NMC case report journal最新文献

Symptomatic Improvement after Surgical Transposition of an Extremely Medialized Carotid Artery Causing Swallowing Discomfort: A Case Report.

NMC case report journal Pub Date : 2025-02-07 eCollection Date: 2025-01-01 DOI: 10.2176/jns-nmc.2024-0158

Nobuto Hirai, Ryuichiro Kajikawa, Yusuke Nishikawa, Motoki Nakamura, Eisaku Terada, Shuhei Kawabata, Takashi Tsuzuki

{"title":"Symptomatic Improvement after Surgical Transposition of an Extremely Medialized Carotid Artery Causing Swallowing Discomfort: A Case Report.","authors":"Nobuto Hirai, Ryuichiro Kajikawa, Yusuke Nishikawa, Motoki Nakamura, Eisaku Terada, Shuhei Kawabata, Takashi Tsuzuki","doi":"10.2176/jns-nmc.2024-0158","DOIUrl":"10.2176/jns-nmc.2024-0158","url":null,"abstract":"An aberrant course of the carotid artery can cause dysphagia by displacing the pharynx, but no definitive treatment strategy has been established for this condition. We report a case in which swallowing discomfort was improved by surgical transposition of a carotid artery following a highly medial course. A 79-year-old man presented with worsening swallowing discomfort over the preceding year. Computed tomography angiography of the head and neck showed tortuous right common and internal carotid arteries running through the retropharyngeal space. Videoendoscopic and videofluorographic examinations revealed intact swallowing function and the carotid artery compressing the right pharyngeal wall. Since the cause of swallowing discomfort was suspected to be the tortuous courses of the right common and internal carotid arteries, we performed surgery to change the course of the carotid artery. The surgical procedure moved the common and internal carotid arteries from the retropharyngeal space. The carotid artery was retracted anterolaterally with the carotid sheath, which was fixed to the sternocleidomastoid muscle to maintain the corrected course. Symptoms showed immediate improvement postoperatively. Our strategy appears effective as a method of treating swallowing discomfort due to tortuosity of the carotid arteries.","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"12 ","pages":"27-31"},"PeriodicalIF":0.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525779","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}

引用次数: 0

Successful Endoscopic Resection of a Chronic Expanding Hematoma Following Gamma Knife Surgery for Cerebral Arteriovenous Malformation: A Case Report.

NMC case report journal Pub Date : 2025-02-07 eCollection Date: 2025-01-01 DOI: 10.2176/jns-nmc.2024-0216

Shogo Wakita, Kentaro Horiguchi, Shigeki Nakano, Yoshinori Higuchi

{"title":"Successful Endoscopic Resection of a Chronic Expanding Hematoma Following Gamma Knife Surgery for Cerebral Arteriovenous Malformation: A Case Report.","authors":"Shogo Wakita, Kentaro Horiguchi, Shigeki Nakano, Yoshinori Higuchi","doi":"10.2176/jns-nmc.2024-0216","DOIUrl":"10.2176/jns-nmc.2024-0216","url":null,"abstract":"Gamma knife surgery is useful for treating cerebral arteriovenous malformations. However, some radiation-induced long-term complications have been reported. One of these is a chronic expanding hematoma. We present a case of chronic expanding hematoma, successfully treated with endoscopic resection. The patient, a woman in her 30s, experienced a cerebral hemorrhage 17 years ago associated with an arteriovenous malformation in the corpus callosum. The lesion was completely embolized with n-butyl-2-cyanoacrylate embolization twice, followed 2 years later by gamma knife surgery. The patient presented to the emergency room with headache and left hemiplegia. A computed tomography scan showed hemorrhagic changes consistent with the cystic lesion and worsening edematous changes around it. An endoscopic tumor resection (interhemispheric approach) was performed, and most of the lesion was removed. Pathology did not detect any neoplastic lesions, and a diagnosis of chronic expanding hematoma was performed based on the presence of abnormal vascular neoplasia. The postoperative course was uneventful, and the headache promptly resolved. The pathophysiology of chronic expanding hematoma involves slow and progressive hematoma expansion due to repeated local hemorrhage, causing intense cerebral edema around the lesion. Surgical removal is effective, and edematous changes and neurological symptoms can be quickly relieved after surgery. Endoscopic surgery is particularly effective for deep lesions owing to its ability to manipulate within a narrow surgical field. In this case, the lesion was removed with minimal invasiveness and no complications, leading to early symptom relief and resolution of the surrounding brain edema changes.","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"12 ","pages":"47-51"},"PeriodicalIF":0.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525778","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}

引用次数: 0

A Primary Spinal Intramedullary Mixed Germ Cell Tumor: A Case Report and Literature Review. 原发性脊髓髓内混合生殖细胞瘤：病例报告与文献综述

NMC case report journal Pub Date : 2025-02-07 eCollection Date: 2025-01-01 DOI: 10.2176/jns-nmc.2024-0202

Shunsuke Nakamura, Hiroya Shimauchi-Ohtaki, Fumiaki Honda, Yuta Goto, Satoshi Nakata, Keishi Horiguchi, Ran Tomomasa, Junko Hirato, Hideaki Yokoo, Soichi Oya

{"title":"A Primary Spinal Intramedullary Mixed Germ Cell Tumor: A Case Report and Literature Review.","authors":"Shunsuke Nakamura, Hiroya Shimauchi-Ohtaki, Fumiaki Honda, Yuta Goto, Satoshi Nakata, Keishi Horiguchi, Ran Tomomasa, Junko Hirato, Hideaki Yokoo, Soichi Oya","doi":"10.2176/jns-nmc.2024-0202","DOIUrl":"10.2176/jns-nmc.2024-0202","url":null,"abstract":"Central nervous system germ cell tumors are rare and account for 2% to 3% of all central nervous system tumors in Japan. Here, we report an extremely rare case of a primary spinal intramedullary mixed germ cell tumor. A 33-year-old man presented with a chief report of dysuria and numbness in the right lower extremity. Magnetic resonance imaging revealed a mass lesion on the left side of the intramedullary spinal cord at the Th10-11 vertebral body level with hyperintensity on T2-weighted images, isointensity on T1-weighted images, and uniform contrast in gadolinium. Cerebrospinal fluid examination revealed a few atypical cells. Although tumor removal using the posterior median sulcus approach was attempted, only a biopsy was performed because intraoperative rapid pathology suggested a possible diagnosis of germinoma. Permanent pathology revealed a mixed germ cell tumor (mainly comprising a germinoma with a yolk sac tumor). Postoperatively, cerebrospinal irradiation and 8 courses of the carboplatin and etoposide regimen were administered. No recurrence or new lesions were observed on magnetic resonance imaging at 94 months postoperatively. Our extensive literature search found only 4 cases of a mixed germ cell tumor of primary intramedullary origin in the spinal cord. Most spinal germ cell tumors described in the literature are either germinomas or mature teratomas; however, mixed germ cell tumors can also occur, albeit infrequently. Although additional cases need to be accumulated, our case suggests that yolk sac elements in spinal mixed germ cell tumors might not be directly associated with poor life expectancy.","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"12 ","pages":"53-58"},"PeriodicalIF":0.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525767","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}

引用次数: 0

A Case of Intracranial Mesenchymal Tumor, FET::CREB Fusion-positive, Diagnosed by Genomic Profiling with FoundationOne CDx.

NMC case report journal Pub Date : 2025-02-07 eCollection Date: 2025-01-01 DOI: 10.2176/jns-nmc.2024-0103

Kousuke Sono, Toshiyuki Enomoto, Hiromasa Kobayashi, Koichiro Takemoto, Takashi Morishita, Mikiko Aoki, Makoto Hamasaki, Hiroshi Abe

{"title":"A Case of Intracranial Mesenchymal Tumor, FET::CREB Fusion-positive, Diagnosed by Genomic Profiling with FoundationOne CDx.","authors":"Kousuke Sono, Toshiyuki Enomoto, Hiromasa Kobayashi, Koichiro Takemoto, Takashi Morishita, Mikiko Aoki, Makoto Hamasaki, Hiroshi Abe","doi":"10.2176/jns-nmc.2024-0103","DOIUrl":"10.2176/jns-nmc.2024-0103","url":null,"abstract":"Intracranial mesenchymal tumor FET::cyclic adenosine monophosphate response element-binding fusion-positive is a soft tissue tumor with an extremely rare intracranial occurrence. Histological diagnosis is sometimes difficult, requiring confirmation of characteristic fusion genes. The patient was a 45-year-old male who presented with a chief complaint of pain and an abnormal sensation in the right trigeminal nerve area, in whom a neoplastic lesion in Meckel's cave was noted. The preoperative diagnoses included meningioma and schwannoma. The tumor was extirpated as much as possible, and the tumor tissue showed a high proliferative potential with rhabdoid features, raising the suspicion of a rhabdoid meningioma. However, immunostaining was positive for desmin and cluster of differentiation 99, suggesting the possibility of angiomatoid fibrous histiocytoma. For diagnosis, Ewing sarcoma breakpoint region1 gene-cyclic adenosine monophosphate response element-binding 1 fusion and Ewing sarcoma breakpoint region1 gene-activating transcription factor 1 fusion were examined at our institution, but were undetectable and did not lead to a diagnosis. Genomic profiling with FoundationOne CDx (Foundation Medicine, Cambridge, MA, USA) confirmed Ewing sarcoma breakpoint region1 gene-cyclic adenosine monophosphate response element modulator fusion and a diagnosis of intracranial mesenchymal tumor FET::cyclic adenosine monophosphate response element-binding fusion-positive was made. Diagnosis of intracranial mesenchymal tumor FET::cyclic adenosine monophosphate response element-binding fusion-positive requires both histological examination and confirmation of the fusion gene. Genomic profiling using the FoundationOne CDx is also useful when the fusion gene cannot be sufficiently confirmed at an individual's institution.","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"12 ","pages":"33-39"},"PeriodicalIF":0.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525766","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}

引用次数: 0

Gauze Packing and Removal: Two-staged Operations for Hemostasis of Traumatic Sinus Injury.

NMC case report journal Pub Date : 2025-02-07 eCollection Date: 2025-01-01 DOI: 10.2176/jns-nmc.2024-0100

Hidekazu Nakata, Nao Shimooka, Takahiro Uno, Hanako Sasaki, Shiromaru Ishida, Makoto Dehara, Yasushi Hagihara

引用次数: 0

Pathogenesis of Spinal Subdural Hematoma Based on Histopathological Findings: A Case Report.

NMC case report journal Pub Date : 2025-02-07 eCollection Date: 2025-01-01 DOI: 10.2176/jns-nmc.2024-0214

Yoshiki Fujikawa, Takahiro Fujishiro, Hideki Tanabe, Toshihiro Takami, Masahiko Wanibuchi

{"title":"Pathogenesis of Spinal Subdural Hematoma Based on Histopathological Findings: A Case Report.","authors":"Yoshiki Fujikawa, Takahiro Fujishiro, Hideki Tanabe, Toshihiro Takami, Masahiko Wanibuchi","doi":"10.2176/jns-nmc.2024-0214","DOIUrl":"10.2176/jns-nmc.2024-0214","url":null,"abstract":"Spinal subdural hematoma is a rare condition whereas intracranial chronic subdural hematoma is well-recognized and documented in clinical settings. Despite various theories that have been proposed, the exact pathogenesis of spinal subdural hematoma remains to be elucidated. Herein, we report a rare case of spinal subdural hematoma with a co-existing intracranial chronic subdural hematoma and deduce its etiology using histopathological findings. A 76-year-old Japanese man with slight hemiparesis due to intracranial chronic subdural hematoma underwent burr hole surgery with successful drainage of the hematoma. The patient could not walk unassisted after the surgery. Spinal magnetic resonance imaging was performed, revealing a subdural hematoma extending from the T11 to S2 levels. The patient subsequently underwent the evacuation of spinal subdural hematoma 12 days after initial surgery. Intraoperatively, we identified a dark liquefied hematoma with capsule formation. Histological examination of the resected capsule revealed loose fibrovascular tissues comprising capillaries, collagen fibers, a small number of macrophages, and hemosiderin deposits. These findings were very similar to the pathology of intracranial chronic subdural hematoma so the pathogenesis of spinal subdural hematoma in this case was considered identical to that of subacute or chronic subdural hematoma. The patient was transferred to a rehabilitation hospital, and 4 months after the lumbar surgery, no recurrence was observed in the magnetic resonance imaging examination. Subacute or chronic spinal subdural hematoma may result from various pathogeneses that clinicians should consider for correct diagnosis and appropriate management. Our case provides important insights into the pathogenesis of subacute or chronic spinal subdural hematoma.","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"12 ","pages":"41-46"},"PeriodicalIF":0.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525769","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}

引用次数: 0

Pitfalls in the Diagnosis and Treatment of Low Back Pain in an Elite Para-athlete Successfully Treated by Transforaminal Full-endoscopic Discectomy with Thermal Annuloplasty: A Case Reports.

NMC case report journal Pub Date : 2025-01-28 eCollection Date: 2025-01-01 DOI: 10.2176/jns-nmc.2024-0127

Yutaro Kanda, Kozaburo Mizutani, Masashi Kumon, Saori Soeda, Kosuke Sugiura, Masatoshi Morimoto, Fumitake Tezuka, Kazuta Yamashita, Koichi Sairyo

{"title":"Pitfalls in the Diagnosis and Treatment of Low Back Pain in an Elite Para-athlete Successfully Treated by Transforaminal Full-endoscopic Discectomy with Thermal Annuloplasty: A Case Reports.","authors":"Yutaro Kanda, Kozaburo Mizutani, Masashi Kumon, Saori Soeda, Kosuke Sugiura, Masatoshi Morimoto, Fumitake Tezuka, Kazuta Yamashita, Koichi Sairyo","doi":"10.2176/jns-nmc.2024-0127","DOIUrl":"10.2176/jns-nmc.2024-0127","url":null,"abstract":"We report a rare case of an elite para-athlete with lumbar disk herniation whose pain generator was difficult to diagnose and treat. A 28-year-old woman with paraplegia below the T10 level felt pain in her low back and left leg during a match. Magnetic resonance imaging revealed a lateral lumbar disk herniation and a high-intensity zone on the left side at the L5-L6 level. Because the pain disappeared following L5 selective nerve block, we performed transforaminal full-endoscopic discectomy alone. Despite the disappearance of leg pain after surgery, her low back pain persisted. We performed thermal annuloplasty because reproducible pain and subsequent temporary pain relief by discography and discoblock after the initial surgery indicated discogenic pain. Her suffering from back pain gradually reduced. She returned to competition 2 months after the second surgery without intensive rehabilitation due to difficulty in performing core exercises for abdominal muscles. During the return match, she experienced a relapse of pain in the low back and left leg, which was caused by a recurrence of disk herniation. We performed a full-endoscopic discectomy with thermal annuloplasty again. Her clinical symptoms were immediately relieved. We enhanced her thoracic spine flexibility to prevent subsequent recurrence. Finally, she returned to international competition 2 months after the third surgery. Close attention to para-athletes is required to achieve an accurate diagnosis of pain generators and prevent recurrence due to their distinctive disorders. Thermal annuloplasty and rehabilitating thoracic movement can be an excellent option for para-athletes with discogenic low back pain.","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"12 ","pages":"7-13"},"PeriodicalIF":0.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451409","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}

引用次数: 0

Multiple Myxoid Meningiomas Exhibiting Rapid Growth: A Case Report and Literature Review.

NMC case report journal Pub Date : 2025-01-28 eCollection Date: 2025-01-01 DOI: 10.2176/jns-nmc.2024-0207

Dai Uzuki, Yuhei Ito, Megumi Koiwai, Tsuyoshi Ichikawa, Kazuhiro Tasaki, Kyouichi Suzuki

引用次数: 0

A Case of Surgically Treated Adult Split Cord Malformation Type 2 with Tethered Cord Syndrome.

NMC case report journal Pub Date : 2025-01-28 eCollection Date: 2025-01-01 DOI: 10.2176/jns-nmc.2024-0164

Keisuke Ohmae, Motoyuki Iwasaki, Izumi Koyanagi, Miki Fujimura

{"title":"A Case of Surgically Treated Adult Split Cord Malformation Type 2 with Tethered Cord Syndrome.","authors":"Keisuke Ohmae, Motoyuki Iwasaki, Izumi Koyanagi, Miki Fujimura","doi":"10.2176/jns-nmc.2024-0164","DOIUrl":"10.2176/jns-nmc.2024-0164","url":null,"abstract":"Split cord malformation (SCM) is a rare congenital anomaly characterised by the division of the spinal cord into 2 distinct hemicords, often accompanied by bony or cartilaginous septum. We experienced a surgical case diagnosed as SCM with tethered cord syndrome (TCS) due to spinal lipoma. A 54-year-old female presented with a history of gradually progressive paraparesis and bladder dysfunction for a few months. Her magnetic resonance imaging revealed low-positioned conus medullaris below the level of S3 due to spinal lipoma and accompanied by other small multiple lipomas and a split cord below the level of L4/L5 without bony separation. The final diagnosis was SCM type II with TCS. Under careful intraoperative inspection, fibrous connecting strings were arising from the dorsal interface of the split cord to the dorsal arachnoid membrane as one of the responsible tethering structures. Circumferential meticulous dissection was performed around the split cord, followed by standard dissection of tethered conus owing to lipoma at the caudal end. Her symptoms were alleviated immediately after surgery. Although the surgical procedure has not been established because of its rarity, dissection around the split cord should precede the usual untethering of the caudal spinal cord.","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"12 ","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451407","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}

引用次数: 0

Lack of Apparent Neurotoxicity in Older Patients with Primary Central Nervous System Lymphoma Receiving Long-term Tirabrutinib: Report of 2 Cases.

NMC case report journal Pub Date : 2024-12-25 eCollection Date: 2024-01-01 DOI: 10.2176/jns-nmc.2024-0098

Novita I Khairunnisa, Fumiyuki Yamasaki, Ushio Yonezawa, Akira Taguchi, Shumpei Onishi, Iori Ozono, Nobutaka Horie

引用次数: 0