Interdisciplinary Neurosurgery: Advanced Techniques and Case Management最新文献

{"title":"Laminoplasty versus laminectomy for treatment of cervical spondylotic myelopathy: A randomized controlled Trial","authors":"Mohamed Salah Mohamed Ahmed Metwaly,&nbsp;Ahmed Mohamed Ezzat Abdel Fattah Mostafa,&nbsp;Ahmed Mohammed AlaaEldin Abd Elfattah Shalaby,&nbsp;Essam M. Youssef","doi":"10.1016/j.inat.2025.102069","DOIUrl":"10.1016/j.inat.2025.102069","url":null,"abstract":"<div><h3>Background</h3><div>Cervical spondylotic myelopathy (CSM) is a prevalent cause of spinal cord dysfunction in older adults, often requiring surgical intervention for relief of spinal cord compression. This study aimed to compare the outcomes of two common surgical techniques, laminoplasty and laminectomy, in the treatment of multilevel CSM.</div></div><div><h3>Methods</h3><div>In a prospective cohort study, 30 patients with symptomatic multilevel CSM were randomly assigned to undergo either laminectomy or laminoplasty. Preoperative and postoperative evaluations included clinical assessments using the Visual Analog Scale (VAS), Nurick grade, Neck Disability Index (NDI), Japanese Orthopaedic Association (JOA) score, as well as radiological evaluations (MRI, X-ray). Surgical outcomes, complications, and long-term recovery were also assessed.</div></div><div><h3>Results</h3><div>Both groups showed significant postoperative improvements in clinical measures, including VAS, Nurick, and NDI scores. However, the laminoplasty group demonstrated greater improvements in NDI scores (p &lt; 0.001) and lower postoperative VAS scores (p = 0.003). Radiologically, laminectomy provided greater decompression, as evidenced by a larger increase in the dural sac cross-sectional area (p &lt; 0.001). Both groups exhibited similar complication rates, but the laminectomy group had a higher incidence of C5 radiculopathy and axial neck pain (p = 0.003 for both).</div></div><div><h3>Conclusion</h3><div>Overall, both procedures demonstrated significant clinical benefits, and the choice of technique should be tailored to individual patient needs based on factors such as cervical alignment and risk of complications. Further studies with larger cohorts are needed to refine surgical decision-making in CSM treatment.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102069"},"PeriodicalIF":0.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242531","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 case of dural arteriovenous fistula showing high uptake on methionine positron emission tomography and mimicking diffuse intrinsic pontine glioma","authors":"Yuki Sunohara,&nbsp;Kinya Yokoyama,&nbsp;Kai Takayanagi,&nbsp;Kazuki Ishii,&nbsp;Fumiaki Kanamori,&nbsp;Kojiro Ishikawa,&nbsp;Masahiro Nishihori,&nbsp;Takashi Izumi,&nbsp;Ryuta Saito","doi":"10.1016/j.inat.2025.102053","DOIUrl":"10.1016/j.inat.2025.102053","url":null,"abstract":"<div><h3>Background</h3><div>Intracranial dural arteriovenous fistula (dAVF) and gliomas sometimes present with similar imaging findings. Methionine positron emission tomography (MET-PET) is used to diagnose gliomas; however, the findings for dAVF are unknown.</div></div><div><h3>Case report</h3><div>We report the case of a 59-year-old man who presented with headaches and diplopia. Magnetic resonance imaging showed edema and dilated blood vessels in the pons. The same area had a gadolinium contrast enhancement effect, and MET-PET showed high uptake. Imaging findings suggested diffuse intrinsic pontine glioma with a developmental venous anomaly. However, cerebral angiography revealed a dAVF on the posterior surface of the left petrous bone that had flowed back into the transpontine vein. A shunt ligation was performed. Postoperatively, the symptoms disappeared, and the transpontine vein was thrombosed.</div></div><div><h3>Conclusion</h3><div>dAVF can cause high MET-PET uptake; therefore, treatment for patients with suspected diffuse intrinsic pontine gliomas should also consider the vasculature surrounding the lesion. In our case, the characteristic imaging finding of a dilated transpontine vein was observed; however, the prognosis was good without requiring postoperative anticoagulants.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102053"},"PeriodicalIF":0.4,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144230036","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":"Letter to the Editor re: “Delayed presentation of giant cerebral hydatid cyst with epilepsy: A case report”","authors":"Almonzer Al-Qiami ,&nbsp;Abdulqadir J. Nashwan","doi":"10.1016/j.inat.2025.102052","DOIUrl":"10.1016/j.inat.2025.102052","url":null,"abstract":"","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102052"},"PeriodicalIF":0.4,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144138215","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":"Comparing the outcomes of traumatic cervical spinal cord injuries in patients presenting with fracture-dislocation versus those with cervical canal stenosis","authors":"Morteza Taheri,&nbsp;Abdolhadi Daneshi,&nbsp;Mohammad Hossein Ghazvini,&nbsp;Parisa Javadnia","doi":"10.1016/j.inat.2025.102051","DOIUrl":"10.1016/j.inat.2025.102051","url":null,"abstract":"<div><h3>Aim</h3><div>In this research, we evaluated the long-term outcomes of patients who experienced traumatic cervical spinal cord injuries resulting from fracture-dislocation or canal stenosis.</div></div><div><h3>Methods</h3><div>Seventy-two patients with traumatic cervical spinal cord injuries, aged 18 to 72 months post-injury, were evaluated. Participants were categorized based on the etiological mechanism of injury, specifically canal stenosis versus fracture-dislocation. Comparative analyses were conducted between these two groups to assess differences and outcomes.</div></div><div><h3>Results</h3><div>The mean age of patients was 44.47 ± 15.32 years, with a male predominance at 81.9 %. Among the patients, 43 experienced cervical cord injuries attributed to fracture-dislocations of the cervical vertebrae, while 29 had injuries resulting from cervical canal stenosis. The predominant mechanism of trauma was falls, followed by motor vehicle accidents. The C5 vertebra was the most frequently fractured level, with C5/C6 and C6/C7 noted as the most common dislocation levels. The mean interval from injury to surgical decompression was 4.27 ± 6.98 days, with an average hospitalization duration of 22.83 ± 21.76 days. The mean follow-up period was 43.83 ± 14.43 months. Statistical analysis revealed significant differences between the two groups concerning age, hospitalization duration, trauma mechanism, clinical presentation, incomplete cord injury status, and in-hospital mortality. However, the outcomes—including post-discharge mortality and scores on SF12 PCS and SF12 MCS—showed no significant differences between the groups.</div></div><div><h3>Conclusion</h3><div>This study demonstrated that, while short-term outcomes, particularly in-hospital mortality, are elevated in patients presenting with fracture dislocation compared to those with cervical canal stenosis, long-term prognoses do not inherently indicate worse outcomes in terms of mortality or quality of life for the former group.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102051"},"PeriodicalIF":0.4,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144138126","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":"Preservation of nasal septal cartilage in endoscopic transsphenoidal approach surgery","authors":"Taishi Nakamura ,&nbsp;Yamato Oki ,&nbsp;Kenta Fukui ,&nbsp;Katsumi Sakata ,&nbsp;Hiromitsu Hatakeyama ,&nbsp;Tetsuya Yamamoto ,&nbsp;Nobuhiko Oridate","doi":"10.1016/j.inat.2025.102050","DOIUrl":"10.1016/j.inat.2025.102050","url":null,"abstract":"<div><h3>Background</h3><div>The transseptal approach is widely used in a range of cases in endoscopic transsphenoidal neurosurgery. However, dissecting the mucosa from the septum can lead to perforation in some cases, and the resultant postoperative mucosal perforation can cause symptoms of discomfort, such as recurrent epistaxis, nasal crusting, headache, and nasal obstruction. In this study, we analyzed a technique for preserving the nasal septal cartilage to reduce nasal septal mucosal perforation in terms of the size and frequency of the perforations as well as the symptoms caused by them. We also evaluated the technical complexity of this technique and its potential to cause obstruction of vision and manipulation.</div></div><div><h3>Materials and methods</h3><div>We enrolled a consecutive series of patients who underwent endoscopic transsphenoidal surgery using the nasal septal cartilage-preserving technique. Intraoperative and postoperative mucosal perforations of the nasal septum were confirmed.</div></div><div><h3>Results</h3><div>Eighteen patients underwent surgery using this technique. Surgery was previously performed in only one patient with a pituitary neuroendocrine tumor. Among the other 17 patients who underwent primary surgery, seven showed intraoperative perforation of some size during detachment of the nasal septal mucosa from the nasal septum. Three cases, including a reoperation case, showed nasal septal perforation on outpatient examination a few months later, and no symptoms were associated with postoperative perforation in these three patients.</div></div><div><h3>Conclusion</h3><div>Preserving the septal cartilage prevents perforation of the anterior component of the nasal septum and contributes to reducing the risk of postoperative perforation and its symptomatic occurrence without obstructing intraoperative manipulation.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102050"},"PeriodicalIF":0.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144138212","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":"Delayed-onset recurrent spinal epidural hematoma: A case of unusual postoperative complications in a high-risk patient","authors":"Guive Sharifi ,&nbsp;Elham Paraandavaji ,&nbsp;Mohammad Mehdi Mousavi Nasab ,&nbsp;Bardia Hajikarimloo ,&nbsp;Esmaeil Mohammadi ,&nbsp;Mehdi Pourghazi","doi":"10.1016/j.inat.2025.102038","DOIUrl":"10.1016/j.inat.2025.102038","url":null,"abstract":"<div><h3>Background</h3><div>Recurrent postoperative spinal epidural hematoma (PSEH) following spinal surgery is an exceedingly rare condition, primarily affecting the lower cervical and upper thoracic regions. Delayed-onset PSEH, which occurs between three days and two weeks after surgery, poses distinct diagnostic and therapeutic challenges.</div></div><div><h3>Case presentation</h3><div>A patient in his 70 s, with multiple comorbidities including type 2 diabetes and chronic kidney disease, underwent a C1-C5 posterior neck laminectomy and fusion to address C1-C2 instability and significant canal stenosis. Ten days after the procedure, he developed right-sided hemiplegia, prompting an MRI that revealed spinal epidural hematoma. Remarkably, ten days following a second surgery to evacuate the hematoma, the patient experienced another recurrence, requiring yet another evacuation. Fortunately, he recovered fully without any lasting neurological deficits.</div></div><div><h3>Conclusion</h3><div>Recurrent delayed-onset PSEH, while rare, can lead to severe consequences if not diagnosed and treated accordingly. Increased awareness and early intervention are essential to mitigate the risk of permanent neurological impairment, particularly in high-risk patients.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102038"},"PeriodicalIF":0.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144138213","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":"Preserving of the sphenoid sinus mucosa at endoscopic supraorbital eyebrow approach for tuberculum sellae meningioma effectively prevents cerebrospinal fluid leakage: a case report","authors":"Hiroki Ohata ,&nbsp;Tsuyoshi Sasaki ,&nbsp;Bing Liu ,&nbsp;Chihiro Nakagawa ,&nbsp;Kenichi Ishibashi ,&nbsp;Yutaka Mitsuhashi ,&nbsp;Takeo Goto","doi":"10.1016/j.inat.2025.102045","DOIUrl":"10.1016/j.inat.2025.102045","url":null,"abstract":"<div><div>Tuberculum sellae meningiomas (TSMs) have generally been removed by a transcranial microscopic approach or a transsphenoidal endoscopic approach. A small craniotomy endoscopic tumor resection for TSMs has been reported in recent years, but prevention of cerebrospinal fluid leakage is still an issue of controversy in any surgical method. Herein, the authors describe the nuances and efficacy of preservation of the sphenoid sinus mucosa for preventing cerebrospinal fluid leakage after small craniotomy endoscopic tumor removal for tuberculum sellae meningioma.</div><div>A 64-year-old female presented with left optic nerve dysfunction. Imaging findings showed a tumor at the tuberculum sellae that extended to the left optic canal. The preoperative diagnosis was TSM. Tumor resection was performed by a small craniotomy endoscopic approach. Tumor was successfully observed and resected. Postoperative imaging findings showed the sphenoid sinus mucosa was fall down. Two weeks after surgery, however, the sphenoid sinus mucosa returned to its original position. Cerebrospinal fluid leakage or infection was not observed. We advocate that preservation of the sphenoid sinus mucosa was quite useful in preventing cerebrospinal fluid leakage during small craniotomy endoscopic tumor removal for TSM.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102045"},"PeriodicalIF":0.4,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942189","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 study on remote-controlled microscopy for enhanced surgical visualisation: The precision vision digiscope","authors":"Vaidehi Satushe,&nbsp;Vibha Vyas,&nbsp;Preshit Gujar,&nbsp;Vishwajeet Kadam,&nbsp;Sayali Sarode","doi":"10.1016/j.inat.2025.102044","DOIUrl":"10.1016/j.inat.2025.102044","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the Precision Vision Digiscope’s ability to improve surgical visualization, accuracy, and workflow efficiency.</div></div><div><h3>Methods</h3><div>A mixed-methods study incorporating both quantitative metrics intraoperative diagnosis accuracy, procedure time, error rates and qualitative insights surgeon feedback, usability surveys, obtained during simulated and real surgical cases in several neurosurgery departments.</div></div><div><h3>Results</h3><div>The use of Digiscope was characterized by significant improvements in surgical precision, operation time, error rate, and surgeons were pleased with the visualization and ergonomics.</div></div><div><h3>Conclusions</h3><div>Unlike traditional methods of capturing surgical images, the use of remote-controlled microscopy with the Precision Vision Digiscope is shown to dramatically improve surgical visualization and efficiency and suggests further clinical application. More study is needed to determine long-term benefits and wider applicability.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102044"},"PeriodicalIF":0.4,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942253","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":"Medullary tuberculosis mimicking a multiple schwannoma","authors":"Mèhomè Wilfried Dossou ,&nbsp;Wilfried Innocent Munkado Meuga ,&nbsp;Ibrahim Issa Assoumane ,&nbsp;Kpègnon Nicaise Agada ,&nbsp;Laté Dzidoula Lawson ,&nbsp;Konan Médard Kakou","doi":"10.1016/j.inat.2025.102046","DOIUrl":"10.1016/j.inat.2025.102046","url":null,"abstract":"<div><h3>Background</h3><div>Despite progress in the management of Tuberculosis (TB), it remains a major public health problem. Intramedullary tuberculosis is rare, and the rarity of this disease in the medullary cone makes preoperative diagnosis difficult. We report a case of intramedullary tuberculosis assimilated to a multiple schwannoma.</div></div><div><h3>Case presentation</h3><div>A 14-year-old patient presented with a 7-month history of decreased hearing associated with micturition problems ranging from overflow voiding to acute urine retention 2 weeks ago. Clinical examination revealed right-sided hypoacusis and terminal cone syndrome. On paraclinical examination, audiometry showed conductive hearing loss on the right and a slight transmission loss on the left. A CT scan of the hip did not reveal any abnormality in the urinary tract. Thoracolumbar MRI showed a diffuse intramedullary lesion extending between T11 and L1, suggesting a low-grade glial lesion, particularly an astrocytoma or ependymoma. Given the auditory symptoms, the hypothesis of a multiple neuroma with cerebral and intramedullary localization was raised and a cerebral CT scan performed for this purpose came back normal. Tumour resection revealed a heterogeneous whitish process with a fleshy and soft necrotic portion. The pathological examination concluded that the tumor was tuberculous. The PCR came back negative and the patient was put on anti-tuberculosis treatment and corticosteroid therapy for 30 days. Progression was favorable, with progressive motor recovery from day 6 and complete recovery at day 60. Hearing loss persisted and was managed by ENT specialists.</div></div><div><h3>Conclusion</h3><div>Intramedullary tuberculosis remains a reality. The insidious clinical picture and the atypical imaging appearance are factors in misdiagnosis. An effective <em>meta</em>-analysis would be timely to clarify the diagnostic presentation and allow agreement on the role of surgery in the face of chemotherapeutic measures.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102046"},"PeriodicalIF":0.4,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144138214","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 cervical epidural hematoma following persistent cough in a patient on dual antiplatelet therapy","authors":"Ali Guler ,&nbsp;Yigit Can Senol","doi":"10.1016/j.inat.2025.102047","DOIUrl":"10.1016/j.inat.2025.102047","url":null,"abstract":"<div><div>This case report highlights a rare but serious medical condition called spontaneous spinal epidural hematoma (SSEH) that occurred in a 57-year-old patient with a history of thromboembolic events and chronic cough while undergoing antiplatelet therapy. The patient presented with progressive paresis and hypoesthesia in the right upper extremity and required hematoma evacuation with posterior cervical decompression and fusion. Despite newly developed neurological deficits after surgery, the modified Rankin score (mRS) improved from 4 preoperatively to 2 at the 6-month postoperative follow-up. This case underscores the importance of considering acute spinal hematoma in patients on antiplatelet therapy who present with acute neurological deficits and chronic cough and highlights the need for prompt diagnosis and appropriate management to prevent potential morbidity and mortality.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102047"},"PeriodicalIF":0.4,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942188","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}