Journal of Neurosurgery: Case Lessons最新文献_第7页

Presence of intra-aneurysmal thrombi with delayed coil migration after embolization of an aneurysmal subarachnoid hemorrhage: illustrative case. 动脉瘤性蛛网膜下腔出血栓塞后出现动脉瘤内血栓并延迟线圈移位：一个例证性病例。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-06-26 DOI: 10.3171/CASE23196

Koichiro Suzuki, Kazunori Oda, Yoshinobu Horio, Dai Kawano, Noriko Hirao, Takaaki Amamoto, Hiromasa Kobayashi, Koichiro Takemoto, Takashi Morishita, Hiroshi Abe

{"title":"Presence of intra-aneurysmal thrombi with delayed coil migration after embolization of an aneurysmal subarachnoid hemorrhage: illustrative case.","authors":"Koichiro Suzuki, Kazunori Oda, Yoshinobu Horio, Dai Kawano, Noriko Hirao, Takaaki Amamoto, Hiromasa Kobayashi, Koichiro Takemoto, Takashi Morishita, Hiroshi Abe","doi":"10.3171/CASE23196","DOIUrl":"10.3171/CASE23196","url":null,"abstract":"Background: Coil migration is a rare, but notable complication of endovascular treatment. Risk factors include communicating segment aneurysms, aneurysmal shape, and technical factors. Although cerebral blood flow obstruction caused by early coil migration requires urgent coil removal, delayed coil migration is often asymptomatic, making it difficult to determine a treatment strategy.Observations: A 47-year-old woman was referred to the institute with acute-onset headache. She was diagnosed with subarachnoid hemorrhage due to rupture of the right internal carotid artery-posterior communicating artery aneurysm and underwent endovascular coil embolization. Following the procedure, the patient showed no obvious complications; however, 14 days later, images showed coil migration to the distal side, leading to surgical removal. Right frontotemporal craniotomy was performed, and the remaining coil was removed. The aneurysm was clipped again, and blood flow was confirmed. The patient was discharged 12 days after the craniotomy with transient oculomotor nerve palsy. At the 15-month follow-up, there was no aneurysm recurrence and the oculomotor nerve palsy showed improvement.Lessons: Retrieval of the migrated coil by craniotomy is an effective remedial measure; however, intraoperative complications are common. Early detection, established protocols, and prompt treatment decisions are important for preventing undesirable outcomes.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"5 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/50/00/CASE23196.PMC10550549.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9747532","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

Development of multifocal glioblastoma after radiotherapy for craniopharyngioma: illustrative case. 颅咽管瘤放疗后多灶性胶质母细胞瘤的发展：一个例证性病例。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-06-26 DOI: 10.3171/CASE2377

Edith Yuan, Michelle Lin, Elliot Min, Kristie Liu, Frank J Attenello

引用次数: 0

Infraclavicular de novo placement of a responsive neurostimulator for a patient with eloquent glioma-associated epilepsy: illustrative case. 一例有神经胶质瘤相关癫痫患者的锁骨下新放置反应性神经刺激器：一个例证性病例。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-06-26 DOI: 10.3171/CASE22528

Ahmad R Masri, Bailey R Yekzaman, Bradley J Estes, Christopher S Park, Patrick Landazuri, Michael Kinsman

{"title":"Infraclavicular de novo placement of a responsive neurostimulator for a patient with eloquent glioma-associated epilepsy: illustrative case.","authors":"Ahmad R Masri, Bailey R Yekzaman, Bradley J Estes, Christopher S Park, Patrick Landazuri, Michael Kinsman","doi":"10.3171/CASE22528","DOIUrl":"10.3171/CASE22528","url":null,"abstract":"Background: The authors present a 50-year-old female with high-grade glioma involving the motor cortex as the cause of her drug-resistant epilepsy (DRE). Responsive neurostimulation (RNS) was chosen for epilepsy treatment. Due to concerns regarding the generator impeding the regular imaging surveillance required for treatment and monitoring of her glioma, surgeons placed the internal pulse generator (IPG) within an infraclavicular chest pocket.Observations: Implantation of the RNS device and IPG within the infraclavicular pocket was uneventful. However, both subdural and depth electrodes were used and connected to the IPG, and subdural electrodes are considerably shorter than depth electrodes (37 vs 44 cm). The shorter strip leads presumably generated significant tension, leading to fracture of the leads. Therefore, surgery was repeated using only depth electrodes for more length and less tension. The device has good-quality electrocorticography signals that continue to be used for device programming. The seizure burden was reduced, and quality of life improved for the patient.Lessons: The RNS system with infraclavicular IPG placement reduced the seizure burden and improved the quality of life of a patient with glioma-associated epilepsy. Surgeons may consider the infraclavicular location as an alternative site for implantation for RNS candidates who require recurrent intracranial magnetic resonance imaging.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"5 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a2/ce/CASE22528.PMC10550545.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9744411","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

Focal drug-resistant temporal lobe epilepsy associated with an ipsilateral anterior choroidal artery aneurysm: illustrative case. 与同侧脉络膜前动脉瘤相关的局灶性耐药颞叶癫痫：一例例证。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-06-26 DOI: 10.3171/CASE23156

H Westley Phillips, Shivani D Rangwala, Joanna Papadakis, David J Segar, Melissa Tsuboyama, Anna L R Pinto, Joseph P Harmon, Sulpicio G Soriano, Carlos J Munoz, Joseph R Madsen, Alfred P See, Scellig S Stone

{"title":"Focal drug-resistant temporal lobe epilepsy associated with an ipsilateral anterior choroidal artery aneurysm: illustrative case.","authors":"H Westley Phillips, Shivani D Rangwala, Joanna Papadakis, David J Segar, Melissa Tsuboyama, Anna L R Pinto, Joseph P Harmon, Sulpicio G Soriano, Carlos J Munoz, Joseph R Madsen, Alfred P See, Scellig S Stone","doi":"10.3171/CASE23156","DOIUrl":"10.3171/CASE23156","url":null,"abstract":"Background: The occurrence of both an intracranial aneurysm and epilepsy, especially drug-resistant epilepsy (DRE), is rare. Although the overall incidence of aneurysms associated with DRE is unclear, it is thought to be particularly infrequent in the pediatric population. Surgical ligation of the offending aneurysm has been reported in conjunction with resolving seizure activity, although few cases have cited a combined approach of aneurysm ligation and resection of an epileptogenic focus.Observations: We present the case of a 14-year-old female patient with drug-resistant temporal lobe epilepsy and an ipsilateral supraclinoid internal carotid artery aneurysm. Seizure semiology, electroencephalography monitoring, and magnetic resonance imaging all indicated a left temporal epileptogenic focus, in addition to an incidental aneurysm. The authors recommended a combined surgery involving resection of the temporal lesion and surgical clip ligation of the aneurysm. Near-total resection and successful ligation were achieved, and the patient has remained seizure free since surgery at 1 year postoperatively.Lessons: In patients with focal DRE and an adjacent intracranial aneurysm, a combined surgical approach involving both resection and surgical ligation can be used. Several surgical timing and neuroanesthetic considerations should be made to ensure the overall safety and efficacy of this procedure.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"5 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/02/b1/CASE23156.PMC10550554.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9802604","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

Subependymal giant cell astrocytoma in the absence of tuberous sclerosis: illustrative case. 没有结节性硬化的室管膜下巨细胞星形细胞瘤：一个例证性病例。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-06-19 DOI: 10.3171/CASE23192

India Shelley, Aria Mahtabfar, Christopher J Farrell

{"title":"Subependymal giant cell astrocytoma in the absence of tuberous sclerosis: illustrative case.","authors":"India Shelley, Aria Mahtabfar, Christopher J Farrell","doi":"10.3171/CASE23192","DOIUrl":"10.3171/CASE23192","url":null,"abstract":"Background: Subependymal giant cell astrocytoma (SEGA) is a benign intraventricular tumor classically arising near the Foramen of Monro. SEGAs almost always present as a component of tuberous sclerosis complex (TSC), an autosomal dominant disorder characterized by lesions in multiple organs.Observations: A 22-year-old female with no past medical history presented with new-onset right-eye pressure, floaters in the right visual field, and pulsatile tinnitus. Imaging revealed an avidly enhancing mass abutting the right Foramen of Monro, causing obstructive hydrocephalus. Following resection, histopathological analysis identified the lesion as a SEGA. However, on further workup, the patient was found to have no genetic or clinical findings of TSC, which exemplifies a rare case of SEGA in the absence of a TSC diagnosis.Lessons: It is essential for physicians to be aware of the possibility of SEGA in the absence of other characteristics of TSC, which has many implications for a patient's clinical course. The authors present the seventh case of SEGA without genetic or clinical features of TSC described in the literature.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"5 25","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/32/1d/CASE23192.PMC10550529.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10041760","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

Terson syndrome secondary to aneurysmal subarachnoid hemorrhage in a child: illustrative case. 儿童动脉瘤性蛛网膜下腔出血继发的Terson综合征：一例例证。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-06-19 DOI: 10.3171/CASE2390

Jacob M Mazza, Parth Tank, Melissa A LoPresti, Jonathan P Scoville, Brenda L Bohnsack, Sandi Lam

{"title":"Terson syndrome secondary to aneurysmal subarachnoid hemorrhage in a child: illustrative case.","authors":"Jacob M Mazza, Parth Tank, Melissa A LoPresti, Jonathan P Scoville, Brenda L Bohnsack, Sandi Lam","doi":"10.3171/CASE2390","DOIUrl":"10.3171/CASE2390","url":null,"abstract":"Background: Terson syndrome is the phenomenon of intraocular hemorrhage in the setting of subarachnoid hemorrhage (SAH). Vision loss can lead to morbidity for the affected individual. Aneurysmal SAH related to intracranial aneurysms is rare in children. Studies have shown the incidence of Terson syndrome in adults with aneurysmal SAH to be over 40%; however, few cases of Terson syndrome in pediatric aneurysmal SAH have been reported.Observations: A 9-year-old male presented with altered mental status and seizures. Computed tomographic angiography showed aneurysmal SAH from a ruptured, left-sided posterior inferior cerebellar artery aneurysm. The patient underwent endovascular treatment with coiling and external ventricular drainage for SAH. Ophthalmological consultation for blurry vision revealed the diagnosis of Terson syndrome with decreased vision in the left eye, which was managed conservatively.Lessons: Terson syndrome after SAH can occur in children. Prompt ophthalmological evaluation in pediatric patients with aneurysmal SAH is vital for recognition and management to decrease overall morbidity.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"5 25","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/42/f0/CASE2390.PMC10550527.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10041763","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

Cronobacter brain abscess and refractory epilepsy in a newborn: role of epilepsy surgery. Illustrative case. 新生儿克罗诺杆菌脑脓肿和难治性癫痫：癫痫手术的作用。说明性案例。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-06-19 DOI: 10.3171/CASE23140

Meredith Yang, John Tsiang, Melissa A LoPresti, Sandi Lam

{"title":"Cronobacter brain abscess and refractory epilepsy in a newborn: role of epilepsy surgery. Illustrative case.","authors":"Meredith Yang, John Tsiang, Melissa A LoPresti, Sandi Lam","doi":"10.3171/CASE23140","DOIUrl":"10.3171/CASE23140","url":null,"abstract":"Background: Neonatal meningitis due to Cronobacter is associated with powdered infant formula. Prompt recognition of this rare but aggressive infection is critical.Observations: The authors report a unique case of neonatal Cronobacter meningoencephalitis complicated by brain abscess and status epilepticus, requiring surgical intervention in a preterm 4-week-old male and related to contaminated powdered infant formula. They discuss the medical and surgical management in this patient, as well as the role of epilepsy surgery in acute drug-resistant epilepsy. This is paired with a literature review examining Cronobacter infections in infants to provide a summative review of the existing literature.Lessons: Cronobacter contamination in powdered infant formula and breast pumps is rare but can cause life-threatening infections. When evaluating patients with Cronobacter central nervous system infections, serial neuroimaging, infection control, and prompt surgical management are essential. Future studies are needed regarding the role of epilepsy surgery in the acute infectious period.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"5 25","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/58/f2/CASE23140.PMC10550530.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10041762","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

Rare clival localization of an eosinophilic granuloma: illustrative case. 嗜酸性肉芽肿的罕见斜坡定位：例证性病例。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-06-19 DOI: 10.3171/CASE22490

Martin E Weidemeier, Steffen Fleck, Werner Hosemann, Silke Vogelgesang, Karoline Ehlert, Holger N Lode, Henry W S Schroeder

引用次数: 0

Cavernous sinus dural arteriovenous fistula embolized through an occluded superior petrosal sinus: illustrative case. 海绵窦硬脊膜动静脉瘘通过闭塞的岩上窦栓塞：一个例证性病例。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-06-19 DOI: 10.3171/CASE23143

Natsuki Akaike, Hiroyuki Ikeda, Kensuke Takada, Minami Uezato, Masanori Kinosada, Yoshitaka Kurosaki, Masaki Chin

{"title":"Cavernous sinus dural arteriovenous fistula embolized through an occluded superior petrosal sinus: illustrative case.","authors":"Natsuki Akaike, Hiroyuki Ikeda, Kensuke Takada, Minami Uezato, Masanori Kinosada, Yoshitaka Kurosaki, Masaki Chin","doi":"10.3171/CASE23143","DOIUrl":"10.3171/CASE23143","url":null,"abstract":"Background: Transvenous embolization for cavernous sinus (CS) dural arteriovenous fistulas (CS-DAVFs) with limitations of the major access routes to the CS is challenging.Observations: A 74-year-old woman presented with left-sided conjunctival injection and exophthalmos. Cerebral angiography showed a left CS-DAVF draining into the left uncal vein and superior ophthalmic vein, with the fistulous point located in the posterosuperior compartment of the left CS. The left inferior petrosal sinus and internal jugular vein were occluded, and no drainage route from the left superior ophthalmic vein was seen. The anterior segment of the left superior petrosal sinus (SPS) was occluded, but the posterior segment was not. Microangiography from the posterior segment of the left SPS showed a beak-like orifice in the anterior segment of the left SPS toward the left CS. A micro-guidewire was guided through the beak-like orifice, and the microcatheter was advanced into the left CS. The left CS was packed and the DAVF was occluded.Lessons: Transvenous embolization through an occluded SPS may be an option in the endovascular treatment of CS-DAVFs. Penetration along the beak-like orifice of the occluded SPS visualized by venography at the blind end of the SPS may be useful in reaching the CS via the SPS.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"5 25","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9e/e0/CASE23143.PMC10550532.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10054180","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

Direct withdrawal of a retained foreign body bisecting the thoracic spinal canal in a neurologically intact pediatric patient: illustrative case. 神经系统完整的儿童患者直接取出保留的异物，将胸椎管一分为二：一个示例性病例。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-06-19 DOI: 10.3171/CASE2363

David R Peters, Trent VanHorn, Brandon Karimian, Benjamin Pruden, Scott D Wait, Roy T Daniel, Constantin Tuleasca

{"title":"Direct withdrawal of a retained foreign body bisecting the thoracic spinal canal in a neurologically intact pediatric patient: illustrative case.","authors":"David R Peters, Trent VanHorn, Brandon Karimian, Benjamin Pruden, Scott D Wait, Roy T Daniel, Constantin Tuleasca","doi":"10.3171/CASE2363","DOIUrl":"10.3171/CASE2363","url":null,"abstract":"Background: Nonmissile penetrating spinal cord injury (NMPSCI) with a retained foreign body (RFB) is rare and usually results in permanent neurological deficits. In extremely rare cases, patients can present without significant neurological deficits despite an RFB that traverses the spinal canal. Given the rarity of these cases, a consensus has not yet been reached on optimal management. In a patient with an RFB and a neurologically normal clinical examination, the risk of open surgical exploration may outweigh the benefit and direct withdrawal may be a better option.Observations: A 10-year-old female suffered an NMPSCI to the thoracic spine with an RFB that bisected the spinal canal but remained neurologically intact. Direct withdrawal of the RFB was chosen instead of open surgical exploration, leading to an excellent clinical outcome. The literature was reviewed to find other examples of thoracic NMPSCI with RFB and neurologically normal examinations. Management strategies were compared.Lessons: For NMPSCI with RFB and without significant neurological deficits, direct withdrawal is a viable and possibly the best treatment option. The use of fast-acting anesthesia without intubation minimizes patient manipulation, speeds up recovery, and allows early assessment of neurological status after removal.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"5 25","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/22/66/CASE2363.PMC10550528.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9683354","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