In the presented case, at the 6

postoperative month, the patient was Grade 1 in the Rankin Modified Scale and without hydrocephalus. This procedure can be used routinely as an additional tool to microsurgical clipping to improve patients outcome.

In the presented case, at the 6th postoperative month, the patient was Grade 1 in the Rankin Modified Scale and without hydrocephalus. This procedure can be used routinely as an additional tool to microsurgical clipping to improve patients outcome.

Some patients come to the hospital presenting with ischemic neurological deficits due to postsubarachnoid hemorrhage (SAH) cerebral vasospasm. In such a situation, neurosurgeons tend to avoid direct clipping, since mechanical irritation to the vessels could worsen the vasospasm and exacerbate ischemic symptoms. The optimal timing of direct clipping in patients with evidence of vasospasm is undetermined. Herein, we present the case of a patient who underwent direct clipping in the presence of severe symptomatic and post-SAH angiographic vasospasm. During surgery, we coated the severely spastic artery with nicardipine.

A 49-year-old woman was admitted to our hospital with the diagnosis of ruptured intracranial aneurysm and severe vasospasm. On the admission day, we performed direct clipping together with direct application of nicardipine to the spastic artery. Postoperative immediate cerebral angiography showed complete disappearance of the vasospasm.

Direct clipping should not be contraindicated during the vasospasm period in patients with a ruptured aneurysm, and direct application of nicardipine on the spastic artery would completely relieve vasospasm.

Direct clipping should not be contraindicated during the vasospasm period in patients with a ruptured aneurysm, and direct application of nicardipine on the spastic artery would completely relieve vasospasm.

Trapped fourth ventricle (TFV) usually develops as a complication of supratentorial ventricular CSF shunting, especially when hydrocephalus is caused by intraventricular hemorrhage and/or infection. This study aimed to assess the feasibility of endoscopic aqueduct stenting using a single refashioned shunt tube to treat cases presenting with both TFV and shunt malfunction.

We retrospectively collected and analyzed data from patients presenting with TFV and supratentorial shunt malfunction who underwent endoscopic aqueduct stenting using a refashioned shunt tube. Herceptin All cases were treated at our institution between January 2010 and July 2019. The surgical technique is described.

Eighteen patients were enrolled in our study. There were ten males and eight females. The mean age was 11.2 years (range = 1-33 years). Headache, nausea, and vomiting were the most common clinical presentations. The mean duration of follow-up was 22.1 months (range = 6-60 months). All cases showed clinical and radiological improvement after surgery.

Endoscopic antegrade aqueductoplasty and stenting with the refashioned panventricular shunt catheter are an adequate treatment option for both TFV and supratentorial shunt malfuncion.

Endoscopic antegrade aqueductoplasty and stenting with the refashioned panventricular shunt catheter are an adequate treatment option for both TFV and supratentorial shunt malfuncion.

Gangliogliomas are neoplasms containing both astrocytic and neuronal components. We present a case of gangliogliomas of the optic chiasm, which are extremely rare pathologies.

A 16-year-old female patient referred to our clinic with gradual deterioration of vision for the age of 1 year mostly in the right eye. Ophthalmic examination confirmed reduced visual acuity with only perception of light in the left eye. Brain magnetic resonance imaging showed a solid mass lesion involving the hypothalamus and the optic chiasm, which was hypointense on T1-weighted images, hyperintense on T2-WI, and marked homogenous contrast enhancement. The patient was operated and bulging of the optic chiasm and the site of lamina terminalis was seen. Subtotal resection of the tumor was achieved. Histopathological examination revealed ganglioglioma (WHO Grade I). Follow-up of the patient was for 3 years and 8 months with stable neurologic and radiologic findings.

To the best of our knowledge, 20 cases, including ours, have been reported in the literature and a presurgical diagnosis of ganglioglioma is very infrequent with confused radiologically with low-grade pilocytic astrocytomas.

To the best of our knowledge, 20 cases, including ours, have been reported in the literature and a presurgical diagnosis of ganglioglioma is very infrequent with confused radiologically with low-grade pilocytic astrocytomas.

Meningiomas are common central nervous system neoplasms, accounts for 30% of all primary intracranial neoplasms; the occurrence of meningiomas with cystic lesions is an exceptionally rare. Lymphoplasmacyte-rich meningioma (LPRM) is a rare pathological entity belong to the World Health Organization Grade I meningiomas. LPRM is characterized by abundant lymphoplasmacytic infiltrates which over-shadow the underlying meningothelial component.

A 42-year-old male was admitted to our hospital with a chronic headache for about 3 weeks prior to admission. His symptoms worsen, and subsequently, he experienced left extremities weakness about 1 week before admission. His brain magnetic resonance imaging revealed an irregular and heterogeneously enhancing solid lesion with intratumoral cystic changes at the temporal lobe. A gross total resection was performed; pathological examination revealed a cystic LPRM.

This rare variant of meningioma is a benign tumor entity featured with massive inflammatory cell infiltration and often less proportion of meningothelial elements. Surgical resection remains the treatment of choice. This is the first report regarding cystic LPRM from Indonesia; we also summarized relevant literature upto-date, May 2020, reported LPRM cases.

This rare variant of meningioma is a benign tumor entity featured with massive inflammatory cell infiltration and often less proportion of meningothelial elements. Surgical resection remains the treatment of choice. This is the first report regarding cystic LPRM from Indonesia; we also summarized relevant literature upto-date, May 2020, reported LPRM cases.