We present a patient with an intracerebral haematoma occurring at a remote site following evacuation of a chronic subdural haematoma. Recurrence of the haematoma, infection, seizure, cerebral edema, tension pneumocephalus and failure of the brain to expand due to cerebro-cranial disproportion are the major complications following operations for chronic subdural haematoma. An intracerebral haematoma following such evacuation is rare. Characteristically, haemorrhagic events on the ipsilateral side to the subdural haematoma is reported in the literature. According to our search, this is the first report of an intracerebral haematoma occurring at a remote site to the original lesion following evacuation of a chronic subdural haematoma.
Fig. 1 Cranial axial T 1 -weighted magnetic resonance image revealing a mass lesion with surrounding cerebral edema in the left frontal lobe and probable aneurysm formation in the interhemispheric space.
AbstractA 52-year-old woman presented with bilateral distal anterior cerebral artery (ACA) mirror aneurysms, in addition to two right middle cerebral artery (MCA) aneurysms. The left distal ACA and right MCA aneurysms were clipped through right interhemispheric and right pterional craniotomies. The right distal ACA aneurysm was thrombosed. Distal ACA aneurysms tend to be multiple, but mirror aneurysms are rare, especially in the absence of congenital vascular anomaly. Single stage unilateral craniotomy is recommended for surgical treatment.
Epidermoid tumors are rarely encountered within the fourth ventricle. There are slightly more than 100 cases reported in the literature. Congenital posterior arch defects of the atlas are also rare with less than 50 cases reported in the literature. The coexistence of these two pathologies in one patient has not been previously reported. We present a 51-year-old-woman with an epidermoid tumor of the fourth ventricle and accompanying posterior arch defect of the atlas.
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