An unusual type of congenital subgaleal cyst, either dermoid or epidermoid, was found in 21 Nigerian infants. This entity was located in the midline of the scalp, anywhere from above the nasion to the inion, and occupied the subgaleal space. These cysts were noted soon after birth and gradually enlarged. They had no intracranial extension and were easily excised intact. Clinically, radiologically, and histologically they were similar to congenital inclusion dermoid cysts of the anterior fontanel. The histology and some of the peculiarities of these cysts are described. Although most of these cysts occur at the anterior fontanel, they can occur anywhere in the midline, and the subgaleal space of the anterior fontanel is not the exclusive site, as has been claimed by previous authors.

Introduction: There is limited literature on the representation of women in leading roles in neuroanesthesiology and neurocritical care academia. We aimed to determine the representation of women as first and corresponding authors in articles published in 3 dedicated journals of neuroanesthesiology and neurocritical care during last 5 years.

We report a case of hydrocephalus with Dandy–Walker malformation in a 2-month-old girl child recently recovered from COVID-19. The child was detected to have acyanotic heart disease with left-to-right shunt and severe pulmonary arterial hypertension during the preoperative evaluation process for ventriculoperitoneal (VP) shunt placement. We share our experience of the perioperative management for pulmonary artery banding (PAB) and patent ductus arteriosus ligation as a part of staged cardiac corrective surgery, followed by VP shunt to relieve hydrocephalus in the single setting. Our management was focused on the preservation of the normal cerebral and cardiac physiology to prevent rise in intracranial pressure and pulmonary artery pressure. A multidisciplinary team, consisting of cardiac- and neuroanesthesiologists and cardiac and neurosurgeons, was involved in management of the case. Diligent maintenance of airway, stable hemodynamics, meticulous ventilation, along with postoperative ICU management helped in the successful outcome of this unique case.

Open Access article distributed under the terms of the Creative Commons License [CC BY-NC-ND 4.0] http://creativecommons.org/licenses/by-nc-nd/4.0 A prospective, randomised, controlled clinical trial to evaluate the effect of nitrous oxide on propofol requirement in elective craniotomy in which entropy was used to measure depth of anaesthesia Background: Propofol is known to have a favourable effect on cerebral haemodynamics. The role of nitrous oxide (N 2 O) in neurosurgical anaesthesia is still being debated. The primary aim of this study was to assess the dose-sparing effect of N 2 O on propofol infusion maintenance dosing. Method: Fifty American Society of Anesthesiology (ASA) grade I and II adults scheduled for elective craniotomies for supratentorial tumours were enrolled in the study. The patients received a standard anaesthetic comprising a fentanyl 2 μg/kg bolus prior to propofol induction. Anaesthesia was maintained with an infusion of fentanyl (2 μg/kg/hour), atracurium and propofol. The patients were randomised into two groups. Group A received 67% N 2 O. Group B did not receive N 2 O concomitantly with the propofol infusion. Entropy was used to guide the titration of the propofol infusion in both groups. Results: The propofol maintenance dose requirements were 47% lower in Group A (54.30 ± 11.47 μg/kg/minute) vs. Group B (102.30 ± 14.00 μg/kg/minute), (p < 0.001). Conclusion: The use of supplemental N 2 O significantly decreased propofol infusion rate requirements, compared with the propofol infusion alone, in ASA I and II patients undergoing elective supratentorial tumour excision.