Background: Porencephalic cysts are rare cerebrospinal fluid-filled cavities within the brain parenchyma, classified as either congenital or acquired (secondary to trauma, surgical interventions, ischemia, or infections). Clinical presentations vary depending on the cyst’s size, location, and associated mass effect, with diagnosis established through neuroimaging. This report describes a rare, life-threatening exacerbation of a chronic porencephalic cyst in an adult, progressing to hydrocephalus and acute intracranial hypertension (IH). Case Description: A 57-year-old female presented to an outpatient clinic with an 8-month history of gait disturbances, memory impairment, apathy–abulia, and wheelchair dependence. Eight years earlier, she had sustained a mild traumatic brain injury, during which a porencephalic cyst was incidentally detected on cranial computed tomography (CT) scan; however, she had not been followed up, and the finding was not disclosed during the current evaluation. A new cranial CT and magnetic resonance imaging revealed a large porencephalic cyst in the left frontal lobe with mass effect, bilateral foramen of Monro obstruction, and hydrocephalus. An elective endoscopic cyst-ventricle communication was planned. Two weeks later, the patient presented signs of acute IH, including severe headache, diplopia, and blurred vision. An emergent external ventricular drain (EVD) was placed into the cyst cavity, leading to rapid symptom relief. The EVD was subsequently replaced by a cyst-peritoneal shunt. One year later, the proximal catheter became exposed and required complete shunt removal. Since then, she has remained clinically stable and shunt free. Conclusion: This case represents a rare, adult-onset, life-threatening exacerbation of chronic porencephaly. It demonstrates the importance of long-term follow-up in patients with known porencephalic cysts, even if previously asymptomatic, and the efficacy of timely neurosurgical intervention and close radiological monitoring in preventing severe or potentially fatal complications.

Endolymphatic sac tumor (ELST) is a rare lesion. It may be sporadically or associated with Von Hippel-Lindau syndrome.

Background: The cervical spine represents the most common site of spinal trauma, typically associated with vertebrae dislocation with locked facets. Accurate assessment of the entire spine is essential to prevent diagnostic and therapeutic failures. Here, we present a case of a patient with C6-C7 dislocation who underwent two unsuccessful surgical procedures, highlighting the technical challenges associated with revision surgery and persistent facet locking. Case Description: A 26-year-old male arrived at an emergency hospital after a motorcycle accident with paraplegia, C6 roots strength grade 2, and C7, C8, and T1 paralysis. The cervical computed tomography scan revealed C6-C7 dislocation, left C7-T1 locked facet, and right C6-C7 facet subluxation. After two unsuccessful surgical procedures, a combined 540-degree posterior-anterior-posterior (P-A-P) approach was performed. After the combined P-A-P cervical spine approach, the patient remained paraplegic, with no further neurological deterioration during follow-up. Conclusion: Early diagnosis and management of locked facets is crucial to avoid unstable constructions and subsequently hardware failure in patients with cervical spinal trauma.

Temporal bone squamous cell carcinoma (TBSCC) is a very rare condition. The prognosis is dismal for advanced tumors. Due to its rarity, information in the literature is scarce. Here, we report a unique case of TBSCC with cerebellar invasion and hydrocephalus. A 46-year-old reported right-sided hearing loss and a painful right retroauricular mass for 4 months. Magnetic resonance imaging revealed a 8.7 × 7.6 × 6.4 cm mass invading the right temporal and occipital bones. After a biopsy and 3 surgical procedures over 6 months, the diagnosis of TBSCC was obtained. Due to invasion of the cerebellar tissue and obstructive hydrocephalus, a ventriculoperitoneal shunt was performed. The patient was referred for adjuvant radiotherapy. However, palliative care was initiated due to tumor progression. We report a case of advanced TBSCC with poor prognosis despite surgical treatment and radiotherapy. More data are necessary to provide new and better treatment to these patients.