Introduction. Arachnoid cysts are benign lesions comprising about 1 % of all intracranial space occupying lesions. The majority are asymptomatic, while surgical intervention, consisting of fenestration, is suggested in the presence of mass phenomena.The aim of the study – to present the case of a patient with arachnoid cysts in the cerebellopontine angle and its treatment.Materials and methods. A 53‑years old female patient was referred to our Department of Neurosurgery for the surgical management of a cerebellopontine angle mass. The patient reported tingling sensation and causalgia of her left hemiface, dysarthria, hoarseness, difficulty swallowing solid food and liquids, tinnitus and pain distributed along the ophthalmic branch of the trigeminal nerve.Results. The patient was subjected to retrosigmoid craniotomy with fenestration of the cyst and concurrent placement of a Torkildsen shunt. No complete resection of the capsule of the cyst was attempted, due to its tight adhesions to the adjacent structures. Postoperatively, there was an improvement in the dysarthria and swallowing of the patient.Conclusions. Cerebellopontine angle cystic lesions while histologically benign, may become clinically apparent due to compression of adjacent structures. Simple fenestration of the cyst may be sufficient for the remission of symptoms.
Carotid cavernous fistula is commonly caused by head trauma. Carotid cavernous fistula may be associated with intracavernous aneurysm of internal carotid artery, but occurrence of aneurysm at other site is rare. Management becomes complicated when carotid cavernous fistula is associated with aneurysm. Carotid cavernous fistula and aneurysm are managed by endovascular coiling with or without stenting. The management is more complicated if aneurysm is in cervical internal carotid artery along with carotid cavernous fistula. The decision to first obliterate what varies according to patient and doctor. We are reporting one of the rarest case of post-traumatic cervical internal carotid artery pseudo-aneurysms with carotid cavernous fistula following blunt head-neck injury and evidence based management strategies in such cases.
Astroblastoma is a rare tumor, which is mostly found in pediatric population. Due to scarcity of literature, the data about treatment is lacking. We are reporting case of brainstem astroblastoma in an adult female. A 45-year-old lady presented with complaint of headache, vertigo, vomiting, and nasal regurgitation for 3 months. On examination, she had weak gag, left hemiparesis. Magnetic resonance imaging brain reported medulla oblongata mass, dorsally exophytic. She underwent suboccipital craniotomy and decompression of mass. Histopathology confirmed diagnosis of astroblastoma. She underwent radiotherapy and recovered well. Brainstem astroblastoma is an extremely rare entity. The surgical resection is possible due to well-defined plane. For best outcome, maximum resection and radiation are indicated.
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