Extra-axial primary meningeal pleomorphic xanthoastrocytoma: a case report.

Pleomorphic xanthoastrocytoma (PXA) is a rare low-grade glial neoplasm of the central nervous system accounting for less than 1% of all astrocytomas. Similar to other gliomas, it can rarely arise from glial nests in the meninges, manifesting as an extra-axial mass mimicking a meningioma. Extra axial PXA is an extremely rare entity. Therefore, there are no standardized guidelines. In this article, we report the fourth case, so far, of a solitary primary extra-axial PXA mimicking a meningioma in a 23-year-old woman who presented with temporal seizures and features of raised intracranial pressure. Through this case, we tried to discuss all treatment options.

Can we consider ventriculo-gallbladder shunt a first-line treatment in selected patients? Case report of a successful management.

INTRODUCTION: Ventriculo-gallbladder shunt (VGS) has been recognized as a last-resort alternative to treat hydrocephalus when the peritoneum and/or other distal sites can no longer receive shunts. In some specific conditions, it may be conceded as a first-line treatment. CASE PRESENTATION: We report the case of a 6-month-old girl with progressive post-hemorrhagic hydrocephalus who presented a concomitant chronic abdominal symptom. Specific investigations ruled out acute infection and led to the diagnosis of chronic appendicitis. Both problems were managed in a one-stage salvage procedure consisting of laparotomy sanctioning to treat the abdominal pathology and seize the opportunity to perform a VGS as a first option since the abdomen is prone to ventriculoperitoneal shunt (VPS) failure. CONCLUSION: Only few cases have reported the use of VGS as the first option to handle uncommon complex cases due to abdominal or cerebrospinal fluid (CSF) conditions. We wish to draw attention to VGS as an effective procedure not only in children with multiple shunt failures but also as first-line management in some selected cases.

Remote cerebellar hemorrhage after the evacuation of a subdural hematoma: a case report.

Remote intracranial hemorrhage is postoperative bleeding that occurs away from the surgical site. Remote cerebellar hemorrhage (RCH) is a cerebellar hemorrhage that may occur in 0.04-0.8% of cases after supratentorial and spinal procedures. We report a case of a 73-year-old male who developed signs of increased intracranial pressure two days after the evacuation of a subdural hematoma. Brain computed tomography showed RCH with the "zebra sign" and triventricular hydrocephalus that indicated the placement of external ventricle drain in emergency. Therefore, surgeons must pay special attention to this rare postoperative complication because it can be devastating in terms of patient outcome especially due to its possible complications requiring surgical treatment.