NMC case report journal最新文献

{"title":"Choroid Plexus Cyst with Parenchymal Localization in a Symptomatic 50-year-old Male: A Case Report.","authors":"Berkay Ayhan, Hüseyin Ömer Semiz, Zeyad Kamar, Ülker Karagece Yalçin, Tuğçe Aycan Akbal Ersöz","doi":"10.2176/jns-nmc.2025-0252","DOIUrl":"10.2176/jns-nmc.2025-0252","url":null,"abstract":"<p><p>Choroid plexus cysts are typically benign lesions found within the ventricular system during prenatal imaging and are usually asymptomatic. Intraparenchymal choroid plexus cysts, especially in adults, are exceptionally rare, with very few reported cases. This case report aims to present a rare instance of a symptomatic, intraparenchymal choroid plexus cyst in an adult patient and to discuss the diagnostic and surgical considerations involved. We present the case of a 50-year-old man with complaints of lower extremity weakness and imbalance who was found to have a bilobulated cyst in the frontal cortex causing significant mass effect and midline shift. The patient underwent cyst fenestration through endoscope-assisted open craniotomy, with marked postoperative reduction in cyst size and resolution of neurological symptoms. Histopathology confirmed the diagnosis of a choroid plexus cyst. This case highlights the importance of considering rare pathologies such as choroid plexus cysts in the differential diagnosis of cystic brain lesions with mass effect in adults.</p>","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"13 ","pages":"77-84"},"PeriodicalIF":0.0,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13016787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147523518","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":"Intra-aneurysmal Thrombectomy Using Exo-endoscopic 2-step Approach for Thrombosed Vertebral Artery Aneurysm: A Technical Case Report.","authors":"I Gusti Ketut Agung Surya Kencana, Kenichiro Iwami, Masahiro Nishihori, Kazuhito Takeuchi, Yuichi Nagata, Eriko Okumura, Yoshiki Sato, I Wayan Niryana, Tjokorda Gde Bagus Mahadewa, Ryuta Saito","doi":"10.2176/jns-nmc.2025-0316","DOIUrl":"10.2176/jns-nmc.2025-0316","url":null,"abstract":"<p><p>Although rare, thrombosed vertebral artery aneurysms can lead to severe symptoms and are challenging to treat due to their proximity to vital structures. The location of a thrombosed aneurysm on the anterior aspect of the brainstem poses a significant challenge to conventional microscopic approaches. We herein report a 78-year-old man with a thrombosed right vertebral artery aneurysm who developed progressive quadriparesis, dysphagia, and respiratory failure despite prior interventions, including flow diverter stent placement, parent artery occlusion, and microscopic thrombectomy. Given worsening medullary compression and poor clinical status, intra-aneurysmal thrombectomy was performed using an exo-endoscopic 2-step approach. The procedure involved reopening the previous suboccipital craniotomy, partial condylectomy, and C1 hemilaminectomy. Exoscopic thrombus de-bulking was followed by endoscopic evacuation of the residual thrombus compressing the ventral brainstem. Postoperatively, no complication was observed, and the patient demonstrated gradual neurological improvement, including recovery of spontaneous respiration and the ability to wean from mechanical ventilation within 3 weeks. Follow-up imaging confirmed resolution of medullary compression without thrombus recurrence. The exo-endoscopic 2-step approach is a viable option for surgical decompression of thrombosed vertebral artery aneurysms that cause brainstem compression. This enhances surgical access and visualization, particularly in the ventral brainstem, while potentially minimizing brainstem manipulation. Further investigation is warranted to better define the indications, efficacy, and safety of the management of complex thrombosed aneurysms.</p>","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"13 ","pages":"91-96"},"PeriodicalIF":0.0,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13017038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147577200","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":"Cerebral Hemodynamics in Pediatric Abusive Head Trauma: 3 Severe Cases with Preserved Motor Cortex, Hyperperfusion, and Recovery of Mild Paralysis.","authors":"Mitsuru Tamura, Shinji Yamashita, Tomoki Kawano, Satoru Komaki, Takeru Tsukino, Koutarou Kojima, Kenichi Maeda, Yasuhiro Kimoto, Yoshihito Kadota, Minako Azuma, Yoshiko Okita","doi":"10.2176/jns-nmc.2025-0258","DOIUrl":"https://doi.org/10.2176/jns-nmc.2025-0258","url":null,"abstract":"<p><p>Abusive head trauma in infants and young children can have a significant impact on neurological outcomes and, in severe cases, may be life-threatening. We report 3 cases of abusive head trauma that presented with acute subdural hematomas on computed tomography scans, accompanied by extensive low-density areas and parenchymal brain swelling. All patients exhibited impaired consciousness due to brain injury and underwent craniotomy for hematoma evacuation as well as extensive decompressive craniectomy. Despite the severity of the initial presentation, hemiparesis was mild and gradually improved over several months. Postoperative magnetic resonance imaging revealed widespread parenchymal injury but preservation of the corticospinal tract, including the precentral gyrus. In the acute phase, diffusion-weighted imaging showed no irreversible infarction in the motor cortex, and arterial spin labeling demonstrated increased perfusion in peri-motor regions of the affected hemisphere. These findings suggest that preserved corticospinal pathways and compensatory hyperperfusion may correlate with favorable motor recovery even in the presence of extensive parenchymal damage. These cases highlight the radiological features and short-term neurological outcomes of abusive head trauma, demonstrating preserved motor function despite extensive parenchymal damage.</p>","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"13 ","pages":"69-75"},"PeriodicalIF":0.0,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12995511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147489277","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":"Complete Liberation from Mechanical Ventilation Using Diaphragm Pacing in a Patient with Traumatic Spinal Cord Injury Despite Persistent Unilateral Diaphragmatic Paralysis.","authors":"Shinya Tokunaga, Akinori Miyakoshi, Shinsuke Sato, Yoshihito Hirata, Hiromasa Adachi, Daisuke Arai, Tsukasa Sato, Yoshifumi Kawanabe","doi":"10.2176/jns-nmc.2025-0231","DOIUrl":"https://doi.org/10.2176/jns-nmc.2025-0231","url":null,"abstract":"<p><p>We report a case of successful diaphragm pacing in a patient with severe traumatic spinal cord injury resulting in complete ventilator dependence. A 29-year-old man sustained a traumatic cervical spinal injury at the C3 level. On admission, he exhibited tetraplegia, complete sensory loss below the C6 dermatome, and acute respiratory failure. Emergency spinal decompression surgery was performed; however, neurological deficits showed no improvement. Despite intensive respiratory rehabilitation, the patient remained fully dependent on mechanical ventilation. Diaphragm pacing implantation was planned approximately 17 weeks post-injury. Intraoperative electrical stimulation revealed no responsiveness in the left diaphragm, whereas the right diaphragm demonstrated sufficient contractility. After estimating that adequate tidal volumes could be achieved through unilateral right diaphragmatic stimulation, bilateral diaphragmatic electrodes were laparoscopically implanted. Diaphragm pacing was initiated on postoperative day one, gradually increasing pacing duration daily while maintaining exertion levels below the Borg scale 4. By day 46 post-implantation, the patient achieved complete independence from mechanical ventilation despite persistent left diaphragmatic paralysis. Enhanced right diaphragmatic function was confirmed by increased diaphragmatic thickness and thickening fraction. Additionally, improved sputum clearance allowed withdrawal from cough-assist therapy and subsequent closure of tracheostomy. At 1-year follow-up, the patient maintained independent respiration without device-related complications. This case highlights the potential efficacy of early diaphragm pacing implantation in patients with high cervical spinal cord injury, demonstrating favorable respiratory outcomes even in the presence of unilateral diaphragmatic dysfunction.</p>","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"13 ","pages":"55-61"},"PeriodicalIF":0.0,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12995512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147488594","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":"Crystal Violet Staining Facilitates Boundary Recognition in the Removal of Spinal Arachnoid Pathology.","authors":"Aya Endo, Hime Suzuki, Sho Matsunaga, Yoshifumi Horita, Masayoshi Takigami, Takahiro Tsuji, Nobuhiro Mikuni, Takeshi Mikami","doi":"10.2176/jns-nmc.2025-0200","DOIUrl":"https://doi.org/10.2176/jns-nmc.2025-0200","url":null,"abstract":"<p><p>Spinal arachnoid cysts are relatively uncommon lesions, broadly classified as either congenital or acquired. Acquired cysts may develop following trauma, hemorrhage, or post-infectious inflammation. Depending on their location, these cysts can cause a range of symptoms, including quadriplegia, pain, sensory disturbances, and gait impairment. Surgical resection may be indicated in cases with significant neurological symptoms. We report the case of a 77-year-old woman who presented with persistent bilateral leg numbness and pain. Magnetic resonance imaging revealed a suspected intradural spinal arachnoid cyst or arachnoid web at the Th7-8 level, and surgery was planned to relieve the symptoms. A laminectomy was performed, revealing a cystic, membrane-like structure in the subdural space. By injecting a crystal violet staining solution into the cyst, we enhanced the visibility of the boundary between the normal arachnoid membrane and the cyst, allowing for complete resection. Postoperatively, the patient experienced improvement in leg pain and numbness. This case demonstrates that crystal violet staining can facilitate clear boundary recognition during arachnoid cyst resection, enabling more precise cyst removal.</p>","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"13 ","pages":"49-54"},"PeriodicalIF":0.0,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12995513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147488879","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":"Direct Carotid Artery Exposure for Mechanical Thrombectomy in a Patient with Marfan Syndrome and Prior Total Arch Replacement.","authors":"Kengo Kishida, Hideki Oka, Keisuke Fuji, Shigeomi Yokoya, Hitoshi Kawano, Hidesato Takezawa","doi":"10.2176/jns-nmc.2025-0276","DOIUrl":"https://doi.org/10.2176/jns-nmc.2025-0276","url":null,"abstract":"<p><p>Marfan syndrome presents unique challenges for mechanical thrombectomy in acute ischemic stroke due to vascular fragility and complex aortic anatomy, often from prior surgeries. We describe the case of a man in his 50s with Marfan syndrome, total aortic arch replacement, mechanical valve replacement, and extensive chronic dissections, who presented with acute ischemic stroke due to right internal carotid artery occlusion. Conventional transfemoral access failed due to anomalous prosthetic brachiocephalic artery graft anatomy. Consequently, mechanical thrombectomy was performed via direct surgical exposure and puncture of the right common carotid artery. Despite initial avoidance of a stent retriever due to Marfan syndrome-related vessel fragility, an stent retriever was ultimately used in a combined technique with aspiration in the third pass, achieving partial recanalization (thrombolysis in cerebral infarction 2a) and retrieval of a fibrin-rich thrombus. This case highlights direct carotid access as a feasible alternative in Marfan syndrome patients with prohibitive conventional access and suggests stent retrievers can be used cautiously.</p>","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"13 ","pages":"63-68"},"PeriodicalIF":0.0,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12995514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147488825","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 Myxoid Glioneuronal Tumor in the Lateral Ventricle.","authors":"Wataru Ueki, Terushige Toyooka, Keisuke Kuboshima, Tetsuya Yamamoto, Kazuya Fujii, Satoru Takeuchi, Arata Tomiyama, Fumihisa Kumazawa, Kimiya Sato, Hideaki Yokoo, Kojiro Wada","doi":"10.2176/jns-nmc.2025-0220","DOIUrl":"10.2176/jns-nmc.2025-0220","url":null,"abstract":"<p><p>Myxoid glioneuronal tumor is a newly included entity in the 2021 World Health Organization classification of central nervous system tumors, based on both pathological and molecular evidence, characterized by platelet-derived growth factor receptor alpha mutations. A 23-year-old female presented with intermittent visual field abnormalities and dizziness. Magnetic resonance imaging revealed a 2-cm mass occupying both foramens of Monro, leading to non-communicating hydrocephalus. Endoscopic surgery via the transcortical approach achieved gross total resection of the tumor. Postoperatively, she developed cognitive dysfunction involving recent memory disturbance and progressive ventricular dilation, necessitating a ventriculoperitoneal shunt, which led to significant cognitive recovery. Histopathological analysis confirmed myxoid glioneuronal tumor with a platelet-derived growth factor receptor alpha p.K385L mutation. A review of 23 cases, including ours, indicates that surgical resection is the preferred treatment and is generally associated with a favorable prognosis. However, recurrence and meningeal dissemination have been reported in some cases, emphasizing the need for long-term follow-up. Myxoid glioneuronal tumor is frequently located close to critical structures like the fornix, so careful surgical planning is essential to balance maximal resection with functional preservation. Endoscopic techniques offer advantages for deep-seated lesions by minimizing cortical damage while allowing adequate tumor resection. Further studies are needed to establish the optimal treatment strategies and clarify the long-term prognosis of myxoid glioneuronal tumor.</p>","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"13 ","pages":"41-47"},"PeriodicalIF":0.0,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12962740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147380230","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":"Reply to the Editor: \"Coil Embolization of a Ruptured Traumatic Pseudoaneurysm of the Middle Meningeal Artery: A Case Report\".","authors":"Naoki Nishizawa, Tomoki Kidani, Shin Nakajima, Yonehiro Kanemura, Katsunori Asai, Nobuyuki Izutsu, Saki Kawamoto, Koji Kobayashi, Mikako Nomoto, Yosuke Fujimi, Masayoshi Kida, Toshiyuki Fujinaka","doi":"10.2176/jns-nmc.2025-0349","DOIUrl":"10.2176/jns-nmc.2025-0349","url":null,"abstract":"","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"13 ","pages":"39-40"},"PeriodicalIF":0.0,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12962736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147380265","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":"Adult Medullary Diffuse Midline Glioma Presenting with Orthostatic Hypotension: A Case Report.","authors":"Mizuho Inoue, Kentaro Mori, Shinichi Numazawa, Sadayoshi Watanabe","doi":"10.2176/jns-nmc.2025-0286","DOIUrl":"10.2176/jns-nmc.2025-0286","url":null,"abstract":"<p><p>Diffuse midline glioma, H3K27-altered, is a rare and aggressive central nervous system tumor that typically affects children, whereas adult cases are uncommon and less well characterized. We report a 43-year-old woman who experienced progressive lightheadedness for 10 months and was diagnosed with orthostatic hypotension on the basis of a positive tilt-table test result. Despite treatment with midodrine, her symptoms worsened, and dysarthria, dysphagia, sensory disturbance, and gait instability later developed. Magnetic resonance imaging confirmed an intra-axial mass in the dorsal medulla oblongata. Partial resection was performed, and histopathological examination with immunohistochemistry confirmed the diagnosis of H3K27-altered diffuse midline glioma. The patient subsequently received adjuvant chemoradiotherapy. Although her motor function improved postoperatively, severe orthostatic hypotension persisted, leading to recurrent syncopal episodes that significantly hindered rehabilitation. The solitary nucleus in the dorsal medulla plays a central role in the baroreflex by relaying sympathetic and parasympathetic signals within the central autonomic network. Disruption of this network by medullary tumors can impair blood pressure regulation, causing orthostatic hypotension. Although orthostatic hypotension has been reported in association with various medullary tumors, gliomas are rarely implicated. To our knowledge, this is the first reported case of medullary diffuse midline glioma presenting with orthostatic hypotension under the current World Health Organization molecular classification. This case highlights the importance of considering brain magnetic resonance imaging in patients with newly developed or severe orthostatic hypotension, particularly when accompanied by neurological symptoms, to enable timely diagnosis and management.</p>","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"13 ","pages":"33-36"},"PeriodicalIF":0.0,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12962737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147380271","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":"Comment on \"Coil Embolization of a Ruptured Traumatic Pseudoaneurysm of the Middle Meningeal Artery: A Case Report\".","authors":"Myoung Soo Kim","doi":"10.2176/jns-nmc.2025-0127","DOIUrl":"10.2176/jns-nmc.2025-0127","url":null,"abstract":"","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"13 ","pages":"37-38"},"PeriodicalIF":0.0,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12962738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147380193","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}