NMC case report journal最新文献

{"title":"Mechanical Thrombectomy for N-butyl-2 Cyanoacrylate Cerebral Embolism via Portopulmonary Venous Anastomosis Following Endoscopic Injection Sclerotherapy: A Case Report.","authors":"Ichiro Maeda, Taichiro Imahori, Shigeru Miyake, Hiroki Goto, Rikuo Nishii, Haruka Enami, Daisuke Yamamoto, Shouichi Nakayasu, Hirotoshi Hamaguchi, Naokazu Miyamoto, Takashi Sasayama","doi":"10.2176/jns-nmc.2025-0076","DOIUrl":"10.2176/jns-nmc.2025-0076","url":null,"abstract":"<p><p>Cerebral embolism following endoscopic injection sclerotherapy using N-butyl-2 cyanoacrylate for esophagogastric varices is a rare but serious complication. This condition occurs due to the migration of N-butyl-2 cyanoacrylate into the cerebral circulation, which has traditionally been attributed to paradoxical embolism via a patent foramen ovale. However, recent reports have suggested the possibility of alternative embolic pathways. We report the case of a 76-year-old woman who presented with acute gastric variceal bleeding and underwent endoscopic injection sclerotherapy using N-butyl-2 cyanoacrylate and Lipiodol. Shortly after the procedure, the patient developed global aphasia and right hemiparesis. Head computed tomography revealed scattered ultra-hyperdense materials and magnetic resonance imaging confirmed left middle cerebral artery M2 occlusion. Mechanical thrombectomy was performed, achieving successful recanalization and neurological improvement. Imaging findings and histopathological analysis of the retrieved thrombus strongly supported the diagnosis of N-butyl-2 cyanoacrylate embolism. Retrospective evaluation of preoperative contrast-enhanced computed tomography identified a portopulmonary venous anastomosis, a right-to-left shunt connecting gastric varices to the pulmonary veins. This anastomosis is a collateral pathway associated with portal hypertension. This case suggests that even in the absence of a patent foramen ovale, portopulmonary venous anastomosis can serve as a route for N-butyl-2 cyanoacrylate migration into the cerebral circulation. To the best of our knowledge, this is the first reported case of mechanical thrombectomy for N-butyl-2 cyanoacrylate cerebral embolism following endoscopic injection sclerotherapy. This case underscores the importance of early detection and risk assessment of such right-to-left shunting and highlights mechanical thrombectomy as a viable intervention for cases where thrombolysis is contraindicated.</p>","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"12 ","pages":"289-294"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Difficulties of Differentiating Primary Histiocytic Sarcoma of the Central Nervous System from Glioblastoma in Older Patients: Methylation Analysis and Review of the Literature.","authors":"Ryota Taomoto, Mikiko Aoki, Toshiyuki Enomoto, Noriko Hirao, Hiroshi Abe, Junji Shibahara, Koichi Ichimura, Kaishi Satomi, Makoto Hamasaki","doi":"10.2176/jns-nmc.2024-0335","DOIUrl":"10.2176/jns-nmc.2024-0335","url":null,"abstract":"<p><p>Primary histiocytic sarcoma of the central nervous system is an extremely rare malignancy, with only 43 cases reported to date. It often presents diagnostic challenges due to its rarity and similarities with other central nervous system tumors, particularly glioblastoma. We report a case of primary central nervous system histiocytic sarcoma in a 72-year-old woman, one of the older patients among the reported cases. The patient presented with gait disturbance and left hemiplegia. Initial imaging and intraoperative findings suggested a high-grade glioma. However, comprehensive pathological examination, including immunohistochemistry, electron microscopy, and genetic analyses, led to the diagnosis of histiocytic sarcoma. Notably, the tumor exhibited CDKN2A homozygous deletion and a unique methylation profile distinct from gliomas. Despite treatment with surgery, radiation, and chemotherapy, the patient experienced meningeal dissemination 8 months post-surgery and died 11 months after diagnosis. This case highlights the importance of comprehensive diagnostic evaluation in challenging central nervous system tumors and provides valuable insights into the molecular characteristics of central nervous system histiocytic sarcoma, particularly regarding CDKN2A deletion and methylation patterns. Awareness of this rare entity is crucial for accurate diagnosis and appropriate management of central nervous system tumors.</p>","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"12 ","pages":"275-281"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Efficacy of Atlantoaxial Facet Joint Distraction and Fixation and Foramen Magnum Decompression for Chiari Type 1 Malformation with Basilar Invagination: A Case Report.","authors":"Kotaro Kohara, Tatsuya Maegawa, Eitaro Okumura, Ryo Hashimoto, Motoo Kubota","doi":"10.2176/jns-nmc.2025-0052","DOIUrl":"10.2176/jns-nmc.2025-0052","url":null,"abstract":"<p><p>Foramen magnum decompression is an established surgical method for the treatment of Chiari type 1 malformation with syringomyelia. However, in some cases, neurologic symptoms that improve only after foramen magnum decompression may deteriorate again, and it has been suspected that increased instability of the craniocervical junction may be a factor. We report a case of Chiari type 1 malformation accompanied by basilar invagination and syringomyelia in which atlantoaxial facet joint distraction and fixation was performed as a revision surgery for deteriorating neurologic symptoms after foramen magnum decompression. The patient was a 16-year-old boy with chief complaints of gait disturbance and repeated falls. He was diagnosed with Chiari type 1 malformation accompanied by basilar invagination and syringomyelia. The clivo-axial angle was narrow at 105.8°. Initially, only foramen magnum decompression was performed, and the symptoms were relieved after the procedure but re-exacerbated within 2 weeks. The condition was speculated to have worsened instability at the atlantoaxial segment and ventral medullary compression; then, atlantoaxial facet joint distraction and fixation was performed secondarily, and symptoms improved. There is no clear surgical standard for performing foramen magnum decompression, atlantoaxial facet joint distraction and fixation, or a combination of both for Chiari type 1 malformation. Foramen magnum decompression provides horizontal decompression at the craniocervical junction, and atlantoaxial facet joint distraction and fixation achieves vertical indirect decompression of the ventral medulla and stabilization of the atlantoaxial segment in case with basilar invagination. Our experience suggests that combined foramen magnum decompression and atlantoaxial facet joint distraction and fixation may be particularly beneficial in Chiari type 1 malformation cases with basilar invagination and narrow clivo-axial angle.</p>","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"12 ","pages":"283-288"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Case of Brain Biopsy-confirmed Neurolymphomatosis Involving the Central Nervous System Mimicking Polyneuropathy as a Complication of Refractory Sjögren's Syndrome.","authors":"Yusuke Okamura, Hiroaki Nagashima, Kazuhiro Tanaka, Norio Chihara, Kenji Sekiguchi, Riki Matsumoto, Takashi Sasayama","doi":"10.2176/jns-nmc.2024-0150","DOIUrl":"10.2176/jns-nmc.2024-0150","url":null,"abstract":"<p><p>Neurolymphomatosis is a rare lymphoma infiltrating cranial nerves, peripheral nerves, and spinal nerve roots. We present a unique case of neurolymphomatosis involving the central nervous system, initially resembling polyneuropathy in Sjögren's syndrome. A 79-year-old woman experienced dry eye symptoms for 2 years before presenting with left facial nerve palsy and lumbar pain to her previous physician. Brain magnetic resonance imaging revealed high signal intensity on diffusion-weighted imaging solely in the left peripheral facial nerve and lower cranial nerves. Initially diagnosed with Sjögren's syndrome-associated polyneuritis, she underwent treatment with high-dose steroid pulse therapy and intravenous immunoglobulin. Despite treatment, her symptoms progressed, leading to referral to our hospital with multiple peripheral nerve palsies and severe lumbar pain. Subsequent brain magnetic resonance imaging demonstrated gadolinium enhancement in the bilateral caudate nucleus heads and the left facial and lower cranial nerves. Stereotactic brain tumor biopsy-confirmed diffuse large B-cell lymphoma upon pathological analysis. Treatment with rituximab, high-dose methotrexate significantly improved her symptoms, with no recurrence observed for 12 months. These findings underscore the diagnosis of neurolymphomatosis involving the central nervous system, initially masquerading as Sjögren's syndrome. Neurolymphomatosis should be considered in cases of refractory Sjögren's syndrome presenting with multiple nerve palsies.</p>","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"12 ","pages":"249-254"},"PeriodicalIF":0.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrence of Central Nervous System Methotrexate-related Lymphoproliferative Disorder after Methotrexate Discontinuation: A Case Report.","authors":"Yoshihiro Okada, Yusuke Tomita, Hisakazu Nishimori, Hiroki Ueno, Kanji Matsuura, Keigo Makino, Naoya Kidani, Kenichiro Muraoka, Nobuyuki Hirotsune, Shigeki Nishino","doi":"10.2176/jns-nmc.2024-0296","DOIUrl":"10.2176/jns-nmc.2024-0296","url":null,"abstract":"<p><p>Methotrexate-related lymphoproliferative disorder is a rare but serious complication of methotrexate treatment. Recurrent methotrexate-related lymphoproliferative disorder in the central nervous system is uncommon. An 86-year-old woman, who had been on methotrexate for 3 years to treat rheumatoid arthritis, was admitted with left hemiplegia and sensory disturbance. Brain magnetic resonance imaging revealed a right basal ganglia lesion that was hyperintense on diffusion-weighted imaging and showed patchy enhancement. Methotrexate-related lymphoproliferative disorder was suspected, and methotrexate was discontinued, which led to improvement in her symptoms and partial remission. Twenty-eight months after methotrexate cessation, the patient presented with reduced activity and left hemiparesis. Brain magnetic resonance imaging showed homogeneously enhancing lesions in the right frontal lobe, basal ganglia, and brainstem. A craniotomy for biopsy of the right frontal lobe lesion confirmed the diagnosis of methotrexate-related lymphoproliferative disorder. Whole-brain radiation (40 Gy in 20 fractions) was administered without chemotherapy due to her advanced age and poor performance status. Her symptoms improved, and she was transferred to a rehabilitation hospital. Methotrexate-related lymphoproliferative disorder of the central nervous system can recur spontaneously, even without resumption of methotrexate, making long-term follow-up necessary after methotrexate cessation.</p>","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"12 ","pages":"255-260"},"PeriodicalIF":0.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Combined Transtemporal and High-parietal Approach for Large Intraventricular Trigone Meningioma: A Case Series and Review of the Literature.","authors":"Kosuke Nakajo, Hiroki Morisako, Tsutomu Ichinose, Takeo Goto","doi":"10.2176/jns-nmc.2025-0031","DOIUrl":"10.2176/jns-nmc.2025-0031","url":null,"abstract":"<p><p>The trigone of the lateral ventricle is deep and surrounded by eloquent gyri and subcortical fibers. Resection of intraventricular trigone tumors has therefore been challenging, and the optimal surgical approach to the trigone of the lateral ventricle remains controversial. Three patients with large intraventricular trigone meningioma (≥4 cm in diameter) underwent surgical excision using a combined transtemporal and high-parietal approach at Osaka City University Hospital between July 2016 and January 2021. Clinical and imaging studies, as well as surgical complications, were retrospectively reviewed based on medical records from our institution. We also reviewed 153 patients with intraventricular trigone meningioma from 11 reports in the literature and assessed pre- and postoperative symptoms. Gross total resection of the tumor was achieved in all cases. None of the patients showed deterioration of neurological symptoms at 3 months after tumor resection, although one patient experienced transient language dysfunction several weeks after surgery. No cases showed recurrence or required additional therapy. According to our literature review, postoperative visual field defects are more likely to persist than postoperative language dysfunction at 3 months postoperatively. In conclusion, combining the transtemporal and high-parietal approaches appears to be useful for treating large intraventricular trigone meningioma. Postoperative language dysfunction after resection of intraventricular trigone meningioma may tend to resolve more rapidly than postoperative visual field defect.</p>","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"12 ","pages":"267-273"},"PeriodicalIF":0.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lumbar Disc Herniation during Pregnancy: A Case Report and Literature Review.","authors":"Yoshiyuki Takaishi, Hiroto Kajimoto, Hirotomo Tanaka, Masahiro Sugihara, Takeshi Kondoh, Mayu Ooi","doi":"10.2176/jns-nmc.2025-0038","DOIUrl":"10.2176/jns-nmc.2025-0038","url":null,"abstract":"<p><p>Low back pain during pregnancy is common. However, lumbar disc herniation in pregnancy is rare, and when severe, it can cause lower extremity pain that resists conservative treatment or lead to cauda equina syndrome. In this report, we describe a case of severe lower back pain that did not improve with conservative treatment, necessitating surgery at 12 weeks of gestation. Additionally, we reviewed the literature. A 35-year-old woman, 7 weeks pregnant, presented to our outpatient clinic with right lower extremity pain. Magnetic resonance imaging revealed a herniated disc at the right L4/5. Acetaminophen, a pregnancy-safe analgesic was prescribed. Despite initiating treatment, the pain persisted, and the patient was hospitalized for bed rest. After one month of conservative treatment with no relief, a repeat magnetic resonance imaging showed an enlarged herniated disc. After consulting with the patient and her family, surgery was performed at Kobe University Hospital, which offers comprehensive neurosurgery, obstetrics and gynecology, and anesthesiology services. At 12 weeks of gestation, the patient underwent a microscopic discectomy in the prone position under general anesthesia. Fluoroscopy for surgical level confirmation was minimized. The surgery lasted approximately 1 hour, and the right lower extremity pain was alleviated. Five months later, the patient delivered a healthy child. We report a case of surgery for a herniated disc during pregnancy, along with a review of the literature.</p>","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"12 ","pages":"261-265"},"PeriodicalIF":0.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Papilledema in NF2-related Schwannomatosis without Ventriculomegaly and Overt Intracranial Hypertension: A Case Series and Literature Review.","authors":"Eiji Ito, Kiyoshi Saito, Masazumi Fujii, Shigenori Takebayashi, Lushun Chalise, Ryuta Saito, Tadashi Watanabe","doi":"10.2176/jns-nmc.2025-0034","DOIUrl":"10.2176/jns-nmc.2025-0034","url":null,"abstract":"<p><p>Neurofibromatosis 2-related schwannomatosis is a rare genetic disorder marked by the development of multiple central nervous system tumors and, occasionally, non-hydrocephalic intracranial hypertension. This report details two cases of papilledema in patients with neurofibromatosis 2-related schwannomatosis, characterized by normal ventricular morphology on Magnetic resonance imaging and refractory to conservative treatment. Both patients-a 23-year-old and a 31-year-old female-demonstrated complete resolution of papilledema and restoration of visual function following ventriculoperitoneal shunt placement. These cases underscore the critical role of early ventriculoperitoneal surgical intervention in mitigating vision loss and emphasize the necessity for rigorous clinical surveillance in this unique patient population.</p>","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"12 ","pages":"241-247"},"PeriodicalIF":0.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visual Evoked Potential Monitoring in Long-term Anesthesia Maintenance and Challenging Environments for Cerebral Arteriovenous Malformation Treatment: A Technical Case Report.","authors":"Shoto Yamada, Ayumu Yamaoka, Kanae Hashimoto, Katsuya Komatsu, Sangnyon Kim, Yukinori Akiyama, Mika Taniuchi, Yuki Sakurai, Sho Matsunaga, Takeshi Mikami, Tomoki Hirahata, Tomohiro Chaki, Nobuhiro Mikuni","doi":"10.2176/jns-nmc.2024-0341","DOIUrl":"10.2176/jns-nmc.2024-0341","url":null,"abstract":"<p><p>The monitoring of intraoperative optic nerve protection using visual evoked potential has been increasingly used in neurosurgical procedures. Although visual evoked potential is a valuable tool, its application is often hindered by anesthetic limitations and challenges related to measurement and recording environments. This case study indicates the successful use of visual evoked potential monitoring during long-term anesthesia maintenance and in artifact-prone environments for the treatment of a ruptured cerebral arteriovenous malformation. We report the case of a woman in her 30s who underwent surgical treatment for a ruptured cerebral arteriovenous malformation in the right occipital lobe, adjacent to the optic radiation. Visual evoked potential monitoring was essential during both transarterial embolization and subsequent microsurgical resection. During transarterial embolization, the implementation of improved measurement environments, localized light stimulation, and optimized recording conditions facilitated stable visual evoked potential monitoring despite the high levels of environmental noise in the angiography suite. Post-embolization, deep sedation was required to mitigate the risk of postoperative bleeding, causing an 18-hr duration of anesthesia before microsurgical resection. Despite the prolonged anesthesia, visual evoked potential monitoring was successfully maintained by carefully managing anesthesia depth. This case shows that visual evoked potential monitoring can be reliable and reproducible during extended periods of anesthesia and in challenging, artifact-rich environments. These findings underscore the feasibility of using visual evoked potential in complex neurosurgical cases, even under less-than-ideal conditions.</p>","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"12 ","pages":"233-239"},"PeriodicalIF":0.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling the Possibility of Subclinically Present Congenital Hydrocephalus Triggered by Thalamic Hemorrhage in Late-onset Years: A Case Report.","authors":"Yousuke Tomita, Yoshiaki Adachi, Nobuo Tamesa, Isao Date","doi":"10.2176/jns-nmc.2024-0233","DOIUrl":"10.2176/jns-nmc.2024-0233","url":null,"abstract":"<p><p>Congenital hydrocephalus manifesting in old age is exceptionally rare. We present a case of hydrocephalus in an older woman, where congenital hydrocephalus was suggested following a thalamic hemorrhage. A woman in her 90s gradually developed gait and cognitive impairments. Eight months before her admission, she suffered a thalamic hemorrhage, after which she became bedridden and was transferred to our hospital following impaired consciousness from asphyxiation. Upon admission, her Japan Coma Scale score was 200. A head computed tomography scan revealed significant ventricular enlargement. A tap test was conducted to diagnose normal pressure hydrocephalus, resulting in a slight improvement in her Japan Coma Scale score to 20. Consequently, a ventriculoperitoneal shunt was performed. Two weeks after the ventriculoperitoneal shunt, her consciousness improved to a Japan Coma Scale score of 2, and she resumed oral intake. Two months after the surgery, head magnetic resonance imaging revealed tetraventriculomegaly, an open aqueduct, a wide foramen of Magendie, and a large cisterna magna. These findings raised the suspicion of previously undetected congenital hydrocephalus, exacerbated by panventriculomegaly with a wide foramen of Magendie and a large cisterna magna, revealed after the thalamic hemorrhage. At the final evaluation, she required only minimal assistance with oral intake, showing significant improvement not only compared with her condition before the ventriculoperitoneal shunt procedure but also to her state before the thalamic hemorrhage.</p>","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"12 ","pages":"209-213"},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12187197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}