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Introduction: Ventriculo-gallbladder shunt (VGS) has been recognized as a last-resort alternative to treat hydrocephalus when the peritoneum and/or other distal sites can no longer receive shunts. In some specific conditions, it may be conceded as a first-line treatment. Case presentation: We report the case of a 6- month-old girl with progressive post-hemorrhagic hydrocephalus and who presented a concomitant chronic abdominal symptom. Specific investigations ruled out acute infection and led to the diagnosis of chronic appendicitis. Both problems were managed in a one-stage salvage procedure consisting of laparotomy sanctioning to treat the abdominal pathology and seize the opportunity to perform a VGS as a first option since the abdomen is prone to ventriculoperitoneal shunt (VPS) failure. Conclusion: Only few cases have reported the use of VGS as the first option to handle uncommon complex cases due to abdominal or Cerebro-Spinal Fluid (CSF) conditions. We wish to draw attention to VGS as an effective procedure not only in children with multiple shunt failures but also as first-line management in some selected cases.

Pleomorphic xanthoastrocytoma (PXA is a rare low-grade glial neoplasm of the central nervous system accounting for less than 1% of all astrocytomas. Similar to other gliomas, it can rarely arise from glial nests in the meninges, manifesting as an extra-axial mass mimicking a meningioma.In this article, we report the fourth case, so far, of a solitary primary meningeal PXA in a 23-year-old woman who presented with temporal seizures and features of raised intracranial pressure.

Remote intracranial hemorrhage is postoperative bleeding that occurs away from the surgical site. Remote cerebellar hemorrhage (RCH) is a cerebellar hemorrhage that may occur in 0.04-0.8% of cases after supratentorial and spinal procedures. We report a case of a 73-year-old male who developed signs of increased intracranial pressure two days after the evacuation of a subdural hematoma. Brain computed tomography showed RCH with the "zebra sign" and triventricular hydrocephalus that indicated the placement of external ventricle drain in emergency. Therefore, surgeons must pay special attention to this rare postoperative complication because it can be devastating in terms of patient outcome especially due to its possible complications requiring surgical treatment.

Primary mucinous adenocarcinoma is an exceptionally rare neoplasm with a propensity for local recurrence and metastasis. We report the second case in the literature of a primary mucinous adenocarcinoma of the orbit in a 66-year-old male with its clinical, histological features, and management of this tumor.

Introduction Les malformations arterioveineuses (MAV) sont souvent revelees par un episode hemorragique. Ils presentent une morbidite et une mortalite assez considerables. Objectifs Nous rapportons une serie chirurgicale de MAV afin de degager les caracteristiques cliniques et radiologiques, evaluer le risque de recidive ainsi que le pronostic general apres un premier saignement. Patients et methodes Il s’agit d’une etude retrospective de 31 cas de MAV colliges dans le service de neurochirurgie de Monastir au cours des 20 dernieres annees. Les donnees epidemiologiques, cliniques, therapeutiques et evolutives etaient revues. Resultats Les modes de presentation sont domines par un tableau d’accident hemorragique dans 67,7 % des cas, une epilepsie dans 25,8 % des cas, des cephalees isolees dans 19,35 % des cas. L’embolisation a ete realisee chez 5 malades. La chirurgie d’exerese etait associee a 35 % de mortalite. Quatre patients ont ete traites de maniere conservative, dont deux ont presente un episode hemorragique apres un delai de 3 mois et de 5 ans. Discussion La survenue d’un premier episode hemorragique augmente le risque de survenue d’un nouveau saignement. Le moyen therapeutique est souvent choisi en fonction des habitudes et de l’entrainement des equipes et peut associer differentes techniques therapeutiques. Aucun de ces traitements n’est anodin et le risque est non negligeable quel que soit le choix adopte dont l’objectif reste toujours l’exclusion complete de la MAV. Conclusion Les MAV sont une entite rare et potentiellement dangereuse. Une approche multidisciplinaire est indispensable pour optimiser et personnaliser la prise en charge des patients.

Introduction: Primary Intraventricular meningiomas are rare and occur in much younger age group than other the intracranial meningiomas. Calcified intraventricular meningioma in elderly has never been reported before. Case Report: Here we report the unique case of an 82 year-old female who presented for headache and vomiting following a traffic accident. The neurological examination disclosed no abnormalities. The CT scan revealed a calcified Intraventricular meningioma. Conclusion: Since the patient was aged over 70 years and was asymptomatic, the lesion was not removed. Follow-up imaging showed no changes in the tumor.