Yousaf Bashir Hadi

Acute cerebellitis successfully managed with temporary cerebrospinal fluid diversion using a long tunnel external ventricular drain: a long-term radiological follow-up of two cases

Acute cerebellitis (AC) is a rare inflammatory childhood disorder. Although there is no consensus on standard treatment for cerebellitis, its outcome is usually favourable. We report two cases of AC in the paediatric age group, successfully managed with long tunnel external ventricular drain (EVD). The first patient was an 8-year-old boy with a history of fever and headache. Sequential MRI showed diffuse cerebellar swelling with tonsillar herniation and resulting hydrocephalus. The second patient was a 6-month-old boy who presented with high-grade fever associated with chills. CT scan of the head showed triventricular hydrocephalus with obliteration of cerebrospinal fluid spaces and cisterns. Both patients underwent immediate emergency right-sided long tunnel EVD insertion. The EVD was removed on the 9th day in the first patient and the 10th day in the second patient; the patients showed no neurological deficits at a follow-up of 2 years and 1 year, respectively.

Clinoidal meningioma associated with an internal carotid artery aneurysm.

Coexistence of primary brain neoplasms with intracranial aneurysms is rare but presents a diagnostic and therapeutic challenge to healthcare providers. We describe the case of a 60-year-old woman who had a left internal carotid artery aneurysm with a small ipsilateral clinoidal meningioma. The meningioma was an unexpected finding encountered during the surgery for aneurysmal clipping. Both the lesions were dealt with simultaneously.

Cranioplasty after Craniectomy in a Pediatric Population: Single-Center Experience from a Developing Country

Cranioplasty is a frequently performed procedure in neurosurgery. The pediatric population for this procedure is distinct from the adult one because of the growing skulls and thinner bones of the calvarium. A paucity of data on the outcomes of this procedure in the pediatric population has been identified repeatedly. We conducted a retrospective cohort study to investigate the outcomes in a pediatric population that underwent cranioplasty after craniectomy at our institute in a developing-world country. Our cohort showed no association of complication rate or cosmetic outcomes with the timing of cranioplasty, area of skull defect, type of implant used, or method of storage.

Autoimmune pancreatitis mimicking Klatskin tumour on radiology

Autoimmune pancreatitis (AIP) is categorised into two distinct types, AIP type 1 and 2. Although there can be multisystem involvement, rarely, the cholangitis associated with AIP can present radiologically in a manner similar to that of Klatskin tumour. We present the case of a 65-year-old man who was almost misdiagnosed with a Klatskin tumour because of the similarity in radiological features of the two aforementioned clinical entities. The patient presented with a history of jaundice, pruritus and abdominal pain, and work up showed deranged liver function tests, elevated cancer antigen 19-9 levels and positive antinuclear antibodies. CT scan of the abdomen showed findings suggestive of Klatskin tumour but due to diffuse enlargement of the pancreas and surrounding low-attenuation halo found on a closer review, a diagnosis of AIP was performed. The patient was started on standard corticosteroid therapy and responded well, with complete resolution of the radiological findings.