Humans with CC are incidental intermediate hosts, which replace the pig in the life cycle of the T. solium. Children are more frequently affected by parenchyma infestation of cysticercus, of which the main clinical manifestation is epilepsy. Hydrocephalus is more common in adults and is caused by cerebrospinal fluid blockage by ventricular cysts and inflammatory reactions (ependimitis/arachnoiditis). Treatment should be individualized based on clinical presentation, degree of infestation, location and viability of cysticercus, and host response. Hydrocephalus can be controlled only by removal of obstructive intraventricular cysts or associated with either ventriculoperitoneal shunt or endoscopic third ventriculostomy. The degree of infestation and complications related to the shunt represents the most important prognostic factors in the outcome of NCC.

Birth-related traumatic brain injury may cause serious complications in newborn infants. Its successful management includes special training, teamwork, and an individual approach.

Frontal-orbital advancement is the preferred procedure to correct unicoronal synostosis due to its universal indication regardless of the age and degree of deformation of the anterior plagiocephaly.

Constipation can cause transient malfunction of the ventriculoperitoneal shunt (VPS). Patients with myelomeningocele or cerebral palsy are often diagnosed with hydrocephalus and constipation due to neurogenic bowel. These patients are more prone to VPS dysfunction, often requiring surgical revision. The authors report the case of a 6-year-old girl with a VPS that had been implanted due to hydrocephalus secondary to myelomeningocele. The patient was brought to the emergency department with intermittent headache, vomiting, constipation, and abdominal distension and pain. A CT scan revealed ventricular dilatation and radiography of the abdomen showed bowel loop distension. After a Fleet enema and digital maneuvers, her abdominal distension and symptoms improved. A CT scan obtained 24 hours later showed a reduction in ventricular size. The mechanism by which constipation can lead to VPS malfunction can be traced to indirect increases of intraabdominal pressure and direct obstruction of the catheter by distended intestinal loops. Treating constipation can restore the free circulation of the CSF and avoid surgical intervention. Careful neurological monitoring of these patients is essential, because some measures used to treat constipation can increase intracranial pressure. The objective of this report was to highlight constipation as a possible cause of transient VPS malfunction, thereby avoiding unnecessary surgical revisions, to which children with hydrocephalus are frequently submitted.

The authors describe a rare case of idiopathic distal lenticulostriate artery (LSA) aneurysm in a 5-year-old boy who presented in the emergency department with a sudden onset of headache. Admission computed tomography scans revealed an intracerebral hemorrhage in the left caudate nucleus with intraventricular extension. Angiographic studies demonstrated a left medial LSA aneurysm. The patient underwent a left parasagittal frontal craniotomy, the lateral ventricle was accessed via the anterior transcallosal approach, and the aneurysm was removed after sectioning of the parent vessel. The child left the hospital after 5 days; at that time he was asymptomatic and without motor impairment. The optimum treatment of aneurysms involving small perforating arteries is controversial and depends mainly on the causative factors. The pathogenesis and treatment of these unusual aneurysms are discussed.

Dog bites are increasingly being recognized as posing a major public health problem. In the U.S., Weiss et al. reported a rate of 12.9 per 10,000 persons, for dog-bite related injuries resulting in a total of 333,687 visits to Emergency Departments 1 . Children most commonly fall victim, where the head and neck are the most frequent sites of injury accounting for some 80% of such cases.To date, craniocerebral injury cases caused by dog bites have been little published in the medical literature 2,3 . Two cases of penetrating head injury from dog bites are presented and discussed in the context of the current literature on clinical and radiological evaluation, and treatment. CaseThis study was approved by the commission of ethics of the institution and we obtained the informed consent of the responsible for the patients for publication. Case 1On January, 2006 a previously healthy two-year-old boy was brought to the "Hospital das Clínicas" of São Paulo 12 hours after being attacked by a Rotweiller dog in the head. The boy did not lose consciousness, remained alert and responded appropriately. Examination showed a scalp injury on both sides of the head. The CT scan disclosed a depressed skull fracture in the right temporal bone, where the scalp injury was larger (Fig 1A). The child was submitted to surgery with a large incision. There were five depressed skull fractures in the temporal and parietal bones, not directly under the scalp injury itself, which were repaired with a wide craniotomy. The next day the child presented CSF leakage on the left side from the scalp injury, and underwent surgery for a second time. The second CT scan showed a skull fracture in the left temporal bone, not revealed in the first CT scan (Fig 1B). Surgery was carried out on this side and two depressed skull fractures were found not under the scalp wound, but some distance away (Fig 1C, 1D). A large craniotomy was performed and the dural laceration was treated. The boy received a wide spectrum prophylactic antibiotic (oxacilin, ceftriaxone and metronidazol) for 14 days, anti-rabies and anti-tetanus vaccines, rabies immunoglobulin, where treatment was complemented with psychological therapy. At a twelve month-follow-up, the boy was normal without any handicap. Case 2On May, 2006 a previously healthy three-year-old girl was brought to the "Hospital das Clínicas" of São Paulo 10 hours after she had been attacked to the head by a pitbull dog. She did not lose consciousness and presented scalp injuries on both sides of the head as well as to the posterior region of the head. The girl was conscious and responded appropriately. The CT scan showed a complex depressed skull fracture in the left temporal bone; two depressed skull fractures in the occipital bone and signs of pneumocephalus. The 3D CT showed both bone and brain injuries (Fig 2). The girl was submitted to surgery with wide exposure of the lesions. Fractures and dural lacerations were corrected and (Figs 3 and 4). After surgical treatment she received prophylactic antibiotics (oxacili...

VOB shunting may be considered an acceptable technique to CSF shunting when the anterior peritoneum loses or decreases its CSF absorption capacity.

The most important clinical features specific to the clinical diagnosis of synostotic occipital plagiocephaly, not present in the positional posterior plagiocephaly, were bulging of the ipsilateral mastoid process, edge effect of the synostotic lambdoid suture, tilt of the head, and slant of the bimastoid line viewed from behind, inferior deviation of the ear, and contralateral parietal bossing.