Arachnoid cyst is a benign congenital lesion which can be located in various regions like; suprasellar, sylvian, posterior fossa, spine & so on. The most common location of arachnoid cyst is the middle fossa or sylvian fissure usually behind the greater wing of sphenoid bone (50%). Here we are presenting a case of a 59 year-old woman brought to the emergency department with history of sudden onset loss of consciousness associated with generalized tonic clonic seizure. CT-scanning of head showed Galassi type 3 arachnoid cyst. She was managed with fenestration and partial marsupialization of cyst with excellent outcome.

Background: Pneumocephalus is defined as presence of intracranial gas. It can be at any site in the cranium; isolated or at different sites simultaneously. Quantity of gas along with extent of mass effect caused by it & severity of clinical symptoms will determine the modality of treatment; i.e. conservative or surgical. Among many etiologies trauma is one, which is one of the most common cause as in our case. Multiple foci of gas scattered within the subarachnoid space, especially in the cisterns seen on CT scan of brain has been described as “Air bubble sign”, indicating of subdural tension PNC. Here we have presented our case with review of management of such condition, especially conservative. Case: A case of 55yrs male with history of road traffic accident was referred from another hospital. CT scan of Brain done in previous center showed diffuse PNC scattered throughout the subarachnoid space. The patient was managed conservatively and successive repeat CT scan showed gradual to complete resorption of gas and simultaneous clinical improvement of the patient. Conclusion: “Air bubble sign” described as a sign of tension PNC can be managed conservatively in absence of significant clinical symptoms and may not only be associated with subdural tension PNC. The modality of treatment of PNC as well for tension PNC should be tailored according to the patient’s clinical status.

Background: Sagittal suture has been used as an external landmark of superior sagittal sinus since the very beginning of neurosurgery. However, most of the time the sinus is not exactly under the suture line, rather, it has some displacement to one side. So, to analyze the variation of the lateral limit of superior sagittal sinus from the external part of sagittal sinus this study was performed. Materials and methods: Consecutive cases of MRI brain with contrast done in B&C Medical College Teaching Hospital was collected over 3 months, Age, gender, right, and left lateral limits of the superior sagittal sinus from the sagittal suture at its mid-point was collected in preformed proforma. Mean and standard deviation was calculated for the continuous variables, ANOVA was done to evaluate the association of gender with the lateral limits of sinus and Pearson correlation was done to see the relation of age with the lateral limits of the sinus. All the analysis was done using IBM SPSS 20. Results: There were a total of 40 patients enrolled in the study. The mean age was 39.8 years with male (75%) predominance. The lateral right limit of the superior sagittal sinus was up to 23mm and in the left up to 17.1mm from the outer limit of the sagittal suture. There was no significant association of gender with both the right and left limits of the superior sagittal sinus. Similarly, there was no significant correlation of age with the lateral limit of the superior sagittal sinus. Conclusion: The mean existence of superior sagittal sinus is 9.57mm in the right to 5.78mm in the left side from the outer limit of the sagittal suture. However, in extreme stances it's lateral limits can extend up to 17mm in left to 23mm in the right from the outer limit of the sagittal suture.

The orbital blowout fracture is most common in its inferior and medial wall; however we are presenting here a rare case of superior orbital wall blowout fracture with intact vision. This is a presentation of a 55 year-old right handed gentleman following road traffic accident had left orbital injury causing orbital roof fracture. Despite of such a huge injury there was no deterioration of his vision and his movements of the eye balls were also absolutely preserved.