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Background: chronic subdural hematoma is a common pathology, especially in the elderly. Although it has a good prognosis, it poses the problem of recurrence after surgical evacuation. Objective: To analyze the risk factors of reoperation in patients surgically treated for chronic subdural hematoma (cSDH) and evaluate the outcome of patients who benefited from a reoperation. Materials and Methods: A retrospective review was conducted in a single University Hospital Center in Rabat (Morocco) on 49 patients operated on from January 2020 to June 2021 for cSDH. Possible risk factors described in the literature were analyzed and the outcome of post-operative course was evaluated. Statistical significance was defined by p-value < 0.005. Results: 49 patients underwent surgical evacuation of cSDH. The sex ratio of male/female was 3.08. The mean age was 70.6 years. Concerning the medical history, 8.2% were diabetics, 10.2% had heart disease, 18.4% had hypertension, 16.3% associated of comorbidities, 2% had pulmonary embolism, and 2% had neoplasm. 18.4% were on anticoagulation therapy, no patients were on new oral anticoagulants. The clinical findings upon admission were motor deficit at 57.1%, signs of intracranial hypertension at 20.4%, altered consciousness at 16.9% and impaired behavior at 6.1%. 28.6% of patients had a past history of head trauma. The pre-operative CT scan showed unilateral cSDH at 81.6%, midline shifts at 77.6%, and false membranes at 34.7%. Blood appeared chronic at 40.8%, subacute at 24.5%, and mixed densities at 34.7%. The post-operative course was uneventful in 73.5%. According to Ibanez grading 8 patients had mild complications (grade I) and 5 moderate complications (grade II) after the first surgery. We recorded 10.2% of patients who needed a second surgery How to cite this paper:

Background: Hydatid disease is a parasitic disease caused by the larval stage of Echinococcus granulosus. It’s commonly affects the liver and lungs but can rarely affect the brain. Case presentation: A 5-year-old boy from a rural area with no pathological history was admitted to pediatric emergency for sudden decreased level of consciousness with right‑sided hemiparesis and intermittent vomiting. On Physical examinations, he was disoriented with bilateral papilledema and right‑sided hemiparesis. Brain CT scan revealed a large cystic lesion in the left fronto‑parietal region with mass effect. There was no contrast enhancement , suggestive of hydatid cyst. Radiological investigations of thorax and abdomen disclosed no evidence of hydatid disease. The patient underwent craniotomy and the lesion was removed by irrigating saline between cyst wall and brain interface. Pathological examination confirmed hydatid cysts. Immediate improvement of the symptoms was observed and the patient was discharged on albendazole for 3 months. Conclusion: The incidence of primary hydatid cyst of brain is very rare. The CT and MRI are the best diagnostic investigation and surgery extirpation of the intact cyst is the treatment of choice, resulting in complete recovery.

Background: Brown tumors (BTs) are rare non-neoplastic lesions that arise secondary to hyperparathyroidism largely involving mandible, ribs, pelvis, and large bones. Spinal involvement is extremely rare and may result in cord compression. Case Description: A 72-year-old female with the primary hyperparathyroidism developed a thoracic spine BT causing T3–T5 spinal cord compression warranting operative decompression. Conclusion: BTs should be included in the differential diagnosis in lytic-expansive lesions involving the spine. For those who develop neurological deficits, surgical decompression may be warranted followed by parathyroidectomy.