Swelling in popliteal region is a common presentation with usual differential diagnosis of bakers cyst, ganglionic cysts. Schwannoma of common peroneal nerve although a clinically rare entity may also have similar presentation. The treatment of choice for such schwannoma is surgical excision with preservation of nerve integrity. Without knowledge of this consideration and disrespecting nerve planes during surgery may have devastating complications. We here present a similar rare case report of common peroneal nerve schwannoma with brief review of literature; the case was managed by complete surgical excision with no neurological deficit in post operated phase.
Background: Echinococcosis also known as hydatid disease is an endemic zoonotic disease with growing public health concern with an estimated financial burden of US Dollars 193,539,740 annually. Its definitive host being carnivores and man being an accidental intermediate host. The most common organ affected is the liver, the brain is involved in about 2% of cases. Intracranial hydatid carries high morbidity owing to pressure effect and a slow-growing hence the diagnosis is often delayed. Surgery is the mainstay of treatment, medical management being reserved for selected cases. Materials and method: A retrospective analysis of all the cases of intracranial hydatid disease managed at our department was done from 2013 to 2020 and data were analysed. Results: A total of 6 cases were found with an incidence of 1.33% of all intracranial space-occupying lesions during the study period with male to female ratio of 5:1, mean age at presentation 21.2 years, 4 out of 6 patient in the pediatric age group, cyst localised mainly in middle cerebral artery territory, mostly solitary but multiple in one case, all cases managed surgically with preoperative rupture in one case, recurrence noted in another one, Albendazole was given to cases only with rupture or recurrence. Conclusions: Intracranial hydatid disease should be suspected in all non-enhancing cystic brain lesions especially in endemic regions and all patients should have preferably surgical excision using the “Dowling technique” with medical management reserved for inaccessible lesions, patients unfit for surgery, rupture and recurrent cases. Its high time when public health strategies should also be focussed on prevention and control of disease with appropriate measure at the community level.
Meningiomas are one of the common brain tumours which have origin for arachnoid cap cells. Extradural meningiomas are rarer variants classified into primary and secondary in nature based on their source of origin. The common location of primary extradural meningiomas is head and neck with paranasal sinuses being a common site in head and neck. The treatment of choice lies with complete excision of tumour which usually follows a good prognosis and low rates of recurrences. Current literature is scarce about primary extradural meningiomas with majority being case reports or short case series only. We here present a case report of a primary extradural meningioma of right frontal and ethmoidal sinus treated by surgical excision. This case report adds on to the current knowledge of literature about primary extradural meningiomas. Summary A 28 year old male presented with chief complaints of right eye proptosis and right frontal headache with no neurological deficit reported to our centre with a trans nasal biopsy report of his lesion done elsewhere to be psamomatous meningioma Grade I. On reviewing his MRI Brain and paranasal sinuses, a totally extradural space occupying lesion in right frontal and ethmoidal sinuses communicating into intracranial cavity pushing right frontal lobe up and extending into roof of right orbit was found. Patient underwent right frontal craniotomy with complete excision of tumour with subsidence of proptosis in immediate post operative period. Primary extradural meningiomas are rare entities with scarce literature available. We write this case report to add on to current literature available and also briefly discuss the literature review known currently.
Introduction: Giant encephalocele are encephalocele more than the size of head from which it arises. They pose a management challenge in view of risk of associated anomaly, challenges in anaesthesia and surgical management. There is no literature available from peripheral tertiary care centres from India apart from few case reports. Methods: This case series comprises of seven cases operated at our institute from 2014 to 2021. After routine clinical examination, patients subjected to recommended radiological investigations. Patients were anaesthetised with standard protocol with intubation in lateral or supine position with head hanging at edge of table and supported at table. Surgery carried out in lateral position with complete excision of sac with CSF diversion if pre existing hydrocephalus was present. Results: Out of seven cases, 3 were males and four female with age range from 12 days to 14 Mo. All patients were anaesthetised with standard protocol and had excision of sac with CSF diversion if required with satisfactory outcome in post operative phase and follow up. No death was recorded. Conclusion: With careful assessment and all recommended investigation with standard practice of anaesthesia and surgery, acceptable outcomes can be expected. Emphasis should be laid for good antenatal folate supplementation and possible antenatal diagnosis of meningoencephaloceles.
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