Paediatric strokes are a different entity owing to the difference in pathological entity causing the stroke as well as difficulty in treatment and management due to the presence of a growing brain and small vascular volume making surgery and endovascular intervention dangerous. Yet, the high neuronal plasticity coupled with unique surgical and endovascular procedures makes surgery in these conditions

Tuberculosis of the central nervous system (CNS) remains endemic in developing countries with high morbidity and mortality despite advances in imaging and treatment. The objective of our work was to describe the diagnostic and therapeutic difficulties of this pathology in the context of a country with limited health resources. We retrospectively studied 8 cerebral tuberculosis abscess files, collected

Management of lumbar canal stenosis should be started with conservative treatment and preferably with a multimodal approach, but in cases of severe pain with extensive neurogenic claudication symptoms, surgical intervention is indicated. This retrospective study targets to evaluate the outcome of classic laminectomy surgery alone versus laminectomy with fixation surgery in patients with lumbar canal

Posterior fossa brain tumours are one of the most devastating forms of human illnesses which are more common in children. Brainstem compression, herniation and death are the risks with tumours in this critical location. To evaluate our results, complications and outcome of posterior fossa tumour surgery in Benha University Hospital. A prospective study including 44 patients with posterior fossa tumours

Meningioma arising from locations in the vicinity of the optic nerve or chiasm may affect the visual function and sometimes the presentation of such tumors. Decompression of the optic nerve or chiasm can give a chance for the visual function to recover. Thirty patients who had visual function affection and underwent meningioma excision are followed up for a period of 1 year with regular follow of their

Cryptococcal infection of the brain usually occurs in immunocompromised individuals and manifests with signs and symptoms suggestive of meningoencephalitis. It is rare to come across this infection as a brain granuloma manifesting with focal neurological deficits and without any overt immune deficiency. A 55-year-old male presented with dysphasia. His vital signs were normal at presentation and he

The anterior skull base region can be reached through multiple corridors. The most frequently used are the pterional, bifrontal, unifrontal, and orbitozygomatic approaches. These approaches are more extensive and time consuming. The lateral supraorbital approach is a less extensive frontal modification of the classic pterional approach designed to manage tumors and aneurysms of this region. To evaluate

Odontoid fractures are the most common cervical fractures specially type II. Anterior odontoid screw fixation has many advantages with low incidence of surgical complications. To evaluate the role of single odontoid screw fixation in surgical treatment of odontoid fracture type II. A retrospective clinical case series. Twelve patients with acute traumatic odontoid fracture type II were surgically treated

Intracerebral hemorrhage is hemorrhage occurring in the brain that can occur because of immediate trauma or structural disease process. The age-standardized mortality rate is decreasing worldwide especially in the past 20 years, but the number of cases and incidence along with number of disability-adjusted life-years and deaths keeps rising. Despite having half the incidence as ischemic stroke, intracerebral

Anterior cervical foraminotomy represents a relatively recent minimally invasive approach that can potentially preserve the intervertebral disc and thus the functional motion segment. This study aims to evaluate the clinical outcome of microendoscopic anterior cervical foraminotomy (MACF) for patients with cervical unilateral radiculopathy due to single level soft disc herniation or hard disc-osteophyte

Subdural hematoma (SDH) at a remote operative site is uncommon following neurosurgical procedures. However, supratentorial SDH is one of the rare complications following microvascular decompression (MVD). We report a case of supratentorial SDH following MVD. The welling of cerebrospinal fluid (CSF) in the cerebellomedullary fissure was observed unexpectedly during the dissection. It is a signal case

Due to increased number of patients suffering from hydrocephalus (HCP) and lack of data concerning volumetric changes after shunting operations, this study aims to assess the volumetric changes in brain ventricles after successful ventriculoperitoneal (VP) shunt surgery in correlation with clinical improvement. This study included 20 patients; all of them are below the age of 2 years. All the patients

Hemifacial spasm (HFS) is a chronic movement disorder characterized by twitching of muscles of facial expression which is innervated by the facial nerve. The condition is unilaterally, beginning in the orbicularis occuli, and later on progress to involve the perioral, platysma, and other muscles of facial expression. Endoscopic assisted microvascular decompression is considered the state of the art

Thalamic space-occupying lesions (SOL) are considered challenging for microsurgical removal. Unfortunately, the pathological features of lesions occurring in the thalamic region are different with a wide variation in clinical behavior and outcome. Although microsurgery is still the gold standard in the management of these lesions through different approaches, questions remain whether surgery is feasible

This study aims to evaluate different prognostic factors after surgical management of metastatic spinal tumors regarding clinical condition, preoperative investigations, histopathological results, and surgical data. Seventy patients diagnosed as metastatic spinal tumors with neurological deficits and/or unstable spine operated for spinal decompression with or without instrumental fixation according

Neurosurgical services is an essential component of tertiary level of health care, this field is still evolving in Nigeria with lack of material and manpower. There is a near complete absence of neurosurgeons in the rural communities in Nigeria with over 95% resident in urban area. Starting a neurosurgical services takes a huge sacrifice from the neurosurgeon who is faced with a decision to do something

The management of impalement brain injury is very challenging, because of its complexity, risk of intracranial infection, neurological damage and functional impairment of the affected persons; in addition to the paucity of standardised treatments guidelines. The objective of this paper was to describe the clinical presentation and management outcome of patients admitted with impalement brain injuries

Thoracic kyphosis is not so uncommon, which presents with devastating myelopathy. In the past, the surgical treatment for it had been somewhat controversial. Traditionally, it had been addressed by open decompression and stabilization with significant dissection and disruption of normal tissues and complications. Recently, correction techniques have evolved as the standard of care. A substantial body

Increasing traumatic brain injury (TBI) has paralleled the need for decompression surgery for acute subdural (ASDH) and acute extradural haematoma (AEDH). Knowledge of key determinants of clinical outcomes of such patients is mandatory to guide treatment protocols. To determine the 30-day clinical outcomes and predictor variables for patients with extra-axial hematomas at Mulago National Referral Hospital

Ventriculoperitoneal shunt is one of the most popular cerebrospinal fluid diversion procedures worldwide. Complications are common, but uncommon complications are rarely reported in the literature making a standardized guideline on management of unusual complications unavailable. We report this series of uncommon complications managed in our centre to share our experience and contribute to the pool

Microvascular decompression is the definitive treatment of various neuralgias affecting cranial nerves. The compression on a cranial nerve could be at the root entry zone, especially the trigeminal nerve. Endoscope-assisted microsurgery may help avoid missing a hidden vascular structure. Retrospective clinical case series. Twenty-five patients with facial pain and five patients with hemifacial spasm

Various surgical options are used for the treatment of ulnar nerve entrapment at the elbow. In this study, anterior trans-muscular transposition of the ulnar nerve was used for the treatment of cubital tunnel syndrome. To evaluate the surgical results of anterior trans-muscular transposition technique for the treatment of cubital tunnel syndrome with particular emphasis on clinical outcome. Forty patients

Hydatid disease is widely distributed worldwide; it is caused by a parasite belonging to the Echinococcus species. It mostly affects the liver and the lungs, involvement of the spinal canal is reported to be around 0.2%, but affection of the peripheral nerves is extremely rare. A 42-year-old lady was complaining from left loin pain and backache, with pain in the outer aspect of the left thigh for the

The Egyptian Journal of Neurosurgery was transferred to Springer Nature in 2018. The last volume published was Volume 31. The first volume published by Springer Nature should have been Volume 32, but due to a technical error by the publisher, this was published as Volume 33 of the journal. For bibliographic and indexing purposes, Volume 32 of this journal will be skipped. Affiliations Consortia Egyptian

Kleeblattschädel skull, also known as the cloverleaf is a complex synostosis which presents with an enlarged tri-lobar skull resulting temporal bulging and a flat posterior skull, a rare find in the population. This pansynostosis is associated with other congenital syndromes which include Crouzon, Pfeifer, and Carpenter’s. The genetic disorder Pfeiffer syndrome results from skull bones’ premature fusion

Each year, there are approximately 5 million new vertebral fractures worldwide. Being a mobile flexible segment that is prone to severe stresses and loads, thoracolumbar fractures are considered one of the most controversial and challenging fracture types to manage. The aim of this study is to explore the technique and to evaluate feasibility, safety, and outcome of percutaneous transpedicular fixation

The purpose of this study was to correlate lumbosacral spinal ultrasound (LUS) and magnetic resonance imaging (MRI) findings in patients with lumbosacral spinal dysraphisms to evaluate the value of LUS in diagnosis, intraoperative use, and during follow-up of those patients. A total of 24 patients aged up to 6 years old were operated for lumbosacral spinal dysraphisms at the Neurosurgery Department

Herniation of the cervical disk material results in interruption of the posterior longitudinal ligament (PLL) in the majority of patients. Routine opening of the PLL during ACDF is a necessary step for complete removal of all disk fragments. Safety measures during PLL opening during microscopic anterior cervical discectomy and risk-free surgery A retrospective clinical case series The study was conducted

Assessment of visual field outcomes following the medical or surgical management of increased intracranial pressure in patients with idiopathic intracranial hypertension. Thirty-two patients diagnosed with idiopathic intracranial hypertension who met all the modified Dandy criteria were included in this study. Magnetic resonance brain imaging with contrast and magnetic resonance venography were performed

Gangliogliomas are rare tumors of the central nervous system. They can occur anywhere in the central nervous system but are most commonly located in the temporal lobe and are mainly found in children. Anaplastic ganglioglioma can result from either de novo or transformation of a pre-existing lesion. We report a case of de novo anaplastic ganglioglioma in the parieto occipital region, which is a rare

Meningitis is a life-threatening infection often associated with high morbidity. Recurrent bacterial meningitis poses a clinical challenge, both clinically and diagnostically. To prevent further recurrences, the underlying causes of recurrent bacterial meningitis should be investigated intensively. Here, we aim to present a patient referred to our clinic with rhinorrhea and found to the Staphylococcus

Degenerative spondylolisthesis is a common spinal pathology. Traditionally, spinal fusion is an accepted standard surgical treatment for listhesis. But fusion is a major intervention with its known pitfalls. With technological progression, minimally invasive spinal fusion (MISF) procedures are becoming mainstream. Percutaneous trans-foraminal endoscopic lumbar discectomy/decompressions (PTELD) without

Surgery in a prone position is necessary when access to posterior anatomical structures is needed. A procedure in this position is associated with complications such as injuries to the eyes, peripheral nerves, and pressure points and swelling of the tongue. We report a rare complication of isolated lower lip swelling following neck dissection in the prone position. A 25-year-old male patient presented

Pediatric idiopathic intracranial hypertension is a rare condition, but inappropriate diagnosis and management may lead to devastating outcome with loss of vision and lifelong handicap. Dandy criteria are used for diagnosis of idiopathic intracranial hypertension (IIH) in adult, but these criteria cannot be applied in all pediatric patients. The aim of this study is to evaluate the diagnostic criteria

Endoscopic third ventriculostomy (ETV) is becoming a popular option of treatment in carefully selected patients with hydrocephalus (Drake et al., Childs Nerv Syst 25:467-472, 2009). The success or possible outcome of its application in treating hydrocephalus can be predicted by employing a preoperative scoring system. An example of such a system is the endoscopic third ventriculostomy success score

Intraoperative use of ultrasound in brain surgery needs good understanding of the brain anatomy in ultrasound images. This study aims to compare ultrasound imaging of brain anatomical landmarks during surgery to perioperative computed tomography (CT), and perioperative magnetic resonance imaging (MRI) as demonstration for encouraging usage as low cost, available and hazardless device. In total; 350

Chronic subdural hematomas (CSDH) initially present as focal neurological deficits with or without signs of increased intracranial pressure, for which admission to the general medical ward may occur if they present with poorly understood neurological deficits and no evident history of trauma. The symptoms may be long standing and mimic stroke upon presentation. Their distribution and specific clinical

Intracranial arachnoid cysts are collections of cerebrospinal fluid within the arachnoid membrane and subarachnoid space of the cisterns and major cerebral fissures that account for about 1% of all intracranial lesions. Expansion of the cyst and compression on surrounding structures may became symptomatic, which reflects its size and anatomic distribution. Here, we present a very rare case of patient

To evaluate the efficacy and safety of trans-sulcal or fissure approach in surgical treatment of supratentorial lesions Retrospective clinical case series This study included 42 patients. Age ranged from 4 to 78 years. Sulcal dissection was done in 26 patients at or near the eloquent areas, and in 16 patients, it was done in non-eloquent areas. Diffusion tensor tractography, neuronavigation, and intraoperative

Various surgical procedures have been recommended for the treatment of lumbar spondylolisthesis, but controversy still exists regarding the optimal surgical technique. In this study, we compared the clinical and radiologic outcomes of posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) with pedicle screw fixation in the treatment of single-level lumbar spondylolisthesis

The goal of modern vestibular schwannoma surgery is not only to complete tumor removal but also to preserve functions. Cerebellopontine angle surgery carries a significant risk of impairing facial nerve function especially with large masses. Avoidance of facial nerve injury postoperatively requires preoperative and intraoperative identification and hence the role of preoperative imaging and intraoperative

Non-missile penetrating brain injuries are rarely seen in the surgical practice and few international literatures’ reported case reports or small case series, and it comprises a small percentage of head trauma cases. We reported a group of 18 cases of penetrating injuries with different tools and various mechanisms. We reported their epidemiological criteria, mechanism of trauma, complications, and

The vertebral column represents the most common bony site for metastasis with an incidence ranged from 30% to 70% in patients with metastatic neoplasms. The dorsal spine carries the highest frequent site for metastasis all over the vertebral column followed by the lumber spine. These metastatic lesions are clinical entities that often necessitate a complex spinal decompression and anterior reconstruction

Far lateral lumbar disc herniation (FLLDH) compresses the nerve root at the same level. The laterally herniated disc fragment typically could not be exposed by the standard posterior hemi-laminectomy technique, and a total facetectomy including wide bone removal is usually mandatory for good exposure and removal of the herniation but simultaneously increasing the risk of instability. In the present

There is a debate over the origin of bleeding in case of spontaneous spinal epidural hematoma (SSEH). The most widely accepted theory is of venous origin. Since the epidural veins are valveless, there will be increased venous pressure transmitted from intrathoracic and intraabdominal compartments on straining, causing rupture. Another view is that only arterial bleeding can cause rapid compression

Intra-thecal baclofen pump has been proven a safe and effective treatment of spasticity. Subdural hematoma has been rarely described following intra-thecal drug delivery device insertion. We report on the rare case of a 45-year-old male with multiple sclerosis who presented with symptoms of intra-cranial hypotension 1 month after insertion of an intra-thecal baclofen pump for severe spasticity. Non-contrast

We aim to summarize the role of surgical treatment of spontaneous basal ganglionic hemorrhage based on prospective analysis of our patients and determine the factors that favor the outcome. A prospective analysis was done of 66 patients from January 2014 to June 2017. Inclusion criteria for the patients in this study were as follows: patients aged between 15 and 60 years; CT scan showed basal ganglionic

Lumbar disc prolapse has been rarely described in young children. In this report, we reported a lumbar disc prolapse in an overweight 9-year-old girl after trauma. The girl had a severe radicular pain that did not respond to conservative treatment. Operative management was conducted, and histopathologic examination of the prolapsed disc material revealed chondrocyte proliferation, tears and clefts

Cerebral edema and increased intracranial pressure are of the major consequences of traumatic brain injury that affects the outcome. The aim of this study is to assess the efficacy of dexmedetomidine as an adjunct to conventional sedative therapy (propofol) compared to conventional sedative therapy alone in patients with traumatic brain injury, as regards its effects on hemodynamics and intracranial

Arachnoid cysts account for about 1% of all intracranial mass lesions. Intraparenchymal arachnoid cysts are an uncommon entity. Only a few reports are available in adults with the intraparenchymal arachnoid cyst. We present a 40-year-old lady with right-side progressive hemiparesis, and radiology revealed a cystic mass located in the left posterior frontal area. She underwent craniotomy and excision

Pneumocephalus is a common complication presented as air in the cranial cavity after cranial surgery. We present a very rare case of isolated new onset aphasia due to pneumocephalus after evacuation of subdural hematoma (SDH). Tension pneumocephalus presenting as isolated aphasia has not been reported earlier although associated paresis has been reported. We present the case of a 13-year-old male child

This is a letter to the editor commenting on “Carpal tunnel syndrome: evaluation of its provocative clinical tests.”

Trigeminal neuralgia may be idiopathic or may involve other causes. It can be secondary to posterior fossa tumors many times. In the present case, posterior fossa meningioma was detected with trigeminal neuralgia together. However, relevant meningioma is not seen as a cause of trigeminal neuralgia clinic with posterior fossa settlement. Tumor localization and the story of the patient suggest that the

Although neurofibromatosis type 1 (NF1) is a common genetical disorder, symptoms due to neural involvement are rare among infants and children. Ganglioneuromas are slow-growing tumors and can be seen in patients with NF1. However, bilateral symmetrical involvement is very rarely reported in the literature. We present a rare pediatric case with NF1 who presented with upper cervical bilateral symmetrical

Primary central nervous system lymphoma (PCNSL) is an uncommon extranodal non-Hodgkin lymphoma. This tumor is common in the fifth to seventh decade and is located commonly in the periventricular region and in the cerebral hemisphere. Corpus callosum is a rare site. We report a case of diffuse large B cell lymphoma with corpus callosum and contralateral side involvement in immunocompetent patient. A

The relationships of the fourth ventricle to the cerebellar surfaces and the fissures through which the fourth ventricle is approached surgically are among the most complex in the brain. The area in and around the fourth ventricle may be affected by a variety of neoplasms. Some are unique to the fourth ventricle; others are also found in different locations. The two most common surgical approaches

Most of the studies that examined the prognosis of acute subdural hematoma (ASDH) in severe head injury patients stated their overall prognosis as one group. The aim of the present study was to assess the prognosis of ASDH of > 10 mm in thickness in head injury patients with an extension or no motor response to pain after resuscitation. This retrospective study reviewed the severe head injury patients

Management of chronic subdural hematoma (CSDH) is usually surgical; burr hole craniostomy using double burr hole under general anesthesia is the most commonly used technique for its evacuation. However, single burr hole under local anesthesia may be an alternative deserving the study. The aim of this work is to evaluate the prognosis of single burr hole under local anesthesia in the management of CSDH