centric, informed therapeutic decisions. This approach ensures that the management of MS is not only comprehensive but also adaptable to the evolving understanding of the disease and its treatments.

Deep brain stimulation in Parkinson's disease: A scientometric and bibliometric analysis, trends, and research hotspots.

Parkinson disease (PD), a prevalent neurodegenerative ailment in the elderly, relies mainly on pharmacotherapy, yet deep brain stimulation (DBS) emerges as a vital remedy for refractory cases. This study performs a bibliometric analysis on DBS in PD, delving into research trends and study impact to offer comprehensive insights for researchers, clinicians, and policymakers, illuminating the current state and evolutionary trajectory of research in this domain. A systematic search on March 13, 2023, in the Scopus database utilized keywords like "Parkinson disease," "PD," "Parkinsonism," "Deep brain stimulation," and "DBS." The top 1000 highly cited publications on DBS in PD underwent scientometric analysis via VOS Viewer and R Studio's Bibliometrix package, covering publication characteristics, co-authorship, keyword co-occurrence, thematic clustering, and trend topics. The bibliometric analysis spanned 1984 to 2021, involving 1000 cited articles from 202 sources. The average number of citations per document were 140.9, with 31,854 references. "Movement Disorders" led in publications (n = 98), followed by "Brain" (n = 78) and "Neurology" (n = 65). The University of Oxford featured prominently. Thematic keyword clustering identified 9 core research areas, such as neuropsychological function and motor circuit electrophysiology. The shift from historical neurosurgical procedures to contemporary focuses like "beta oscillations" and "neuroethics" was evident. The bibliometric analysis emphasizes UK and US dominance, outlining 9 key research areas pivotal for reshaping Parkinson treatment. A discernible shift from invasive neurosurgery to DBS is observed. The call for personalized DBS, integration with NIBS, and exploration of innovative avenues marks the trajectory for future research.

Bridging Minds and Machines: The Recent Advances of Brain-Computer Interfaces in Neurological and Neurosurgical Applications.

Brain-computer interfaces (BCIs), a remarkable technological advancement in neurology and neurosurgery, mark a significant leap since the inception of electroencephalography in 1924. These interfaces effectively convert central nervous system signals into commands for external devices, offering revolutionary benefits to patients with severe communication and motor impairments due to a myriad of neurological conditions like stroke, spinal cord injuries, and neurodegenerative disorders. BCIs enable these individuals to communicate and interact with their environment, using their brain signals to operate interfaces for communication and environmental control. This technology is especially crucial for those completely locked in, providing a communication lifeline where other methods fall short. The advantages of BCIs are profound, offering autonomy and an improved quality of life for patients with severe disabilities. They allow for direct interaction with various devices and prostheses, bypassing damaged or nonfunctional neural pathways. However, challenges persist, including the complexity of accurately interpreting brain signals, the need for individual calibration, and ensuring reliable, long-term use. Additionally, ethical considerations arise regarding autonomy, consent, and the potential for dependence on technology. Despite these challenges, BCIs represent a transformative development in neurotechnology, promising enhanced patient outcomes and a deeper understanding of brain-machine interfaces.

Recurrent artery of Heubner aneurysms in focus: insights into occurrence and current treatment paradigms.

INTRODUCTION: The recurrent artery of Heubner (RAH), also known as the medial striate artery, is the most clinically important perforator of the anterior cerebral artery. RAH aneurysm is relatively rare, with 11 cases found in the present literature review, but poses significant clinical challenges due to potential impact on cognitive and motor functions. This systematic review explored available case reports to comprehensively understand clinical presentation, diagnosis, management and outcome in RAH aneurysm. MATERIALS AND METHODS: Following PRISMA guidelines, this systematic review extensively explored RAH aneurysms, covering demographics, symptoms, diagnosis, treatments and outcomes. Comprehensive searches on PubMed, Scopus, Google Scholar, and Science Direct employed keywords such as "recurrent artery of Heubner aneurysm" and "Heubner's artery." RESULTS: After extensive screening, 9 qualifying studies were identified, with 11 patients diagnosed with rare RAH aneurysm. Median age was 55 years (standard deviation, 15.3 years), with 54.5% males. 45.5% of patients presented risk factors, including Moyamoya disease in 2 patients. The majority were classified as grade I/II on the Hunt and Hess (H&H) and World Federation of Neurological Societies (WFNS) systems. Aneurysms were predominantly located in the A1 segment, with a mean size of 4.7 mm. Treatments varied, with clipping being the most frequent (63.6%). The mortality rate was 18.2%. Clipping was associated with favorable outcomes but higher rates of infarction. CONCLUSION: This analysis highlighted the various symptoms, therapy methods and outcomes of RAH aneurysm, with A1 being the predominant origin. Future research should explore potential genetic predisposition factors and novel therapeutic interventions to address gaps in our knowledge.

Sushruta: The Father of Indian Surgical History.

Sushruta, an ancient surgeon from 600 BCE in Kashi, India, is a pioneering figure in medical history. His innovations in surgical techniques, predating Hippocrates and Galen, have left an indelible mark in the field. This review article focuses on Sushruta's contributions to surgery, particularly his foundational work in plastic and reconstructive procedures. We delve into the Sushruta Samhita, the oldest surgical text, covering essential principles, pathology, anatomy, and surgical management. Sushruta's approach emphasized cleanliness, cadaver dissection, and innovative practices in anesthesia. Our article underscores the enduring impact of Sushruta's work on modern surgical science.

Mapping the circle of Trolard: A holistic view of its role in neurosurgical practice, anatomical perspectives and clinical applications.

Introduction: An anatomical structure that resembles the circle of Willis, the circle of Trolard is generated in the basal cistern and travels around the midbrain in a roundabout manner, passing adjacent to the lateral side of the cerebral peduncle. Research question: The primary objective of this article is to provide neurosurgeons with a comprehensive understanding of Trolard's circle, emphasizing its anatomical features and clinical significance. Material and methods: A comprehensive evaluation of the available literature pertaining to the venous circle of Trolard was conducted by conducting searches in the PubMed, Web of Science, and Scopus databases. In the present overview, the terminologies "venous circle of Trolard," "basal venous circle," and "basal vein of Rosenthal" were employed. Results: Upon doing a comprehensive examination of the existing literature and primary sources pertaining to the venous circle of Trolard, it was discovered that an only six studies had been conducted on this particular subject matter. We made observations regarding the anatomical characteristics of the subject and engaged in a discussion regarding their prospective applications and importance within the context of neurosurgical procedures. Discussion and conclusion: The scarcity of research on these structures is attributed to the challenges associated in studying them in vivo. Through directing focus towards these structures, our aim is to stimulate further investigation into their potential involvement in a range of neurological and neurosurgical disorders.

Post COVID-19 vaccination medium vessel vasculitis: a systematic review of case reports.

PURPOSE: Vaccinations are essential in minimizing the effects of global health crises including COVID-19 pandemic. This study investigates the potential association between COVID-19 vaccination and the occurrence of medium vessel vasculitis. METHODS: Several databases were utilized to conduct a comprehensive literature review. The studies were carefully evaluated to ensure their quality and eliminate any potential bias. RESULTS: After reviewing 935 search results and removing duplicates, we selected 10 case reports. We discovered that medium vessel vasculitis may occur after COVID-19 vaccination, typically appearing around 16.2 days after vaccination. The patients in the study had a median age of 43.5 years and were predominantly males (80%). Additionally, half of the cases were reported after the second dose of vaccination. CONCLUSIONS: Vaccination-associated vasculitis is a rare yet possible complication of COVID-19 vaccination and lacks a clear treatment protocol.

An In-Depth Analysis of the Artery of Salmon: Anatomy and Neurosurgical Implications.

BACKGROUND: Michel Salmon was a prominent person in the field of plastic surgery during the early 20th century. His pioneering work contributed significantly to our understanding of human anatomy, particularly with the identification of the artery of Salmon (AOS). The objective of this study is to thoroughly investigate the AOS by conducting a comprehensive literature review, providing insights into its anatomy and surgical implications. METHODS: This review was undertaken after a thorough examination of literature encompassing papers about the AOS. Right up until January 2024, databases like PubMed, ScienceDirect, and Web of Science were explored. The search was conducted using specific terms such as "Artery of Salmon," "suboccipital artery," and "vertebral artery anatomy." An in-depth assessment was conducted to examine the anatomy, and surgical significance of the AOS. RESULTS: The AOS is a branch of the V3 segment of the vertebral artery that supplies the suboccipital muscles. The ability, to identify it, is critical for distinguishing the origins of intraoperative hemorrhage. Through careful surgical intervention, the artery was able to devascularize tumors and vascular lesions. We also touched on the technical issues of its possible application in bypass operations for aneurysms of the posterior inferior cerebellar artery or vertebral artery. CONCLUSIONS: The AOS is sometimes vital in neurosurgery, facilitating precise interventions and serving as a conduit in suboccipital bypass surgeries. Understanding its variations is essential for neurosurgeons, showcasing ongoing advancements in patient care.

Acute pancreatitis secondary to moderate hypertriglyceridemia: A case report.

Key Clinical Message: It is crucial to remain vigilant about acute pancreatitis, even in cases with moderately elevated triglycerides. Triglycerides as a cause of acute pancreatitis must be considered even in the absence of other risk factors. Abstract: Hypertriglyceridemia is one of the most common causes of acute pancreatitis (AP), with triglyceride levels greater than 1000 mg/dL being an established risk factor for AP. Cases of acute pancreatitis due to triglyceride levels less than 1000 mg/dL have rarely been reported in the literature. We report a case of a 26-year-old para-2, living-2 (P2L2) female who presented with epigastric pain and fever, with a serum triglyceride level of 579 mg/dL. A diagnosis of acute pancreatitis was made based on the clinical features and radiological findings, despite no identifiable risk factors. Hypertriglyceridemia was managed with no complications of acute pancreatitis during treatment.

Indoxacarb poisoning causing methemoglobinemia treated with parenteral vitamin C: a case report.

INTRODUCTION: This case study reports on a suicide attempt involving indoxacarb and vitamin C. Indoxacarb is a neurotoxic insecticide used in agriculture and as a flea controller in pets. Cotton, vegetables, and fruits are treated with indoxacarb, an insecticide that can be applied both indoors and outdoors. It causes skin allergies, methemoglobinemia, and hemolytic anemia. It is also attributed to allergic reactions through ingestion, inhalation, physical contact, and translaminar action. This case report highlights use of vitamin C in methemoglobinemia caused by indoxacarb poisoning. Indoxacarb poisoning has the potential to be extremely serious and even lethal. In this instance, the patient initially had no symptoms after ingesting a substance containing indoxacarb in an attempt at suicide. However, further tests revealed methemoglobinemia and low oxygen levels. CASE PRESENTATION: A 28-year-old south-east Asian female patient ingested an insecticide containing 5.25% novaluron, 4.5% indoxacarb, and 25% thiamethoxam, and reported that she noticed muddy brown urine but presented with no active signs or symptoms of poisoning. Upon examination, the patient was fully conscious, alert, and hemodynamically stable, but had an oxygen saturation of 84%. Gastric lavage was performed, and blood investigations revealed a muddy-brown-colored blood sample and methemoglobin levels of 12%. The patient was treated with high-dose vitamin C and showed significant improvement, with a drop in methemoglobin levels to 1.2% and an increase in oxygen saturation to 97%. DISCUSSION: Indoxacarb poisoning can cause severe methemoglobinemia. Vitamin C may be a useful treatment option for methemoglobinemia caused by indoxacarb, particularly in cases in which traditional treatment with methylene blue is contraindicated or not tolerated. Hence high doses of ascorbic acid, that is, vitamin C, were administered to the patient, which lowered their methemoglobin levels and improved oxygen levels without much safety concerns. CONCLUSION: This example emphasizes the significance of early indoxacarb poisoning detection and treatment as well as the possible advantages of utilizing ascorbic acid in the management of methemoglobinemia, and highlights the use of vitamin C in the treatment of methemoglobinemia caused by indoxacarb poisoning. Therefore, it is important for healthcare professionals to be aware of the potential for indoxacarb to cause methemoglobinemia and to consider vitamin C as a treatment option.

Pulmonary tuberculosis in an adult presenting with severe hyponatremia: A case report and review of literature.

Key Clinical Message: Identifying pulmonary pathology while evaluating electrolyte disorders is crucial for optimal patient management. Physicians working in endemic regions of tuberculosis should consider this pathology as a differential for electrolyte imbalances. Abstract: Hyponatremia, a common electrolyte imbalance, can arise from various underlying etiologies such as diuretics, diarrhea, vomiting, congestive heart failure, and liver and renal disease. We present a case report of a 74-year-old man highlighting the association between pulmonary tuberculosis (TB) and the development of hyponatremia. GeneXpert assay of the patient's sputum sample led to the identification of underlying active pulmonary TB as the cause of hyponatremia. The patient was started on anti-TB therapy, and concurrent fluid restriction and sodium supplementation were initiated to correct the electrolyte imbalance. Over the next 3 days, the patient demonstrated clinical improvement with the resolution of hyponatremia. This case also highlights the importance of considering TB as a potential etiology in patients presenting with hyponatremia, especially in endemic areas. Further research is warranted to explore the mechanistic pathways linking pulmonary TB and hyponatremia, aiding in the development of targeted therapeutic interventions.

Insights into Anton Syndrome: When the brain denies blindness.

INTRODUCTION: Anosognosia, a neurological condition, involves a lack of awareness of one's neurological or psychiatric deficits. Anton Syndrome (AS), an unusual form of anosognosia, manifests as bilateral vision loss coupled with denial of blindness. This systematic review delves into 64 studies encompassing 72 AS cases to explore demographics, clinical presentations, treatments, and outcomes. MATERIALS AND METHODS: The study rigorously followed PRISMA guidelines, screening PubMed, Google Scholar, and Scopus databases without timeframe limitations. Only English human studies providing full text were included. Data underwent thorough assessment, examining patient demographics, etiological variables, and treatment modalities. RESULTS: Sixty-four studies met the stringent inclusion criteria. Examining 72 AS cases showed a median age of 55 (6 to 96 years) with no gender preference. Hypertension (34.7 %) and visual anosognosia (90.3 %) were prevalent. Stroke (40.3 %) topped causes. Management included supportive (30.6 %) and causal approaches (30.6 %). Improvement was seen in 45.8 %, unchanged in 22.2 %, and deterioration in 11.1 %. Anticoagulation correlated with higher mortality (p < 0.05). DISCUSSION: AS, an unusual manifestation of blindness, stems mainly from occipital lobe damage, often due to cerebrovascular incidents. The syndrome shares features with Dide-Botcazo syndrome and dates back to Roman times. Its causes range from strokes to rare conditions like multiple sclerosis exacerbation. Accurate diagnosis involves considering clinical presentations and imaging studies, distinguishing AS from similar conditions. CONCLUSION: This comprehensive review sheds light on AS's complex landscape, emphasizing diverse etiologies, clinical features, and treatment options. Tailored treatments aligned with individual causes are crucial. The study's findings caution against blanket anticoagulation therapy, suggesting a nuanced approach. Further research is pivotal to refine diagnostics and optimize care for AS individuals.

Stabilizing the unstable: Tuberculosis of the odontoid process with atlanto-occipital instability-Case report and review of literature.

Key Clinical Message: Tuberculosis (TB) of the odontoid process is a rare but potentially, a debilitating condition. Surgical intervention, in the form of stabilizing the spine and decompressing the spinal cord, offers a tailored approach to managing this condition effectively and improving prognosis. Abstract: Odontoid process tuberculosis (TB) is a rare condition that can cause spinal instability and neurological complications. Diagnosis of odontoid process TB is difficult and requires a combination of clinical, radiographic, and histopathological examinations. This report describes the treatment of a 46-year-old female with quadriparesis and intermittent fever. Radiological findings showed TB of the odontoid process with atlanto-axial dislocation causing compressive myelopathy. She underwent C1-C3 decompressive laminectomy and stabilization from C1 to C5. GeneXpert for TB was positive and she was started on anti-tuberculous medications. She regained power gradually and at 1 year follow-up she was ambulant without any support. The C1-C5 lateral mass screw and C1-C3 decompressive laminectomy approach, as highlighted in this case, offers an effective solution, enhancing patient quality of life, and preventing disease progression.

Refining mutanome-based individualised immunotherapy of melanoma using artificial intelligence.

Using the particular nature of melanoma mutanomes to develop medicines that activate the immune system against specific mutations is a game changer in immunotherapy individualisation. It offers a viable solution to the recent rise in resistance to accessible immunotherapy alternatives, with some patients demonstrating innate resistance to these drugs despite past sensitisation to these agents. However, various obstacles stand in the way of this method, most notably the practicality of sequencing each patient's mutanome, selecting immunotherapy targets, and manufacturing specific medications on a large scale. With the robustness and advancement in research techniques, artificial intelligence (AI) is a potential tool that can help refine the mutanome-based immunotherapy for melanoma. Mutanome-based techniques are being employed in the development of immune-stimulating vaccines, improving current options such as adoptive cell treatment, and simplifying immunotherapy responses. Although the use of AI in these approaches is limited by data paucity, cost implications, flaws in AI inference capabilities, and the incapacity of AI to apply data to a broad population, its potential for improving immunotherapy is limitless. Thus, in-depth research on how AI might help the individualisation of immunotherapy utilising knowledge of mutanomes is critical, and this should be at the forefront of melanoma management.

Non-colloid-cyst primary brain tumors: A systematic review of unexpected fatality.

OBJECTIVE: Primary brain tumors have the potential to present a substantial health hazard, ultimately resulting in unforeseen fatalities. Despite the enhanced comprehension of many diseases, the precise prediction of disease progression continues to pose a significant challenge. The objective of this study is to investigate cases of unexpected mortality resulting from primary brain tumors and analyze the variables that contribute to such occurrences. METHODS: This systematic review explores research on individuals diagnosed with primary brain tumors who experienced unexpected deaths. It uses PRISMA standards and searches PubMed, Google Scholar, and Scopus. Variables considered include age, gender, symptoms, tumor type, WHO grade, postmortem findings, time of death - time taken from first medical presentation or hospital admission to death, comorbidity, and risk factors. RESULTS: This study examined 46 studies to analyze patient-level data from 76 individuals with unexpected deaths attributed to intracranial lesions, deliberately excluding colloid cysts. The cohort's age distribution showed an average age of 37 years, with no significant gender preference. Headache was the most common initial symptom. Astrocytomas, meningiomas, and glioblastoma were the most common lesions, while the frontal lobe, temporal lobe, and cerebellum were common locations. Meningiomas and astrocytomas showed faster deaths within the first hour of hospital admission. CONCLUSION: The etiology of unforeseen fatalities resulting from cerebral tumors elucidates an intricate and varied phenomenon. Although unexpected deaths account for a very tiny proportion of total fatalities, it is probable that their actual occurrence is underestimated as a result of underreporting and misdiagnosis.