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Background: A chronic subdural hematoma (CSDH) is one of the most common neurosurgery operations. This study aimed to evaluate the effect of topical corticosteroids combined with surgery in patients with CSDH. Materials and Methods: The present study is a clinical trial study on patients referred to hospitals associated with Ahvaz University of Medical Sciences with chronic subdural hematoma in 2019. Patients requiring surgical drainage of chronic subdural hematoma who met the inclusion criteria underwent open craniotomy surgery on the side of the hematoma. A drain was placed in the open craniotomy site. On the third day after the operation, before removing the drain, 40 mg of methylprednisolone sodium succinate was injected through the drain into the subdural space, after which the drain was pulled entirely. Patients were evaluated with the Markwalder Grading Scale (MGS) on the third day, third month, and sixth month after surgery for improved or worsened neurological symptoms. Also, in the third and sixth months after surgery, the patients underwent Computerized Tomography Scan imaging and were checked for recurrence. Results: 32 patients with CSDH entered the study, including 28 men and four women, with a mean age of 71.62 ± 9.85 years. Moreover, 87.5 % had a unilateral chronic subdural hematoma (uCSDH), and 12.5 % had a bilateral chronic subdural hematoma (bCSDH). Left and right uCSDHs had the same frequency (43. 8 %). After surgery, 26 patients had no postoperative complications, and six patients experienced pneumocephalus. Conclusion: Topical dexamethasone injection through the potential CSDH cavity can result in desirable outcomes.

Along with medulloblastomas, Atypical teratoid/rhabdoid tumors (ATRT) are embryonic in origin and histologically show rhabdoid cells and mixed portions of neuroectodermal, ectodermal, and mesenchymal cells. ATRTs are present according to the location of the tumor within the CNS. Signs of headache, vomiting, gait abnormalities, and instability are typical of cerebellar tumors. There is no clear treatment protocol for ATRTs. In this report, we present the case of a 1-year-old boy who was diagnosed with a supratentorial ATRT. The patient underwent surgery and was referred for adjuvant chemo/radiotherapy.

Highlights • The ABC/2 method is an accurate and simple “bedside” technique to estimate pneumocephalus volume. • The postoperative pneumocephalus volume after bilateral burr-hole drainage was significantly larger than that of unilateral burr-hole drainage (29.34 ml versus 12.21 ml, p < 0.001). • The estimated volumes of pneumocephalus by the formula ABC/2 were significantly correlated to the volumes as measured by the computer-assisted volumetric technique, with r = 0.992 (p < 0.001).

Background: Trigeminal neuralgia, a common condition in clinical practice, often occurs due to vascular compression caused by aberrant or ectopic arterial or venous vessels. Microvascular decompression through a minimally invasive retrosigmoidal approach has shown high rates of pain control, low complication rates, and excellent therapeutic results. Objective: To describe the surgical technique and clinical outcomes in terms of pain relief after microvascular decompression of the trigeminal nerve through a minimally invasive retrosigmoidal parasterional burr-hole technique. Methods: A group of patients with trigeminal neuralgia refractory to medical management who underwent microvascular decompression were examined. The records of the patients were considered retrospectively (2016–2018), and the outcomes were considered based on the Visual Analogue Scale (VAS) and the Barrow Neurological Institute Pain Scale (BNIPS) added to a technical note of the surgical technique for a minimally invasive retrosigmoidal parasterional burr-hole. Results: Twenty-two patients were evaluated, and clinical assessment after surgical intervention showed a decrease in pain according to the VAS, resulting from an average preoperative state of 9.5 ± 0.37 to a postoperative condition of 1.32 ± 1.28, exhibiting statistically significant changes (p < 0.0001, d = 9.356). On the other hand, in relation to the BNIPS scale, a decrease from an average preoperative status of 4.55 ± 0.25 to a postoperative status at 12 months of 1.73 ± 0.54 was also demonstrated, showing significant changes (p < 0.0001, d = 3.960). Conclusion: Microvascular decompression of the trigeminal nerve through a minimally invasive retrosigmoidal parasterional burr-hole is feasible and can be a safe and effective technique for the management of pain. However, further research employing larger sample sizes and longer follow-up periods is necessary.

INTRODUCTION: Intracerebral abscess is a health problem that also has a long duration of hospitalization and antibiotic therapy due to the long treatment process after surgery.There are many parameters that can shorten these two periods. The surgical method chosen for abscess excision or aspiration is one of these parameters.In light of our own clinical experience, we compared the method of abscess aspiration with burr-hole accompanied by neuronavigation and the method of abscess excision with craniotomy accompanied by neuronavigation to show the effect of these methods on hospitalization and antibiotic therapy time. METHODS: 48 intracerebral abscess cases operated using these two methods in the last 10 years were retrospectively examined in our clinic. The data of 16 parameters examined separately for both methods were comparatively revealed and their effect on hospitalization and antibiotic therapy times was investigated. RESULTS: In the evaluation of the average duration of antibiotic therapies used by patients while they were hospitalized and after their discharge, it was found that this period was 6.62 weeks (46.34 days) in the group of abscess aspiration with burr-hole accompanied by neuronavigation, and 7.56 weeks (52.92 days) in the other group. The duration of hospitalization of patients was 14.62 days on average in the group of abscess aspiration with burr-hole accompanied by neuronavigation, and 19.18 days on average in the other group. DISCUSSION AND CONCLUSION: In contrast to many studies, patients with burr-hole abscess aspiration accompanied by neuronavigation had higher neurological recovery rates after surgery, and hospitalization times and antibiotic therapy times were shorter than the other method.

Objective: Chronic subdural hematoma (CSDH) is one of the most frequent neurosurgical conditions in people aging between 70 and 80 years. The cranial burr-hole (CBH) with surgical cavity irrigation through the burr hole and closed drainage system is the treatment of choice but -post-operative outcome can be influenced by pneumocephalus. In this study, we aimed to explore the relationship between the anterior-posterior (AP) burr-hole position and the volume of post-operative pneumocephalus. Patients and Methods: We identified 153 consecutive patients who underwent BHC for CSDH at our institution. Baseline and post-operative data were retrospectively collected from medical records. The linear regression model was used to estimate the association between the volume of post-operative subdural air collection and burr-hole position along with other baseline patients and hematoma variables. Results: The AP position of the burr-hole was independently associated with the volume of post-operative pneumocephalus: lower volume of subdural air was observed in patients with more anterior cranial burr-hole. Conclusions: In patients operated for CSDH, the cranial burr-hole should be performed anteriorly to grant a lesser amount of subdural post-operative air collection.