Interdisciplinary Neurosurgery: Advanced Techniques and Case Management最新文献

{"title":"Dual-incision resection of multiple thoracic meningiomas presenting as lumbar‬ stenosis: Case report‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬","authors":"Philip Zitser ,&nbsp;Michael Brisman ,&nbsp;Jonathan Brisman","doi":"10.1016/j.inat.2025.102135","DOIUrl":"10.1016/j.inat.2025.102135","url":null,"abstract":"<div><h3>Introduction</h3><div>Spinal meningiomas are relatively rare. Multiple spinal meningomas causing symptomatic compression requiring surgery are extremely uncommon. The insidious presentation may delay clinical and surgical intervention.</div></div><div><h3>Case report</h3><div>A 67-year-old diabetic patient with a remote history of prior thoracic spine tumor resections presented with worsening back pain radiating to both legs, bilateral lower extremity weakness, and gait disturbance. Lumbar MRI revealed severe lumbar stenosis. Prior history of tumor excision prompted a full spine MRI, revealing two large intradural extramedullary lesions. The patient underwent a posterior laminectomy and gross total resection of both lesions through separate incisions. Histopathology confirmed meningiomas. Postoperatively, the patient experienced improved neurological function.</div></div><div><h3>Outcome</h3><div>Patient is neurologically recovering well and is fully participating in physical therapy for post-surgical pain.</div></div><div><h3>Conclusion</h3><div>The case highlights the importance of full-spine imaging in patients with prior surgical spinal procedures or when current symptoms are not entirely explained by current imaging. The surgical approach utilizing two separate incisions with separate laminectomies emphasized a less invasive strategy for multilevel tumor resection. This might be relevant to a patient with already extensive laminectomies. In patients with diabetes, additional suspicion should be raised for atypical presentations of surgical spinal pathology. This case highlights the need for routine surveillance in patients with prior spinal tumor excisions. This report adds to the literature by detailing neurosurgical planning and operative technique for a rare and potentially confounding clinical presentation.</div></div><div><h3>Study design</h3><div>Case report.</div></div><div><h3>Patient sample</h3><div>One patient presented to our clinical locations.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"42 ","pages":"Article 102135"},"PeriodicalIF":0.5,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325123","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":"Postpartum intracranial hemorrhage: Diagnostic and therapeutic insights into metastatic choriocarcinoma","authors":"Guizhong Yan,&nbsp;Dengfeng Wang,&nbsp;Kefeng Zhang,&nbsp;Boru Hou","doi":"10.1016/j.inat.2025.102131","DOIUrl":"10.1016/j.inat.2025.102131","url":null,"abstract":"<div><div>This case report describes a 19-year-old primigravida who presented with acute neurological symptoms three months post-delivery, ultimately diagnosed with cerebral metastatic choriocarcinoma complicated by intracranial hemorrhage. Diagnostic evaluation revealed elevated serum β-hCG (80678 IU/L), pulmonary metastases, and a hemorrhagic frontoparietal lesion on neuroimaging. Emergency hematoma evacuation confirmed choriocarcinoma through characteristic histopathological and immunohistochemical findings (CKp +, β-hCG + and H3K27me3 + ). The patient was classified as FIGO stage IV and successfully treated with EMA/CO chemotherapy, demonstrating biochemical response (β-hCG decline to 105 IU/L) without complications. This case highlights several key clinical insights: (1) the diagnostic challenge of differentiating metastatic choriocarcinoma from primary intracranial hemorrhage in reproductive-aged women; (2) the critical importance of serum β-hCG testing in atypical neurological presentations; and (3) the effectiveness of multimodal therapy combining neurosurgical intervention with prompt chemotherapy initiation. The temporal relationship to recent pregnancy (3 months postpartum) and rapid hematogenous spread underscore the aggressive nature of this trophoblastic malignancy. These findings reinforce current management guidelines while emphasizing the need for heightened clinical suspicion when evaluating young women with unexplained neurological deficits and a recent pregnancy history.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"42 ","pages":"Article 102131"},"PeriodicalIF":0.5,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325775","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":"The hidden dangers: Delayed fatal apoplexy in adult-onset optic pathway glioma following biopsy","authors":"Dawit Workneh Gechu ,&nbsp;Mehari Wale Alem ,&nbsp;Abel Gizaw Woldegabriel ,&nbsp;Yordanos Girma Legesse ,&nbsp;Mieraf Bayouh Alemu ,&nbsp;Peniel Zewdie Abera","doi":"10.1016/j.inat.2025.102136","DOIUrl":"10.1016/j.inat.2025.102136","url":null,"abstract":"<div><h3>Background</h3><div>Optic pathway gliomas (OPG) are the most common primary neoplasm of the optic pathway. They are most commonly seen in children less than 8 years of age. Adult onsets OPG are rare entity. Hemorrhage (Apoplexy) in these tumors is rare and it is extremely rare to occur late after a biopsy.</div></div><div><h3>Case presentation</h3><div>We describe a 33 years old right handed male patient presented with status epilepticus and right side motor preference of 5 h duration. He was on 3rd month post operation after Craniotomy and open biopsy was taken for a suspected OPG. Imaging showed massive intatumoral hemorrhage with no evident vascular abnormalities. The initial Pathology report showed pilocytic astrocytoma (PCA). He underwent Craniotomy and hematoma evacuation with right side Kochers point external ventricular drain (EVD). He had significant initial neurologic improvement but on 5th post-operative day (POD) he had re-bleeding with a fatal outcome.</div></div><div><h3>Discussion</h3><div>Apoplexy in optic pathway and hypothalamic gliomas is a rare event. While some risk factors for tumor apoplexy in optic pathway gliomas have been identified, the potential for a biopsy to precipitate delayed bleeding merits cautious consideration. Ultimately, clinical management strategies for these delicate lesions must be individually tailored, weighing the diagnostic yield against the potential for procedural complication.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"42 ","pages":"Article 102136"},"PeriodicalIF":0.5,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325764","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 new era in thrombectomy: the emergence of super large bore aspiration catheters","authors":"Yoichiro Kawamura MD, PhD,&nbsp;Patrick Brouwer MD","doi":"10.1016/j.inat.2025.102138","DOIUrl":"10.1016/j.inat.2025.102138","url":null,"abstract":"<div><div>Mechanical thrombectomy has significantly improved outcomes for acute ischemic stroke (AIS) caused by large vessel occlusion (LVO), yet challenges remain, necessitating further advancements. A key factor influencing thrombectomy success is the aspiration catheter-to-vessel size ratio, with larger-diameter aspiration catheters demonstrating superior efficacy. This has led to the development of super large-bore aspiration catheters (SLACs), particularly those with an inner diameter of 0.088 in. or larger, which are expected to enhance thrombus retrieval.</div><div>SLACs have the possibility to revolutionize thrombectomy, especially for LVOs in critical arteries such as the internal carotid artery, the M1 segment of the middle cerebral artery. Recent clinical trials have shown highly favorable results, supporting their imminent adoption. With a bore size comparable to balloon guide catheters (BGCs), SLACs improve thrombus ingestion and reduce the risk of clot fragmentation during navigation through tortuous vessels. Additionally, they provide a stable base camp for multiple retrieval attempts, increasing procedural efficiency.</div><div>Direct aspiration thrombectomy with SLACs offers advantages such as shorter procedural times, and reduced device usage. As these devices enter clinical practice, they are expected to further refine thrombectomy techniques and improve outcomes for AIS patients.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"42 ","pages":"Article 102138"},"PeriodicalIF":0.5,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325765","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 rare case of spontaneous spinal epidural hematoma after kyphoplasty","authors":"Guan-Sian Wu,&nbsp;Shih-Huang Tai,&nbsp;Yu-Ning Chen,&nbsp;E-Jian Lee","doi":"10.1016/j.inat.2025.102134","DOIUrl":"10.1016/j.inat.2025.102134","url":null,"abstract":"<div><div>Spinal surgery following by spinal epidural hematoma is a rare condition, the Factors related to symptomatic spinal epidural hematomas include coagulopathy, trauma, surgery, and vascular lesions. Most hematomas occur spontaneously without known etiology, but some spontaneous lesions are related to vascular anomalies [<span><span>1</span></span>].The study showed the higher incidence of hematoma associated with spinal deformity, the location of thoracic spine, posterior approach, and minimally invasive surgery [<span><span>2</span></span>].</div><div>We present a case of an obese patient with spinal deformity who underwent multiple spinal surgeries and subsequently developed symptomatic spinal epidural hematomas following kyphoplasty. Early diagnosis via computed tomography scan enabled prompt surgical intervention, minimizing neurological injury.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"42 ","pages":"Article 102134"},"PeriodicalIF":0.5,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325776","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":"Surgical excision of symptomatic multiple nerve root perineural cysts in thoracic intervertebral foramen: A case report","authors":"Fan He,&nbsp;Shirong Gu","doi":"10.1016/j.inat.2025.102133","DOIUrl":"10.1016/j.inat.2025.102133","url":null,"abstract":"<div><div>A 68-year-old female patient was admitted to our outpatient clinic with back and low back pain. There were no remarkable physical or neurological findings of the patient. Imaging workup revealed two cystic lesions of the right T8 and left T11 nerve root at the level of the foramen. Conservative treatment for this patient was ineffective in a half-year follow-up period. We performed laminectomies at the level of interests and cysts were dissected from the underlying dura after removal of the cerebrospinal fluid. We found there is an internal fistula at the communication between the cyst and the dura mater and nerve root passing through it. The cysts were excised and the nerve roots were preserved. Surgical resection resulted in significant improvement in patient symptoms, and pathology revealed a perineural cyst. We conclude that back pain may be generated when distention of the cyst activates neural, dural, or bone nociceptors. And surgical treatment can be curative.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"42 ","pages":"Article 102133"},"PeriodicalIF":0.5,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325125","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":"Advancements and challenges in neuroendoscopic training in Egypt","authors":"Islam Abdelsamad ,&nbsp;Ihap Bedier","doi":"10.1016/j.inat.2025.102140","DOIUrl":"10.1016/j.inat.2025.102140","url":null,"abstract":"<div><h3>Background</h3><div>Neuroendoscopy has significantly improved the neurosurgical field, offering minimally invasive solutions for various cranial and spinal conditions. As these techniques become more prevalent worldwide, including in Egypt, the demand for well-structured and high-quality training programs has grown. This study aims to evaluate the current landscape of neuroendoscopic training in Egypt, highlighting key advancements and persisting challenges. Based on practical experience and a comprehensive literature review, we propose strategies to enhance the quality, accessibility, and sustainability of neuroendoscopic education in the country.</div></div><div><h3>Methods</h3><div>Our analysis draws from our extensive clinical and academic involvement in neuroendoscopic procedures and educational courses conducted in Egypt and the United Kingdom. A targeted literature review was performed using PubMed and Google Scholar with relevant search terms. Comparative evaluation of training infrastructure in Egypt versus developed countries was also conducted. Additionally, we assessed existing collaborations, local initiatives, and regulatory frameworks affecting neuroendoscopic education.</div></div><div><h3>Results</h3><div>Three primary domains of advancement were identified: <em>Specialized Workshops</em>: Over 35 cadaveric and non-cadaveric workshops have been conducted since 2009 to the best of our knowledge, significantly improving practical skill acquisition among Egyptian neurosurgeons, <em>International Collaborations</em>: Partnerships have introduced structured fellowships and global training exposure, and <em>Personal Efforts</em>: Individual neurosurgeons have actively pursued external fellowships, initiated local training, and introduced neuroendoscopic practice into their hospitals despite financial and logistical barriers.</div></div><div><h3>Conclusion</h3><div>Egypt has laid a solid foundation for neuroendoscopic education through focused efforts by academic institutions, professional societies, and individual neurosurgeons. With strategic national planning and international support, Egypt is well-positioned to emerge as a regional leader in neuroendoscopic training, setting an example for other developing countries aiming to integrate advanced minimally invasive neurosurgical techniques.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"42 ","pages":"Article 102140"},"PeriodicalIF":0.5,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325762","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":"Basilar artery aneurysm with aplasia of internal carotid artery: A case presentation","authors":"Kumpei Takao,&nbsp;Mitsuhiro Anan,&nbsp;Kouhei Onishi,&nbsp;Masaki Morishige,&nbsp;Nobuhiro Hata,&nbsp;Minoru Fujiki","doi":"10.1016/j.inat.2025.102132","DOIUrl":"10.1016/j.inat.2025.102132","url":null,"abstract":"<div><h3>Background</h3><div>Aplasia of the internal carotid artery (ICA) is rare. Patients with ICA aplasia are complicated with intercranial aneurysms due to hemodynamic factors more often than others, although they are asymptomatic.</div><div>Clinical presentation</div><div>We herein report a case of subarachnoid hemorrhaging due to a ruptured basilar artery (BA) aneurysm associated with congenital left ICA aplasia treated with endovascular therapy. The patient had been diagnosed with congenital ICA aplasia 15 years earlier; however, no aneurysm had been found at that time.</div></div><div><h3>Conclusions</h3><div>Hemodynamic factors associated with ICA aplasia may lead to <em>de novo</em> aneurysm formation. And also, wall share stress may lead to aneurysm formation.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"42 ","pages":"Article 102132"},"PeriodicalIF":0.5,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325763","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":"Trapping and superficial temporal artery to middle cerebral artery bypass for treating middle cerebral myxomatous fusiform aneurysm: a case report and literature review","authors":"Dacheng Ding ,&nbsp;Weidong Xia ,&nbsp;Minggang Shi ,&nbsp;Yanguo Shang ,&nbsp;Xiaoguang Tong","doi":"10.1016/j.inat.2025.102130","DOIUrl":"10.1016/j.inat.2025.102130","url":null,"abstract":"<div><h3>Introduction</h3><div>Cardiac myxomas are rare, predominantly benign tumors that most commonly occur in individuals aged 40–60 years, with a higher incidence in females. These tumors often exhibit friable surfaces, predisposing them to embolization. Systemic embolism occurs in up to 45 % of cases, frequently affecting cerebral circulation and leading to ischemic events.</div></div><div><h3>Case presentation</h3><div>We report the case of a 41-year-old female with a history of left atrial myxoma who presented with recurrent transient paresthesia of the right upper limb. Imaging revealed multiple intracranial myxomatous aneurysms, including a large fusiform aneurysm in the M2 segment of the left middle cerebral artery. Surgical intervention involving aneurysm trapping and a superficial temporal artery–M2 (STA-M2) bypass was successfully performed. Neurological function remained symptom-free at 6-month follow up.</div></div><div><h3>Conclusion</h3><div>Delayed-onset myxomatous fusiform aneurysms are rare and require tailored treatment. This case demonstrates the significance of STA-M2 bypass assisted trapping for complex intracranial aneurysms unsuitable for endovascular therapy, adding to the limited surgical literature.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"42 ","pages":"Article 102130"},"PeriodicalIF":0.5,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145267786","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":"Management of spinal chordomas and sarcomas: WFNS spine committee recommendations","authors":"Mehmet Zileli ,&nbsp;Artem O. Gushcha ,&nbsp;Salman Sharif ,&nbsp;Francesca Costa ,&nbsp;Zan Chen ,&nbsp;Onur Yaman ,&nbsp;Mirza Pojskic ,&nbsp;Corinna C Zygourakis","doi":"10.1016/j.inat.2025.102126","DOIUrl":"10.1016/j.inat.2025.102126","url":null,"abstract":"<div><h3>Objective</h3><div>This retrospective review aims to provide the most up-to-date information on the management of chordomas and sarcomas of the spine.</div></div><div><h3>Material and methods</h3><div>We performed separate literature searches on chordomas and spinal sarcomas from the last ten years (2014–2024), excluding non-English literature, case reports, and irrelevant papers. Using the Delphi method and two rounds of voting at international meetings, ten members of the World Federation of Neurosurgical Societies (WFNS) Spine Committee developed nine consensus statements.</div></div><div><h3>Results and discussion</h3><div>Management of chordomas is complex due to high recurrence rates, with an average life expectancy of six years. Total sacrectomy is viable for sacral chordomas at S2 and below. The preferred management strategy remains surgical resection followed by radiation therapy, as chordomas exhibit high resistance to chemotherapy. Conversely, en bloc resection with wide margins is the gold standard for chondrosarcomas, while radiation therapy is recommended after piecemeal resection. Chondrosarcomas and osteosarcomas are primarily treated with surgical resection, whereas Ewing sarcoma requires a multimodal approach that includes neoadjuvant chemotherapy, surgery, and radiation therapy.</div></div><div><h3>Conclusions</h3><div>Management of spinal chordomas and sarcomas features distinct challenges. Chordomas, particularly in the sacrum, often recur. Sacrectomy is effective for sacral chordomas at S2 and below. Surgical resection is crucial for chondrosarcomas, which are unresponsive to chemotherapy. In contrast, radical surgery is often required for osteosarcoma and Ewing’s sarcoma following neoadjuvant therapy.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"42 ","pages":"Article 102126"},"PeriodicalIF":0.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145267787","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}