Journal of Neurosurgery: Case Lessons最新文献_第4页

Percutaneous transjugular approach without arterial monitoring for the treatment of a direct carotid-cavernous fistula with vascular Ehlers-Danlos syndrome: illustrative case. 无动脉监测的经皮经颈静脉入路治疗血管性埃勒斯-丹洛斯综合征的直接颈动脉海绵窦瘘：一例说明性病例。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-07-31 DOI: 10.3171/CASE23188

Naoyuki Uchiyama, Yosuke Kawahara, Wataru Uchida, Ayumu Nitta, Atsushi Nohara, Yutaka Hayashi

{"title":"Percutaneous transjugular approach without arterial monitoring for the treatment of a direct carotid-cavernous fistula with vascular Ehlers-Danlos syndrome: illustrative case.","authors":"Naoyuki Uchiyama, Yosuke Kawahara, Wataru Uchida, Ayumu Nitta, Atsushi Nohara, Yutaka Hayashi","doi":"10.3171/CASE23188","DOIUrl":"10.3171/CASE23188","url":null,"abstract":"Background: Vascular Ehlers-Danlos syndrome (vEDS) because of COL3A1 mutations is a rare inherited collagen vascular disease associated with spontaneous arterial dissections, aneurysms, vessel rupture, and organ rupture. A direct carotid-cavernous fistula (CCF) is the most common central nervous system vascular anomaly in vEDS; however, its treatment is challenging due to extremely fragile arteries and veins.Observations: A 22-year-old woman presented with pulsatile tinnitus and mild diplopia. CCF formation without trauma, cervical dissecting aneurysms, thin skin, and multiple ligament tears, as well as a genetic analysis, led to a diagnosis of vEDS. To minimize the risk of vascular injury in the thoracoperitoneal cavity, the internal jugular vein was directly punctured and the CCF was embolized transvenously using the triple-overlay road-mapping technique without arterial monitoring. The CCF was completely occluded, and the patient showed an excellent clinical course without neurological or vascular complications.Lessons: Physicians and neurosurgeons should consider vEDS when treating younger patients with spontaneous CCF without trauma and investigate the possibility of genetic abnormalities and systemic vascular pathology. Transvenous embolization of a CCF through the transjugular route using the triple-overlay road-mapping technique can minimize the risk of vascular injury in a patient with vEDS.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"6 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1f/1a/CASE23188.PMC10555584.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9947574","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 thoracic epidural lipomatosis with syringomyelia: illustrative case. 有症状的胸段硬膜外脂肪增多症伴脊髓空洞症：一个例证性病例。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-07-31 DOI: 10.3171/CASE23249

Lukasz Przepiorka, Katarzyna Wójtowicz, Przemysław Kunert

{"title":"Symptomatic thoracic epidural lipomatosis with syringomyelia: illustrative case.","authors":"Lukasz Przepiorka, Katarzyna Wójtowicz, Przemysław Kunert","doi":"10.3171/CASE23249","DOIUrl":"10.3171/CASE23249","url":null,"abstract":"Background: Spinal epidural lipomatosis is a rare but well-described disease. Here the authors present an extraordinary co-occurrence of spinal epidural lipomatosis with syringomyelia that did not improve after laminoplasty but required duroplasty as a definitive treatment.Observations: This is the seventh case in the literature describing a co-occurrence of spinal epidural lipomatosis and syringomyelia. The pragmatic argument for a causative relationship between 2 phenomena is syrinxes reduction after surgery for spinal epidural lipomatosis. Additionally, duroplasty for spinal epidural lipomatosis in the setting of syringomyelia has not previously been reported. Duroplasty offers much better reconstruction of the subarachnoid space as compared with extradural decompression surgeries. It is one of the treatment options for spinal epidural lipomatosis. Last, most of the patients described in the literature with secondary syringomyelia were women with diabetes mellitus.Lessons: The co-occurrence of spinal epidural lipomatosis and syringomyelia is extremely rare. Neurological deficits in such cases respond well to surgical treatment. Accordingly, each case described in the literature resulted in syringomyelia reduction or resolution after surgery. Duroplasty may be necessary in selected cases of spinal epidural lipomatosis. Close follow-up and ongoing management of patients with epidural lipomatosis is therefore important.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"6 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e2/9a/CASE23249.PMC10555583.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10000660","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

Microneurosurgical treatment of a small perimesencephalic pure pial arterial malformation: an under-recognized etiology of angiographically occult subarachnoid hemorrhage. Illustrative case. 一例小的中脑周围纯软脑膜动脉畸形的显微外科治疗：血管造影显示的隐匿性蛛网膜下腔出血的病因尚不清楚。说明性案例。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-07-31 DOI: 10.3171/CASE23246

Robert C Sterner, Garret P Greeneway, Ufuk Erginoglu, Jaime L Martínez Santos, Mustafa K Baskaya

{"title":"Microneurosurgical treatment of a small perimesencephalic pure pial arterial malformation: an under-recognized etiology of angiographically occult subarachnoid hemorrhage. Illustrative case.","authors":"Robert C Sterner, Garret P Greeneway, Ufuk Erginoglu, Jaime L Martínez Santos, Mustafa K Baskaya","doi":"10.3171/CASE23246","DOIUrl":"10.3171/CASE23246","url":null,"abstract":"Background: Pial arterial malformations (PAMs) are rare vascular lesions consisting of dilated tortuous arteries without venous drainage. Current PAM understanding is limited by the lesion's rarity, limited anatomopathological studies, and frequent misclassifications.Observations: A 23-year-old male experienced two spontaneous subarachnoid hemorrhages (SAHs) over 6 months with initially unremarkable diagnostic cerebral angiograms. Magnetic resonance imaging (MRI) and angiography after the second SAH revealed a small perimesencephalic ovoid lesion within the left crural cistern, between the left superior and posterior cerebral arteries, appearing to be an exophytic cavernoma, a thrombosed aneurysm, or a hemorrhagic tumor. Microsurgical resection was achieved with a pterional craniotomy and anterior clinoidectomy. The resected lesion was characteristic of a pure PAM arising from superior cerebellar arterial branches.Lessons: Small pure PAMs can be deceitfully dynamic lesions causing episodes of hemorrhage, complete thrombosis (angiographically occult), recanalization, and rehemorrhage. Small thrombosed vascular malformations or aneurysms should be included in differential diagnoses of angiographically occult SAH. MRI can be diagnostic, but the true angioarchitecture can only be elucidated with microneurosurgery. The only definitive cure is removal. The microneurosurgical strategy should account for worst-case scenarios, provide adequate skull base exposures, and include bypass revascularization options when thrombosed aneurysms are encountered.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"6 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/81/a8/CASE23246.PMC10555581.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10000663","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

Pediatric intracranial tuberculoma: illustrative case. 小儿颅内结核瘤：一个例证性病例。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-07-24 DOI: 10.3171/CASE23236

Eva Liu, Pramath Kakodkar, Henry Pan, Amy Zhou, Patrick Toyota, Amit Rahul Persad, Kristen Marciniuk, Chunjie Wang, Roland Nikolaus Auer, Stephen Sanche, Aleksander Vitali, Julia Radic

{"title":"Pediatric intracranial tuberculoma: illustrative case.","authors":"Eva Liu, Pramath Kakodkar, Henry Pan, Amy Zhou, Patrick Toyota, Amit Rahul Persad, Kristen Marciniuk, Chunjie Wang, Roland Nikolaus Auer, Stephen Sanche, Aleksander Vitali, Julia Radic","doi":"10.3171/CASE23236","DOIUrl":"10.3171/CASE23236","url":null,"abstract":"Background: Tuberculosis is an airborne disease caused by Mycobacterium tuberculosis. Intracranial tuberculoma is a rare complication of extrapulmonary tuberculosis due to hematogenous spread to subpial and subependymal regions. Intracranial tuberculoma can occur with or without meningitis.Observations: A 3-year-old male who had recently emigrated from Sudan presented to the emergency department with right-sided seizures lasting 30 minutes, which were aborted with levetiracetam and midazolam. Head computed tomography revealed a multilobulated left supratentorial mass with solid and cystic components and measuring 8.0 × 4.8 × 6.5 cm. The patient had successful resection of the mass, which was positive for M. tuberculosis. He was started on rifampin, isoniazid, pyrazinamide, ethambutol, and fluoroquinolone and was discharged home in stable condition.Lessons: A literature review on pediatric intracranial tuberculoma was performed, which included 48 studies (n = 49). The mean age was 8.8 ± 5.4 years with a slight female predilection (59%). Predominant solitary tuberculomas (63%) were preferentially managed with both resection and antituberculosis therapy (ATT), whereas multifocal tuberculomas were preferentially managed with ATT. Intracranial tuberculoma is a rare but treatable cause of space-occupying lesions in children. Clinicians should maintain a high level of suspicion in patients from endemic regions and involve the infectious disease service early.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"6 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bb/12/CASE23236.PMC10555599.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9937498","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

Selective transarterial embolization for arterial hemorrhage after upper third molar extraction: illustrative cases. 选择性经动脉栓塞治疗上第三磨牙拔除后动脉出血：一例例证。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-07-24 DOI: 10.3171/CASE23118

Kohei Tokuyama, Hiro Kiyosue, Ryuichi Shimada, Satomi Miyamoto, Ayaka Abe, Kenji Kawano, Yoshiki Asayama

{"title":"Selective transarterial embolization for arterial hemorrhage after upper third molar extraction: illustrative cases.","authors":"Kohei Tokuyama, Hiro Kiyosue, Ryuichi Shimada, Satomi Miyamoto, Ayaka Abe, Kenji Kawano, Yoshiki Asayama","doi":"10.3171/CASE23118","DOIUrl":"10.3171/CASE23118","url":null,"abstract":"Background: The present report describes 2 cases of arterial bleeding after removal of the upper third molar that were successfully treated with selective transarterial embolization.Observations: The first patient underwent removal of the left upper third molar. A few hours later, facial swelling and massive bleeding appeared near the extraction socket involving the posterolateral wall of the maxillary sinus. Angiography showed a pseudoaneurysm involving the posterior superior dental artery, and the lesion was selectively embolized with an N-butyl cyanoacrylate (NBCA)-lipidiol mixture. The second patient underwent removal of the left upper third molar, and massive bleeding occurred from the extraction socket involving the greater palatine foramen. Angiography revealed the pseudoaneurysm of the greater palatine artery, and the lesion was selectively embolized with an NBCA-lipiodol mixture. Both patients were discharged uneventfully, and no recurrent bleeding was observed during the 82- and 5-month follow-up periods.Lessons: Massive arterial bleeding after a third molar extraction occurs from either the posterior superior dental artery or the greater palatine artery, which is associated with the location of the extraction socket. Selective transarterial glue embolization is a useful option for the treatment of arterial bleeding after the removal of the upper third molars.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"6 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/16/33/CASE23118.PMC10555597.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9931477","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

Lateral ventricle subependymoma resected with a transcallosal approach: illustrative case. 经同种异体骨入路切除侧脑室室管膜下瘤：一例说明性病例。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-07-24 DOI: 10.3171/CASE23265

Franco Rubino, Michael P Catalino, Romulo A Andrade de Almeida, Sujit S Prabhu

{"title":"Lateral ventricle subependymoma resected with a transcallosal approach: illustrative case.","authors":"Franco Rubino, Michael P Catalino, Romulo A Andrade de Almeida, Sujit S Prabhu","doi":"10.3171/CASE23265","DOIUrl":"10.3171/CASE23265","url":null,"abstract":"Background: Subependymomas are World Health Organization grade I tumors, and 30% occur in the lateral ventricles. Surgery is the mainstay of treatment, and the transcallosal or transcortical/transsulcal approaches are preferred for those tumors occurring near the foramen of Monro or atrium. Visualization, proximity to the fornix and basal ganglia, hydrocephalus, and brain retraction during surgery make these operations challenging. The authors present the case of a 65-year-old male with a subependymoma located in the left lateral ventricle. The tumor was completely resected using an interhemispheric/transcallosal approach.Observations: The authors analyze the anatomopathological features of subependymoma, along with the clinical behavior and therapeutic options. The authors discuss in detail the advantages and disadvantages of the interhemispheric/transcallosal approach for resection of these tumors.Lessons: Subependymomas are slow-growing lesions with an indolent yet complicated course making surgical removal challenging yet feasible using the correct techniques. The interhemispheric transcallosal approach offers an excellent route for the resection of large subependymomas, but there is still a significant risk for postoperative complications.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"6 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/29/3d/CASE23265.PMC10555596.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9935375","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

Pachymeningeal en plaque metastasis from gastric cancer mimicking subdural hematoma: illustrative case. 癌症模拟硬膜下血肿的膜前神经斑块转移：一例例证。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-07-24 DOI: 10.3171/CASE2389

Hsuan-Yi Wu, Chee-Tat Lam, Ai Seon Kuan, Tong-Jong Chen, Chen-Shu Wu, Ming-Cheng Tsai

{"title":"Pachymeningeal en plaque metastasis from gastric cancer mimicking subdural hematoma: illustrative case.","authors":"Hsuan-Yi Wu, Chee-Tat Lam, Ai Seon Kuan, Tong-Jong Chen, Chen-Shu Wu, Ming-Cheng Tsai","doi":"10.3171/CASE2389","DOIUrl":"10.3171/CASE2389","url":null,"abstract":"Background: Pachymeningeal metastasis associated with gastric cancer, especially in its early stages, is extremely rare.Observations: The authors describe a 77-year-old man with a past medical history of lung cancer and previously treated chronic subdural hematoma who was admitted to their hospital because of hematemesis and newly diagnosed gastric cancer. He became unconscious during the hospitalization. The preoperative brain imaging studies had the appearance of recurrent subdural hematoma and extracranial tumor with skull invasion. Craniotomy revealed pachymeningeal carcinomatosis and en plaque metastasis of tumor. The histopathology of the tumors was consistent with metastatic gastric adenocarcinoma.Lessons: This is the first reported case of metastatic gastric cancer as a pachymeninges-based en plaque entity. This report highlights the rare radiological presentation and operative findings in this case. The authors also summarize those case reports associated with dural metastasis arising from gastric cancer.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"6 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/07/95/CASE2389.PMC10555598.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9937491","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

Severe hyperglycorrhachia and status epilepticus after endoscopic aqueductoplasty: illustrative case. 内镜下水管成形术后严重高血糖血症和癫痫持续状态：一例说明性病例。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-07-17 DOI: 10.3171/CASE23252

Anand A Dharia, Ahmad Masri, Jay F Rilinger, Christian B Kaufman

{"title":"Severe hyperglycorrhachia and status epilepticus after endoscopic aqueductoplasty: illustrative case.","authors":"Anand A Dharia, Ahmad Masri, Jay F Rilinger, Christian B Kaufman","doi":"10.3171/CASE23252","DOIUrl":"10.3171/CASE23252","url":null,"abstract":"Background: While hypoglycorrhachia is observed and managed frequently, there are few reports in the literature of clinically significant hyperglycorrhachia after neurosurgery. Understanding the effects and management of severe hyperglycorrhachia is important to the neurosurgeon and neurocritical care teams who care for patients in these rare scenarios.Observations: The authors present the case of a 3-month-old male with congenital hydrocephalus who faced profound hyperglycorrhachia and status epilepticus after an endoscopic aqueductoplasty using an irrigant composed of lactated Ringer's solution with dextrose 5% in water. A multidisciplinary approach was developed to monitor and treat the patient's seizures and cerebrospinal fluid (CSF) osmolytes.Lessons: This case provides several learning opportunities for understanding CSF physiology, pathogenesis of common brain injuries related to osmotic shifts and inflammatory states, as well as clinical management of hyperglycorrhachia. It also reiterates the significance of meticulous intraoperative assessment to avoid preventable medical errors.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"6 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/76/22/CASE23252.PMC10555569.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9865712","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

Pedicle subtraction metallectomy with complex posterior reconstruction for fixed cervicothoracic kyphosis: illustrative case. 椎弓根减影金属切除术结合复杂的后部重建治疗固定性颈胸后凸：一个例证性病例。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-07-17 DOI: 10.3171/CASE23180

Harman Chopra, José Manuel Orenday-Barraza, Alexander E Braley, Alfredo Guiroy, Olivia E Gilbert, Michael A Galgano

{"title":"Pedicle subtraction metallectomy with complex posterior reconstruction for fixed cervicothoracic kyphosis: illustrative case.","authors":"Harman Chopra, José Manuel Orenday-Barraza, Alexander E Braley, Alfredo Guiroy, Olivia E Gilbert, Michael A Galgano","doi":"10.3171/CASE23180","DOIUrl":"10.3171/CASE23180","url":null,"abstract":"Background: Iatrogenic cervical deformity is a devastating complication that can result from a well-intended operation but a poor understanding of the individual biomechanics of a patient's spine. Patient factors, such as bone fragility, high T1 slope, and undiagnosed myopathies often play a role in perpetuating a deformity despite an otherwise successful surgery. This imbalance can lead to significant morbidity and a decreased quality of life.Observations: A 55-year-old male presented to the authors' clinic with a chin-to-chest deformity and cervical myelopathy. He previously had an anterior C2-T2 fixation and a posterior C1-T6 instrumented fusion. He subsequently developed screw pullout at multiple levels, so the original surgeon removed all of the posterior hardware. The T1 cage (original corpectomy) severely subsided into the body of T2, generating an angular kyphosis that eventually developed a rigid osseous circumferential union at the cervicothoracic junction with severe cord compression. An anterior approach was not feasible; therefore, a 3-column osteotomy/fusion in the upper thoracic spine was planned whereby 1 of the T2 screws would need to be removed from a posterior approach for the reduction to take place.Lessons: This case highlights the devastating effect of a hardware complication leading to a fixed cervical spine deformity and the complex decision making involved to safely correct the challenging deformity and restore function.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"6 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9b/c2/CASE23180.PMC10555571.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9867690","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

Disappearance of a moyamoya-related distal anterior cerebral artery aneurysm after target bypass revascularization: illustrative case. 靶向旁路血运重建术后与烟雾相关的大脑前动脉远端动脉瘤消失：一例说明性病例。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-07-17 DOI: 10.3171/CASE23200

Taro Kusakabe, Kazunori Oda, Hiromasa Kobayashi, Dai Kawano, Shintaro Yoshinaga, Hironori Fukumoto, Koichiro Takemoto, Takashi Morishita, Hiroshi Abe

{"title":"Disappearance of a moyamoya-related distal anterior cerebral artery aneurysm after target bypass revascularization: illustrative case.","authors":"Taro Kusakabe, Kazunori Oda, Hiromasa Kobayashi, Dai Kawano, Shintaro Yoshinaga, Hironori Fukumoto, Koichiro Takemoto, Takashi Morishita, Hiroshi Abe","doi":"10.3171/CASE23200","DOIUrl":"10.3171/CASE23200","url":null,"abstract":"Background: Aneurysm formation is a complication of moyamoya disease (MMD). Distal anterior cerebral artery (ACA) aneurysms account for approximately 1% of MMD-related aneurysms. We report a case of target bypass for adult patients with MMD who presented with intracranial hemorrhage due to rupture of a distal ACA aneurysm, whose disappearance was confirmed postoperatively.Observations: A 45-year-old woman presented with sudden-onset headache and loss of consciousness. Head computed tomography showed hemorrhage in the genu of the corpus callosum with intraventricular extension. Digital subtraction angiography (DSA) revealed Suzuki stage III MMD and a left A3 segment aneurysm. Superficial temporal artery (STA)-middle cerebral artery (MCA) bypass and STA-ACA target bypass were performed to reduce hemodynamic stress on the left ACA. DSA 6 months after surgery showed patency of both bypasses and disappearance of the aneurysm. At the 20-month follow-up, the patient was asymptomatic and neurologically intact.Lessons: Bypass revascularization may be an effective treatment to reduce hemodynamic stress and eliminate MMD-related aneurysms.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"6 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/67/8c/CASE23200.PMC10555570.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9865706","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