Interdisciplinary Neurosurgery: Advanced Techniques and Case Management最新文献

{"title":"Large anterior communicating artery aneurysm successfully obliterated by straightening the parent artery: an illustrative case","authors":"Kengo Yamada ,&nbsp;Masashi Kotsugi ,&nbsp;Ryosuke Maeoka ,&nbsp;Hiromichi Hayami ,&nbsp;Tomoya Okamoto ,&nbsp;Yoshiaki Kakehi ,&nbsp;Ryosuke Matsuda ,&nbsp;Ichiro Nakagawa","doi":"10.1016/j.inat.2025.102081","DOIUrl":"10.1016/j.inat.2025.102081","url":null,"abstract":"<div><h3>Background</h3><div>Endovascular devices for cerebral aneurysms have advanced, but large aneurysms with complex shapes remain difficult to cure. A steep branching angle for the parent artery can be a key factor in recurrence after endovascular treatment. We report a case in which a large anterior communicating artery (Acom) aneurysm (left A1–A2 junction) with a hairpin-shaped parent artery was completely occluded by straightening the parent artery using a neck-bridging stent.</div></div><div><h3>Case description</h3><div>The patient in his 60 s was referred to our department after cerebral magnetic resonance imaging (MRI) in a dementia evaluation revealed a large Acom aneurysm 20 mm in diameter. Initial coil embolization was successful, but recurrence was observed six months later, requiring retreatment. After embolizing the recurrent aneurysm, a neck-bridging stent was placed in the left A1–A2 segment with a hairpin curve, successfully straightening the parent artery. The postoperative course was uneventful, with no hemorrhagic or ischemic complications, and the patient was discharged independently. No recurrence was observed on MRI a year later.</div></div><div><h3>Conclusion</h3><div>This successful use of a neck-bridging stent to straighten angulation of the parent artery in refractory large Acom aneurysms suggests a potential method for preventing aneurysm recurrence.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102081"},"PeriodicalIF":0.4,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144338885","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":"Midbrain radiation-induced cavernous malformation after treatment for Pontine Glioma: A case report","authors":"Rong-Tse Hsu ,&nbsp;Hung-Lin Lin ,&nbsp;Ji-An Liang","doi":"10.1016/j.inat.2025.102079","DOIUrl":"10.1016/j.inat.2025.102079","url":null,"abstract":"<div><h3>Background</h3><div>Adult brainstem gliomas are rare tumors, with concurrent radiation therapy (RT) and temozolomide being the standard treatment approach. Another uncommon condition, adult brainstem radiation-induced cavernous malformation (RICM), presents a significant risk of hemorrhage and focal neurological deficits. While surgery is typically recommended for symptomatic RICM, its location in the brainstem makes the procedure riskier.</div><div>We report a case of a brainstem glioma treated with chemoradiation, followed by the development of a brainstem RICM 10 years later. The patient was monitored with routine imaging follow-ups, demonstrating stable clinical and radiographic findings.</div></div><div><h3>Case Description</h3><div>A 36-year-old woman experienced dizziness, unsteady gait, and paresthesia for 2–3 months. Brain magnetic resonance imaging (MRI) in October 2014 revealed an infiltrative brainstem tumor. Biopsy confirmed a WHO grade 3 anaplastic astrocytoma. The primary treatment consisted of concurrent RT, 56 Gray (Gy) over 28 fractions, along with temozolomide. Adjuvant temozolomide therapy was continued for 10 years. In October 2024, a follow-up MRI showed a new cavernous malformation (CM) in the midbrain. Owing to the patient’s stable neurological status, continued observation with imaging surveillance was chosen.</div></div><div><h3>Conclusions</h3><div>This case highlights our experience in treating adult brainstem glioma and brainstem RICM. There is no established consensus on the standard management for these uncommon conditions. The treatment strategies employed in our case appeared to contribute to favorable long-term survival for the brainstem glioma and short-term stable condition for the brainstem RICM. Further studies are necessary to develop a standardized approach to treating these rare diseases.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102079"},"PeriodicalIF":0.4,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144329698","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":"Minimally invasive surgical management of patients with cerebral hemorrhage after PCI and literature review","authors":"Xuanbo Luo,&nbsp;Dawei Zhao,&nbsp;Haoquan Wang,&nbsp;Kai Liu,&nbsp;Guosheng Shi,&nbsp;Wei Bu","doi":"10.1016/j.inat.2025.102075","DOIUrl":"10.1016/j.inat.2025.102075","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative bleeding after percutaneous coronary intervention (PCI) is a major early mortality factor for patients, and cerebral haemorrhage is one of the most dangerous and serious one, and there is no effective treatment guideline and expert consensus for post-PCI cerebral haemorrhage.</div><div>Case presentation</div><div>The Third Hospital of Hebei Medical University admitted two patients with post-PCI cerebral haemorrhage from October 2023 to July 2024, and the patients were treated with minimally invasive drilling and drainage under stereotactic positioning. Past medical history showed that the patients underwent PCI, and preoperative CT confirmed acute cerebral haemorrhage, and the patients were treated with minimally invasive drilling and drainage under stereotactic positioning, and they recovered well after the operation.</div></div><div><h3>Conclusion</h3><div>For patients with large amount of cerebral haemorrhage or even cerebral herniation, the necessity of surgical treatment becomes more prominent. In the same time, Minimally invasive surgical management could take better prognosis for patients.</div><div>Percutaneous coronary intervention (PCI) is widely used in clinical practice, but a serious complication, bleeding, often occurs after PCI. Post-PCI bleeding is the most important factor in early death, and cerebral haemorrhage is the most dangerous and fatal one [<span><span>1</span></span>]. The choice of treatment for patients undergoing PCI is made difficult by the fact that they are often subjected to DAPT, which results in coagulation abnormalities and an elevated risk of haemorrhage. Usually, for patients with a small amount of cerebral haemorrhage, conservative medical treatment including nerve nutrition, dehydration to lower the cranial pressure, and prevention of cerebral vasospasm are given priority, but when a large amount of cerebral haemorrhage occurs or even cerebral herniation is formed in the patient, surgical treatment becomes an important and should be considered as a priority treatment modality, including craniectomy for haematoma removal and decompression of debridement flap, minimally invasive drilling and drainage under stereotactic positioning, and neuroendoscopic haematoma removal [<span><span>[2]</span></span>, <span><span>[3]</span></span>, <span><span>[4]</span></span>], there is no expert consensus or guideline for the treatment of these patients, this paper aims to discuss the choice of treatment options for these patients, and adopts two patients hospitalised in our hospital, using minimally invasive drilling and drainage under stereotactic positioning, the patients’ postoperative haematomas were better absorbed, and the prognosis was good, with no obvious neurological impairment left.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102075"},"PeriodicalIF":0.4,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144313873","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":"Atlas realignment as novel approach to whiplash recovery: A case study on cervical stability and neurovascular flow","authors":"Jonathan Verderame ,&nbsp;Muhammad Shakib Arslan ,&nbsp;Zaheer Abbas","doi":"10.1016/j.inat.2025.102074","DOIUrl":"10.1016/j.inat.2025.102074","url":null,"abstract":"<div><div>This case report illustrates the significant improvement of a male patient suffering from whiplash-associated disorder (WAD) following atlas vertebral realignment. The patient, who experienced headaches, neck pain, brain fog, a heavy feeling in the head, and dizziness, underwent an upright MRI of the cervical spine, which revealed ligamentous disruptions, loss of cervical lordosis, internal jugular vein compression, reduced blood flow, and altered cerebrospinal fluid (CSF) flow. Post-adjustment, notable improvements in CSF and blood flow were observed, correlating with symptomatic relief. This case underscores the potential benefits of atlas vertebral realignment in managing WAD, emphasizing the importance of craniocervical junction (CCJ) integrity, conservative management, and specialized imaging in understanding and treating the complex manifestations of WAD.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102074"},"PeriodicalIF":0.4,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144313906","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":"Spontaneous and early thrombosis of a ruptured aneurysm dependent on a perforating branch of P1","authors":"Matias Javier Rodriguez ,&nbsp;Firas Farhat","doi":"10.1016/j.inat.2025.102064","DOIUrl":"10.1016/j.inat.2025.102064","url":null,"abstract":"<div><div>Spontaneous thrombosis of intracranial aneurysms (IA) is a rare event with a poorly understood mechanism. Several factors may induce a thrombogenic state inside the aneurysmal sac, such as vasospasm, hypotension, hemodynamic alterations, IA geometrical configuration, or local vessel wall damage. Thrombosis is more frequent in ruptured aneurysms than in non-ruptured aneurysms, often occurring as a delayed event, suggesting that subarachnoid hemorrhage may play a role. Here, we describe a patient who presented with early thrombosis of a ruptured IA in the P1 segment of the posterior cerebral artery.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102064"},"PeriodicalIF":0.4,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144271831","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":"“A point, V point, U point” as the acupotomy approach to treat cervical spondylosis: A technical note","authors":"Zehao Hu ,&nbsp;Zhanxin Li","doi":"10.1016/j.inat.2025.102072","DOIUrl":"10.1016/j.inat.2025.102072","url":null,"abstract":"<div><div>This technical note describes a clinically-derived needle-knife technique for cervical spondylosis treatment, developed through our experience with 118 confirmed cases of degenerative cervical myelopathy (DCM).<!--> <!-->The approach combines surgical decompression principles with the minimally invasive advantages of acupotomy by targeting three anatomical entry points: posterior (A point), posterolateral (V point), and lateral (U point). These access points allow for selective release of six clinically-identified cervical physiological narrowings, thereby relieving nerve root and spinal cord compression from surrounding tissues. In our case series, this standardized approach demonstrated an 86.8% success rate with a 2.2% incidence of minor transient complications.<!--> <!-->The technique offers a potentially valuable alternative to conventional surgical interventions for specific DCM subtypes, particularly in cases where full surgical decompression may not be immediately warranted. However, further controlled studies are needed to establish comparative efficacy and long-term outcomes.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102072"},"PeriodicalIF":0.4,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144279625","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":"Armored brain and the need for surveillance imaging in shunted patients: A case report","authors":"Nebil Abdella Shukralla ,&nbsp;Mengistu Ayele Yigzaw ,&nbsp;Mikiyas G. Teferi ,&nbsp;Abel Gizaw ,&nbsp;Tsegazeab Laeke Teklemariam","doi":"10.1016/j.inat.2025.102070","DOIUrl":"10.1016/j.inat.2025.102070","url":null,"abstract":"<div><div>The occurrence of chronic subdural hematoma (CSDH) in patients with ventriculoperitoneal shunts is a well known complication, with calcification of these hematomas being being a rare occurrence; delayed diagnosis is frequent, significantly complicating management, particularly when the calcification presents as an ’armored’ type, characterized by extensive, dense calcification encasing the brain. We present a unique case of a 23-year-old female patient, previously shunted for Dandy-Walker malformation in childhood, who developed massive bilateral calcified CSDH, a challenging case successfully managed through craniotomy and hematoma evacuation. Surgical excision of calcified CSDH, while complex, can be effectively performed in carefully selected young patients, however, the potential for irreversible brain atrophy due to long-term mass effect highlights the critical need for vigilant neuroimaging surveillance, as early detection and intervention of CSDH in shunted patients are paramount to facilitate simpler surgical procedures and improve outcomes.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102070"},"PeriodicalIF":0.4,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144271830","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":"Spinal cord infarction as a complication of supratentorial cerebral arteriovenous malformation embolization","authors":"Vsevolod Shurkhay,&nbsp;Tyler Auschwitz,&nbsp;M. Yashar S. Kalani","doi":"10.1016/j.inat.2025.102066","DOIUrl":"10.1016/j.inat.2025.102066","url":null,"abstract":"<div><h3>Background</h3><div>Infarction of the anterior spinal artery after embolization of a supratentorial AVM with Onyx has not been reported. We present a case of a male patient in the fourth decade of life who underwent an uneventful embolization of a Spetzler-Martin grade I supratentorial arteriovenous malformation (AVM) using Onyx-18 in preparation for surgical resection. The patient awoke from anaesthesia with weakness in the bilateral arms below the C4 dermatome. His lower extremities were unaffected, and he had no thoracic dermatomal findings. Over the course of the next 4–6 h, he gradually lost the ability to move his lower extremities. Magnetic resonance imaging (MRI) demonstrated abnormal signal in the anterior spinal artery territory (ASA) in the cervical cord from C3 down to the cervicothoracic junction. Detailed study of the vertebral artery angiography demonstrates that the ASA arises from the bilateral vertebral arteries at the vertebrobasilar junction, but it is discontinuous, and muscular branches at the level of C5 reconstitute the ASA below C5. There is an angiographic discontinuity between the superior portion of the ASA and the lower half of the ASA at the level of C5, representing a watershed zone.</div><div>This devastating complication, we speculate, was the result of a watershed infarction due to transient hypotension during the embolization procedure.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102066"},"PeriodicalIF":0.4,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144313905","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":"A patient who underwent two thrombectomies within a week due to Trousseau syndrome: A case report","authors":"Richeng Zhou,&nbsp;Bingjie Jiang","doi":"10.1016/j.inat.2025.102065","DOIUrl":"10.1016/j.inat.2025.102065","url":null,"abstract":"<div><h3>Background</h3><div>Since the first description by Trousseau, substantial progress has been made in understanding the development of thromboembolic events associated with malignant tumors. The pathophysiological mechanism is understood to involve activation of the coagulation cascade by the tumor cells themselves or as a result of treatment, and only a few patients receive endovascular treatment for Trousseau syndrome. There is a lack of evidence that patients suspected of having Trousseau syndrome have received antiplatelet therapy or anticoagulant therapy, even after receiving antitumor treatment or anticoagulant therapy.</div></div><div><h3>Case</h3><div>A 66-year-old female was admitted to The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital on September 5, 2023 with a chief complaint of ’sudden-onset aphasia accompanied by right-sided weakness for more than 1 h.’ Within the first week of hospitalization, the patient underwent successive thrombectomies of the left middle cerebral artery and the basilar artery. After each thrombectomy, the patient’s NIH Stroke Scale (NIHSS) score improved. Abnormalities in coagulation function were detected during hospitalization, and chest CT revealed enlarged lymph nodes in the bilateral supraclavicular and hepatotactic regions. Lymph node aspiration biopsy confirmed the diagnosis of lung adenocarcinoma.</div></div><div><h3>Conclusion</h3><div>The patient did not experience recurrent stroke following the administration of rivaroxaban and ametinib. Multiple infarctions in different cerebral arterial supply areas caused by Trousseau syndrome are rare and require optimal planning involving endovascular treatment, antitumor therapy, and anticoagulant therapy.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102065"},"PeriodicalIF":0.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144230037","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":"Ruptured saccular cavernous carotid aneurysm presenting as a rare cause of epistaxis: a case report and comprehensive literature review","authors":"Jehad Al Habsi ,&nbsp;Qais Alrashidi ,&nbsp;Hashem AlSalman ,&nbsp;Miguel Lemus ,&nbsp;Marie-Christine Brunet","doi":"10.1016/j.inat.2025.102068","DOIUrl":"10.1016/j.inat.2025.102068","url":null,"abstract":"<div><div>Epistaxis with an intracranial cause is typically attributed to either traumatic carotid cavernous fistula or mycotic aneurysm rupture secondary to sinusitis with skull base erosion. In rare cases, it is described following the rupture of an idiopathic saccular aneurysm originating in the cavernous segment of the carotid artery with protrusion into the paranasal sinuses. Here, we report the case of a 71-year-old patient who presented with multiple episodes of epistaxis secondary to a ruptured cavernous carotid aneurysm that extended to the left sphenoid sinus. The patient was treated by coil embolization, followed by occlusion of the left internal carotid artery because of recanalization.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102068"},"PeriodicalIF":0.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144297936","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}