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Objective: Neurocysticercosis (NCC) is still a frequent cause of neurosurgical consultations in most developing countries. Conventional approaches for the resection of large cysts have been used for many years. We report here our experience in the neurosurgical management of NCC using diverse minimally invasive approaches according to the localization of lesions: minimal craniotomy for lesions in the Sylvian fissure, stereotactic surgery for lesions in the posterior fossa, and endonasal neuroendoscopy for lesions in the basal cisterns. Methods: We reviewed the charts of 24 consecutive NCC patients who had minimally invasive surgery to resect NCC lesions in a neurological referral center in Lima, Peru. Three approaches were used: microcraneotomies through the anterior Sylvian point (n = 16), stereotactic surgery (n = 6), and endonasal endoscopy (n = 2), between January 1, 2016, and July 31, 2022. Demographic and clinical data as well as post-surgical evolution are presented using descriptive statistics. Results: Clinical improvement was observed in 23 out of 24 cases, with complete resolution of symptoms in nine and partial in 14. One patient evolved poorly and worsened his symptoms. Twenty-two patients received antiparasitic treatment after surgery. Relapse of NCC lesions was observed in three patients. There were no significant complications in any of the cases. Conclusions: Minimally invasive surgical approaches provide an excellent alternative for the management of patients with NCC, with good surgical and functional results, also markedly reducing the parasitic mass for further antiparasitic treatment.

Introduction: Chronic subdural hematomas (CSDH) are common problems in neurosurgery, generally secondary to head trauma, although they me be in rare cases associated to underlying pathologies. Between these possible causes, arachnoid cysts (usually asymptomatic benign congenital lesions) can be a risk factor for subdural hematoma in young patients, who may spontaneously develop a CSDH and require surgery to relieve intracranial hypertension.Case Report.We present the case of a 23-year-old male, incidentally diagnosed two years before with a right temporal arachnoid cyst (middle fossa), asymptomatic, who began with symptoms of intracranial hypertension two weeks prior to surgery. A right fronto-parieto-temporal CSDH was verified on MRI, requiring emergency surgery with a small craniotomy, evacuation of the hematoma, and fenestration of the arachnoid cyst. Conclusions: In young patients with a diagnosis of an arachnoid cyst, the differential diagnosis of CSDH should be considered when presenting with acute neurological symptoms.

Background: Hemangioblastomas are benign vascular neoplasms, World Health Organization grade I, with the most frequent location in the cerebellum. Complete microsurgical resection can be a challenge due to excessive bleeding, which is why preoperative embolization takes importance., Case Description: Two clinical cases are presented, a 25-year-old woman and a 75-year-old man, who presented with intracranial hypertension symptoms due to obstructive hydrocephalus; a ventriculoperitoneal shunt was placed in both cases; in addition, they presented with cerebellar signs. Both underwent embolization with ethylene vinyl alcohol copolymer, with blood flow reduction. After that, they underwent microsurgical resection within the 1 st -week post embolization, obtaining, in both cases, gross total resection without hemodynamic complications, with clinical improvement and good surgical outcome. It is worth mentioning that surgical management is the gold standard that allows a suitable surgical approach, like in our patients, for which a lateral suboccipital craniotomy was performed., Conclusion: Solid hemangioblastomas are less frequent than their cystic counterparts. The treatment is the surgical resection, which is a challenge and always has to be considered as an arteriovenous malformation in the surgical planning, including preoperative embolization to reduce perioperative morbidity and mortality and get good outcomes., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Surgical Neurology International.)