RESUMO
Background: Neurocysticercosis (NCC) is the most common infestation of the central nervous system, caused by the larval stage of the pig tapeworm Taenia solium. It is prevalent in regions with poor sanitation and underdevelopment, such as Latin America. Case Description: We present four cases in which they harbored an intraventricular/intraparenchymal, frontal convexity, cerebellomedullary, and intraparenchymal NCC cyst of medium size, respectively. Three of them underwent complete removal of the cyst by craniotomy; the fourth had a shunt for obstructive hydrocephalus first, followed by excision of a suboccipital cyst 8 months later. Conclusion: The intraventricular/intraparenchymal lesion was more complex to treat than its subarachnoid counterparts because the average brain should be transected and dissected away to achieve total removal. Waterjet dissection, arachnoid microdissection, and cyst drainage allowed minor brain damage than capsule coagulation and traction. Populated prospective studies are needed better to understand the surgical nuances of these rare entities.
RESUMO
Background: There are numerous procedures in which, beyond adequate manipulation of the temporalis muscle and cranial closure, patients may present bone and muscle defects due to atrophy and consequent facial asymmetry, causing psychological discomfort and functional deterioration. The objective of our work is to combine the knowledge of plastic surgery and apply it to cranial reconstructions with fat transfers in post-neurosurgical patients, analyzing its results. Methods: During the year 2022, 45 fat transfer procedures were performed for the correction of craniofacial defects, of which 29 were female and 16 were male. All had a surgical history of pterional craniotomies and their variants, orbitozygomatic and transzygomatic approaches, with the consequent volume deficit. Results: The procedure was performed on an outpatient basis, with local anesthesia, and in an average time of 30-40 min. The lower hemiabdominal region was used as the donor area, processing the fat using the decantation technique and injecting it into the receptor area at the craniofacial level. The patients tolerated the procedure adequately without intraoperative complications or superadded events. Conclusion: Fat transfer is a minimally invasive, effective, and cost-effective technique that plastic surgery offers us to implement in post-neurosurgical patients, as it achieves natural results that stand the test of time.