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Hydatid disease is a parasitic infestation caused by Echinococcus granulosus, affecting both children and adults. Its intracranial form is extremely uncommon and can present a diagnostic and therapeutic challenge.To analyze the clinical manifestations, radiological features and surgical outcomes in 21 pediatric patients with intracranial hydatidosis and to share our experience managing this pathology, with a review of relevant literature.We report a case series of 21 pediatric patients operated on for intracranial hydatid cyst in the neurosurgical department of Ibn Tofail Hospital, Mohammed VI University Hospital, Marrakech, Morocco, between January 2012 and December 2019. We performed a comparison of our results with results from 18 case series in a review of the literature.The most common presenting symptom was intracranial hypertension, followed by neurological deficit. Other symptoms included visual impairment, cranial nerve palsy and seizures. A computed tomography scan confirmed the diagnosis in all patients. Serological analysis was positive in 5 patients, all of whom had an associated extracerebral location. All patients were operated on successfully using the Arana Iniguez technique.Intracranial hydatid disease should be suspected in case of intracranial hypertension in children and adolescents from endemic countries. The diagnosis is confirmed by head CT. Treatment is mainly surgical and prognosis is favorable. Prevention is the most effective way of addressing this disease and we therefore stress the importance of investing in population education and animal control.

Resume But Determiner les facteurs de severite chez les traumatises crâniens graves. Methodes Etude prospective descriptive des traumatises crâniens graves admis a l’hopital Ibn Tofail du CHU de Marrakech de Mai a Octobre 2015. Les donnees suivantes ont ete recueillies : circonstances, clinique, biologie, radiologie, traitements et evolution. Resultats Cent dix-neuf cas ont ete colliges (101 hommes, 84,9 %). L’âge moyen etait de 37,73 ± 15,7 ans. Les accidents de la voie publique etaient les plus frequents (84 %). Le score median de l’echelle de Glasgow (GCS) etait de 7. Nous avons note 36 anisocories (30,3 %), 32 mydriases (26,9 %) et 72 hypoxies (60,5 %). Les contusions cerebrales (66,1 %) et l’hemorragie meningee (66,6 %) etaient les lesions les plus frequentes. Quarante-sept patients (42 %) avaient des lesions stade VI de Marshall. Vingt-quatre patients (20,1 %) ont beneficie d’une intervention neurochirurgicale, 12 pour evacuation d’hematome extra dural et 10 pour plaie craniocerebrale. La mortalite etait de 64,7 % (77 deces), dont la cause principale etait neurologique chez 50 patients. Dans ce dernier groupe, nous avons observe plus frequemment un âge plus eleve (p = 0,00001), un delai de prise en charge prolonge (p = 0,011), un GCS initial bas (p = 0,000001), une mydriase bilaterale areactive (p = 0,0001), une hypoxie (p = 0,0002), une hemorragie meningee (p = 0,008), un score de Marshall eleve (p = 0,017) et une anemie (p = 0,046). Conclusion Les traumatismes crâniens representent un probleme de sante publique. Les victimes sont jeunes et les sequelles sont frequemment invalidantes. Plusieurs parametres sont lies a un pronostic plus severe dont l’âge, l’etat neurologique initial et le retard a la prise en charge.

La morsure de serpent constitue la forme la plus grave des envenimations. Son incidence annuelle dépasse six millions avec une mortalité non négligeable. Les morsures par vipère sont souvent responsables d´une coagulopathie à l´origine d´un syndrome hémorragique, cependant les complications ischémiques sont rares. Nous rapportons l´observation d´une fille de 6 ans victime d´une morsure de vipère identifiée comme vipère Cérastes cérastes au niveau de la cheville gauche, admise 4 jours après la morsure en trouble de conscience avec un tableau de coagulation intra-vasculaire disséminée. L´examen a mis en évidence une hémiparésie gauche et un syndrome vipérin au membre inferieur gauche. La tomodensitométrie cérébrale a objectivé une ischémie temporo-pariétale droite. L´évolution a été marquée par l´aggravation neurologique nécessitant une ventilation mécanique. Les accidents vasculaires cérébraux, en particulier ischémiques secondaires à une envenimation vipérine grave sont exceptionnels. Le mécanisme physiopathologique n´est pas clairement élucidé mais semble être multifactoriel nécessitant plusieurs recherches.

Background: In developing countries, where there is a chronic shortage of neurosurgeons and medical infrastructures, the pandemic has taken a heavy toll on neurosurgical activities. In the absence of a curative treatment, reaching herd immunity through mass vaccination campaigns is the best hope we have of ending this pandemic. Therefore, the purpose of our study was first to assess the effect of coronavirus disease 2019 (COVID-19) outbreak on neurosurgical services of a Moroccan tertiary hospital. Secondarily, we aimed to describe current vaccination compliance rate in our country, and its impact on the recovery of neurosurgical practice. Methods: To examine how COVID-19 challenged the neurosurgical delivery of care in our unit, we compared emergency and elective admissions during COVID-19 and pre-COVID-19 period using the registry of neurosurgery department. Second, after evaluating vaccine acceptance rates among 1463 healthcare workers and patients admitted to our hospital, we compared the number of surgeries performed in our department after implementation of a mass vaccination campaign. Results: The overall number of procedures dropped from n = 197 (pre-COVID-19) to n = 150 during COVID-19. The number of elective surgeries declined from an average of 10.5 operations per week before COVID-19 to four surgeries per week during the COVID-19 pandemic. Conversely, an average of 3.5 emergency operations was performed each week before COVID-19 compared to 5.6 per week during the pandemic. On the other hand, our results showed that willingness to get the COVID-19 vaccine among the participants was high (81.7%) with significantly less hesitant individuals among healthcare workers (P = 0.001). This successful vaccine rollout helped resuming gradually elective surgeries in our department. Conclusion: Our study found a high acceptance rate of COVID-19 vaccines among Moroccans, which gives a glimmer of hope of restoring all our neurosurgical services. However, despite the high acceptance rate, the authorities must address concerns among hesitant individuals and raise awareness on the importance of COVID-19 immunization.

This paper discusses the petrol-station replenishment problem with adjustable demands (PSRP-AD). This problem originates from a practical application of fuel delivery, where the main object...