Journal of Neurosurgery: Case Lessons最新文献_第2页

Isolated calvarial aneurysmal bone cyst in a pediatric patient: illustrative case 一名儿童患者的孤立性犊鼻动脉瘤性骨囊肿：示例病例

Journal of Neurosurgery: Case Lessons Pub Date : 2024-04-15 DOI: 10.3171/CASE2472

Amanda Muhs Saratsis, Nahren Asado, J. Ruge, Daphne Li

{"title":"Isolated calvarial aneurysmal bone cyst in a pediatric patient: illustrative case","authors":"Amanda Muhs Saratsis, Nahren Asado, J. Ruge, Daphne Li","doi":"10.3171/CASE2472","DOIUrl":"https://doi.org/10.3171/CASE2472","url":null,"abstract":"BACKGROUND Aneurysmal bone cysts (ABCs) are benign, osteolytic lesions that can occur in long bones, vertebrae, or rarely, the skull. Here the authors present the case of a 15-year-old male with a primary ABC of the left frontoparietal skull along with a review of the literature to provide insight into the nature of this rare disease. OBSERVATIONS An otherwise healthy 15-year-old male presented with a tense, painful lesion of the left frontoparietal scalp. He could not identify any inciting trauma, but first noted the lesion less than 2 weeks prior to presentation with progressive enlargement. Cranial imaging revealed a lytic skull lesion with fluid-fluid levels suggestive of ABC. Curative therapy was provided via wide excision of the lesion and calvarial reconstruction of the resultant skull defect. This was performed without complication, and histopathological evaluation confirmed the diagnosis of primary ABC. LESSONS ABCs of the skull are rare entities and most often arise in the skull base versus the calvaria. Typically, these lesions are associated with an underlying bone pathology (secondary ABCs) but can be rarely seen as isolated lesions (primary ABCs). Clinical management consists of excision and adjuvant therapy for underlying pathology where appropriate.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"53 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140698943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Phantom limb pain, traumatic neuroma, or nerve sheath tumor? Illustrative case 幻肢痛、创伤性神经瘤还是神经鞘瘤？示例病例

Journal of Neurosurgery: Case Lessons Pub Date : 2024-04-15 DOI: 10.3171/CASE247

BS Patrick J. Halloran, MD E. Antonio Chiocca, MD PhD Andres Santos

{"title":"Phantom limb pain, traumatic neuroma, or nerve sheath tumor? Illustrative case","authors":"BS Patrick J. Halloran, MD E. Antonio Chiocca, MD PhD Andres Santos","doi":"10.3171/CASE247","DOIUrl":"https://doi.org/10.3171/CASE247","url":null,"abstract":"BACKGROUND Phantom limb pain and traumatic neuromas are not commonly seen in neurosurgical practice. These conditions can present with similar symptoms; however, management of traumatic neuroma is often surgical, whereas phantom limb pain is treated with conservative measures. OBSERVATIONS A 77-year-old female patient with a long-standing history of an above-the-knee amputation experienced severe pain in her right posterior buttocks area for several years’ duration, attributed to phantom limb pain, which radiated down the stump of her leg and was treated with a variety of conservative measures. A recent exacerbation of her pain led to a prolonged hospitalization with magnetic resonance imaging of her leg stump, revealing a mass in the sciatic notch, at a relative distance from the stump. The anatomical location of the mass on the sciatic nerve in the notch led to a presumed radiological diagnosis of nerve sheath tumor, for which she underwent excision. At surgery, a neuroma of the proximal portion of the transected sciatic nerve that had retracted from the amputated stump to the notch was diagnosed. LESSONS Traumatic neuromas of transected major nerves after limb amputation should be considered in the differential diagnosis of phantom limb pain.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"33 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140702298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Neurocysticercosis of the third ventricle: illustrative case 第三脑室神经囊虫病：例证

Journal of Neurosurgery: Case Lessons Pub Date : 2024-04-08 DOI: 10.3171/CASE23769

John Choi, Grace Cullen, Dawn Darbonne, Dennis Adams, Christina M. Coyle, Joseph Cooper, Harminder Singh

引用次数: 0

Intraoperative application of indocyanine green and temporary venous occlusion test to assess collateral flow during microvascular decompression for venous-related trigeminal neuralgia: illustrative case 在静脉相关性三叉神经痛的微血管减压术中应用吲哚菁绿和临时静脉闭塞试验评估侧支血流：示例病例

Journal of Neurosurgery: Case Lessons Pub Date : 2024-04-08 DOI: 10.3171/CASE2469

K. Fujimoto, Yosuke Akamatsu, Y. Nishikawa, Kuniaki Ogasawara

{"title":"Intraoperative application of indocyanine green and temporary venous occlusion test to assess collateral flow during microvascular decompression for venous-related trigeminal neuralgia: illustrative case","authors":"K. Fujimoto, Yosuke Akamatsu, Y. Nishikawa, Kuniaki Ogasawara","doi":"10.3171/CASE2469","DOIUrl":"https://doi.org/10.3171/CASE2469","url":null,"abstract":"BACKGROUND In microvascular decompression (MVD) for vein-related trigeminal neuralgia (TN), determining whether transection of the offending vein is safe can be challenging. Here, the authors present a case of vein-related TN successfully treated by sacrificing the offending vein on the basis of findings from indocyanine green (ICG) video angiography and a temporary venous occlusion test to assess the collateral flow of the offending vessel. OBSERVATIONS A 43-year-old man presented with TN, which had failed to respond to previous medical therapy. Gadolinium-enhanced magnetic resonance imaging (MRI) revealed that the transverse or superior petrosal vein was the offending vein. The patient underwent MVD. Because the transposition of the offending vein was anatomically challenging, a temporary vein occlusion test was performed using ICG video angiography. During and after temporary occlusion, bidirectional flow in the offending vein was observed, suggesting collateral flow even after vein occlusion. On the basis of these findings, the offending vein was transected, resulting in relief from pain without any complications. Postoperative MRI revealed no new lesions in the brainstem or the cerebellar hemisphere. The patient has been free from neuralgia for 6 months. LESSONS The temporary vein occlusion test under ICG video angiography was useful for evaluating collateral flow in the offending vein in TN.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"189 S520","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140730889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Time course of tumorigenesis of a newly developed sporadic hemangioblastoma in an elderly patient: illustrative case 一名老年患者新发散发性血管母细胞瘤的肿瘤发生时间过程：示例病例

Journal of Neurosurgery: Case Lessons Pub Date : 2024-04-08 DOI: 10.3171/CASE23757

Yu Sugiyama, Shunichiro Kuramitsu, K. Eguchi, Masashi Ito, R. Ando, Hiroki Matsuno, Noriyuki Suzaki, Satoshi Maesawa

引用次数: 0

Migratory schwannoma of the cauda equina with a change in radicular pattern: illustrative case 马尾移行性分裂瘤伴根状形态改变：说明性病例

Journal of Neurosurgery: Case Lessons Pub Date : 2024-04-08 DOI: 10.3171/CASE23706

Matthew S Parr, Sanford R Williams, James H Mooney, Travis Atchley, Mamerhi O. Okor

{"title":"Migratory schwannoma of the cauda equina with a change in radicular pattern: illustrative case","authors":"Matthew S Parr, Sanford R Williams, James H Mooney, Travis Atchley, Mamerhi O. Okor","doi":"10.3171/CASE23706","DOIUrl":"https://doi.org/10.3171/CASE23706","url":null,"abstract":"BACKGROUND Intradural spinal tumors are an uncommon entity with a variety of pathologies and symptom patterns. Few cases reports in the literature have described tumor migration within the spinal canal. OBSERVATIONS A 38-year-old male presented with bilateral upper lumbar radicular symptoms of anterior thigh pain, with an enhancing tumor of the cauda equina initially located at L1–2. He declined surgery initially, and at a follow-up 3 years later, his symptoms were unchanged but the tumor was now located at T12–L1. He again declined surgery, but 3 months later, he had a significant change in his pain distribution, which was now along his posterolateral right leg to his foot with associated dorsiflexion and extensor hallicus longus weakness. At this time, the tumor had migrated to L2–3. He underwent laminectomy and tumor resection with resolution of his radicular symptoms and improvement in his strength back to baseline by the 1-month follow-up. Pathology was consistent with a World Health Organization grade I schwannoma. LESSONS Migratory schwannoma is a rare entity but should be considered when radicular symptoms acutely change in the setting of a known intradural tumor. Repeat imaging should be performed to avoid wrong-level surgery. Intraoperative imaging can also be used for tumor localization.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"24 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140732189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Successful resection of bilateral parafalcine meningioma with unilateral interhemispheric and contralateral transfalcine approach under nonintubated spontaneous breathing conditions: illustrative case 在非插管自主呼吸条件下，通过单侧大脑半球间和对侧经椎体入路成功切除双侧副脑膜瘤：示例病例

Journal of Neurosurgery: Case Lessons Pub Date : 2024-04-08 DOI: 10.3171/CASE2424

S. Hirono, Keisuke Kawano, Masato Ito, Kana Saito, Taiichiro Hayashida, Yoshinori Higuchi

{"title":"Successful resection of bilateral parafalcine meningioma with unilateral interhemispheric and contralateral transfalcine approach under nonintubated spontaneous breathing conditions: illustrative case","authors":"S. Hirono, Keisuke Kawano, Masato Ito, Kana Saito, Taiichiro Hayashida, Yoshinori Higuchi","doi":"10.3171/CASE2424","DOIUrl":"https://doi.org/10.3171/CASE2424","url":null,"abstract":"BACKGROUND The best surgical approach for resecting bilateral parafalcine meningioma, as well as the optimal anesthesia and airway management for craniotomy in patients with interstitial pneumonia (IP) for preventing postsurgical exacerbation, remains unclear. OBSERVATIONS A 66-year-old female with a history of multiple relapses of IP underwent craniotomy for resection of a 4.5-cm bilateral parafalcine meningioma located just beneath the inferior sagittal sinus. To avoid mechanical ventilation or high-concentration oxygenation, the entire procedure was performed under nonintubated spontaneous breathing conditions with a supraglottic airway/laryngeal mask airway (SGA/LMA) device. Half of the tumor was resected using the ipsilateral interhemispheric approach, while the remaining half was resected using the contralateral transfalcine approach (CTA). No brain retractors were required. Preoperative embolization contributed toward reducing blood loss and surgery duration. During most of the operation, additional oxygen administration was not required. The postoperative course was uneventful, without exacerbation of the IP. LESSONS This case demonstrated the utility and feasibility of a unilateral interhemispheric approach combined with CTA for resection of a bilateral parafalcine meningioma. Additionally, this case provides an alternative method of airway and anesthesia management with an SGA/LMA device and nonintubated spontaneous breathing for the prevention of postoperative acute exacerbation of IP.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"5 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140729872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Successful coil embolization of a ruptured pseudoaneurysm of the superior gluteal artery after a percutaneous awake robot-assisted sacroiliac joint fusion: illustrative case 经皮清醒机器人辅助骶髂关节融合术后臀上动脉假性动脉瘤破裂的成功线圈栓塞：示例病例

Journal of Neurosurgery: Case Lessons Pub Date : 2024-04-08 DOI: 10.3171/CASE2413

Samah Morsi, Alyssa M. Bartlett, Andrew A. Hardigan, Mounica R Paturu, Shawn W Adams, Malcolm R DeBaun, Waleska Pabon-Ramos, Muhammad M. Abd-El-Barr

{"title":"Successful coil embolization of a ruptured pseudoaneurysm of the superior gluteal artery after a percutaneous awake robot-assisted sacroiliac joint fusion: illustrative case","authors":"Samah Morsi, Alyssa M. Bartlett, Andrew A. Hardigan, Mounica R Paturu, Shawn W Adams, Malcolm R DeBaun, Waleska Pabon-Ramos, Muhammad M. Abd-El-Barr","doi":"10.3171/CASE2413","DOIUrl":"https://doi.org/10.3171/CASE2413","url":null,"abstract":"BACKGROUND Robot-assisted sacroiliac joint (SIJ) fusion has gained popularity, but it carries the risk of complications such as injury to the superior gluteal artery (SGA). The authors present the case of an awake percutaneous robot-assisted SIJ fusion leading to an SGA pseudoaneurysm. OBSERVATIONS An 80-year-old male, who had undergone an awake percutaneous robot-assisted SIJ fusion, experienced postoperative left hip pain and bruising. Subsequent arteriography demonstrated an SGA branch pseudoaneurysm requiring coil embolization. LESSONS An SGA injury, although uncommon (1.2% incidence), can arise from percutaneous screw placement, aberrant anatomy, or hardware contact. Thorough preoperative imaging, precise robot-assisted screw insertion, and soft tissue protection are crucial to mitigate risks. Immediate angiography aids in prompt diagnosis and effective intervention. Comprehensive knowledge of anatomical variants is essential for managing complications and optimizing preventative measures in robot-assisted SIJ fusion.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"150 S296","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140731565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Connectomics as a prognostic tool of functional outcome in glioma surgery of the supplementary motor area: illustrative case. 结缔组织学作为辅助运动区神经胶质瘤手术功能结果的预后工具：一个例证性病例。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-08-07 DOI: 10.3171/CASE23286

Eric Suero Molina, Matthew J Tait, Antonio Di Ieva

{"title":"Connectomics as a prognostic tool of functional outcome in glioma surgery of the supplementary motor area: illustrative case.","authors":"Eric Suero Molina, Matthew J Tait, Antonio Di Ieva","doi":"10.3171/CASE23286","DOIUrl":"10.3171/CASE23286","url":null,"abstract":"Background: The supplementary motor area (SMA) is essential in facilitating the commencement and coordination of complex self-initiated movements. Its complex functional connectivity poses a great risk for postoperative neurological deterioration. SMA syndrome can occur after tumor resection and comprises hemiakinesia and akinetic mutism (often, but unpredictably temporary). Although awake surgery is preferred for mapping and monitoring eloquent areas, connectomics is emerging as a novel technique to tailor neurosurgical approaches and predict functional prognosis, as illustrated in this case.Observations: The authors report on a patient presenting with recurrent oligodendroglioma after subtotal resection 7 years earlier. After extensive neuropsychological and neuroradiological assessment (including connectomics), awake surgery was indicated. No intraoperative deficits were recorded; however, the patient presented with postoperative right-sided akinesia and mutism. Postoperative neuroimaging demonstrated the connectome overlapping the preoperative one, and indeed, neurological symptoms resolved after 3 days.Lessons: Comparison of the pre- and postoperative connectome can be used to objectively evaluate surgical outcomes and assess patient prognosis. To the best of the authors' knowledge, this is the first case demonstrating the feasibility of quantitative functional connectivity analysis as a prognostic tool for neurological improvement after surgery. A better understanding of brain networks is instrumental for improving diagnosis, prognosis, and treatment of neuro-oncological patients.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"6 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/18/ea/CASE23286.PMC10555591.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9991512","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

Percutaneous lumbopelvic fixation for pathologic sacral fractures and spinopelvic dissociation: patient series. 经皮腰叶内固定治疗病理性骶骨骨折和脊柱骨盆分离：患者系列。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-08-07 DOI: 10.3171/CASE23205

Nikolas Baksh, Caleb Yeung, Max Vaynrub

{"title":"Percutaneous lumbopelvic fixation for pathologic sacral fractures and spinopelvic dissociation: patient series.","authors":"Nikolas Baksh, Caleb Yeung, Max Vaynrub","doi":"10.3171/CASE23205","DOIUrl":"10.3171/CASE23205","url":null,"abstract":"Background: Because patients with advanced cancer live longer, the number of patients with the sequelae of metastatic spine disease has increased. Pathologic instability of the mobile spine has been classified, and minimally invasive surgery has been well described. However, pathologic sacral instability is uncommon and often underdiagnosed. Although most sacral fractures are stable, patients with unstable U- or H-type fractures have spinopelvic dissociation and can experience progressive pain, sacral kyphosis, and neurological injury. Open lumbopelvic fusion carries a high perioperative risk for this patient population, which has often been previously radiated and is medically frail. The authors investigated the utility and safety of percutaneous lumbopelvic fixation, as previously described for traumatic spinopelvic dissociation, in the oncological setting. The authors retrospectively reviewed five consecutive patients with unstable pathologic sacral fractures who had undergone percutaneous lumbopelvic fixation after conservative management failed.Observations: Patients experienced significant improvement between pre- and postoperative visual analog scale scores (9.2 and 1.6, respectively) and Eastern Cooperative Oncology Group grades (median 3 and 1, respectively). All patients were independently ambulatory at the final follow-up. Sagittal alignment remained stable in four patients and worsened in one. There were no major medical or surgical complications.Lessons: Percutaneous lumbopelvic fixation shows promising results for palliation, durability, and safety for pathologic sacropelvic instability.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"6 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2b/c2/CASE23205.PMC10555589.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9991509","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