Problems with appearance may negatively affect the mental health of individuals with disfigurement so, cranioplasty has an important role in improving the physical appearance of patients as well as their psychological symptoms. This study aims to highlight the aesthetic as well as the psychological outcomes of cranioplasty using the two most widely used synthetic graft materials; polymethyl methacrylate (PMMA) and titanium mesh.

We did not find national reports on ruptured aneurysms treated in the context of the pandemic, this being one of the first studies that demonstrate the impact of the COVID-19 pandemic in patients with ruptured intracranial aneurysm. The population should be educated on how to act in case of specific symptoms such as sudden intense headache, neurological deficit, or acute chest pain, which should receive timely care, immediate referral, and priority of treatment in referral hospitals in order to reduce morbidity and mortality of complex neurological pathologies.

The alteration at the anatomical and/or functional level, both motors, sensory and cognitive, a product of the sudden exchange of mechanical energy caused by an external force on the skull, is what defines a traumatic brain injury (TBI). Clinical observation in mild TBI includes observing children under 2 years of age with trauma without fracture or admission criteria clinically for 2 to 4 hours and observing children with symptoms or mechanism of fall for 4 to 6 hours not known. We studied mild TBI at Baca Ortiz Pediatric Hospital, Ecuador, from January 2016 to December 2019.

Petroclival meningiomas constitute 3 to 10% of meningiomas of the posterior fossa, they originate in the petroclival fissure, in the upper part of the clivus, petrosal apex, and medial to the trigeminal nerve. Resection of these tumors is a neurosurgical challenge. The combined partial petrosectomy approach associated with a sub-temporal approach is a technique described by various authors; however, its performance is considered highly complex. We report the case of a petroclival meningioma operated successfully in our hospital using this combined approach. 

Orbital schwannoma is a rare pathology, which constitutes approximately 1 to 6.5% of orbital tumors, and can originate from the ophthalmic branch of the 5th cranial nerve or from perioptic sympathetic nerves. The first-line treatment is surgery, and total resection provides a good prognosis.  We presented a case of 12-year-old woman, with a 9-year illness, characterized by a progressive decrease in right visual acuity until reaching amaurosis.

We evaluated the effectiveness of isolated choroid plexus coagulation (CPC) as a treatment for hydrocephalus in various clinical settings and the variables associated with its success. We found that Choroid Plexus Coagulation (CPC) is a viable treatment alternative in the management of hydranencephaly, choroid plexus hyperplasia (CPH), and in selected cases of hydrocephalus without the aforementioned characteristics. However, studies are needed to compare CPC with shunt therapies before qualifying it as the first line of treatment.

The complexity of an intracranial aneurysm is defined by its location, size, previous treatment, presence or absence of collateral circulation, intraluminal thrombus, or calcification of the aneurysm wall. The treatment of these aneurysms must be based on the balance between the associated risks and the benefit for the patient; Within microsurgical techniques, the extradural minipterional approach is described.

The treatment of arteriovenous malformations (AVMs) of the basal ganglia, the thalamus, and the insula is complex, due to the eloquence of the neural structures involved. They constitute between 4.3% and 11% of all AVMs and are associated with a high rate of morbidity and mortality due to the high risk of bleeding due to their inaccessible location. Recent advances in endovascular therapy have allowed obtaining good results with curative potential.

Intracerebral (ICH) and intraventricular (IVH) hemorrhage cause severe morbidity and a high mortality rate. Early surgical evacuation with minimal damage to brain tissue is essential. Endoscopic evacuation using an Endoport system is a promising technique. We present the results of the endoscopic evacuation of ICH and IVH in patients operated from 2010-2019 at the Almenara Hospital in Lima-Peru.

Subarachnoid hemorrhage (SAH) due to rupture of a cerebral aneurysm continues to be a disease with high morbidity and mortality in our setting, despite advances in microsurgery and endovascular therapy. The objective of the present study was to determine the demography, vascular territory, and complications that occur in the perioperative management of patients with ruptured cerebral aneurysms treated at the Cayetano Heredia Hospital.