Interdisciplinary Neurosurgery: Advanced Techniques and Case Management最新文献

{"title":"Functional outcomes reporting using an adjusted outcomes index for mechanical thrombectomy in anterior cerebral artery occlusions – A case series","authors":"Michael Fana ,&nbsp;Praveen Sanmugananthan ,&nbsp;Giulia Santangelo ,&nbsp;Max Kole ,&nbsp;Alex B. Chebl ,&nbsp;Horia Marin","doi":"10.1016/j.inat.2025.102021","DOIUrl":"10.1016/j.inat.2025.102021","url":null,"abstract":"<div><h3>Introduction</h3><div>The decision to intervene with mechanical thrombectomy (MT) for anterior cerebral artery (ACA) strokes is often made based on anticipated long-term functional outcomes using modified Rankin scores (mRS) which is primarily based on ambulatory status. Here, we review our single-center experience with ACA MT and evaluate the utility of various functional outcomes reporting.</div></div><div><h3>Methods</h3><div>A case series of 15 patients undergone MT for ACA stroke using the Solitaire or Trevo stent-retrievers was completed. The data retrieved included patient demographics, initial National Institute of Health Stroke Scale (NIHSS), thrombolysis in cerebral infarction (TICI) scores and number of passes, post-procedure 24-hour NIHSS, intra-operative or post-operative complications, discharge NIHSS and mRS, and 90-day mRS.</div></div><div><h3>Results</h3><div>There were 87 % favorable ACA TICI scores (i.e. 2B/C and 3) and 80 % first pass recanalization rate. The Solitaire 4 mm stent-retriever was employed in the majority of cases (60 %). No procedural complications were noted in 73 % of cases and no hemorrhagic conversion in 87 % of cases. 90-day mRS scores of 0–2 were noted in 26 % of patients. Using an adjusted outcomes index, 80 % of patients had favorable outcomes based on the 24-hour baseline-adjusted NIHSS score decrease of ≥41 %.</div></div><div><h3>Conclusion</h3><div>Our preliminary findings here highlight successful radiographic and favorable functional outcomes using the Solitaire and Trevo stent-retrievers (3–6 mm luminal diameter) for ACA MT when reporting with the adjusted outcomes index as compared to the 90-day mRS score. Further studies comparing these outcomes reporting metrics with a larger sample size will be needed to further elucidate this notable difference.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102021"},"PeriodicalIF":0.4,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143777107","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}

{"title":"Surgical versus nonsurgical management of civilian craniocerebral gunshot injuries","authors":"Wesley Shoap ,&nbsp;George Austin Crabill ,&nbsp;Roboan Guillen ,&nbsp;Kaleb Derouen ,&nbsp;Jack Leoni ,&nbsp;Zhide Fang ,&nbsp;Berje Shammassian","doi":"10.1016/j.inat.2025.102022","DOIUrl":"10.1016/j.inat.2025.102022","url":null,"abstract":"<div><h3>Introduction</h3><div>Craniocerebral gunshot wounds in the civilian population constitute a devastating subset of traumatic<!--> <!-->brain injuries (TBI). The aim of this study was to determine the association of mortality, intensive care unit length of stay (ICU LOS), and the Glasgow Outcome Scale Extended (GOS-E) among craniocerebral gunshot patients based on timing and type of intervention.</div></div><div><h3>Methods</h3><div>The<!--> <!-->trauma database was queried for GSWH<!--> <!-->patients ages 15 and older who received neurosurgical intervention from January 1st<!--> <!-->2016 to June 1st<!--> <!-->2023. Operative notes were reviewed and patients were then divided into three groups; intracranial pressure monitor only with medical treatment (ICP), primary decompressive craniectomy (pDC), or secondary decompressive craniectomy (sDC). The Surviving Penetrating Injury to the Brain (SPIN) score was calculated. Outcomes included mortality, ICU LOS, and GOS-E.</div></div><div><h3>Results</h3><div>Overall, 72 patients were identified who underwent either decompressive craniectomies or ICP monitoring. Mean SPIN scores were similar: ICP, pDC and sDC (30.5, 32.67, 31.55 (p = 0.4252)). When comparing two groups, the odds of death was higher in the ICP group compared to the pDC group (OR = 3.71, 95 % CI = 1.06, 14.35). With regard to hospital trajectory, ICU LOS (mean days) was different among the groups: ICP, pDC, sDC (16.7, 17.4, 23.4; p = 0.0002).</div></div><div><h3>Conclusion</h3><div>Mortality was reduced with primary decompressive craniectomy when compared to ICP monitoring with medical management alone and is associated with shorter ICU LOS compared to secondary decompressive craniectomy. In the appropriately selected patient, early and aggressive decompression should be considered.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102022"},"PeriodicalIF":0.4,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143758981","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}

{"title":"Surgical management of sacral fractures: A comprehensive series and review at a Level I trauma center","authors":"Alejandro Carrasquilla ,&nbsp;Pemla Jagtiani ,&nbsp;Danielle Chaluts ,&nbsp;James Speed Rogers ,&nbsp;Salazar Jones ,&nbsp;Hang Byun ,&nbsp;David Joseph ,&nbsp;Zachary Hickman ,&nbsp;Konstantinos Margetis","doi":"10.1016/j.inat.2025.102020","DOIUrl":"10.1016/j.inat.2025.102020","url":null,"abstract":"<div><h3>Objective</h3><div>This case series aims to classify various sacral fractures and their surgical treatment to generate more comprehensive treatment strategies and improve standardization of care.</div></div><div><h3>Methods</h3><div>After obtaining IRB approval, sacral fractures managed surgically among five surgeons at a Level I trauma center in New York City were collected retrospectively from the five surgeons’ case logs from 2007 to 2021. Pre-operative imaging was retrospectively gathered for each sacral fracture and classified using the AO spine, Denis, Modified Roy-Camille, Isler and lumbosacral injury classification system (LSICS) schemas. Each classification was correlated to LSICS.</div></div><div><h3>Results</h3><div>A total of 42 patients were included; 14 patients were treated by neurosurgery alone, 17 patients were treated by orthopedics alone, and 11 patients were treated by both neurosurgery and orthopedic surgery. Lumbopelvic or iliosacral fixation was used independently or in combination. Roy-Camille classification significantly correlated with LSICS severity scores, while other systems did not. Fixation type was not predicted by any classification system, suggesting variability in surgical technique.</div></div><div><h3>Conclusion</h3><div>Sacral fractures represent an area of growing collaboration between neurosurgeons and orthopedic surgeons. This study suggests that the Roy-Camille and Denis classifications correlate with LSICS scores of sacral fractures. Classification systems inconsistently correlate with injury severity and do not predict fixation choice. Surgical management of sacral fractures should be individualized, highlighting the need for standardized fixation guidelines.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102020"},"PeriodicalIF":0.4,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143740026","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}

{"title":"Comparative study of cases with and without C5 palsy after cervical spine surgery","authors":"Kosuke Fukuzawa,&nbsp;Masashi Uehara,&nbsp;Shota Ikegami,&nbsp;Yoshinari Miyaoka,&nbsp;Hiroki Oba,&nbsp;Terue Hatakenaka,&nbsp;Daisuke Kurogochi,&nbsp;Takuma Fukuzawa,&nbsp;Shinji Sasao,&nbsp;Keisuke Shigenobu,&nbsp;Tetsuhiko Mimura,&nbsp;Jun Takahashi","doi":"10.1016/j.inat.2025.102019","DOIUrl":"10.1016/j.inat.2025.102019","url":null,"abstract":"<div><h3>Objective</h3><div>C5 palsy is a known complication after cervical spine surgery, although incidence rates range widely from 0 to 30% in the literature. The causes of C5 palsy also remain unknown, with many studies describing contradictory risk factors. This comparative investigation sought to clarify the incidence and risk factors of C5 palsy in patients receiving cervical spine surgery.</div></div><div><h3>Methods</h3><div>The medical data of 433 consecutive patients (305 male and 128 female; mean age: 67.7 years) who underwent their first cervical spine surgery were retrospectively examined. The cohort was divided into the C5 palsy group and the non-C5 palsy group, and associated factors were examined by multivariate analysis.</div></div><div><h3>Results</h3><div>Postoperative C5 palsy was observed in 57 of 433 (13.2 %) patients. Atlantoaxial subluxation (AAS) was significantly more common in the C5 palsy group (10.5 %) than in the non-C5 palsy group (3.7 %) (p = 0.035). Regarding procedural details, surgical range including C4-5 was significantly more common in the C5 palsy group (80.7 % vs. 63.8 %, p = 0.015). Multivariate analysis revealed significant associations with C5 palsy for male gender (p = 0.025), AAS (p &lt; 0.001), and surgical range including C4-5 (p = 0.002).</div></div><div><h3>Conclusion</h3><div>C5 palsy occurred in 13.2% of patients undergoing cervical spine surgery. Significant associations with male gender, AAS, and surgical range including C4-5 suggest the need for additional perioperative considerations in such patients.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102019"},"PeriodicalIF":0.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143714681","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}

{"title":"Brainstem lesion diagnostic Dilemma: The role of multiparametric magnetic resonance imaging","authors":"Xuanxuan li ,&nbsp;Benjamin Butler ,&nbsp;Jhanvi Sawlani ,&nbsp;Samer Al-Ali ,&nbsp;Michael Bowen ,&nbsp;Markand Patel ,&nbsp;Robert Flintham ,&nbsp;Jane Herbert ,&nbsp;Nigel Davies ,&nbsp;Vijay Sawlani","doi":"10.1016/j.inat.2025.102018","DOIUrl":"10.1016/j.inat.2025.102018","url":null,"abstract":"<div><h3>Objectives</h3><div>Brainstem lesions pose a significant diagnostic challenge. The critical nature of the brainstem renders invasive biopsy difficult, often yielding inconclusive results. Multiparametric magnetic resonance imaging (MRI) is a useful addition to standard MRI sequences and can aid in the differentiation between neoplastic and non-neoplastic lesions. Although few studies have examined its utility for this purpose. Here we present our experience in characterising brainstem lesions using multiparametric MRI at a tertiary neurosciences centre.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed multiparametric MRI studies performed at our institution between 2015–2020. Brainstem lesion characterists on standard contrast-enhanced T1- and T2-weighted sequences, Dynamic Susceptibility Contrast (DSC) MRI, Diffusion Weighted Imaging (DWI), including Apparent Diffusion Co-efficient (ADC) maps, and MR spectroscopy were examined.</div></div><div><h3>Results</h3><div>Multiparametric MRI was performed on 560 patients, 31 (5.5%) of whom were assessed for indeterminate brainstem lesions. Of these, 18 (58%) provided useful additional diagnostic information to correctly differentiate neoplastic and inflammatory lesions. Cases of note include a low-grade glioma, non-enhancing high-grade glioma (transforming glioma), enhancing high-grade glioma, Bickerstaff encephalitis and neurosarcoidosis.</div></div><div><h3>Conclusion</h3><div>Standard MRI sequences in combination with multiparametric data can provide an accurate and non-invasive means of differentiating between inflammatory and neoplastic brainstem lesions, potentially avoiding biopsy in some cases.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102018"},"PeriodicalIF":0.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768421","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}

{"title":"Concomitant Vestibular Schwannoma and Pituicytoma: A case report and review of the literature","authors":"Aaron Lerch ,&nbsp;Anthony Minh Tien Chau ,&nbsp;Kym M. Rae ,&nbsp;Benjamin Sly ,&nbsp;James Bowman ,&nbsp;David Wong ,&nbsp;Eloise House ,&nbsp;Martin Wood ,&nbsp;Damian Amato","doi":"10.1016/j.inat.2025.102017","DOIUrl":"10.1016/j.inat.2025.102017","url":null,"abstract":"<div><h3>Background</h3><div>Vestibular schwannomas co-occurring with other intracranial tumours, particularly pituitary tumours, are exceptionally rare. Our review revealed only 48 cases documented in the literature. We additionally present a unique case of synchronous vestibular schwannoma and pituicytoma, a combination not previously reported.</div></div><div><h3>Case report</h3><div>A 51-year-old healthy male presented with rapid-onset sensorineural hearing loss and tinnitus. Diagnostic imaging revealed a vestibular schwannoma and incidental pituitary tumour, later confirmed histologically as a pituicytoma. Surgical management involved a staged resection utilising translabyrinthine and transsphenoidal approaches for tumour removal. At 18 months postoperatively, the patient remains asymptomatic, with complete resolution of his presenting symptoms.</div></div><div><h3>Conclusions</h3><div>To our knowledge, this is the first reported case of synchronous vestibular schwannoma and pituicytoma. We highlight the multidisciplinary approach that contributed to the favourable clinical outcome, underscoring the importance of collaborative management in complex cases involving multiple intracranial pathologies.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102017"},"PeriodicalIF":0.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143759548","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}

{"title":"A rare but serious case of subdural hematoma following transsphenoidal surgery for a pituitary adenoma","authors":"Mehdi Mahmoodkhani ,&nbsp;Narjes Koohi ,&nbsp;Alireza Motamedi ,&nbsp;Sam Rahimi ,&nbsp;Fatemeh Abbasi","doi":"10.1016/j.inat.2025.102016","DOIUrl":"10.1016/j.inat.2025.102016","url":null,"abstract":"<div><div>Transsphenoidal endoscopy is a prevalently performed surgical procedure aimed at removing pituitary lesions. This procedure can lead to various complications, including CSF leakage, tension pneumocephalus, and hypernatremia following the removal of a pituitary adenoma. In this particular case, we present a patient with a pituitary adenoma who unexpectedly got a spontaneous subdural hematoma (ASDH), nine days after undergoing transsphenoidal surgery, despite having a minor CSF leak. We speculate that this complication was linked to severe hypernatremia and a sudden decrease in consciousness level, necessitating immediate surgical intervention for hematoma removal. this case represents the first reported instance of ASDH associated with severe hypernatremia and negligible CSF leakage.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102016"},"PeriodicalIF":0.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143696687","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}

{"title":"The safe surgical strategy using preoperative embolization for cervical dumbbell tumor with large vertebral body Involvement: A case report","authors":"Nobuaki Tadokoro ,&nbsp;Masaaki Shiomi ,&nbsp;Shuhei Mizobuchi ,&nbsp;Katsuhito Kiyasu ,&nbsp;Masahiko Ikeuchi ,&nbsp;Motohiro Kawasaki ,&nbsp;Tomohiro Matsumoto ,&nbsp;Takuji Yamagami","doi":"10.1016/j.inat.2025.102015","DOIUrl":"10.1016/j.inat.2025.102015","url":null,"abstract":"<div><h3>Background</h3><div>The resection of a cervical spine dumbbell tumor extending into the vertebral body with vertebral artery encasement is a surgical challenge in terms of safe tumor resection with minimal intraoperative blood loss.</div></div><div><h3>Case presentation</h3><div>A seventy-six female patient suffering from left arm pain and progressive myelopathy presented with a cervical spine dumbbell tumor mainly located at the left C3-4 foramen with large C3 and C4 vertebral body involvement and encasement of the left vertebral artery. Because en-bloc tumor resection was difficult due to extensive tumor localization, piecemeal tumor resection by posterior and anterior approach was planned. To reduce intraoperative blood loss and complexity of surgical procedures, she underwent preoperative embolization and staged posterior and anterior surgery. The total tumor resection and spinal reconstruction were successfully carried out with minimal intraoperative blood loss.</div></div><div><h3>Conclusion</h3><div>Although complex tumor resection and reconstruction surgery should be planned on an individualized, case-by-case basis, preoperative embolization is reserved as an option for surgical strategies.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102015"},"PeriodicalIF":0.4,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143698131","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}

{"title":"A rare case of ectopic pituitary adenoma originating from the third ventricle floor: Surgical approach and outcomes","authors":"Guive Sharifi ,&nbsp;Elham Paraandavaji ,&nbsp;Shahin Naghizadeh ,&nbsp;Yalda Nilipour ,&nbsp;Mohammad Ali Kazemi ,&nbsp;Mahbube Ebrahimpur ,&nbsp;Ali Jafari ,&nbsp;Farzad Taghizadeh-Hesary","doi":"10.1016/j.inat.2025.102014","DOIUrl":"10.1016/j.inat.2025.102014","url":null,"abstract":"<div><h3>Introduction</h3><div>Ectopic pituitary adenomas (EPAs) are uncommon tumors originating outside the sella turcica, posing diagnostic challenges due to varied presentations. We report the third documented case of an EPA arising from the third ventricle floor (3VF), who was successfully treated surgically.</div></div><div><h3>Case presentation</h3><div>A 70-year-old male presented with visual impairment. Visual field tests addressed compressive optic neuropathy. Imaging revealed a well-defined mass arising from 3VF compressing the optic chiasm, confirmed as a nonfunctional EPA through histopathological and hormonal analyses. The patient underwent a lateral subfrontal translamina terminalis approach for tumor resection, ensuring maximal preservation of adjacent neurovascular structures. The procedure involved meticulous debulking of the tumor, careful preservation of the optic chiasm and hypothalamus, and watertight dural closure to minimize postoperative complications. Surgical intervention resulted in complete tumor resection without complications, leading to improved visual and endocrine function postoperatively.</div></div><div><h3>Conclusions</h3><div>This technique emphasized minimal brain manipulation and optimal preservation of neural integrity, contributing to the patient’s successful recovery following surgery. This surgical technique can be applied in similar 3VF cases, ensuring successful outcomes with minimal complications.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102014"},"PeriodicalIF":0.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683212","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}

{"title":"Rapid recovery in degenerative cervical myelopathy: A case report highlighting neuroplasticity following surgical decompression","authors":"Wilson David Campos Figueredo ,&nbsp;Raul Ramirez Grueso ,&nbsp;Maria Paola Barrero Medina ,&nbsp;Paula Andrea Arenas ,&nbsp;José Corredor Santos ,&nbsp;Luisa Jaimes","doi":"10.1016/j.inat.2025.102013","DOIUrl":"10.1016/j.inat.2025.102013","url":null,"abstract":"<div><h3>Introduction</h3><div>Degenerative cervical myelopathy (DCM) causes progressive compression of the spinal cord, leading to permanent and sometimes irreversible nerve damage if left untreated or not promptly treated. The nerve damage is associated with impaired sensory and motor function below the spinal cord injury (SCI) level, leading to a functional disability that affects the patient and the patient’s family quality of life. Early surgical decompression of the spinal canal remains one of the preferred options among physicians. Neuronal plasticity (NP) can take place after the initial injury and has been shown to be a complex process where the neurons use different adaptive strategies to regain their functions.</div></div><div><h3>Case report</h3><div>In this article, we present a case of a 65-year-old male with a history of obesity and rheumatologic disease, who, without prior medical monitoring, presented with posterior cervical pain, right-sided hemicranial headache, and progressive right hemiparesis that advanced to severe quadriparesis. Magnetic resonance imaging (MRI) and computed tomography (CT) revealed a narrowed cervical canal with evidence of compressive myelopathy. During the second surgical intervention, Intraoperative Neurophysiological Monitoring (IONM) was performed, showing Motor Evoked Potentials (MEP) in the right hemibody following decompression. The patient experienced an early and successful recovery, regaining sensory and motor functions sooner than expected after the second decompression.</div></div><div><h3>Conclusion</h3><div>Spinal cord injury (SCI) in adults is believed to cause definitive and non-treatable damage to the neurons. However, the presence of early MEP during the IONM and the rapid recovery of the patient after the surgical decompression demonstrated the potential for neuroplasticity and the opportunity to enhance it with different therapy strategies.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102013"},"PeriodicalIF":0.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143714680","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}