Introduction: Cerebral hydatid disease, accounts for 1 – 25 of all hydatid cases. In this paper, we report a rare case of a giant primary cerebral hydatid cyst presenting solely as a seizure in a two-year-old child. This case is unique both in the size of the cyst and clinical presentation. We additionally review the literature on giant cerebral hydatid cysts. 

Methods: A PubMed database search was conducted using the following combination of medical subject headings terms: “giant cerebral hydatid cyst” OR “giant intracranial hydatid cyst”. The focus of the review was to identify cases of giant intracranial hydatid cyst in the pediatric age group and whether it was associated with seizures. The following set of data was collected from each study: age, gender, presence of seizure, other presentations, site of intracranial hydatid cyst, and other organ involvement.

Results: A total of 23 studies (26 cases) were included in the review of those, nine studies (10 cases) including ours described the presence of seizures. The most common presentations were headache (17 cases), papilledema (15 cases), hemiparesis, seizure, and vomiting (10 cases). The most common location for intracranial cysts was intraventricular at 19.2% (five cases). The next common locations were the parietal and frontoparietal, accounting for 30.6% (eight cases) of all cases. Other reported sites were temporoparietal (11.5%, three cases), frontotemproparietal (3.8%, one case), and cerebellar (3.8%, one case).

Conclusion: Giant cerebral hydatid cysts should be in the differential of children presenting with seizures and cystic brain masses, especially in endemic regions. Meticulous surgical technique is paramount to maximize patient outcomes.  

Keywords: Giant cysts; cerebral hydatid disease; pediatric seizures

Background: Surgical approaches to the trigone of the lateral ventricle are challenging because of the eloquent nature of the surrounding anatomy. In this article, we described trigone intraventricular meningioma on the right side and its management in the developing country of Bandung Indonesia.

Case presentation: A 43 years old male came to our hospital with a chief complaint of headache and homonymous hemianopia on the left eye for the past two months before surgery. He had severe vomiting seven days prior to admission. Magnetic resonance imaging with contrast revealed an enhanced tumor in the right intraventricular trigone. Preoperatively he underwent a tractography to see the optic radiation. We performed craniotomy tumor removal by using a trans-sulcal approach on the parietooccipital sulcus to avoid damaging fibers of the internal capsule and optic radiation. The safe entry zone was confirmed with neuronavigation during surgery. The pathology showed a fibroblastic meningioma.

Conclusion: We have successfully performed a total craniotomy tumor removal on the right trigone intraventricular meningioma. For the best outcome, it was mandatory to use multimodal tools during surgery, such as preoperative tractography, high magnification microscope, neuronavigation, and intraoperative monitoring as well as surgical strategy to avoid the evidence of new neurological deficits.

Keywords: case report; developing country; intraventricular; meningioma

Background: Surgical site infections (SSIs) in spine surgeries represent one of the commonest hospital-acquired infections.

Literature review: SSI (refers to infection of the surgical wound within 30 days of surgery or one year of implant usage) portends a huge disease burden with devastating consequences to the patient and the hospital facility with attendant physical and psychological trauma to the patient and it is associated increase rate of morbidity and mortality. Despite, the improved surgical protocol for asepsis and the role of prophylactic antibiotics in clean spine surgeries. There is still a substantial increase in the rate of SSIs.

Conclusion: Reviewing and identifying factors that predispose a spine patient to SSIs is essential and this is aimed at formulating a local protocol that will help to curtail SSIs and could be reproducible in any setting in the world putting into perspective the limitations encountered in our settings.

Keywords: challenges, local protocol, predisposing factors, prevention, surgical site infection

Background: Traumatic spinal cord injury (SCI) is a trauma that affects the spinal cord. The most commonly encountered form of SCI is acute traumatic central cord syndrome (ATCCS). Currently, there are a few debates on the management of ATCCS. In this case series, we aimed to explain the results of surgical intervention and also the prognosis following the surgical treatment

Case presentation: We presented two cases of SCI. Both patients have a history of trauma and a chief complaint of pain in the neck. Weaknesses in the upper and lower extremity were presented in both patients. Through the magnetic resonance imaging examination, we found a canal impingement with spinal cord stenosis at the level of C3 – C4 on the first patient, and a compression on C4, C5, and C6 with vertebral body protrusion to the spinal canal on the second patient. Both patients went through surgery; decompressive laminectomy on the first patient and cervical corpectomy on the second patient. Both patients showed improvement post-surgery.

Conclusion: Surgical intervention, in the appropriate patient, is associated with an earlier improvement in neurologic status, shorter hospital stay, and shorter intensive care unit stay. However, in patients with mechanical instability, the role of surgery is critical to both address the ATCCS as well as the instability

Keywords: case series; traumatic central cord syndrome; traumatic spinal cord injury