NMC case report journal最新文献_第2页

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

Shunt Dependency Syndrome Combined with Sinus Stenosis after Cyst-peritoneal Shunting of Arachnoid Cyst: A 20-year Rare Complication.

NMC case report journal Pub Date : 2024-12-25 eCollection Date: 2024-01-01 DOI: 10.2176/jns-nmc.2024-0147

Mengying Chen, Mengyuan Zhang, Hong Sun, Huiyang Qu, Yuxuan Cheng, Jiaxin Fan, Qingling Yao, Xiaodong Zhang, Shuyin Ma, Shuqin Zhan

{"title":"Shunt Dependency Syndrome Combined with Sinus Stenosis after Cyst-peritoneal Shunting of Arachnoid Cyst: A 20-year Rare Complication.","authors":"Mengying Chen, Mengyuan Zhang, Hong Sun, Huiyang Qu, Yuxuan Cheng, Jiaxin Fan, Qingling Yao, Xiaodong Zhang, Shuyin Ma, Shuqin Zhan","doi":"10.2176/jns-nmc.2024-0147","DOIUrl":"10.2176/jns-nmc.2024-0147","url":null,"abstract":"Shunt dependence syndrome is a serious long-term complication characterized by symptoms and signs of increased intracranial pressure with normal-sized lateral ventricles after several years of arachnoid cyst-peritoneal shunting. It is easy to misdiagnose and overlook when combined with sinus stenosis, thus delaying treatment. Here, we present a 35-year-old man with an unexplained headache and binocular horizontal diplopia with high intracranial pressure. Based on stenosis of the right transverse sinus and absent filling of the left transverse sinus found by cerebral angiography, we first suspected cerebral venous sinus thrombosis (CVST). However, the treatment of anticoagulation and enhanced dehydration did not work. Twenty years ago, he had a cyst-peritoneal (CP) shunt performed for an asymptomatic arachnoid cyst. Finally, neurosurgeons ruled out CVST by direct retrograde cerebral venography and diagnosed shunt dependence syndrome. All his symptoms resolved well after ventriculoperitoneal (VP) shunt treatment. This case reminds pediatrics and neurology colleagues to consider shunt dependence syndrome first when someone has a history of CP shunting of arachnoid cysts presented with a severe headache, even if imaging shows a thin or occlusive venous sinus. Once high intracranial pressure secondary to shunt dependence is diagnosed, timely reconstruction of the cerebrospinal fluid (CSF) pathway is recommended rather than osmotic therapies because cerebral herniation formation will be life-threatening if ongoing increased intracranial pressure is not relieved.","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"11 ","pages":"389-394"},"PeriodicalIF":0.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030530","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

Three Years of Progression-free after Biopsy of BRAF V600E-negative Ganglioglioma in the Adult Brainstem: A Case Report and the Literature Review.

NMC case report journal Pub Date : 2024-12-25 eCollection Date: 2024-01-01 DOI: 10.2176/jns-nmc.2024-0189

Toshiki Ishikura, Seiichiro Hirono, Masayuki Ota, Daiki Yokoyama, Masayoshi Kobayashi, Tomoo Matsutani, Yasuo Iwadate

{"title":"Three Years of Progression-free after Biopsy of BRAF V600E-negative Ganglioglioma in the Adult Brainstem: A Case Report and the Literature Review.","authors":"Toshiki Ishikura, Seiichiro Hirono, Masayuki Ota, Daiki Yokoyama, Masayoshi Kobayashi, Tomoo Matsutani, Yasuo Iwadate","doi":"10.2176/jns-nmc.2024-0189","DOIUrl":"10.2176/jns-nmc.2024-0189","url":null,"abstract":"Ganglioglioma, a glioneuronal neoplasm, typically presents in adolescents' temporal lobes. While pediatric brainstem gangliogliomas (BSGGs) are well documented, adult BSGGs are limited, resulting in a lack of comprehensive understanding of their pathophysiology and prognosis. A 41-year-old woman who presented with dizziness and numbness in her right upper extremity and right face underwent radiological examination. A dorsally exophytic tumor in the medulla oblongata was identified. Moderate uptake of 11C-methionine on positron emission tomography suggests a low-grade glioma. Histopathological evaluation, following a suboccipital craniotomy and biopsy under neuromonitoring, confirmed the tumor as a mix of neoplastic ganglion cells and glial cells, which exhibited immunoreactivity for chromogranin A and OLIG2, respectively. Eosinophilic granular bodies and Rosenthal fibers were also observed. These findings confirmed the diagnosis of a ganglioglioma. The BRAF V600E mutation tested negative by real-time polymerase chain reaction. No postoperative adjuvant treatment was administered, and no progression of the residual tumor was noted 34 months post-surgery. Increased reporting of adult BSGGs, complete with detailed radiological, molecular, and genetic profiles, as well as their clinical course, is essential for clarifying our understanding of this rare entity's oncogenic pathway, optimal management strategy, and prognosis.","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"11 ","pages":"427-433"},"PeriodicalIF":0.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030658","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

Non-convulsive Status Epilepticus as a Potentially Under-recognised Cause of Consciousness Disturbance Following Mechanical Thrombectomy: A Case Report.

NMC case report journal Pub Date : 2024-12-25 eCollection Date: 2024-01-01 DOI: 10.2176/jns-nmc.2024-0181

Kiichi Yanagisawa, Takuya Saito, Tatsuhito Ishii, Keishiro Sato, Kazunari Homma, Yoshiyuki Kondo

引用次数: 0

Syringomyelia with Central Canal Enlargement Caused by Postoperative Inflammation after Surgery for Intradural Lumbar Disc Herniation.

NMC case report journal Pub Date : 2024-12-25 eCollection Date: 2024-01-01 DOI: 10.2176/jns-nmc.2024-0165

Hiroki Hagizawa, Yu Moriguchi, Tomonori Yamada, Masafumi Kashii

{"title":"Syringomyelia with Central Canal Enlargement Caused by Postoperative Inflammation after Surgery for Intradural Lumbar Disc Herniation.","authors":"Hiroki Hagizawa, Yu Moriguchi, Tomonori Yamada, Masafumi Kashii","doi":"10.2176/jns-nmc.2024-0165","DOIUrl":"10.2176/jns-nmc.2024-0165","url":null,"abstract":"Intradural lumbar disc herniation (ILDH) is a very rare condition, with cerebrospinal fluid (CSF) leakage as a postoperative complication. The central canal of the conus medullaris was reported to communicate with the subarachnoid space through a caudal aperture; however, this aperture has never been observed in vivo. Herein, we report a case of L1/2 ILDH with postoperative spinal adhesive arachnoiditis and syringomyelia in which the communication considered to be a caudal aperture was detected. A 67-year-old woman complained of acute lower back pain and right leg pain with muscle weakness. Magnetic resonance imaging (MRI) revealed a large mass in the spinal canal at the L1/2 level. Intraoperatively, no herniated fragments were found in the epidural space. Thus, ILDH was suspected, and an intradural examination revealed tightly adherent herniated fragments in the swollen cauda equina and surrounding neovascularization. Postoperatively, symptoms improved once; however, 3 months later, severe bilateral leg muscle weakness and urinary retention developed. She was diagnosed with postoperative syringomyelia by MRI, and myelography and follow-up computed tomography was performed. Immediately after the administration of nonionic contrast agents, the syrinx of conus and epiconus were delineated through the central canal, and the communication between the central canal and the subarachnoid space could be visualized. Symptoms improved after syringo-subarachnoid shunt and duroplasty. It is likely that when CSF perfusion was impaired because of adhesive arachnoiditis around the conus medullaris, the central canal, which had been obstructed with growth, reopened, and the patient presented with syringomyelia.","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"11 ","pages":"421-425"},"PeriodicalIF":0.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030629","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

Two Postmortem Cases of Moyamoya Disease with Different RNF213 p.R4810K Variant Statuses.

NMC case report journal Pub Date : 2024-12-25 eCollection Date: 2024-01-01 DOI: 10.2176/jns-nmc.2024-0134

Tomo Kinoshita, Natsumi Tamada, Shoko Hara, Maki Mukawa, Hiroshi Shintaku, Motoki Inaji, Yoji Tanaka, Tadashi Nariai, Taketoshi Maehara

{"title":"Two Postmortem Cases of Moyamoya Disease with Different RNF213 p.R4810K Variant Statuses.","authors":"Tomo Kinoshita, Natsumi Tamada, Shoko Hara, Maki Mukawa, Hiroshi Shintaku, Motoki Inaji, Yoji Tanaka, Tadashi Nariai, Taketoshi Maehara","doi":"10.2176/jns-nmc.2024-0134","DOIUrl":"10.2176/jns-nmc.2024-0134","url":null,"abstract":"Moyamoya disease (MMD) is characterized by distinct histopathological changes in intracranial arteries, such as narrowing of the arterial lumen due to thickening of the tunica intima, waving of the internal elastic membranes, and thinning of the tunica media. Ring finger protein 213 (RNF213) is a susceptibility gene for MMD that affects clinical outcomes. However, little is known about its relationship with histopathology. Herein, we present the postmortem histopathological evaluation of 2 MMD cases with and without RNF213 p.R4810K variant. The first patient was a 39-year-old female, with a history of undergoing bilateral indirect revascularization at the age of 10 years, who died from brainstem ischemic stroke. The second patient was a 32-year-old female who was conservatively treated from the age of 14 years but died from intraventricular hemorrhage. Postmortem analysis revealed that the first patient had a homozygous variant, whereas the second patient lacked this variant. Both cases exhibited similar advanced stages of MMD with posterior artery involvement on magnetic resonance angiography. However, compared with the second patient without the RNF213 p.R4810K variant, the first patient with this homozygous variant showed more prominent histopathological changes, such as narrowing of the arterial lumen due to thickening of the tunica intima, waving of the internal elastic membranes, and thinning of the tunica media. Although an accumulation of cases is required to draw a definite conclusion, these cases suggest that RNF213 p.R4810K variant status may affect the vascular histopathology of MMD and its clinical outcome.","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"11 ","pages":"413-419"},"PeriodicalIF":0.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030661","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

Anterior Cerebral Artery Fusiform Aneurysm Attributable to Bilateral Persistent Primitive Olfactory Artery: Case Report.

NMC case report journal Pub Date : 2024-12-25 eCollection Date: 2024-01-01 DOI: 10.2176/jns-nmc.2024-0156

Miku Tsuruya, Kenta Koketsu, Kyongsong Kim, Minoru Ideguchi, Hiroyuki Dan, Yasuo Murai

{"title":"Anterior Cerebral Artery Fusiform Aneurysm Attributable to Bilateral Persistent Primitive Olfactory Artery: Case Report.","authors":"Miku Tsuruya, Kenta Koketsu, Kyongsong Kim, Minoru Ideguchi, Hiroyuki Dan, Yasuo Murai","doi":"10.2176/jns-nmc.2024-0156","DOIUrl":"10.2176/jns-nmc.2024-0156","url":null,"abstract":"Persistent primitive olfactory arteries (PPOAs) are a rare variant of the anterior cerebral artery (ACA). Cerebral aneurysms may arise in the PPOA; most are saccular and on the unilateral PPOA. We report a 66-year-old male with bilateral PPOAs and a fusiform aneurysm on the left side detected at a health check-up. A brain magnetic resonance imaging (MRI) scan revealed a fusiform dilation in the proximal portion of the left ACA on a brain MRI. Good surgical results were obtained by combining trapping-and bonnet bypass surgery. Brain MRI and cerebral angiograms showed bilateral PPOAs and a fusiform aneurysm with the pearl-and-string sign in the proximal portion of the left PPOA. The aneurysm was trapped and a bonnet bypass using a radial artery (RA) graft was placed between the left superficial temporal artery and the distal portion of the left PPOA. The postoperative course was uneventful and 30 months after surgery he had no neurological symptoms; MRA showed no recurrence. In this patient, aneurysmal trapping and an A3-A3 bypass were an option, however, it would have placed an additional load on the right PPOA. Our decision to trap the aneurysm and perform bonnet bypass surgery using an RA graft led to success.","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"11 ","pages":"401-405"},"PeriodicalIF":0.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029898","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