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We report on one case of variant origin of right ophthalmic artery (OA) from C4 choroidal segment of the right supraclinoid internal carotid artery. A 41-year-old woman affected by bitemporal hemianopsia performed Magnetic Resonance Imaging with gadolinium showing tuberculum sellae meningioma. During angiography we observed this variant of origin of OA. At surgical dissection, we observed this variant in carotid cistern.

We describe a rare case of giant intracranial chordoma, emphasizing the patient's long survival and his excellent response to radiotherapy that led to a progressive regression of neurological symptomatology up to disappearance, in the absence of cerebral white matter damages.

BACKGROUND Various reconstructive techniques using hair-bearing scalp to manage unsightly scalp defects have been described in 1983 Fonseca and in 1984. Horowits emphasized the use of galeal-pericranial flaps in scalp wounds with exposed bone in 1986. Matthews and Missoten described early tissue expansion to close a traumatic defect of the scalp, and in 1990 Kiyono placed tissue expander in a pocket adjacent to the defect that was covered with Martex Mesh. METHODS The authors present a case of 23-year-old man with a scalp lacetation over a depressed fracture of the skull and a dural tear, after a traffic accident. The repair procedures at another hospital failed, resulting in an area of scalp necrosis with a cerebrospinal fluid (CSF) leak. At our observation, the reconstructive technique using hair-bearing scalp with tissue expander was performed to managed unsightly scalp necrosis. Moreover the neurosurgical treatment was necessary to avoid the complications of the CSF leak. CONCLUSIONS A 9-year review showed more than 40 patients treated by this technique that allows a pericranial flap of every size. When scalp defects are too large, the tissue expander allows good aesthetic results.