NMC case report journal最新文献_第2页

NMC case report journal Pub Date : 2025-04-01 eCollection Date: 2025-01-01 DOI: 10.2176/jns-nmc.2024-0215

Motoki Ishida, Naoki Shimoya, Hiromi Shibata, Takayuki Ohno, Takashi Iwata, Atsuhito Taishaku, Kentaro Yamada, Shingo Inaguma, Noritaka Aihara

{"title":"Amyloid β-related Angiitis Presenting with Subarachnoid Hemorrhage Diagnosed by Brain Biopsy: A Case Report.","authors":"Motoki Ishida, Naoki Shimoya, Hiromi Shibata, Takayuki Ohno, Takashi Iwata, Atsuhito Taishaku, Kentaro Yamada, Shingo Inaguma, Noritaka Aihara","doi":"10.2176/jns-nmc.2024-0215","DOIUrl":"https://doi.org/10.2176/jns-nmc.2024-0215","url":null,"abstract":"Cerebral amyloid angiopathy is a vascular disorder characterized by amyloid β deposition in leptomeningeal and cortical blood vessels. Rarely, amyloid β accumulation induces inflammatory responses, classified as cerebral amyloid angiopathy-related inflammation or amyloid β-related angiitis, with the latter being extremely rare. We report a case of a 74-year-old woman presenting with visual field disturbance, occipital pain, speech impairment, agraphia, and acalculia. Imaging revealed subarachnoid hemorrhage without an identifiable source on cerebral angiography. Magnetic resonance imaging demonstrated abnormal enhancement in the dura and pia mater of the left temporal and parietal lobes. Brain biopsy confirmed amyloid β-related angiitis, showing histopathological findings of amyloid deposition with granulomatous inflammation. Steroid pulse therapy led to marked clinical and radiological improvement. This case highlights the importance of considering amyloid β-related angiitis in the differential diagnosis of angiographically negative subarachnoid hemorrhage. Early recognition and immunosuppressive therapy are essential to reduce neurological deficits, with brain biopsy providing a definitive diagnosis.","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"12 ","pages":"97-101"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12009643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051285","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

Spinal Chronic Subdural Hematoma Cured by Lumbar Drainage: A Case Report and Literature Review. 腰椎引流治疗脊柱慢性硬膜下血肿1例并文献复习。

NMC case report journal Pub Date : 2025-04-01 eCollection Date: 2025-01-01 DOI: 10.2176/jns-nmc.2024-0210

Jiro Akimoto, Hirokazu Fukuhara, Yuta Nakamura, Yamato Yoshioka, Sho Onodera

{"title":"Spinal Chronic Subdural Hematoma Cured by Lumbar Drainage: A Case Report and Literature Review.","authors":"Jiro Akimoto, Hirokazu Fukuhara, Yuta Nakamura, Yamato Yoshioka, Sho Onodera","doi":"10.2176/jns-nmc.2024-0210","DOIUrl":"https://doi.org/10.2176/jns-nmc.2024-0210","url":null,"abstract":"Chronic spinal subdural hematoma is an extremely rare condition. We recently encountered a case of symptomatic thoracolumbar chronic spinal subdural hematoma in an older patient caused by a fall. The patient was a man in his 80s with a history of cerebral infarction, who was receiving oral antiplatelet therapy. He was hospitalized for conservative treatment for a brain contusion and mild acute subdural hematoma, and was discharged home after 6 days. However, 9 days after the injury, the patient developed back pain, weakness in both lower limbs, and urinary incontinence and was brought to our hospital. A computed tomography scan on admission displayed a high-density area in the thoracolumbar spinal canal, and magnetic resonance imaging 2 weeks after the fall displayed a spinal subdural hematoma from 8th thoracic to sacral 2nd, with a hyperintensity signal on T1weighted image and T2 weighted image and partial low intensity on T2* imaging. On day 22 after the injury, lumbar drainage was performed, and a motor-oil-like hematoma was aspirated. A total of 330 mL of hematoma content was drained for 3 days. Immediately after treatment, the patient's back pain and lower limb weakness improved, and imaging confirmed the disappearance of the spinal subdural hematoma. Most reported cases to date of chronic spinal subdural hematoma were treated with invasive laminectomy for hematoma removal. In the present case, the authors suspected this condition from the late subacute stage of onset and were able to cure the patient with minimum invasive lumbar drainage after diagnosis of liquefaction of the hematoma by magnetic resonance imaging.","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"12 ","pages":"121-125"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12009645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061438","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 Normal-pressure Hydrocephalus Caused by Cauda Equina Capillary Malformation. 马尾毛细血管畸形致常压脑积水1例。

NMC case report journal Pub Date : 2025-04-01 eCollection Date: 2025-01-01 DOI: 10.2176/jns-nmc.2024-0241

Tetsuo Ota, Daisu Abe, Hiroshi Shintaku, Motoki Inaji, Yoji Tanaka, Taketoshi Maehara

{"title":"A Case of Normal-pressure Hydrocephalus Caused by Cauda Equina Capillary Malformation.","authors":"Tetsuo Ota, Daisu Abe, Hiroshi Shintaku, Motoki Inaji, Yoji Tanaka, Taketoshi Maehara","doi":"10.2176/jns-nmc.2024-0241","DOIUrl":"https://doi.org/10.2176/jns-nmc.2024-0241","url":null,"abstract":"Capillary malformations in the central nervous system, especially in the cauda equina, are rare. Although the typical symptoms are lower back pain and motor weakness in the lower extremities, we report here a rare case in which the initial symptom of a capillary malformation in the cauda equina was normal-pressure hydrocephalus. A 67-year-old woman was admitted to our hospital for close examination of hydrocephalus. Imaging studies showed no abnormalities other than an 8-mm intradural extramedullary tumor at the lumbar 2 level. Given lumbar puncture revealed a high protein level and the pressure was within the normal range, we assumed the hydrocephalus was caused by a schwannoma in the cauda equina. Within 7 days after admission, the patient's consciousness level decreased rapidly. Therefore, we immediately placed a ventriculoperitoneal shunt. Nine months after admission, the tumor increased from 8 mm to 12 mm in diameter, and tumor resection was performed. Because intraoperative neuromonitoring revealed that the tumor arose from a motor nerve, and the appearance of the tumor was not that of a typical schwannoma, we decided to remove the tumor subcapsularly. The pathological diagnosis was a capillary malformation. No neurological deficits developed in the patient postoperatively, and the high cerebrospinal fluid protein level normalized after the tumor resection. Although hydrocephalus caused by a capillary malformation in the cauda equina is relatively rare, it should be differentiated, and the strategy for its resection should be considered using the information obtained from preoperative neurological symptoms and intraoperative neuromonitoring.","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"12 ","pages":"103-108"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12009647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059432","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

Spontaneous Regression of Rathke's Cleft Cysts: A Report of Three Cases. Rathke裂隙囊肿自发性消退3例报告。

NMC case report journal Pub Date : 2025-03-07 eCollection Date: 2025-01-01 DOI: 10.2176/jns-nmc.2024-0238

Yumi Kondo, Yasuo Sasagawa, Sho Tamai, Mitsutoshi Nakada

{"title":"Spontaneous Regression of Rathke's Cleft Cysts: A Report of Three Cases.","authors":"Yumi Kondo, Yasuo Sasagawa, Sho Tamai, Mitsutoshi Nakada","doi":"10.2176/jns-nmc.2024-0238","DOIUrl":"10.2176/jns-nmc.2024-0238","url":null,"abstract":"Herein, we present 3 cases of Rathke's cleft cysts that shrank spontaneously within a short period. In addition, we present a literature review, discussing the characteristics and of action mechanisms of rapid Rathke's cleft cyst regression. Case 1 was that in a 17-year-old boy diagnosed with an Rathke's cleft cyst on the basis of magnetic resonance imaging. The Rathke's cleft cysts had expanded to compress the optical chiasm. Therefore, surgical intervention was planned. However, without any medical treatment, magnetic resonance imaging performed 3 months later revealed a spontaneous reduction in size, and surgery was canceled. Case 2 was in a 10-year-old boy who presented with a severe headache. Surgery was planned for a sellar cystic lesion; however, magnetic resonance imaging performed 2 months later revealed spontaneous shrinkage without any treatment. The patient's symptoms disappeared, and the surgery was canceled. Case 3 was in a 25-year-old man who presented with a headache. Magnetic resonance imaging at presentation revealed a cystic lesion in the sella turcica, but repeat magnetic resonance imaging 4 months later revealed spontaneous shrinkage. Fifty-nine cases of spontaneously shrinking Rathke's cleft cysts, initially characterized by severe headache (54.2%), have been reported; of these, 57% of cases were in patients younger than 39 years. Furthermore, 64% of patients showed evidence of cyst reduction on magnetic resonance imaging within 6 months. Type 1-weighted magnetic resonance imaging scans showed isointensity or high signal intensity in 91% of cases. In conclusion, spontaneous shrinkage of Rathke's cleft cysts can occur within a few months. Type 1-weighted images are characterized by high signal intensity, and episodic headaches may indicate shrinkage. The possibility of short-term regression of Rathke's cleft cyst should be considered before scheduled surgery.","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"12 ","pages":"79-84"},"PeriodicalIF":0.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733856","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 Rare Case of Giant Congenital/Infant-type Hemispheric Glioma Harboring Concomitant ALK and EGFR Alteration. 巨大先天性/婴儿型半球胶质瘤伴ALK和EGFR改变1例。

NMC case report journal Pub Date : 2025-03-07 eCollection Date: 2025-01-01 DOI: 10.2176/jns-nmc.2023-0286

Derya Karatas, Saygi Uygur, Irmak Tekeli Barut, Hamide Sayar, Ahmet Dagtekin, Emel Avci

{"title":"A Rare Case of Giant Congenital/Infant-type Hemispheric Glioma Harboring Concomitant ALK and EGFR Alteration.","authors":"Derya Karatas, Saygi Uygur, Irmak Tekeli Barut, Hamide Sayar, Ahmet Dagtekin, Emel Avci","doi":"10.2176/jns-nmc.2023-0286","DOIUrl":"10.2176/jns-nmc.2023-0286","url":null,"abstract":"Infant-type hemispheric glioma is a subtype of pediatric high-grade glioma that is seen among those under the age of 3-5 years and congenital infant-type hemispheric gliomas are another subtype which is seen among those under 6 months of age. The molecular features and overall survival of infant-type hemispheric gliomas are distinct from those of pediatric and adult high-grade gliomas. The present study reports a fraternal twin case of a giant hemispheric infant-type hemispheric glioma diagnosed at the age of 2 months and treated with gross total resection. Even though the Ki-67 proliferative index of the tumor was 70%, she has been surviving for 4 years. After molecular analysis, the first case of infant-type hemispheric glioma that had concurrent echinoderm microtubule-associated protein-like 4::anaplastic lymphoma kinase gene fusion and an A269V point mutation on exon 7 in epidermal growth factor receptor gene was identified. Among echinoderm microtubule-associated protein-like 4::anaplastic lymphoma kinase gene fusion cases, the present study presents a rare twin case of giant infant-type hemispheric glioma that has a long recurrence-free survival without radiation or targeted therapy. In contrast, the neurocognitive test results of this case at the age of 4 years corresponded to 12-15 months of age.","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"12 ","pages":"73-78"},"PeriodicalIF":0.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733854","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

Combined Transcranial and Endonasal Approach for Clipping of a Partially Thrombosed Giant Aneurysm of the Lower Basilar Artery. 经颅鼻内联合入路夹闭部分血栓形成的基底动脉下段巨大动脉瘤。

NMC case report journal Pub Date : 2025-03-07 eCollection Date: 2025-01-01 DOI: 10.2176/jns-nmc.2024-0240

Ryohei Saito, Takeshi Mikami, Yukinori Akiyama, Katsuya Komatsu, Yasuhiro Takahashi, Ayumu Yamaoka, Sho Matsunaga, Nobuhiro Mikuni

{"title":"Combined Transcranial and Endonasal Approach for Clipping of a Partially Thrombosed Giant Aneurysm of the Lower Basilar Artery.","authors":"Ryohei Saito, Takeshi Mikami, Yukinori Akiyama, Katsuya Komatsu, Yasuhiro Takahashi, Ayumu Yamaoka, Sho Matsunaga, Nobuhiro Mikuni","doi":"10.2176/jns-nmc.2024-0240","DOIUrl":"10.2176/jns-nmc.2024-0240","url":null,"abstract":"The conventional transcranial approach for treating lower basilar artery aneurysms is challenging because the deep and narrow surgical field limits surgical maneuvering for clipping. We report a case of a 77-year-old female who presented with right hemiparesis caused by a partially thrombosed giant aneurysm in her lower basilar artery. We performed neck clipping and thrombus debulking using a combined transcranial and endonasal approach. This approach enabled us to secure the parent artery from the endonasal side, which is difficult to achieve with the transcranial approach alone. It also allowed for early thrombus removal, thereby widening the surgical field on the transcranial side. Additionally it compensated for the transcranial blind spot by observing the clip tip from the endonasal side. After surgery, the patient required 3 months of rehabilitation for residual right hemiparesis before being discharged. Follow-up imaging revealed a reduction in the size of the partially thrombosed aneurysm. To our knowledge, this is the first report of a combined transcranial and endonasal approach for the treatment of a basilar artery aneurysm. For lower basilar artery aneurysms, this combined approach may offer advantages in achieving safe parent artery control, thrombus debulking, and neck clipping.","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"12 ","pages":"59-64"},"PeriodicalIF":0.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733855","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

Verbal Memory Localized in Non-language-dominant Hemisphere: Atypical Lateralization Revealed by Material-specific Memory Evaluation Using Super-selective Wada Test. 语言记忆定位于非语言优势半球：利用超选择性Wada测试的材料特异性记忆评价揭示的非典型偏侧化。

NMC case report journal Pub Date : 2025-03-07 eCollection Date: 2025-01-01 DOI: 10.2176/jns-nmc.2024-0217

Hana Kikuchi, Shin-Ichiro Osawa, Kazuo Kakinuma, Shoko Ota, Kazuto Katsuse, Kazushi Ukishiro, Kazutaka Jin, Hidenori Endo, Nobukazu Nakasato, Kyoko Suzuki

{"title":"Verbal Memory Localized in Non-language-dominant Hemisphere: Atypical Lateralization Revealed by Material-specific Memory Evaluation Using Super-selective Wada Test.","authors":"Hana Kikuchi, Shin-Ichiro Osawa, Kazuo Kakinuma, Shoko Ota, Kazuto Katsuse, Kazushi Ukishiro, Kazutaka Jin, Hidenori Endo, Nobukazu Nakasato, Kyoko Suzuki","doi":"10.2176/jns-nmc.2024-0217","DOIUrl":"10.2176/jns-nmc.2024-0217","url":null,"abstract":"Hippocampectomy is effective for drug-resistant mesial temporal lobe epilepsy with hippocampal sclerosis. However, multiple studies have reported high risks associated with hippocampectomy in patients with mesial temporal lobe epilepsy without hippocampal sclerosis on magnetic resonance imaging and in those with preserved memory function. Verbal memory and language functions are believed to coexist in the same hemisphere. We present a case of left mesial temporal lobe epilepsy with atypical memory function lateralization revealed by super-selective infusion of propofol to the intracranial artery (super-selective Wada test). A 24-year-old right-handed man with drug-resistant focal impaired awareness seizures was diagnosed with left mesial temporal lobe epilepsy without hippocampal sclerosis, but he showed preserved verbal intelligence quotient and memory, suggesting a high risk of severe memory decline after hippocampectomy. We performed super-selective Wada test to the posterior cerebral artery to assess the lateralization of verbal and visual memory separately, and to the middle cerebral artery to assess language function. The results revealed right-sided dominance for both verbal and visual memory, although the language was left-dominant. Hippocampectomy was performed and resulted in freedom from seizures. Memory assessments 1 year postoperatively showed no decline in all subtests. In patients with drug-resistant epilepsy exhibiting atypical neuropsychological profiles, the memory-dominant, and language-dominant hemispheres may not align; detailed evaluations of function lateralization are necessary for tailored treatment.","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"12 ","pages":"65-71"},"PeriodicalIF":0.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732906","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

Symptomatic Improvement after Surgical Transposition of an Extremely Medialized Carotid Artery Causing Swallowing Discomfort: A Case Report. 极度内侧化颈动脉手术转位引起吞咽不适后的症状改善：一例报告。

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

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

Successful Endoscopic Resection of a Chronic Expanding Hematoma Following Gamma Knife Surgery for Cerebral Arteriovenous Malformation: A Case Report. 颅脑动静脉畸形伽玛刀手术后慢性扩张性血肿内镜切除成功一例。

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