NMC case report journal最新文献

{"title":"Prolonged Transcortical Mixed Aphasia Following Awake Glioma Resection: Functional Language Network Disruption Associated with Persistent Epileptiform Activity.","authors":"Minako Kawaguchi, Yutaka Fujioka, Nobutaka Mukae, Masayuki Yanagida, Masako Fujise, Eriko Watanabe, Ayumi Sakata, Ryusuke Hatae, Taisei Yamada, Kazuhisa Kuwabara, Hiroshi Shigeto, Koji Yoshimoto","doi":"10.2176/jns-nmc.2026-0122","DOIUrl":"10.2176/jns-nmc.2026-0122","url":null,"abstract":"<p><p>Aphasia occurring after tumor resection in the language-dominant hemisphere is commonly interpreted as a consequence of irreversible structural injury. In awake craniotomy, intraoperative language mapping enables real-time functional monitoring and is expected to reduce the risk of postoperative aphasia. However, postoperative language impairment is not always attributable to structural damage alone, and functional network disturbances may also contribute. We report a case of prolonged aphasia following awake glioma resection in the dominant hemisphere, in which epileptiform activity was suspected to underlie a prolonged functional disruption of the language network. Intraoperative language mapping confirmed preserved language function throughout tumor resection. However, during the late intraoperative phase, stimulation-induced after-discharges were observed on electroencephalography, followed by the emergence of unstable language output. Postoperatively, severe aphasia persisted despite the absence of new ischemic or hemorrhagic lesions on neuroimaging. Serial electroencephalography demonstrated sustained epileptiform activity within the interictal-ictal continuum, raising concern for possible aphasic status epilepticus. Detailed language assessment revealed severe impairment of spontaneous speech and auditory comprehension, with relative preservation of repetition, reading aloud, and writing. This pattern was consistent with transcortical mixed aphasia, classically described as isolation of the speech area, suggesting functional disconnection of the language network despite anatomical preservation of core language cortices. Although electroencephalographic abnormalities gradually attenuated with antiseizure treatment, language impairment remained prolonged. Prolonged aphasia after awake glioma resection may reflect potentially reversible language network disconnection associated with persistent epileptiform activity rather than structural injury alone, supported by SLTA-confirmed recovery at 6 months.</p>","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"13 ","pages":"507-515"},"PeriodicalIF":0.0,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198585","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 Case of Bow Hunter's Syndrome Caused by C3/4 Facet Joint Hypertrophy: Hemodynamic Complexity and Surgical Strategy.","authors":"Satoka Shidoh, Katherine J Jensen, Clayton L Rosinski, Kathleen E Dlouhy, Satoshi Yamaguchi","doi":"10.2176/jns-nmc.2026-0089","DOIUrl":"10.2176/jns-nmc.2026-0089","url":null,"abstract":"<p><p>Bow Hunter's syndrome results from rotational insufficiency of the vertebral artery. Though traditionally associated with C1-C2 level compression, subaxial cervical causes are increasingly recognized. We report a 68-year-old man with codominant vertebral arteries presenting with dizziness and transient visual disturbances during head rotation. Imaging showed severe focal stenosis caused by an osteophyte at the left C3-C4 facet joint. Dynamic angiography revealed that the left vertebral artery was nearly occluded during rotation; despite faint distal residual flow, contrast failed to reach the basilar artery. The patient underwent a left C3-C4 facetectomy and posterior C2-C5 fusion. Intraoperative angiography confirmed restoration of antegrade flow, and the patient's symptoms resolved postoperatively. Identifying the underlying hemodynamic mechanism and selecting an appropriate surgical route are important for the successful management of this condition.</p>","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"13 ","pages":"457-462"},"PeriodicalIF":0.0,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198608","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":"Trochlear Nerve Palsy Caused by a Quadrigeminal Cistern Arachnoid Cyst Successfully Treated with a Hybrid Exoscope-endoscope Keyhole Approach: A Case Report.","authors":"Mayuko Kunii, Toru Umehara, Takeshi Morimoto, Chisato Yokota, Ryuichi Hirayama, Noriyuki Kijima, Satoru Oshino, Haruhiko Kishima","doi":"10.2176/jns-nmc.2026-0090","DOIUrl":"10.2176/jns-nmc.2026-0090","url":null,"abstract":"<p><p>Quadrigeminal cistern arachnoid cysts are rare intracranial lesions. While most intracranial arachnoid cysts in adults are incidentally detected and asymptomatic, quadrigeminal cistern arachnoid cysts, located adjacent to the dorsal midbrain and cerebral aqueduct, may become symptomatic, most often with obstructive hydrocephalus. Trochlear nerve palsy secondary to quadrigeminal cistern arachnoid cysts has been reported only rarely, and the pathophysiology and optimal management remain unclear. We report a 60-yr-old man who presented with progressive diplopia due to left trochlear nerve palsy. Magnetic resonance imaging revealed a 35-mm arachnoid cyst in the quadrigeminal cistern compressing the dorsal midbrain near the left trochlear nerve without hydrocephalus; no other causative lesion was identified. As the diplopia interfered with the patients daily activities, hybrid exoscope-endoscope-assisted keyhole cyst fenestration was performed 1 month after symptom onset. Communication between the cyst cavity and the ambient and superior cerebellar cisterns was successfully established to reduce the risk of cyst re-expansion. Postoperatively, the diplopia improved rapidly. Follow-up imaging demonstrated cyst shrinkage and decompression around the dorsal midbrain and left trochlear nerve. No perioperative complications were observed. This case supports a compressive mechanism for quadrigeminal cistern arachnoid cyst-related trochlear nerve palsy and suggests that timely surgical decompression may provide favorable outcomes when symptoms correlate with radiological compression. Hybrid exoscope-endoscope-assisted keyhole fenestration may be a useful surgical option for quadrigeminal cistern arachnoid cysts requiring surgical decompression.</p>","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"13 ","pages":"499-505"},"PeriodicalIF":0.0,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198620","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":"Brain Abscess Caused by <i>Enterococcus Faecalis</i> Following Intracerebral Hemorrhage and Mimicking Chronic Encapsulated Intracerebral Hematoma: A Case Report.","authors":"Hiroki Okabe, Junichi Akiyama, Yohei Kagami, Keita Saito, Shiko Shimada, Takahiro Ota, Masakazu Ogiwara","doi":"10.2176/jns-nmc.2026-0185","DOIUrl":"10.2176/jns-nmc.2026-0185","url":null,"abstract":"<p><p>Brain abscess developing at the site of intracerebral hemorrhage has rarely been reported. We report herein a case of brain abscess following intracerebral hemorrhage that mimicked a chronic encapsulated intracerebral hematoma. An 80-year-old man presented with right hemiparesis caused by a left frontoparietal subcortical intracerebral hemorrhage, which was managed conservatively. During hospitalization, progressive motor aphasia developed. Two weeks after admission, magnetic resonance imaging demonstrated worsening perihematomal edema and ring enhancement along the hematoma margin. Diffusion-weighted imaging demonstrated hyperintensity with heterogeneous restricted diffusion on the apparent diffusion coefficient map. Because there were no systemic signs of infection, chronic encapsulated intracerebral hematoma was initially suspected. However, the neurological and radiological deterioration progressed, prompting neuroendoscopic evacuation of the hematoma cavity. Microbiological examination revealed <i>Enterococcus faecalis</i> within the cavity, confirming the diagnosis of brain abscess. Targeted antimicrobial therapy led to clinical improvement. The possibility of a secondary brain abscess should be considered if delayed-onset neurological deterioration and worsening perihematomal edema are observed after intracerebral hemorrhage even in the absence of systemic signs of infection or typical diffusion restriction. Early microbiological evaluation of the hematoma cavity is essential to establish the diagnosis and determine the optimal treatment.</p>","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"13 ","pages":"485-491"},"PeriodicalIF":0.0,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198671","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":"Mechanical Thrombectomy of the Left Brachial Artery for Graft Occlusion after Debranching Thoracic Endovascular Aortic Repair: A Case Report.","authors":"Koichi Nakashima, Tomoaki Murakami, Shingo Toyota, Kosei Okochi, Shuki Okuhara, Shuhei Yamada, Takamune Achiha, Maki Kobayashi, Haruhiko Kishima","doi":"10.2176/jns-nmc.2026-0091","DOIUrl":"10.2176/jns-nmc.2026-0091","url":null,"abstract":"<p><p>In patients who have undergone debranching thoracic endovascular aortic repair, the access route and system for mechanical thrombectomy must be carefully selected on a case-by-case basis. We report an 82-year-old man in whom mechanical thrombectomy was successfully performed via the left brachial artery for occlusion of a bypass graft. He was admitted with impaired consciousness and was diagnosed with left common carotid artery occlusion on magnetic resonance angiography. The patient had previously undergone debranching thoracic endovascular aortic repair with a right subclavian artery-left common carotid artery-left subclavian artery bypass for a thoracic aortic aneurysm 4 years earlier. Because a femoral artery approach was considered unfeasible, mechanical thrombectomy was performed via the left brachial artery. A 6 Fr guiding sheath was advanced into the left brachial artery, and angiography demonstrated that both the bypass graft to the left common carotid artery and the left common carotid artery itself were occluded by a large thrombus. Multiple mechanical thrombectomy attempts using various techniques were performed, and a thrombus measuring approximately 3 cm was retrieved, resulting in successful grade 2c Thrombolysis in Cerebral Infarction reperfusion. For patients who have undergone debranching thoracic endovascular aortic repair, the brachial approach may be considered as a potential alternative when femoral access is not feasible. The choice of access route might be influenced by the specific type of cervical vascular reconstruction and the location of the lesion.</p>","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"13 ","pages":"463-469"},"PeriodicalIF":0.0,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198602","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":"Durable Complete Remission Achieved by Tirabrutinib Rechallenge in Relapsed Primary Central Nervous System Lymphoma: A Case Report.","authors":"Takamune Achiha, Koji Takano, Yuma Tada, Toru Umehara, Sayako Yuda, Takafumi Yokota, Jun Ishikawa, Hideyuki Arita","doi":"10.2176/jns-nmc.2026-0034","DOIUrl":"10.2176/jns-nmc.2026-0034","url":null,"abstract":"<p><p>Tirabrutinib, a second-generation Bruton tyrosine kinase inhibitor, has shown promising efficacy in patients with relapsed or refractory primary central nervous system lymphomas. However, its clinical effectiveness after a rechallenge remains largely unknown. This case report described a 59-year-old woman with primary central nervous system lymphoma who initially achieved a complete response with tirabrutinib, after discontinuing methotrexate-based chemotherapy due to treatment-related toxicity. The disease relapsed 2.5 months later, and subsequently followed a refractory course. Even high-dose chemotherapy with autologous stem cell transplantation and additional chemoradiotherapy produced only short-lived responses with repeated relapses. Tirabrutinib was re-administered as a rechallenge therapy and resulted in a fourth complete response. The patient experienced sustained complete response for 20 months while under ongoing tirabrutinib monotherapy. This case illustrates that tirabrutinib rechallenge may represent a feasible therapeutic option for select patients with recurrent primary central nervous system lymphoma, who previously received Bruton tyrosine kinase inhibitor therapy. The biological mechanisms underlying renewed drug sensitivity remain uncertain. In carefully selected cases, there may be resultant clinical benefits. Further studies are warranted to clarify the molecular and clinical determinants associated with successful tirabrutinib rechallenge in patients with primary central nervous system lymphoma.</p>","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"13 ","pages":"445-450"},"PeriodicalIF":0.0,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198592","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":"Dual Balloon-assisted Transarterial Embolization of a Cervical Spinal Epidural Arteriovenous Fistula with Intradural Venous Reflux Arising from the Vertebral Artery.","authors":"Sho Suzuki, Sho Nakamura, Tomoko Ikemoto, Shunya Hanakita, Satoshi Iihoshi","doi":"10.2176/jns-nmc.2026-0115","DOIUrl":"10.2176/jns-nmc.2026-0115","url":null,"abstract":"<p><p>Cervical spinal epidural arteriovenous fistulas with intradural venous reflux are exceptionally rare, and endovascular treatment is particularly challenging when the arterial feeder arises directly from the vertebral artery. We report a 69-year-old man with progressive myelopathy caused by a cervical type A spinal epidural arteriovenous fistula with a feeder arising directly from the left vertebral artery at C6, treated by dual balloon-assisted transarterial n-butyl cyanoacrylate embolization. A balloon guiding catheter was used for proximal vertebral artery flow arrest, whereas an occlusion balloon catheter was positioned across the feeder origin for distal protection and flow-directed microcatheter stabilization. After confirming complete segmental flow arrest, 0.15 mL of 25% n-butyl cyanoacrylate mixed with Lipiodol was injected. Complete angiographic obliteration was achieved without complications, and neurological function gradually improved with marked resolution of spinal cord edema on follow-up magnetic resonance imaging at 3 months. Reported series of transarterial embolization for these fistulas show high obliteration rates but carry a risk of reflux into the parent artery when the feeder arises from a major vessel. In this anatomically rare lesion, the dual balloon configuration provided simultaneous proximal flow arrest, distal protection across the feeder origin, and stabilization of the feeder microcatheter, allowing controlled n-butyl cyanoacrylate injection without proximal reflux. This technique may be a useful endovascular option for selected cases of cervical spinal epidural arteriovenous fistula with direct vertebral artery feeders, although its broader efficacy requires confirmation in larger series.</p>","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"13 ","pages":"471-475"},"PeriodicalIF":0.0,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198604","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":"Possible Iatrogenic Cerebral Amyloid Angiopathy Presenting with Recurrent Lobar Hemorrhages: A Case Report.","authors":"Hadzki Matsuda, Takeo Uzuka, Takuma Sumi, Shunsuke Shibao, Miki Sakuma, Yoshihiro Abe, Hiroyoshi Akutsu","doi":"10.2176/jns-nmc.2026-0180","DOIUrl":"10.2176/jns-nmc.2026-0180","url":null,"abstract":"<p><p>Iatrogenic cerebral amyloid angiopathy is a rare condition thought to result from prion-like transmission of amyloid-β, typically after childhood neurosurgery or exposure to cadaveric dura mater, with a latency period of several decades. We report the case of a 60-year-old woman who underwent a right frontal craniotomy for traumatic head injury at the age of 12 years, although it was unknown whether cadaveric dura mater was used. Approximately 48 years later, she developed a right frontal lobar hemorrhage near the prior craniotomy site and experienced more than 15 recurrent intracerebral hemorrhages, predominantly involving lobar regions over 3 months. Histopathology of hematoma-adjacent tissue revealed marked amyloid-β deposition without significant tau pathology or inflammation, and apolipoprotein E genotype was ε3/ε3. Based on clinical, pathological, and epidemiological findings, the case met the Queen Square criteria for possible iatrogenic cerebral amyloid angiopathy. The exceptionally long latency and unusually frequent recurrent hemorrhages were the most striking features of this case. Iatrogenic cerebral amyloid angiopathy should be considered even in older adults, as remote neurosurgical history remains an important diagnostic clue. Because amyloid-β is resistant to conventional sterilization, special attention to the sterilization of surgical instruments is also warranted when patients with a remote neurosurgical history undergo further neurosurgery.</p>","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"13 ","pages":"477-483"},"PeriodicalIF":0.0,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198646","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":"Intracerebral Hemorrhage as the Initial Manifestation of Brain Metastasis from Left Atrial Intimal Sarcoma in a Young Adult: A Case Report.","authors":"Daiki Tanabe, Shunsuke Yamashita, Shunsuke Yamanishi, Ryota Kitano, Tatsuo Hori, Mitsuru Ikeda, Masashi Morikawa, Takashi Sasayama","doi":"10.2176/jns-nmc.2025-0427","DOIUrl":"10.2176/jns-nmc.2025-0427","url":null,"abstract":"<p><p>Intratumoral hemorrhage caused by metastatic brain tumors originating from intimal sarcoma is extremely rare. We report a diagnostically challenging case of cerebral metastasis from a left atrial intimal sarcoma that initially presented as subcortical hemorrhage in a young adult. A 24-year-old woman presented with right homonymous hemianopia and was diagnosed with a subcortical hemorrhage in the left parietal lobe. No obvious source of bleeding was identified, and the patient was managed conservatively and discharged. One month later, fever, dyspnea, and palpitations developed in the patient. Echocardiography revealed a large mass in the left atrium. Brain imaging indicated a mass-like lesion within the prior hematoma cavity, suggesting that the hemorrhage might have been secondary to an underlying neoplasm. After surgical removal of the cardiac tumor, the patient experienced recurrent bleeding in the left parietal lobe and underwent emergency craniotomy for hematoma evacuation. Histopathological analysis of the resected lesion confirmed metastasis involvement from a primary left atrial intimal sarcoma. Although the patient underwent radiotherapy for the left parietal and cardiac lesions followed by systemic chemotherapy, she died 8 months after the initial diagnosis. This case highlights the importance of considering intratumoral bleeding in cases of spontaneous intracerebral hemorrhage without an identifiable cause. Comprehensive follow-up using multiple imaging and systemic evaluations is essential for early detection and accurate diagnosis.</p>","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"13 ","pages":"493-498"},"PeriodicalIF":0.0,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198660","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 Case of Acute Spontaneous Spinal Epidural Hematoma Caused by Repeated Bleeding Thoracic Radiculomeningeal Artery.","authors":"Yukino Irie, Hisaaki Uchikado, Fumiaki Fujiwara, Hiroshi Ohtani, Syuji Hayashi, Tooru Inoue, Hiroshi Abe","doi":"10.2176/jns-nmc.2026-0144","DOIUrl":"10.2176/jns-nmc.2026-0144","url":null,"abstract":"<p><p>Spontaneous spinal epidural hematoma (SSEH) presents with back pain followed by myelopathy. Venous plexus disruption is common, and arterial bleeding is extremely rare. Here, we report a case of acute spontaneous spinal epidural hematoma that showed spot sign on computed tomographic angiography and was treated. A 48-year-old woman with no medical history experienced unprovoked back pain and visited a local hospital, where she was placed under observation. Numbness gradually developed in both legs, and the patient visited our emergency room 5 hours after the onset of symptoms. Magnetic resonance imaging revealed spontaneous spinal epidural hematoma on the left ventrolateral side at the T4-6 level, and computed tomographic angiography showed a spot sign at T5-6. During the examination, the patient's paraplegia progressed, and she presented with bladder-rectum dysfunction. She was diagnosed with spinal shock and underwent emergency surgery 9 hours after the onset of symptoms. The hematoma was removed and the source of arterial bleeding was treated, generating a complete recovery. In cases of acutely progressing paraplegic spontaneous spinal epidural hematoma, contrast-enhanced computed tomographic angiography is useful for identifying the source of bleeding, and in cases of arterial bleeding, emergency decompression and vascular ligation are useful.</p>","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"13 ","pages":"451-455"},"PeriodicalIF":0.0,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198637","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}