N/A

No abstract

Non-powder lateral penetrating craniocerebral gunshot wound in a 10-year-old girl: A case reportIntroduction: Non-powder lateral penetrating craniocerebral gunshot wounds (PCGW) is one of the lethal types of penetrating head injury. The mortality rate is higher in adults than in pediatric populations and influenced by the clinical and radiologic findings as to the important predictors for prognostication in patients with PGCW. Case presentation: A 10-year-old girl presented with a gunshot wound to the head 1 day prior. She was accidentally shot by her brother with an air gun from approximately 2 feet from the gun barrel. She develops a loss of consciousness for 30 minutes and weakness over the left arm. On physical examination, the Glasgow Coma Scale (GCS) was E3V5M6, weakness on the left arm, and an entrance wound over the right temple without an exit wound. The skull X-ray showed the pellet fragment and the computed tomography (CT) scan showed the bullet track starting from the right frontotemporal towards the left parietooccipital region, damaging both hemispheres with associated intraventricular hemorrhage (IVH). She was undergone a craniotomy procedure to remove the bullet fragment, debridement of the necrotic tissue, and evacuate the blood clot over the bullet track. The patient was discharged after postoperative day 7 with good recovery of neurological function and good GCS and Glasgow Outcome Scale (GOS) score. After 6 months of follow-up, neither a new deficit nor other signs and symptoms were developed. Conclusion: Non-powder PCGW can cause significant damage to the intracranial compartment, despite its low velocity. The mortality rate in pediatrics is lower than in the adult population. The management mandated an urgent surgical procedure to remove any blood clot and debridement of any foreign bodies encountered. Such complications in the short-or long term can be developed in any patient and should be treated expectantly.

The authors present an unusual case of a 32-year-old adult male with a capillary hemangioma, which developed within the left cerebellar parenchyma. The histopathological examination reveals a mass mostly formed by the proliferation of capillaries, lined by a layer of flat-plump endothelial cells, some branching and dilating large capillaries, forming a lobulated structure separated by fibrocollagenous connective tissue. Immunohistochemistry examination with CD31 and S100 was positive on the endothelial and stromal cells, respectively, and negative S100 on the endothelial cells. Although rare, capillary hemangioma should be one of the differential diagnoses for diagnosing intra-axial lesions in the cerebellar region. Confirmation of the histopathological characteristic is necessary to determine the diagnosis of capillary hemangioma and exclude other differential diagnoses.

BACKGROUND Xanthoma is a granulomatous lesion that develops from leakage of circulating serum lipoprotein into the surrounding tissue. An isolated intracranial xanthoma is rarely reported and usually misdiagnosed. Intracranial xanthoma is also rarely found in patients with hyperlipidemia. To the best of the authors’ knowledge, no previous studies and literature have reported bilateral involvement of intracranial xanthoma in the frontal lobe. OBSERVATIONS The authors reported an unusual case of bilateral involvement of intracranial xanthoma in the frontal lobe with associated type II hyperlipidemia in a 42-year-old woman. Macroscopically, the tumor had an appearance of greyish-yellow color with a brittle, solid consistency. Histopathological examination revealed numerous lipid-laden macrophages surrounded by a cystic, necrotic, partially hemorrhagic area, with some parts consisting of hemosiderophages and proliferative capillary blood vessels. The histopathological findings indicated the characteristics of xanthoma. LESSONS Bilateral frontal intracranial xanthoma with associated type II hyperlipidemia is an unusual finding. Despite its rarity and wide variety of radiological presentations, it should be considered one of the differential diagnoses of lesions that develop intracranially and intraaxially. Confirmation with histopathological examination is needed to exclude from other differential diagnoses.