The authors report the case of a 10-year-old child who was admitted to the emergency room with a penetrating lumbar spinal injury caused by an iron rod, which occurred accidentally during a recreational activity. The clinical presentation was a ponytail syndrome with paraparesis and cerebrospinal fluid discharge from the lumbar penetration point of the iron rod. The lumbar X-ray and computed tomography (CT) scan performed in the emergency room revealed the iron rod penetrating the spinal canal through the lamina of the L3 vertebra on the left, requiring urgent surgical management, consisting of laminectomy of L3 allowing the removal of the iron rod and repair of the dura mater without any damage to the roots of the cauda equina. The evolution was favorable with complete motor recovery at 3 months follow-up.

Background Aneurysm of vein of Galen is a rare congenital arteriovenous malformation. Clinical manifestations depend on the age of discovery. Endovascular embolization is currently the treatment of choice. This technique is not always available in developing countries. We report 3 cases treated symptomatically by endoscopic third ventriculostomy and ventriculoperitoneal shunt. Cases presentation Three patients, 7 months, 15 years, and 26 years old, received in a table of acute intracranial hypertension, associated for the first one with convulsions and for the second one with moderate heart failure. Bain CT scan revealed triventricular hydrocephalus secondary to sacciform dilatation of the Galen’s vein in all three patients, requiring symptomatic treatment by endoscopic third ventriculostomy for the first patient and ventriculoperitoneal shunt for the other two in the absence of an adequate clinical platform for endovascular embolization. The evolution was favorable at 1 year’s follow-up. Conclusion Galen’s vein aneurysm is a rare vascular malformation. It mainly affects newborns and small children but can be discovered in adulthood. Endovascular embolization is its treatment of choice. This technique is not always available in some countries, which makes it necessary to resort to symptomatic treatment by ventricular shunt.

Introduction: Bilateral aneurysms of the sylvian artery are rare with an incidence of approximately 1% of all intracranial aneurysms and difficult surgical management. We report a case of an intracranial mirror aneurysm of the sylvian artery, revealed by subarachnoid hemorrhage.Observations: A 47-year-old man, with no particular pathological history, seen in the emergency room for an intense ictal headache from the beginning with a one-sided left type of stabbing at first unilateral left then holocranial with brief initial loss of consciousness. The neurological exam was normal. Cerebral computed tomography (CT) coupled with cerebral CT angiography revealed a subarachnoid hemorrhage in the left insular lobe and a mirror aneurysm at the junctions of the M1 and M2 portions of the sylvian arteries, treated by clipping the aneurysm ruptured by the left pterional craniotomy with simple postoperative consequences. Conclusion:intracranial mirror aneurysms of the sylvian artery are rare. Their surgical management is difficult and can be performed unilaterally or bilaterally in one or two operating times.