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.

Cranioplasty is a neurosurgical technique that replaces a bone defect in the skull with hard replacement tissue. It is indicated in particular after a decompressive craniectomy performed in severe head trauma in order to control intracranial hypertension refractory to medical treatment. Cranioplasty is sometimes associated with a significant number of complications, including hydrocephalus. In this article, we report the case of a cranioplasty flap lifting on intracranial hypertension following postoperative hydrocephalus and discuss the clinical relevance with a review of the literature.

Abdominal complications related to ventriculoperitoneal shunting are an entity described in the literature. Among these is evisceration. In this article we present a case of evisceration in a 5-month-old child, six days after DVP placement. We will discuss the probable etiology and prevention of such a complication.