Aim To measure the size of tentorial notch in Indian population, compare it with the western population from the literature available, and analyze the relation between size of tentorial notch and the outcome in patients with head injury. Materials and Methods The study was done using 10 cadavers and 15 autopsy specimens. In all the specimens, tentorial incisura was measured using vernier caliper after opening the skull and cutting the midbrain at the level of tentorial edge carefully without damaging the tentorium. All measurements were done in millimeters. Results Mean values, age-dependent mean values, and percentile values were calculated for various parameters in the tentorial incisura. Majority of the tentorial incisura are of typical type. Cases of tentorial incisura are significantly smaller in the age group of 20 to 25 years. Rate of deterioration of Glasgow coma scale (GCS) is rapid when the tentorial incisura is large. Conclusion There were no significant variations in measurements of tentorial incisura in Indian population compared with the western population. Rate of deterioration of GCS is higher in patients who had large tentorial incisura compared with other groups, which is statistically significance. However, this is to be confirmed by further study using large groups of patients to be used for clinical applications.

The aim of this article was to present a rare and potentially life-threatening complication of malignant cerebral infarct turning into a massive cerebral abscess. Cerebral abscess complicating cerebral infarction is rare. Only 13 cases have been reported. Unexplained fever is the presenting symptom. The case presented here is unique, as the patient was totally asymptomatic and the abscess was detected incidentally during surgery. A 42-year-old man with malignant left anterior cerebral artery and middle cerebral artery territory infarct underwent decompressive craniotomy 5 weeks before presenting to the authors’ institution. The patient had features of sunken skin flap syndrome. Therefore, cranioplasty was planned. During surgery, false dura was inadvertently opened due to adherence with pia and pus started coming out. On exploration, approximately 150 mL of pus was evacuated. The whole infarcted brain was seen to be converted into a cavity full of pus. Adequate drainage and debridement were done. Cranioplasty was deferred. The patient was treated with broad-spectrum antibiotics postoperatively, and he recovered well. Cerebrovascular accident (CVA) is one among the common causes for mortality and morbidity worldwide. The infarcted or ischemic brain acts like a fertile ground for the pathogens to grow. Disruption of blood–brain barrier and lack of normal blood flow by the vascular event facilitate microbial seeding and formation of cerebral abscess. Abscess formation following stroke is rare. It could prove to be fatal if misdiagnosed or not properly treated. Uncontrolled fever in a stroke patient should raise the suspicion of this rare complication. A routine contrast computed tomography of the brain prior to cranioplasty may pick up this complication in asymptomatic patients. Conservative treatment alone proves fatal in almost all cases.

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