Journal of Neurosurgery: Case Lessons最新文献_第9页

Superficial siderosis: comparison of two cases indicates two distinct diagnostic entities. Illustrative cases. 浅表性铁质沉着症：两个病例的比较表明有两个不同的诊断实体。示例性案例。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-05-29 DOI: 10.3171/CASE23161

Asha Krishnakumar, Ashwin Ghadiyaram, Vishal C Patel, Charles F Opalak, Neel Dixit, William C Broaddus

{"title":"Superficial siderosis: comparison of two cases indicates two distinct diagnostic entities. Illustrative cases.","authors":"Asha Krishnakumar, Ashwin Ghadiyaram, Vishal C Patel, Charles F Opalak, Neel Dixit, William C Broaddus","doi":"10.3171/CASE23161","DOIUrl":"10.3171/CASE23161","url":null,"abstract":"Background: Superficial siderosis is the deposition of hemosiderin in the superficial layers of the central nervous system. It has been described in patients with chronic leakage of blood into the cerebrospinal fluid or with amyloid angiopathy, often associated with Alzheimer's disease (AD).Observations: We present two cases of superficial siderosis with vastly different symptomatologies and treatment courses. The patient in case 1 had diffuse superficial siderosis demonstrated on T2-weighted magnetic resonance imaging (MRI), appearing mostly in the inferior cerebellum and extending throughout the neuraxis. He presented with hearing loss, spasticity, gait abnormalities, and urinary incontinence. Ultimately, surgical exploration of the thoracic spinal dura revealed an arteriovenous fistula, which was obliterated. His clinical course stabilized but with persistent deficits. The patient in case 2 had a family history of AD and underwent MRI to evaluate for memory impairment, which demonstrated superficial siderosis of the left occipital lobe. Lumbar puncture demonstrated only traumatic contamination by red blood cells, but tau protein analysis was consistent with the diagnosis of AD.Lessons: Superficial siderosis is a diagnostic term prompted by findings on MRI that can arise due to two different pathological entities. The diagnosis in case 1 should be termed diffuse superficial siderosis and in case 2 should be termed lobar cortical siderosis.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"5 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/23/b9/CASE23161.PMC10550672.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9911794","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

Vasospasm secondary to responsive neurostimulator placement: a previously unreported complication. Illustrative case. 继发于反应性神经刺激器置入的血管痉挛：一种以前未报道的并发症。说明性案例。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-05-29 DOI: 10.3171/CASE22435

Brandon Rogowski, Aaron Miller, Brian F Saway, Jeffrey Wessell, Nathan C Rowland, Jonathan Ross Lena, William A Vandergrift

{"title":"Vasospasm secondary to responsive neurostimulator placement: a previously unreported complication. Illustrative case.","authors":"Brandon Rogowski, Aaron Miller, Brian F Saway, Jeffrey Wessell, Nathan C Rowland, Jonathan Ross Lena, William A Vandergrift","doi":"10.3171/CASE22435","DOIUrl":"10.3171/CASE22435","url":null,"abstract":"Background: The Responsive Neurostimulation (RNS) system is an implantable device for patients with drug-resistant epilepsy who are not candidates for resection of a seizure focus. As a relatively new therapeutic, the full spectrum of adverse effects has yet to be determined. A literature review revealed no previous reports of cerebral vasospasm following RNS implantation.Observations: A 35-year-old man developed severe angiographic and clinical vasospasm following bilateral mesial temporal lobe RNS implantation. He initially presented with concerns for status epilepticus 8 days after implantation. On hospital day 3, a decline in his clinical examination prompted imaging studies that revealed a left middle cerebral artery (MCA) stroke with angiographic evidence of severe vasospasm of the left internal carotid artery (ICA), MCA, anterior cerebral artery (ACA), and right ICA and ACA. Despite improvements in angiographic vasospasm after appropriate treatment, a thrombus developed in the posterior M2 branch, requiring mechanical thrombectomy. Ultimately, the patient was stabilized and discharged to a rehabilitation facility with residual cognitive and motor deficits.Lessons: Cerebral vasospasm as a cause of ischemic stroke after uneventful RNS implantation is exceedingly rare, yet demands particular attention given the potential for severe consequences and the growing number of patients receiving RNS devices.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"5 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/73/c1/CASE22435.PMC10550669.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9541483","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

Uniportal full endoscopic spinous process-preserving laminectomy for bilateral decompression in cervical stenotic myelopathy: patient series. 单门全内窥镜保留棘突椎板切除术治疗颈脊髓狭窄病的双侧减压：患者系列。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-05-29 DOI: 10.3171/CASE2378

Hyun-Jin Ma, Sang-Ho Lee, Chan Hong Park

{"title":"Uniportal full endoscopic spinous process-preserving laminectomy for bilateral decompression in cervical stenotic myelopathy: patient series.","authors":"Hyun-Jin Ma, Sang-Ho Lee, Chan Hong Park","doi":"10.3171/CASE2378","DOIUrl":"10.3171/CASE2378","url":null,"abstract":"Background: Endoscopic decompression for cervical stenotic myelopathy has several advantages over conventional open surgery. However, sometimes performing bilateral decompression, especially contralateral decompression, can be dangerous. The cervical spine has specific characteristics, including a shallower lamina angle and thinner lamina than the lumbar or thoracic lamina. These characteristics may cause cord compression when instruments approach the contralateral side of the lamina. This article introduces a novel surgical technique that can overcome the specificities of the cervical spine and discusses the efficacy and safety of uniportal full endoscopy for cervical decompression.Observations: Fourteen patients underwent uniportal full endoscopic spinous process-preserving laminectomy (ESP-L) for bilateral decompression of multilevel cervical stenotic myelopathy. The mean follow-up period was 13.44 months (range: 4-17 months). The preoperative and postoperative cervical spine angle and cervical range of motion did not differ significantly. The Japanese Orthopaedic Association score significantly improved postoperatively. The numeric rating scale scores significantly improved postoperatively. The mean duration of postoperative hospitalization was 2.3 days.Lessons: ESP-L is a new, safe, effective, and noninvasive technique that can achieve complete decompression of multilevel cervical stenotic myelopathy.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"5 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c2/e8/CASE2378.PMC10550670.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9541480","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

Contralateral lower limb radiculopathy by extraforaminal disc herniation following oblique lumbar interbody fusion in degenerative lumbar disorder: illustrative cases. 退行性腰椎疾病患者斜位腰椎融合术后椎间盘突出引起的对侧下肢神经根病：例证性病例。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-05-29 DOI: 10.3171/CASE23198

Satoshi Hattori, Toru Maeda

{"title":"Contralateral lower limb radiculopathy by extraforaminal disc herniation following oblique lumbar interbody fusion in degenerative lumbar disorder: illustrative cases.","authors":"Satoshi Hattori, Toru Maeda","doi":"10.3171/CASE23198","DOIUrl":"10.3171/CASE23198","url":null,"abstract":"Background: Contralateral lower limb radiculopathy is a potential early complication of oblique lumbar interbody fusion (OLIF) in degenerative lumbar disorders. Among several pathologies related to contralateral radiculopathy following OLIF, extraforaminal disc herniation during the OLIF procedure is very rare.Observations: Case 1 is a 68-year-old male underwent L4-5 and L5-6 OLIF for recurrent lumbar canal stenosis-expressed right leg pain and muscle weakness after surgery. Case 2 is a 76-year-old female on whom L4-5 OLIF was performed for L4 degenerative spondylolisthesis and who presented right leg pain and numbness postoperatively. In both patients, OLIF cages were inserted into the posterior part of the disc space or obliquely and the extraforaminal extruded disc compressed opposite exiting nerve roots (L5 root in case 1 and L4 root in case 2) as shown on magnetic resonance imaging (MRI). Surgical decompression with discectomy was required for pain relief and neurological improvement in both cases.Lessons: When emerging from new-onset opposite limb radiculopathy attributed to the OLIF procedure, extraforaminal disc herniation should be considered a potential pathology and MRI is useful for early diagnosis and selecting a subsequent management, including surgery.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"5 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/17/7e/CASE23198.PMC10550671.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9541481","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 internal auditory canal cavernous hemangioma with rapid progression of sensorineural hearing loss: illustrative case. 儿童内耳道海绵状血管瘤伴感音神经性听力损失的快速进展：一例例证。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-05-29 DOI: 10.3171/CASE23141

Hiroshi Hyakusoku, Yoshihide Tanaka, Yusuke Tsuchiya, Meijin Nakayama

{"title":"Pediatric internal auditory canal cavernous hemangioma with rapid progression of sensorineural hearing loss: illustrative case.","authors":"Hiroshi Hyakusoku, Yoshihide Tanaka, Yusuke Tsuchiya, Meijin Nakayama","doi":"10.3171/CASE23141","DOIUrl":"10.3171/CASE23141","url":null,"abstract":"Background: Cavernous hemangioma of the internal auditory canal is extremely rare and is characterized by symptoms such as vertigo, sensorineural hearing loss, and facial nerve dysfunction.Observations: A health examination on an 11-year-old female in the fifth grade revealed hearing loss in the left ear. She also had dizziness that had persisted for approximately 1 year. Pure-tone audiometry revealed sensorineural hearing loss in her left ear. Rightward horizontal and rotatory nystagmus was detected. Facial paralysis was not present. Magnetic resonance imaging showed a lesion that was suspected to be hemangioma. The authors selected a left suboccipital retrosigmoid approach. The tumor showed a berry-tufted appearance throughout the cerebellopontine angle. The seventh cranial nerve penetrated the tumor and partly circulated outside the tumor with marked adhesion. The authors partially resected the tumor to avoid damaging the facial nerve. A histological examination identified cavernous hemangioma.Lessons: The fundamental treatment for cavernous hemangioma of the internal auditory canal is complete surgical removal; however, any surgical intervention may result in hearing loss and facial paralysis. The extent of surgery needs to be decided intraoperatively based on the balance between preoperative symptoms and postoperative complications.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"5 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/da/9f/CASE23141.PMC10550673.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9911795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Successful treatment with urgent revascularization and parent artery occlusion for a ruptured intratumoral aneurysm following prior meningioma surgery: illustrative case. 脑膜瘤手术后破裂瘤内动脉瘤的紧急血运重建和母动脉闭塞的成功治疗：一个例证性病例。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-05-22 DOI: 10.3171/CASE23149

Tomohiro Okuyama, Kota Kurisu, Masaaki Hokari, Kei Miyata, Kazuki Uchida, Katsuyuki Asaoka, Koji Itamoto, Miki Fujimura

{"title":"Successful treatment with urgent revascularization and parent artery occlusion for a ruptured intratumoral aneurysm following prior meningioma surgery: illustrative case.","authors":"Tomohiro Okuyama, Kota Kurisu, Masaaki Hokari, Kei Miyata, Kazuki Uchida, Katsuyuki Asaoka, Koji Itamoto, Miki Fujimura","doi":"10.3171/CASE23149","DOIUrl":"10.3171/CASE23149","url":null,"abstract":"Background: An intratumoral aneurysm encased within the associated intracranial tumor is rare, and hemorrhage caused by its rupture is even more rare. While urgent and adequate surgical treatment is important, the treatment can be difficult given the limited understanding of this rare condition.Observations: A 69-year-old man who had undergone meningioma surgery 30 years prior presented with a disturbance in consciousness. Magnetic resonance imaging revealed massive intracerebral and subarachnoid hemorrhage. A round, partially calcified mass, which was diagnosed as recurrent meningioma, was also observed. Subsequent cerebral angiography revealed that the source of the hemorrhage was an intratumoral aneurysm in the dorsal internal carotid artery (ICA) encased within the recurrent meningioma. Urgent surgical ICA trapping and high-flow graft bypass were conducted. The postoperative course was uneventful, and he was referred to another hospital for rehabilitation.Lessons: This is the first case report of a ruptured intratumoral aneurysm being treated with urgent combined revascularization and parent artery trapping surgery. This surgical approach may be a feasible treatment option for such a challenging condition. Additionally, this case highlights the importance of diligent long-term follow-up after skull-base surgery, as minor intraoperative vascular wall injury may trigger the development and rupture of an intracerebral aneurysm.","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/52/37/CASE23149.PMC10550652.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9505786","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

Metastatic secondary gliosarcoma: patient series. 转移性继发性胶质肉瘤：患者系列。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-05-22 DOI: 10.3171/CASE232

Shivani Baisiwala, Myungjun Ko, Humza Zubair, Kevin Li, Andrew C Vivas, Richard Everson, Linda Liau, Ausaf Bari, Kunal S Patel

引用次数: 0

Ondine's curse: clinical presentation with diaphragmatic pacing and spontaneous respiratory recovery. Illustrative case. Ondine诅咒：膈肌起搏和自主呼吸恢复的临床表现。说明性案例。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-05-22 DOI: 10.3171/CASE233

Alexander J Schupper, Alex Devarajan, Dong-Seok Lee, Enrique Perez, Raj K Shrivastava

{"title":"Ondine's curse: clinical presentation with diaphragmatic pacing and spontaneous respiratory recovery. Illustrative case.","authors":"Alexander J Schupper, Alex Devarajan, Dong-Seok Lee, Enrique Perez, Raj K Shrivastava","doi":"10.3171/CASE233","DOIUrl":"10.3171/CASE233","url":null,"abstract":"Background: The complexity of posterior fossa surgery can often lead to rare complications due to the anatomy involved. Vestibular schwannoma resection is a common pathology in the posterior fossa, often requiring surgical intervention. Given the proximity of this space to the brainstem, cranial nerve VII/VIII complex, and posterior inferior cerebellar artery (PICA), neurovascular complications are not infrequent. A rare vascular complication from this surgical approach is a lateral medullary infarction from injury to the lateral medullary segment of the proximal PICA, leading to central hypoventilation syndrome (CHS).Observations: This report presents a unique case of a 51-year-old man who underwent a retrosigmoid craniectomy for resection of a vestibular schwannoma. Following surgery, the patient was unable to be weaned off the ventilator and was noted to become apneic while he slept, a clinical picture consistent with Ondine's curse.Lessons: This report discusses the anatomical considerations of this surgical corridor leading to this complication and the management of a patient with acquired Ondine's curse and reviews the scarce literature on this uncommon cause of acquired CHS.","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/c0/ed/CASE233.PMC10550651.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9505790","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

Vascular anomaly, lipoma, and polymicrogyria associated with schizencephaly: developmental and diagnostic insights. Illustrative case. 与脑裂畸形相关的血管异常、脂肪瘤和多微脑回畸形：发育和诊断见解。说明性案例。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-05-22 DOI: 10.3171/CASE2388

Kevin K Kumar, Angus Toland, Nancy Fischbein, Martha Morrell, Jeremy J Heit, Donald E Born, Gary K Steinberg

{"title":"Vascular anomaly, lipoma, and polymicrogyria associated with schizencephaly: developmental and diagnostic insights. Illustrative case.","authors":"Kevin K Kumar, Angus Toland, Nancy Fischbein, Martha Morrell, Jeremy J Heit, Donald E Born, Gary K Steinberg","doi":"10.3171/CASE2388","DOIUrl":"10.3171/CASE2388","url":null,"abstract":"Background: Schizencephaly is an uncommon central nervous system malformation. Intracranial lipomas are also rare, accounting for approximately 0.1% of brain \"tumors.\" They are believed to be derived from a persistent meninx primitiva, a neural crest-derived mesenchyme that develops into the dura and leptomeninges.Observations: The authors present a case of heterotopic adipose tissue and a nonshunting arterial vascular malformation arising within a schizencephalic cleft in a 22-year-old male. Imaging showed right frontal gray matter abnormality and an associated suspected arteriovenous malformation with evidence of hemorrhage. Brain magnetic resonance imaging revealed right frontal polymicrogyria lining an open-lip schizencephaly, periventricular heterotopic gray matter, fat within the schizencephalic cleft, and gradient echo hypointensity concerning for prior hemorrhage. Histological assessment demonstrated mature adipose tissue with large-bore, thick-walled, irregular arteries. Mural calcifications and subendothelial cushions suggesting nonlaminar blood flow were observed. There were no arterialized veins or direct transitions from the arteries to veins. Hemosiderin deposition was scant, and hemorrhage was not present. The final diagnosis was consistent with ectopic mature adipose tissue and arteries with meningocerebral cicatrix.Lessons: This example of a complex maldevelopment of derivatives of the meninx primitiva in association with cortical maldevelopment highlights the unique challenges from both a radiological and histological perspective during diagnostic workup.","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/46/e0/CASE2388.PMC10550650.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9505791","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

Endovascular treatment of a ruptured pure arterial malformation and associated dysplastic middle cerebral artery dissecting aneurysm: illustrative case. 血管内治疗破裂的纯动脉畸形和相关发育异常的大脑中动脉夹层动脉瘤：一个例证性病例。

Journal of Neurosurgery: Case Lessons Pub Date : 2023-05-22 DOI: 10.3171/CASE23150

Christine Marlow, Joshua A Cuoco, Kristine Ravina, Cole A Sloboda, John J Entwistle

{"title":"Endovascular treatment of a ruptured pure arterial malformation and associated dysplastic middle cerebral artery dissecting aneurysm: illustrative case.","authors":"Christine Marlow, Joshua A Cuoco, Kristine Ravina, Cole A Sloboda, John J Entwistle","doi":"10.3171/CASE23150","DOIUrl":"10.3171/CASE23150","url":null,"abstract":"Background: Pure arterial malformations are characterized as unique cerebrovascular lesions with a dilated, coil-like appearance and tortuous arteries without early venous drainage. Historically, these lesions have been described as incidental findings with a benign natural history. However, pure arterial malformations can rarely demonstrate radiographic progression and develop associated focal aneurysms with an unclear risk of rupture. Whether radiographic progression of these lesions or the presence of an associated aneurysm warrants treatment remains controversial.Observations: A 58-year-old male presented with sudden-onset left hemiparesis. Computed tomography revealed a large, acute, right frontotemporoparietal intraparenchymal hemorrhage with underlying irregular curvilinear calcifications. Diagnostic cerebral angiography revealed a dysplastic right middle cerebral artery dissecting aneurysm along the M2 segment associated with a pure arterial malformation, which was treated with endovascular flow diversion in a delayed fashion.Lessons: Pure arterial malformations with associated focal aneurysms may not exhibit a benign natural history as once thought. Intervention should be considered for ruptured pure arterial malformations to mitigate the risk of rerupture. Asymptomatic patients with a pure arterial malformation with an associated aneurysm should at least be followed closely with interval radiographic imaging to evaluate for malformation progression or changes in aneurysmal morphology.","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/1f/16/CASE23150.PMC10550645.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9505792","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