The purpose of this article is to advocate standard skull base technique for removing the clinoidal meningioma and to delineate the technique's advantages that aid in achieving an improved extent of tumor resection and enhancing the patients' overall outcome, specially their visual outcome. Methods: A retrospective analysis was performed on 10 consecutive patients with clinoidal meningiomas who underwent surgical resection at the Bangabandhu Sheikh Mujib Medical University and other private clinics between May 2013 and July 2016. A standard pterional craniotomy technique consisting of extradural anterior clinoidectomy, coupled with optic canal unroofing and optic nerve sheath opening was used in all patients. All patients had thorough preoperative and postoperative ophthalmological evaluations. The follow-up period ranged from 6 to 42 months. Results: Total resection was achieved in 5 (50.0%) of the 10 patients in this series. The majority of the patients with preoperative visual impairment experienced significant visual improvement 7 of 10 patients; 70.0%). Conclusion: In the majority of patients with clinoidal meningiomas, total resection may be achieved with minimal complications. For large tumors encasing the optic nerve and internal carotid artery, or for those tumors causing preoperative visual impairment, use of the cranial base technique delineated in this study may lead to significant improvement in the patients' visual and overall outcomes.

Background: Vascular injuries occur in approximately 25% of all penetrating neck traumas, with carotid artery injuries being particularly lethal. Penetrating neck injuries are potentially fatal. Vascular injuries occur in approximately 25% of cases, which can lead to the formation of arteriovenous fistulas. Case Description: The authors present a case of delayed open surgery to repair a carotid-jugular fistula that resulted in an unprecedented complication, as well as a brief review of the condition’s diagnosis and treatment options. Conclusion: This case report suggests us that, penetrating neck injuries should be thoroughly evaluated for arteriovenous fistulae. To avoid complications, common carotid-jugular fistulas must be treated as soon as possible. Postoperative complications can be effectively managed with prompt action.

A new case of spinal cord compression by an isolated osteochondroma (OC) of the spinal canal arising from the posterior arch of the atlas is added to the 15 previously reported cases in the English-language medical literature. CASE PRESENTATIONA 16-year-old male, with no signifi cant family history, presented with a history of suboccipital headache and progressively increasing quadriparaesis for duration of over 6 months with no bladder or bowel dysfunction. Physical examination revealed spastic quadriparaesis grade 4. INVESTIGATIONSCervical CT scan with 3D reconstruction ( fi gure 1 ), following a questionable plain radiograph, showed an intraspinal OC arising from the posterior arch of the atlas in the midline protruding into the spinal canal. MRI ( fi gure 2 ) showed signifi cant compression of the spinal cord with high signal intensity of the cord at C1 level.

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Meningiomatosis (multiple meningioma) are defined by the presence of at least 2 simultaneous lesions present at different intracranial locations without an association with neurofibromatosis type 2. It accounts for 1-10 % of meningioma. it is usually common in females. It can occur with or without signs of neurofibromatosis. The primary goal of treatment is to remove the lesion causing sign and symptoms and to follow others. Surgery is the main treatment option as like solitary meningioma and the prognosis is usually very good. We will discuss here a case of 52 years female diagnosed as a case of multiple meningioma describe her clinical, radiological and histopathological features. We will also highlight the surgical managements and postoperative course.