Journal of Neurosurgery: Case Lessons最新文献_第10页

Trigeminal neuralgia secondary to vascular compression and neurocysticercosis: illustrative case. 继发于血管压迫和脑囊虫病的三叉神经痛：例证性病例。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-05-22 DOI: 10.3171/CASE23127

Mao Vásquez, Luis J Saavedra, Hector H García, Evelyn Vela, Jorge E Medina, Miguel Lozano, Carlos Hoyos, William W Lines-Aguilar

{"title":"Trigeminal neuralgia secondary to vascular compression and neurocysticercosis: illustrative case.","authors":"Mao Vásquez, Luis J Saavedra, Hector H García, Evelyn Vela, Jorge E Medina, Miguel Lozano, Carlos Hoyos, William W Lines-Aguilar","doi":"10.3171/CASE23127","DOIUrl":"10.3171/CASE23127","url":null,"abstract":"Background: Trigeminal neuralgia (TN) is a frequent neurosurgical problem negatively influencing the quality of life of patients. The standard surgical treatment is microvascular decompression for primary cases and decompression of the mass effect, mainly tumors, for secondary cases. Neurocysticercosis (NCC) in the cerebellopontine angle is a rare etiology of TN. The authors report a case in which NCC cysts around the trigeminal nerve coexisted with a vascular loop, which compressed the exit of the trigeminal nerve from the pons.Observations: A 78-year-old woman presented with a 3-year history of persistent severe pain in the left side of her face, refractory to medical treatment. On gadolinium-enhanced magnetic resonance imaging, cystic lesions were observed around the left trigeminal nerve and a vascular loop was also present and in contact with the nerve. A retrosigmoid approach for cyst excision plus microvascular decompression of the trigeminal nerve was successfully performed. There were no complications. The patient was discharged without facial pain.Lessons: Albeit rare, TN secondary to NCC cysts should be considered in the differential diagnosis in NCC-endemic regions. In this case, the cause of the neuralgia was probably both problems, because when both were treated, the patient improved.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"5 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f1/37/CASE23127.PMC10550649.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9498542","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: 1

Etiology of spastic foot drop among 16 patients undergoing electrodiagnostic studies: patient series. 16例接受电诊断研究的患者痉挛性足下垂的病因：患者系列。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-05-22 DOI: 10.3171/CASE23154

Lisa B E Shields, Vasudeva G Iyer, Yi Ping Zhang, Christopher B Shields

{"title":"Etiology of spastic foot drop among 16 patients undergoing electrodiagnostic studies: patient series.","authors":"Lisa B E Shields, Vasudeva G Iyer, Yi Ping Zhang, Christopher B Shields","doi":"10.3171/CASE23154","DOIUrl":"10.3171/CASE23154","url":null,"abstract":"Background: Differentiating foot drop due to upper motor neuron (UMN) lesions from that due to lower motor neuron lesions is crucial to avoid unnecessary surgery or surgery at the wrong location. Electrodiagnostic (EDX) studies are useful in evaluating patients with spastic foot drop (SFD).Observations: Among 16 patients with SFD, the cause was cervical myelopathy in 5 patients (31%), cerebrovascular accident in 3 (18%), hereditary spastic paraplegia in 2 (12%), multiple sclerosis in 2 (12%), chronic cerebral small vessel disease in 2 (12%), intracranial meningioma in 1 (6%), and diffuse brain injury in 1 (6%). Twelve patients (75%) had weakness of a single leg, whereas 2 others (12%) had bilateral weakness. Eleven patients (69%) had difficulty walking. The deep tendon reflexes of the legs were hyperactive in 15 patients (94%), with an extensor plantar response in 9 patients (56%). Twelve patients (75%) had normal motor and sensory conduction, 11 of whom had no denervation changes of the legs.Lessons: This study is intended to raise awareness among surgeons about the clinical features of SFD. EDX studies are valuable in ruling out peripheral causes of foot drop, which encourages diagnostic investigation into a UMN source for the foot drop.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"5 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fd/fb/CASE23154.PMC10550648.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9505788","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

Missed pituitary microadenoma during endoscopic transsphenoidal surgery for short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing with symptom relief: illustrative case. 内窥镜经蝶窦手术治疗短暂单侧神经痛性头痛期间遗漏的垂体微腺瘤，结膜注射和撕裂症状缓解：一例说明性病例。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-05-22 DOI: 10.3171/CASE23119

Juan Silvestre G Pascual, Madeleine de Lotbiniere-Bassett, Katrina Hannah D Ignacio, David Ben-Israel, Jessica M Clark, Yves P Starreveld

{"title":"Missed pituitary microadenoma during endoscopic transsphenoidal surgery for short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing with symptom relief: illustrative case.","authors":"Juan Silvestre G Pascual, Madeleine de Lotbiniere-Bassett, Katrina Hannah D Ignacio, David Ben-Israel, Jessica M Clark, Yves P Starreveld","doi":"10.3171/CASE23119","DOIUrl":"10.3171/CASE23119","url":null,"abstract":"Background: Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) is a rare headache disorder that has been associated with pituitary adenomas. Resection has been posited to be curative.Observations: A 60-year-old female presented with a 10-year history of SUNCT, which had been medically refractory. Sellar magnetic resonance imaging (MRI) showed a 2 × 2 mm nodule in the right anterolateral aspect of the pituitary. Endoscopic endonasal transsphenoidal resection of the pituitary microadenoma with neuronavigation was performed. The patient felt immediate relief from the headaches. Postoperative MRI showed persistence of the pituitary microadenoma and the resection tract to be inferomedial to the lesion. The right middle and partial superior turbinectomy site was close to the sphenopalatine foramen (SPF). The patient was discharged on postoperative day 1 and remained headache-free without any medications at the 4-month follow-up.Lessons: Resection of pituitary lesions associated with SUNCT may not necessarily be the cause of SUNCT resolution. Manipulation of the middle and superior turbinate close to the SPF may lead to a pterygopalatine ganglion block. This may be the mechanism of cure for SUNCT in patients with related pituitary lesions who undergo endonasal resection.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"5 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4a/1a/CASE23119.PMC10550646.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9876181","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

Pneumorrhachis and pneumocephalus resulting from pneumothorax: illustrative case. 肺出血和肺炎球菌性脑出血：一个例证性病例。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-05-15 DOI: 10.3171/CASE23129

Davaine Joel Ndongo Sonfack, Bilal Tarabay, Jesse Shen, Zhi Wang, Ghassan Boubez, Daniel Shédid, Sung-Joo Yuh

{"title":"Pneumorrhachis and pneumocephalus resulting from pneumothorax: illustrative case.","authors":"Davaine Joel Ndongo Sonfack, Bilal Tarabay, Jesse Shen, Zhi Wang, Ghassan Boubez, Daniel Shédid, Sung-Joo Yuh","doi":"10.3171/CASE23129","DOIUrl":"10.3171/CASE23129","url":null,"abstract":"Background: Pneumorrhachis and pneumocephalus are rare conditions in which air is found within the spinal canal and brain, respectively. It is mostly asymptomatic and can be located in the intradural or extradural space. Intradural pneumorrhachis should prompt clinicians to search and treat any underlying injury of the skull, chest, or spinal column.Observations: A 68-year-old man presented with a history of cardiopulmonary arrest together with pneumorrhachis and pneumocephalus following a recurrent pneumothorax. The patient reported acute headaches with no other neurological symptoms. He was managed conservatively with bed rest for 48 hours following thoracoscopic talcage of his pneumothorax. Follow-up imaging showed regression of the pneumorrhachis, and the patient reported no other neurological symptoms.Lessons: Pneumorrhachis is an incidental radiological finding that self-resolves with conservative management. However, it can be a complication resulting from a serious injury. Therefore, close monitoring of neurological symptoms and complete investigations should be performed in patients with pneumorrhachis.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"5 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e7/ce/CASE23129.PMC10550525.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9497574","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 silent corticotroph adenoma: making the case for a pars intermedia origin. Illustrative case. 一种无症状的促皮质激素腺瘤：为中间部起源提供理由。说明性案例。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-05-15 DOI: 10.3171/CASE2350

Mohammad Bilal Alsavaf, Kyle C Wu, Guilherme Finger, Eman H Salem, Maria Jose Castello Ruiz, Saniya S Godil, Luma Ghalib, Ricardo L Carrau, Daniel M Prevedello

{"title":"A silent corticotroph adenoma: making the case for a pars intermedia origin. Illustrative case.","authors":"Mohammad Bilal Alsavaf, Kyle C Wu, Guilherme Finger, Eman H Salem, Maria Jose Castello Ruiz, Saniya S Godil, Luma Ghalib, Ricardo L Carrau, Daniel M Prevedello","doi":"10.3171/CASE2350","DOIUrl":"10.3171/CASE2350","url":null,"abstract":"Background: Silent corticotroph adenomas (SCAs) are the only pituitary adenomas thought to originate from the pars intermedia. This case report presents the rare finding of a multimicrocystic corticotroph macroadenoma displacing the anterior and posterior lobes of the pituitary gland on magnetic resonance imaging (MRI). This finding supports the hypothesis that silent corticotroph adenomas may originate from the pars intermedia and should be considered in the differential for tumors arising from this location.Observations: A 55-year-old man presented with an episode of confusion and blurred vision. MRI demonstrated separation of the anterior and posterior glands by a solid-cystic lesion located within the pars intermedia that superiorly displaced the optic chiasm. Endocrinologic evaluation was unremarkable. The differential diagnosis included pituitary adenoma, Rathke cleft cyst, and craniopharyngioma. The tumor was confirmed to be an SCA on pathology and was completely removed through the endoscopic endonasal transsphenoidal approach.Lessons: The case highlights the importance of preoperative screening for subclinical hypercortisolism for tumors arising from this location. Knowledge of a patient's preoperative functional status is critical and dictates their postoperative biochemical assessment to determine remission. The case also illustrates surgical strategies for resecting pars intermedia lesions without injuring the gland.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"5 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e2/41/CASE2350.PMC10550526.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9497569","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

Collateral circulation status-guided mechanical thrombectomy in pediatric stroke with an extended ghost infarct core: illustrative case. 侧支循环状态指导下的机械血栓切除术治疗小儿脑卒中伴扩大性重影梗死核心：一个例证性病例。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-05-15 DOI: 10.3171/CASE22404

Tian-Min Lai, Kun-Xin Lin, Ying Fu, Ling Fang, Wen-Long Zhao

{"title":"Collateral circulation status-guided mechanical thrombectomy in pediatric stroke with an extended ghost infarct core: illustrative case.","authors":"Tian-Min Lai, Kun-Xin Lin, Ying Fu, Ling Fang, Wen-Long Zhao","doi":"10.3171/CASE22404","DOIUrl":"10.3171/CASE22404","url":null,"abstract":"Background: Mechanical thrombectomy (MT) has been proved to be a highly effective therapy to treat acute ischemic stroke due to large vessel occlusion. Often, the ischemic core extent on baseline imaging is an important determinant for endovascular treatment eligibility. However, computed tomography (CT) perfusion (CTP) or diffusion-weighted imaging may overestimate the infarct core on admission and, consequently, smaller infarct lesions called \"ghost infarct cores.\"Observations: A 4-year-old, previously healthy boy presented with acute-onset, right-sided weakness and aphasia. Fourteen hours after the onset of symptoms, the patient presented with a National Institutes of Health Stroke Scale (NIHSS) score of 22, and magnetic resonance angiography demonstrated a left middle cerebral artery occlusion. MT was not considered because of a large infarct core (infarct core volume: 52 mL; mismatch ratio 1.6 on CTP). However, multiphase CT angiography indicated good collateral circulation, which encouraged MT. Complete recanalization was achieved via MT at 16 hours after the onset of symptoms. The child's hemiparesis improved. Follow-up magnetic resonance imaging was nearly normal and showed that the baseline infarct lesion was reversible, in agreement with neurological improvement (NIHSS score 1).Lessons: The selection of pediatric stroke with a delayed time window guided by good collateral circulation at baseline seems safe and efficacious, which suggests a promising value of vascular window.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"5 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/36/d3/CASE22404.PMC10550523.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9500811","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

Technical advantages of a novel flow diverter in complex flow diversion: patient series. 新型分流器在复杂导流中的技术优势：患者系列。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-05-15 DOI: 10.3171/CASE2374

Catherine Lei, Cody Heskett, Lane Fry, Aaron Brake, Frank A De Stefano, Jeremy Peterson, Koji Ebersole

{"title":"Technical advantages of a novel flow diverter in complex flow diversion: patient series.","authors":"Catherine Lei, Cody Heskett, Lane Fry, Aaron Brake, Frank A De Stefano, Jeremy Peterson, Koji Ebersole","doi":"10.3171/CASE2374","DOIUrl":"10.3171/CASE2374","url":null,"abstract":"Background: The Surpass Streamline flow diverter (SSFD) possesses 4 attributes that may offer an important advantage in the treatment of complex pathologies: (1) utilization of an over-the-wire (OTW) delivery system, (2) greater device length, (3) larger potential diameter, and (4) propensity to open in tortuosity.Observations: Case 1 leveraged device diameter to embolize a large, recurrent vertebral artery aneurysm. Angiography at 1 year posttreatment showed complete occlusion with a patent SSFD. Case 2 leveraged device length and opening in tortuosity to manage a symptomatic 20-mm cavernous carotid aneurysm. Magnetic resonance imaging at 2 years demonstrated aneurysm thrombosis and patent stents. Case 3 utilized diameter, length, and the OTW delivery system to treat a giant intracranial aneurysm previously treated with surgical ligation and a high-flow bypass procedure. Angiography at 5 months postprocedure demonstrated the return of laminar flow, as the vein graft had healed around the stent construct. Case 4 used diameter, length, and the OTW system to treat a giant, symptomatic, dolichoectatic vertebrobasilar aneurysm. Twelve-month follow-up imaging revealed a patent stent construct with no change to the aneurysm size.Lessons: Increased awareness of the unique attributes of the SSFD may allow a larger number of cases to be treated with the proven mechanism of flow diversion.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"5 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/51/3a/CASE2374.PMC10550524.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9497571","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

Brain and lung metastasis of uterine leiomyosarcoma: illustrative case. 子宫平滑肌肉瘤的脑和肺转移：一个例证性病例。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-05-08 DOI: 10.3171/CASE22557

Hunter Richards, Samir Alsalek, Azim Laiwalla, Mark Attiah, Maya Harary, Wi Jin Kim, Daniel Hirt, Shayan U Rahman

{"title":"Brain and lung metastasis of uterine leiomyosarcoma: illustrative case.","authors":"Hunter Richards, Samir Alsalek, Azim Laiwalla, Mark Attiah, Maya Harary, Wi Jin Kim, Daniel Hirt, Shayan U Rahman","doi":"10.3171/CASE22557","DOIUrl":"10.3171/CASE22557","url":null,"abstract":"Background: Uterine leiomyosarcoma is a rare, extremely aggressive tumor with a high rate of metastasis. Five-year survival for individuals with metastatic disease is only 10%-15%. Metastases to the brain are exceptionally rare and are associated with poor survival.Observations: The authors report a case of uterine leiomyosarcoma that metastasized to the brain in a 51-year-old woman. A single lesion on magnetic resonance imaging was discovered in the right posterior temporo-occipital region 44 months after resection of the primary uterine tumor. The patient underwent a right occipital craniotomy with gross-total resection of the tumor and is receiving adjuvant stereotactic radiosurgery and chemotherapy with gemcitabine and docetaxel. At 8 months postresection, the patient remains alive and asymptomatic with no sign of recurrence. A literature review of prior reported cases was conducted to analyze patterns of approach to patient treatment and survival.Lessons: The authors found an apparent survival benefit in patients receiving adjuvant radiation therapy.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"5 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0c/95/CASE22557.PMC10550687.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9801452","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

Radial nerve myofibroma: a rare benign tumor with perineural infiltration. Illustrative case. 桡神经肌原纤维瘤：一种罕见的伴有神经周围浸润的良性肿瘤。说明性案例。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-05-08 DOI: 10.3171/CASE23115

Kitty Y Wu, David J Cook, Kimberly K Amrami, Robert J Spinner

{"title":"Radial nerve myofibroma: a rare benign tumor with perineural infiltration. Illustrative case.","authors":"Kitty Y Wu, David J Cook, Kimberly K Amrami, Robert J Spinner","doi":"10.3171/CASE23115","DOIUrl":"10.3171/CASE23115","url":null,"abstract":"Background: Myofibromas are benign mesenchymal tumors, classically presenting in infants and young children in the head and neck region. Perineural involvement, especially in peripheral nerves within the upper extremity, is extremely rare in myofibromas.Observations: The authors present the case of a 16-year-old male with a 4-month history of an enlarging forearm mass and rapidly progressive dense motor weakness in wrist, finger, and thumb extension. Preoperative imaging and fine needle biopsy confirmed the diagnosis of a benign isolated myofibroma. Given the dense paralysis, operative management was indicated, and intraoperative exploration showed extensive involvement of tumor within the radial nerve. The infiltrated nerve segment was excised along with the tumor, and the resulting 5-cm nerve gap was reconstructed using autologous cabled grafts.Lessons: Perineural pseudoinvasion can be an extremely rare and atypical feature of nonmalignancies, resulting in dense motor weakness. Extensive nerve involvement may still necessitate nerve resection and reconstruction, despite the benign etiology of the lesion.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"5 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/05/0c/CASE23115.PMC10550692.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9801455","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

Delayed fatal intracranial hemorrhage in a pediatric patient following resection and adjuvant cranial radiotherapy for ependymoma: illustrative case. 一例儿童室管膜瘤切除和辅助颅内放射治疗后的迟发性致命性颅内出血：一个例证性病例。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-05-08 DOI: 10.3171/CASE22470

Matthew L Farmer, Adam M Conley, Joseph F Dilustro

{"title":"Delayed fatal intracranial hemorrhage in a pediatric patient following resection and adjuvant cranial radiotherapy for ependymoma: illustrative case.","authors":"Matthew L Farmer, Adam M Conley, Joseph F Dilustro","doi":"10.3171/CASE22470","DOIUrl":"10.3171/CASE22470","url":null,"abstract":"Background: Cranial radiotherapy (CRT) is an important treatment modality for malignancies of the central nervous system. CRT has deleterious effects that are commonly classified into acute, early delayed, and late delayed. Late-delayed effects include weakening of the cerebral vasculature and the development of structurally abnormal vasculature, potentially leading to ischemic or hemorrhagic events within the brain parenchyma. Such events are not well reported in the pediatric population.Observations: The authors present the case of a 14-year-old patient 8.2 years after CRT who experienced intracerebral hemorrhage. Autopsy demonstrated minimal pathological change without evidence of vascular malformation or aneurysm. These findings were unexpected given the degree of hemorrhage in this case. However, in the absence of other etiologies, it was believed that late-delayed radiation effect was the cause of this patient's fatal hemorrhage.Lessons: Although not all cases of pediatric spontaneous intracerebral hemorrhage will have a determined etiology, the authors' patient's previous CRT may represent a poorly defined risk for late-delayed hemorrhage. This correlation has not been previously reported and should be considered in pediatric patients presenting with spontaneous hemorrhage in a delayed fashion after CRT. Neurosurgeons must not be dismissive of unexpected events in the remote postoperative period.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"5 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b5/b6/CASE22470.PMC10550690.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9801457","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