Intracranial dermoid cysts are congenital benign neoplasms mostly diagnosed in the pediatric hood and usually involve the midline structures. They count approximately less than 1% of all intracranial neoplasms and are believed to arise from ectopic cell rests incorporated in the closing neural tube. These dermoid cysts, especially those involving the posterior fossa and overlying the torcular, are uncommon. We report perhaps the first case of this entity in a third-year-old boy and discuss the physiopathogenesis, the imaging features and the best technical note to manage this cyst in this location.

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Introduction: Rupture of intracranial aneurisms leads to severe morbidity and mortality. There are two modalities of treatment surgery and endovascular treatment. The diagnosis is made by angiography (DSA, CTA, RMA). The angiographic features used to assess the risk of the complications and choose the treatment modality are size, location and aneurism morphology. Materials and Methods: We reviewed and analyzed the computed tomographic angiography and magnetic resonance angiography of all patients admitted to the hospital of Mali with IAs from 2015 to 2021 either 7 years. Patients who were less than 18 years old, those with non-aneurysmal SAH, patients who request a discharge and those with an incomplete angiographic description of the IAs were excluded from the analysis. Results: We have collected 105 patients with 109 aneurysms. The sex ratio was 2/1 in favor of females. The mean age was 44.51 years with the range from 18 to 70 years. The presentation mode was subarachnoid hemorrhage (SAH) in 97% of cases. 76.19% had confirmed high blood pressure before the bleeding. 19.04% were diabetics. 98% of our patients have made a CT angiography and 2% have made MR angiography for the aneurysm diagnosis. 97.24% of aneurisms were located in the anterior part of the Willis circle. 39.44% of these aneurisms were the anterior communicating complex aneurysm. 27.52% of aneurysm had a small size, 42.20% had a medium size, 20.18% large size against 5.50% of the giant (Figure 3) and the middle cerebral artery was the most involved in the least. 95.41% of cases were saccular aneurysms against 4.59% fusiform.

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Introduction Pediatric Hydrocephalus is a common disease in sub-Saharan Africa. In Mali, 350-400 new cases are diagnosed in our center yearly. With a total land mass of 1.241.000 km2, patients in remote areas must travel up to 1500km to access neurosurgical care. Hence, treatment and follow-ups of “shunted” patients are difficult. In this context, endoscopic third ventriculostomy with choroid plexus cauterization (ETV/CPC) provides an opportunity for an affordable and less-constraining treatment for hydrocephalus children under 12 months of age. Methods We performed a retrospective analysis of ETV/CPC performed on infants from July 2013 to January 2015. Patients were followed post operatively on Day 15, Month 6 and Month 12. Statistical analysis was conducted using Prism 9 GraphPad software. ETV successes were categorized according to the patient’s age in 03 groups: < 3 months, 3 - 6 months, and 6 - 12 months. Statistical significance was defined at p <0.05. Results During the study period, 199 patients were included with 40% of patients aged between 0-6 months. The head circumference ranged from 35 cm to 79 cm. The etiology was congenital malformation in 55%. ETV/CPC was a success in 69% of 6–12-month-old patients, 54% in the 3–6-month-old patients, and 29% in < 3month-old patients. Overall, 94 (47%) of patients were successfully treated without a shunt. The post-operative infection rate was 1% and mortality at 12 months was 8%. Discussion/Conclusion In a low-income environment such as Mali, ETV/CPC stands as a viable and alternative treatment option for pediatric hydrocephalus patients, our findings suggest that age is an important factor in predicting ETV success.