World Neurosurgery: X最新文献

{"title":"Managing neurosurgical complications in emergency settings: An evidence-based review of challenges and strategies","authors":"Moustafa A. Mansour ,&nbsp;Salma Medhat ,&nbsp;Alaa Elnomary ,&nbsp;Mohammad M. Selim ,&nbsp;Ahmed Mohsen ,&nbsp;Mohammed Al-Amri ,&nbsp;Salah Musaed ,&nbsp;Mohamed E. Behiry ,&nbsp;Michael Zohney ,&nbsp;Hamdi Nabawi Mostafa","doi":"10.1016/j.wnsx.2025.100525","DOIUrl":"10.1016/j.wnsx.2025.100525","url":null,"abstract":"<div><div>Neurosurgical complications in emergency settings present significant challenges, requiring prompt and expert intervention. This evidence-based review analyzes critical post-operative complications, including infections (post-craniotomy, post-spinal, and rare pathogens), hematomas (epidural, subdural, intracerebral), seizures, cerebrospinal fluid (CSF) leakage, ischemia, elevated intracranial pressure (ICP), and hydrocephalus. Special emphasis is placed on ventriculoperitoneal (VP) shunt malfunctions and aneurysmal subarachnoid hemorrhage (aSAH) rebleeding, highlighting their pathophysiology, diagnostics, and management.</div><div>The review explores risk factors, clinical presentations, and advanced diagnostics like quantitative near-infrared spectroscopy (Q-NIRS) for ischemia. Treatment protocols include surgical interventions (e.g., craniotomy, endoscopic third ventriculostomy), medical management (e.g., antiepileptic drugs, hyperosmolar therapy), and preventive measures.</div><div>From a triage perspective, the review underscores the neurosurgeon's critical role in prioritizing time-sensitive emergencies, such as favoring immediate evacuation for a life-threatening epidural hematoma over other urgent cases, a decision that profoundly impacts survival.</div><div>Ethical and logistical challenges in emergency neurosurgery are examined, particularly in resource-limited settings, addressing triage dilemmas, consent issues, and global disparities in care access. The review synthesizes recent advancements, such as telemedicine and novel therapies like tranexamic acid for aSAH, while underscoring multidisciplinary collaboration.</div><div>By integrating current research and clinical best practices, this review aims to equip neurosurgeons and healthcare providers with actionable insights to optimize patient outcomes in high-stakes emergencies.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"28 ","pages":"Article 100525"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145157608","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}

{"title":"Professor Mahmut Gazi Yaşargil (1925–2025): The pioneer and architect of modern neurosurgery","authors":"Cumhur Kaan Yaltırık ,&nbsp;Murat Şakir Ekşi","doi":"10.1016/j.wnsx.2025.100501","DOIUrl":"10.1016/j.wnsx.2025.100501","url":null,"abstract":"<div><div>Through his work on microsurgical tools and techniques, Professor Mahmut Gazi Yaşargil revolutionized neurosurgery by making it a safer and more successful area of brain surgery. Mahmut Gazi Yaşargil, a Turkish-born neurosurgeon, died in Switzerland in 2025 after being born in 1925. The medical world recognized him as the “Father of Modern Neurosurgery” because he devoted his life to precision, education, and the upbringing of future surgeons. This article examines his life history, scientific discoveries, academic achievements, and his lasting impact on neurosurgery practices around the world.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"28 ","pages":"Article 100501"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681113","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}

{"title":"Single versus double burr holes craniostomy drainage for chronic subdural hematoma: A systematic review and meta-analysis of randomized clinical trials","authors":"Abdulaziz M. Alghamdi ,&nbsp;Abdulrahman Ahmad Takroni ,&nbsp;Abdulwhab M. Alotaibi ,&nbsp;Razan Ayed Alboqami ,&nbsp;Orjwan Hashem Ateeq ,&nbsp;Fares F. Alsayegh ,&nbsp;Faisal Alotaibi","doi":"10.1016/j.wnsx.2025.100495","DOIUrl":"10.1016/j.wnsx.2025.100495","url":null,"abstract":"<div><h3>Objective</h3><div>This systematic review and meta-analysis aimed to compare the efficacy and safety of single- and double-burr hole craniostomies (sBHC) and (dBHC) in the management of chronic subdural hematoma (cSDH).</div></div><div><h3>Methods</h3><div>The PubMed, MEDLINE, Embase, and Cochrane CENTRAL databases were systematically searched for relevant articles. The included articles were randomized controlled trials (RCTs) written in English that compared the efficacy or safety of sBHC to that of dBHC for the treatment of patients with cSDH.</div></div><div><h3>Results</h3><div>Nine RCTs were included in this systematic review. The length of surgery was significantly shorter in the sBHC group (mean difference = −20.65, 95 % CI [-28.58, −12.72], <em>p</em> &lt; 0.00001, I² = 96 %). <strong><u>The mean length of surgery in sBHC was 34.9 min, compared to 55.5 min for a dBHC. There was no significant difference in the postoperative Glasgow Coma Scale (GCS) between the groups, presence of postoperative infections, presence of postoperative pneumocephalus, length of hospital stay, recurrence rates, and mortality rate.</u></strong></div></div><div><h3>Conclusion</h3><div>Both sBHC and dBHC are efficacious surgical techniques for managing cSDH. Based on this meta-analysis of RCTs, the safety and efficacy of sBHC and dBHC were comparable without statistically significant differences.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"28 ","pages":"Article 100495"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144694380","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}

{"title":"Association between postoperative interleukin-6 levels in cerebrospinal fluid and invasiveness of surgery for subarachnoid hemorrhage","authors":"Hidetaka Onda ,&nbsp;Mizuki Kojima ,&nbsp;Nodoka Miyake ,&nbsp;Kenta Shigeta ,&nbsp;Naoki Tominaga ,&nbsp;Shoji Yokobori","doi":"10.1016/j.wnsx.2025.100511","DOIUrl":"10.1016/j.wnsx.2025.100511","url":null,"abstract":"<div><h3>Background</h3><div>Interleukin (IL)-6 levels in cerebrospinal fluid (CSF) may reflect postoperative inflammation and affect the outcomes of aneurysmal subarachnoid hemorrhage (SAH).</div></div><div><h3>Methods</h3><div>This study retrospectively analyzed CSF IL-6 levels on the first postoperative day in 77 patients with SAH treated by craniotomy or endovascular coiling within 12 h of diagnosis. IL-6 levels were measured by enzyme-linked immunosorbent assay and compared between treatment groups. Associations with cerebral vasospasm and clinical outcomes were evaluated by multiple regression analysis.</div></div><div><h3>Results</h3><div>The median IL-6 level in CSF was 10,501 pg/mL [interquartile range 3037.8, 43,118.5] and was significantly lower in the endovascular group than in the craniotomy group (<em>p</em> &lt; 0.001). In the craniotomy group, the IL-6 level was higher in patients with involvement of the anterior communicating artery than in those with aneurysm at other sites (<em>p</em> = 0.008). Cerebral vasospasm was identified in 13.0 % of cases and was associated with elevated IL-6 (<em>p</em> = 0.003). Higher IL-6 levels were correlated with unfavorable outcomes (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Elevated IL-6 levels in CSF on postoperative day 1 were associated with cerebral vasospasm and worse outcomes in patients with SAH. Endovascular treatment resulted in lower IL-6 levels, suggesting that minimally invasive methods may reduce inflammation and improve the prognosis. Regulating IL-6 could be a potential therapeutic strategy in SAH management.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"28 ","pages":"Article 100511"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144904441","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}

{"title":"Prediction of perioperative ischemic events in flow diverter implantation using the adenosine diphosphate-induced platelet aggregation level system","authors":"Kenji Shoda ,&nbsp;Keisuke Kitano ,&nbsp;Yoshihiko Ueno ,&nbsp;Ryosuke Nakanishi ,&nbsp;Tasuku Sakayori ,&nbsp;Ayumu Kanbe ,&nbsp;Aki Oka ,&nbsp;Daisuke Mizutani ,&nbsp;Ryosuke Kikuchi ,&nbsp;Yukiko Enomoto","doi":"10.1016/j.wnsx.2025.100518","DOIUrl":"10.1016/j.wnsx.2025.100518","url":null,"abstract":"<div><h3>Objective</h3><div>Platelet reactivity is associated with perioperative complications during flow diverter (FD) implantation. Our study aimed to evaluate the association between adenosine diphosphate-induced platelet aggregation level (APAL) a platelet reactivity scoring system using light transmission methods and ischemic complications after FD implantation.</div></div><div><h3>Methods</h3><div>This retrospective study included 47 patients who underwent FD implantation for cerebral aneurysms between September 2020 and December 2023 at our institution and who were taking two or more antiplatelet agents before the procedure. Platelet reactivity was assessed using APAL scoring and VerifyNow, with evaluations conducted preoperatively, 1–3 days postoperatively, 1 month postoperatively, and at the time of ischemic complications.</div></div><div><h3>Results</h3><div>Ischemic complications occurred in four patients (8.5 %). The correlation coefficient between APAL and the P2Y12 reaction units (PRU) measured over the entire period was <em>r</em> = 0.553 (<em>p</em> &lt; 0.001). Preoperative APAL values were significantly high in patients with ischemic complications (<em>p</em> = 0.024). The optimal cutoff APAL value calculated from the receiver operating characteristic curve, was 6.6. The APAL system exhibited a moderate correlation with PRU measurements.</div></div><div><h3>Conclusion</h3><div>As a fully automated test, APAL is characterized by fewer manual errors than conventional methods. Therefore, APAL may be useful for evaluating antiplatelet function during FD implantation.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"28 ","pages":"Article 100518"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145018874","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}

{"title":"Reasons for magnetic resonance imaging in subarachnoid hemorrhage patients: A retrospective, single center study","authors":"Sarah E. Nelson ,&nbsp;John Liang ,&nbsp;Alexandra S. Reynolds ,&nbsp;Neha Dangayach ,&nbsp;Hae-Young Baang ,&nbsp;Spyridoula Tsetsou ,&nbsp;Cappi Lay","doi":"10.1016/j.wnsx.2025.100521","DOIUrl":"10.1016/j.wnsx.2025.100521","url":null,"abstract":"<div><h3>Objective</h3><div>Aneurysmal subarachnoid hemorrhage (SAH) is associated with significant morbidity and mortality. MRI holds promise for improving aneurysmal SAH management, and reasons for its performance could improve knowledge of how this modality could be leveraged.</div></div><div><h3>Methods</h3><div>In this single-center cohort study, we retrospectively compared SAH patients who had undergone clinically-indicated MRIs vs those who had not and evaluated patients based on major reason for MRI. Wilcoxon rank-sum tests and chi-square tests were used to make univariate comparisons as appropriate. Performance of MRI was also included in multivariable models evaluating discharge outcomes.</div></div><div><h3>Results</h3><div>Among 132 SAH patients (median age (IQR) 57 (48–67) years, 62.1 % female) hospitalized from 2021 to 2022, 68 (51.5 %) underwent MRI during their acute hospitalization. SAH patients who underwent MRIs had longer hospital lengths of stay (median (IQR): 22 (14–38) vs 17.5 (13–22) days, <em>p</em> = 0.01) and were less frequently discharged as deceased (5.9 % vs 23.4 %, <em>p</em> = 0.004). Most common reasons for MRI performance were to evaluate for SAH cause (<em>n</em> = 23) and to assess for infarct or vasospasm (<em>n</em> = 27). In multivariable analyses, not having had an MRI was a significant predictor for the outcome discharged as deceased, while having had an MRI was a significant predictor of hospital and ICU lengths of stay.</div></div><div><h3>Conclusions</h3><div>In this single-center cohort study, about half of SAH patients underwent MRIs, frequently to assess for SAH cause and for vasospasm or infarct. Those who underwent MRIs had longer hospital stays and less frequently died while in the hospital. Additional studies to confirm these findings are needed.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"28 ","pages":"Article 100521"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145044722","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}

{"title":"Thirty-day mortality in the oldest old with spontaneous subarachnoid hemorrhage","authors":"Yu-Hua Huang ,&nbsp;Tsung-Han Lee","doi":"10.1016/j.wnsx.2025.100523","DOIUrl":"10.1016/j.wnsx.2025.100523","url":null,"abstract":"<div><h3>Objective</h3><div>Spontaneous subarachnoid hemorrhage (SAH) is a severe disease with a high mortality rate that frequently occurs in the elderly. People aged 80 years and over can be regarded as the oldest old and are a rapidly growing segment of the population. It is unknown whether aggressive intervention for SAH is beneficial in this age cohort. We aimed to analyze the incidence and risk factors of 30-day mortality in the oldest old after spontaneous SAH.</div></div><div><h3>Methods</h3><div>A total of 1689 adult patients with a primary diagnosis of spontaneous SAH were retrospectively enrolled. Differences in clinical variables were evaluated between patients aged 18–79 years (N = 1592) and those aged ≥80 years (N = 97).</div></div><div><h3>Results</h3><div>The oldest old comprised 5.7 % of the study population. The 30-day mortality rate was 43.3 % (42/97) in the oldest old patients and 28.8 % (459/1592) in the non-oldest old patients (p &lt; 0.01). In a multivariate logistic regression model, the independent risk factor for 30-day mortality in the oldest old was hydrocephalus [odds ratio (95 % confidence interval) = 6.12 (1.54–24.25); p = 0.01]. The 30-day mortality rate was up to 58.3 % (21/36) among the oldest old patients accompanied by hydrocephalus.</div></div><div><h3>Conclusions</h3><div>The oldest old account for a significant proportion of patients with spontaneous SAH. As the incidence of 30-day mortality is remarkably high in this age group, the decision to aggressively treat the oldest old with SAH requires careful weighing, particularly in those who are highly risky.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"28 ","pages":"Article 100523"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109609","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}

{"title":"Flow diverter treatment for internal carotid artery aneurysm following management of distal cerebral aneurysms: Technical note","authors":"Yuichi Hirata ,&nbsp;Masafumi Hiramatsu ,&nbsp;Kenji Sugiu ,&nbsp;Fukiko Baba ,&nbsp;Juntaro Fujita ,&nbsp;Yuta Sotome ,&nbsp;Masato Kawakami ,&nbsp;Ryu Kimura ,&nbsp;Yuki Ebisudani ,&nbsp;Jun Haruma ,&nbsp;Tomohito Hishikawa ,&nbsp;Shota Tanaka","doi":"10.1016/j.wnsx.2025.100540","DOIUrl":"10.1016/j.wnsx.2025.100540","url":null,"abstract":"<div><h3>Background</h3><div>In recent years, the effectiveness of flow diverters (FDs) for the treatment of intracranial aneurysms has been reported. While FDs are effective, their deployment involves advancing a delivery wire distally, which may pose a risk if a distal aneurysm exists within the same artery. In such cases, the delivery wire could potentially perforate the distal aneurysm. Here, we present two cases of tandem aneurysms in which an internal carotid artery (ICA) aneurysm was treated with an FD following the treatment of a distal cerebral aneurysm.</div></div><div><h3>Case description</h3><div>A 44-year-old woman and a 67-year-old woman underwent magnetic resonance imaging for headache or abducens nerve palsy. In both cases, two aneurysms were revealed: one at the ICA and the other either at the middle cerebral artery or the top of the ICA. Due to the risk of perforation by the delivery wire during FD deployment, the distal aneurysms were treated first—either with surgical neck clipping or stent-assisted coil embolization. One month after the initial treatment, FD placement for the ICA aneurysm was performed as planned without complications in either case.</div></div><div><h3>Discussion</h3><div>This is the first report where tandem aneurysms were successfully treated with treatment for distal cerebral aneurysms, followed by FDs for proximal ICA aneurysms. We emphasize the potential risk of perforation of the distal aneurysm by the delivery wire during FD placement.</div></div><div><h3>Conclusion</h3><div>Treatment of distal cerebral aneurysms beforehand can help ensure the safe and effective use of FDs in patients with tandem aneurysms.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"28 ","pages":"Article 100540"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145319593","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}

{"title":"Distal occlusion and revascularization for microsurgical treatment of ruptured unclippable M1 segment middle cerebral artery aneurysms: Surgical outcomes and complications","authors":"Nasaeng Akharathammachote,&nbsp;Kitiporn Sriamornrattanakul,&nbsp;Chanon Ariyaprakai,&nbsp;Atithep Mongkolratnan","doi":"10.1016/j.wnsx.2025.100549","DOIUrl":"10.1016/j.wnsx.2025.100549","url":null,"abstract":"<div><h3>Background</h3><div>Complex, unclippable aneurysms of the pre-bifurcation segment of the M1 middle cerebral artery (pre-bM1) are rare and challenging to treat due to their association with lenticulostriate arteries (LSAs), particularly in ruptured cases. This study evaluates the outcomes and complications of microsurgical treatment employing distal occlusion and revascularization.</div></div><div><h3>Methods</h3><div>Eight patients with ruptured unclippable pre-bM1 aneurysms treated via distal occlusion and revascularization between 2018 and 2024 were retrospectively analyzed for radiographic and clinical outcomes.</div></div><div><h3>Results</h3><div>Complete aneurysm obliteration was achieved in all patients, with seven (87.5 %) out of eight patients attaining this within 7 days post-surgery. No postoperative rebleeding occurred, and all bypass grafts remained patent. Early postoperative LSA infarctions were detected in five patients (62.5 %), with only one (12.5 %) patient experiencing early worsening of hemiparesis. At discharge, good outcomes were observed in five (5/8: 62.5 %) patients overall and four patients (4/4: 100 %) of those with good preoperative grades.</div></div><div><h3>Conclusions</h3><div>Distal occlusion and revascularization proved safe and effective for treating ruptured unclippable M1 aneurysms. The procedure achieved high rates of aneurysm thrombosis with minimal symptomatic complications. Postoperative LSA infarction was the primary complication, although most cases were asymptomatic. Further refinement of microsurgical techniques is warranted to reduce this complication.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"28 ","pages":"Article 100549"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519576","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}

{"title":"Primary diffuse large B-cell lymphoma (DLBCL) of the sphenoid sinus presenting with oculomotor nerve palsy: A case report and systemic review","authors":"Methee Wongsirisuwan (.),&nbsp;Kritsada Buakate","doi":"10.1016/j.wnsx.2025.100509","DOIUrl":"10.1016/j.wnsx.2025.100509","url":null,"abstract":"<div><h3>Introduction</h3><div>Primary lymphomas of the paranasal sinuses, particularly those affecting the sphenoid sinus, are rare and often diagnostic challenging. Diffuse large B-cell lymphoma (DLBCL) typically presents nonspecific symptoms, resulting in diagnostic delays. Imaging and histopathology evaluation are essential for accurate diagnosis and treatment planning.</div></div><div><h3>Case description</h3><div>A 65-year-old female presented with headache, diplopia, and unilateral ptosis. CT imaging revealed a “ground-glass” appearance with sphenoid sinus erosion, while MRI showed invasion of the cavernous sinus. Endoscopic endonasal resection was performed, and histopathological examination confirmed DLBCL. Following chemotherapy, the patient's headache resolved immediately, and both diplopia and ptosis improved within three months.</div></div><div><h3>Methods</h3><div>A comprehensive literature review was conducted via PubMed up to November 2024 using the terms “sphenoid sinus” and “lymphoma,” Only published, peer-reviewed articles with confirmed diagnoses were included.</div></div><div><h3>Conclusion</h3><div>This report underscores the importance of considering sphenoid sinus lymphoma in the differential diagnosis of skull base lesions presenting with cranial nerve deficits. This rare entity poses significant diagnostic challenges due to its nonspecific clinical and radiologic features. A combined approach of imaging, histopathology, and multidisciplinary treatment offers favorable outcomes.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"28 ","pages":"Article 100509"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144892000","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}