Cranioplasty for repair of a large bone defect in a growing skull fracture in children.

INTRODUCTION: In infants, calvarial defects are generally repaired with autologous grafts. However, with large defects, these techniques can be associated with complications such as bone graft resorption, loss of blood, or local infection. Alternative materials are available for cranioplasty including metals or acrylic. CASE REPORT: We report the case of a 3.2kg boy who had a traumatic vaginal delivery and developed a growing skull fracture resulting in a large cranial defect (50cm(2)). We describe a specific technique of cranioplasty by interposing a titanium plate between the duroplasty and bone elements, without fixation, with autologous bone fragments deposited over the mesh. Long-term follow-up was satisfactory. CONCLUSION: For large skull defects in infants, the technique described affords protection to the intracranial components, induces osteogenesis in a growing cranial skeleton, and provides satisfactory aesthetic results.

[Two cases of neurocysticercosis mimicking brain tumor]. / Deux cas de neurocysticercose intracérébrale à révélation pseudo-tumorale.

Neurocysticercosis is an infectious disorder of the central nervous system caused by Taenia solium larvae. We report two misleading cases, mimicking high grade glioma on radiology. Two patients, aged 14 and 29 respectively, developed seizure, associated with left facial paralysis in the second. For each case, radiological data revealed a solitary lesion highly suggestive of high grade glioma. Microscopically, within an important inflammatory process, a characteristic cystic formation allowed a definite diagnosis of cysticercosis. Then, for both patients, a history of migration from endemic area was demonstrated later. These cases highlight the necessary pathological examination when neurocysticercosis mimics a brain tumor.

Incidence of central nervous system tumors in Gironde, France.

The incidence of CNS tumors is subject to geographical and temporal variations which are poorly understood. The incidence of these tumors was studied in Gironde, a department of southwestern France with 1,058,911 inhabitants older than 16 years. We recorded any malignant or benign central nervous system (CNS) tumor diagnosed between May 1999 and April 2001 in adults living in Gironde. Three hundred and twenty-nine CNS tumors were diagnosed during the study period. The incidence of CNS tumors in adults was therefore 15.5 per 100,000. Overall, the incidence according to sex was 14.7 for males and 16.2 per 100,000 for females. The incidence rate increased according to age up to 80 years (3.7 per 100,000 for 20-29 years of age to 33.4 per 100,000 for 70-79 years of age) and reduced thereafter for gliomas. Our estimation of the incidence of CNS tumors ranks high among the earlier reports. Further analytic studies are ongoing.