Interdisciplinary Neurosurgery: Advanced Techniques and Case Management最新文献

{"title":"Micro-drill craniostomy and perioperative treatment for chronic subdural hematoma: A single-center experience","authors":"Tao Wu,&nbsp;Xu Chen,&nbsp;Yueping Wang,&nbsp;Xianghua Zhang,&nbsp;Jing Zhang,&nbsp;Jianjun Sun,&nbsp;Cang Liu","doi":"10.1016/j.inat.2025.102001","DOIUrl":"10.1016/j.inat.2025.102001","url":null,"abstract":"<div><h3>Background and Objectives</h3><div>The current research focuses on surgical safety and postoperative recurrence of chronic subdural hematoma (CSDH) treatment. This study proposes a micro-drill craniostomy drainage combined with perioperative treatment. The aim is to describe and validate this treatment approach and explore the risk factors influencing recurrence, to further improve the treatment outcomes for CSDH.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on patients who underwent surgery for CSDH from 2018 to 2023. These patients were divided into two groups based on recurrence, and multiple logistic regression analyses were performed to identify the independent factors of postoperative recurrence. Additionally, detailed descriptions of the micro-drill craniostomy drainage surgical technique and perioperative treatment plan were provided.</div></div><div><h3>Results</h3><div>A total of 106 patients with 140 CSDH were treated surgically. All patients experienced varying degrees of improvement in their clinical symptoms. No perioperative deaths or surgical complications occurred. Twelve recurrence cases were observed (8.6 %), 9 of which were managed through conservative treatment. The remaining three cases were treated with the same surgical procedure and urokinase injection, and no recurrence was observed during the last follow-up. After univariate analyses of all the clinical variables, the rate of recurrence was significantly lower in urokinase injection (P = 0.001) and long drainage duration (P = 0.042). Multiple logistic regression analysis identified the absence of postoperative urokinase injection was an independent risk factor for recurrence (odds ratio: 0.011, 95 % confidence interval: 0 – 0.485, P = 0.018), after adjustment for age, anticoagulant therapy, CT density, maximal thickness, pneumocrania, and other risk factors.</div></div><div><h3>Conclusion</h3><div>The combination of micro-drill craniostomy drainage and perioperative atorvastatin treatment is safe and effective for CSDH. It is recommended that urokinase injection as a routine treatment CSDH and further prospective randomized controlled trial is needed to validate its usage details and efficacy.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"39 ","pages":"Article 102001"},"PeriodicalIF":0.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143534983","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":"Inadvertent Compromise of the thalamogeniculate artery during surgery for invasive tentorial notch Meningioma: A case report","authors":"Guive Sharifi ,&nbsp;Esmaeil Mohammadi ,&nbsp;Nader Akbari Dilmaghani ,&nbsp;Elham Paraandavaji ,&nbsp;Ali Jafari","doi":"10.1016/j.inat.2025.102009","DOIUrl":"10.1016/j.inat.2025.102009","url":null,"abstract":"<div><div>Meningiomas, usually benign brain tumors, occasionally exhibit aggressive behavior, as seen in tentorial notch meningiomas (TNMs). We detail a case of a 63-year-old woman with a TNM tightly adhered to vascular structures. Surgical resection led to inadvertent damage to the thalamogeniculate artery branch of posterior cerebral artery, leading to deep brain ischemia likely during clipping of basilar trunk. TNMs, comprising about 5% of meningiomas, present challenges due to their deep-seated location and intricate vasculature. Surgical planning must foresee potential vascular adhesions, and advanced angiography could aid in their identification. This case underscores the need for comprehensive understanding of cerebrovascular anatomy, emphasizing tailored surgical approaches and preparedness for managing vascular complications.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"39 ","pages":"Article 102009"},"PeriodicalIF":0.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143591527","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 significance of admission CD4 count in HIV positive patients with a spontaneous intracerebral hematoma – A prospective cohort study","authors":"Adrian Kelly ,&nbsp;Patrick Lekgwara ,&nbsp;Siyazi Mda","doi":"10.1016/j.inat.2025.102003","DOIUrl":"10.1016/j.inat.2025.102003","url":null,"abstract":"","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"39 ","pages":"Article 102003"},"PeriodicalIF":0.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510044","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":"Delayed presentation of giant cerebral hydatid cyst with epilepsy: A case report","authors":"Yibeltal Zewudu ,&nbsp;Abdi Ermolo ,&nbsp;Abraham Tadele ,&nbsp;Temesgen Wolde ,&nbsp;Eyerusalem Bergene","doi":"10.1016/j.inat.2025.101999","DOIUrl":"10.1016/j.inat.2025.101999","url":null,"abstract":"<div><h3>Background</h3><div>Cerebral hydatid disease, although rare, presents a significant health risk, particularly in low-income countries where delayed diagnosis and treatment are common. This parasitic infection is more prevalent among children and young adults, with symptoms often manifesting only when the cysts grow large due to the disease’s indolent nature.</div><div>Case Description: We report the case of an 18-year-old male presenting with an 8-year history of abnormal body movements (epilepsy) and left-sided weakness. Neurological examination revealed a muscle power of 2/5 in the left upper extremity and 3/5 in the left lower extremity (MRC scale). Imaging identified a large right fronto-parietal cerebral hydatid cyst, confirmed by histopathological analysis. The patient received preoperative oral albendazole (400 mg daily) for 14 days. The cyst was successfully removed intact using Dowling’s technique without rupture.</div></div><div><h3>Conclusion</h3><div>This case highlights the urgent need for increased awareness and timely intervention for cerebral hydatid disease in low-income countries. Delayed presentations with severe neurological symptoms show there are barriers to early diagnosis and treatment. Effective use of Dowling’s technique and preoperative albendazole shows that successful outcomes are possible, even in resource-limited settings. Enhancing healthcare access and education on parasitic infections can improve early diagnosis and patient outcomes.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"39 ","pages":"Article 101999"},"PeriodicalIF":0.4,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488315","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":"Pituitary apoplexy secondary to Immune thrombocytopenic purpura:a case report","authors":"Harshitha Begum ,&nbsp;Archana B MD ,&nbsp;Lawrence D'Cruze MD ,&nbsp;Aishvarya Vijayasekar","doi":"10.1016/j.inat.2025.102000","DOIUrl":"10.1016/j.inat.2025.102000","url":null,"abstract":"","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"39 ","pages":"Article 102000"},"PeriodicalIF":0.4,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143478754","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":"Hemidystonia improved by intrathecal baclofen infusion therapy: A case report","authors":"Takashi Asahi ,&nbsp;Kiyonobu Ikeda ,&nbsp;Shiro Horisawa ,&nbsp;Taku Nonaka ,&nbsp;Yuko Muro ,&nbsp;Nobutaka Yamamoto ,&nbsp;Takaomi Taira","doi":"10.1016/j.inat.2025.101995","DOIUrl":"10.1016/j.inat.2025.101995","url":null,"abstract":"<div><div>Intrathecal baclofen therapy (ITB) is a well-established treatment for limb spasticity due to brain and spinal cord disorders, and it is also indicated for dystonia, though mainly reported in generalized or pediatric cases. This report highlights a 46-year-old male with hemidystonia from writer’s cramp. Diagnosed at age 30, his symptoms persisted despite oral medications, botulinum toxin injections, and deep brain stimulation targeting the left thalamus ventro-oral nucleus and globus pallidus internus. Two years later, his symptoms worsened and extended to the right side. At our clinic, a baclofen screening test significantly reduced muscle tone, enabling writing. Following the implantation of a baclofen pump, his dystonia markedly improved, restoring his writing ability. This case supports considering ITB for patients with severe, refractory dystonia and muscle hypertonus, even in cases without generalized dystonia.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"39 ","pages":"Article 101995"},"PeriodicalIF":0.4,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143421444","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 intracranial hypertension in rickets-related craniosynostosis","authors":"Alessio Iacoangeli ,&nbsp;Sergio Capelli ,&nbsp;Andrea Held ,&nbsp;Emidio Procaccini ,&nbsp;Davide Luglietto ,&nbsp;Matteo Barba ,&nbsp;Alessandro De Benedictis ,&nbsp;Carlo Gandolfo ,&nbsp;Carlo Efisio Marras","doi":"10.1016/j.inat.2025.101998","DOIUrl":"10.1016/j.inat.2025.101998","url":null,"abstract":"<div><div>Hypophosphatemic rickets is occasionally associated with craniosynostosis. Delayed diagnosis can result in intracranial hypertension, potentially leading to serious neurological complications. We report the case of a 9-year-old boy with X-linked hypophosphatemic rickets who presented with headache, fundus oculi edema, and double sinus pericranii. A CT scan revealed fusion of the cranial sutures, and continuous intracranial pressure monitoring confirmed intracranial hypertension. The patient successfully underwent bilateral cranial expansion. Secondary craniosynostosis is a rare condition, with hypophosphatemic rickets being the most common metabolic cause. Sinus pericranii is a rare radiological manifestation of intracranial hypertension. Craniosynostosis presenting after infancy or early childhood should prompt consideration of secondary or metabolic causes. Regular monitoring for head shape abnormalities and signs of intracranial hypertension is essential in patients with hypophosphatemic rickets. Skull expansion is an effective therapeutic option.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"39 ","pages":"Article 101998"},"PeriodicalIF":0.4,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143377595","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":"Management of eight cases of subarachnoid hemorrhage using transpulmonary thermodilution during clazosentan therapy","authors":"Hiroto Iyota ,&nbsp;Yasumasa Kawano ,&nbsp;Hironori Fukumoto ,&nbsp;Takato Tajiri ,&nbsp;Mitsutoshi Iwaasa ,&nbsp;Sinichi Morimoto ,&nbsp;Yoshito Izutani ,&nbsp;Shintaro Yamasaki ,&nbsp;Kazuya Yamauchi ,&nbsp;Hiroki Hatomoto ,&nbsp;Hiroshi Abe ,&nbsp;Yoshihiko Nakamura","doi":"10.1016/j.inat.2025.101997","DOIUrl":"10.1016/j.inat.2025.101997","url":null,"abstract":"<div><div>Clazosentan, an endothelin receptor antagonist, is used to prevent delayed neurological deterioration in patients with subarachnoid hemorrhage due to ruptured cerebral aneurysms. However, fluid management presents challenges. This single-center case series presents the findings from eight patients undergoing fluid management using transpulmonary thermodilution while receiving clazosentan. The median age of the patients was 49 years (interquartile range: 45.5–63.5), and four (50 %) were male. The median World Federation of Neurosurgical Societies classification was 5 (interquartile range: 2–5), and the median Fisher classification was 3 (interquartile range: 3). During clazosentan treatment, the median global end-diastolic volume index based on transpulmonary thermodilution remained at 715.5 ml/m² (interquartile range: 643–788). No ischemic neurological deficits, bilateral pulmonary edema, and pleural effusion were observed. Strict fluid management using transpulmonary thermodilution might prevent the complications associated with clazosentan.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"39 ","pages":"Article 101997"},"PeriodicalIF":0.4,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143377596","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":"Resolution of tremor associated with brainstem arachnoid cyst following surgical intervention: A case report","authors":"Andrey Rostislavovich Sitnikov ,&nbsp;Rezida Maratovna Galimova ,&nbsp;Dmitriy Konstantinovich Krekotin","doi":"10.1016/j.inat.2025.101994","DOIUrl":"10.1016/j.inat.2025.101994","url":null,"abstract":"<div><h3>Introduction</h3><div>Intracranial arachnoid cysts located in the brainstem are extremely rare. Neurological symptoms usually depend on the location of the cyst and present with varying degrees of motor deficit and cranial nerve palsy. Our case report describes the successful surgical treatment of an intraparenchymal brainstem arachnoid cyst followed by significant improvement of severe disabling contralateral tremor.</div></div><div><h3>Case presentation</h3><div>A 34-year-old man was admitted to our clinic with a two-year history of progressive disabling right-sided tremor and muscle weakness. Neurological examination on admission showed moderate left-sided blepharoptosis, right-sided hemiparesis (MRC grade 4 strength) and severe right-sided kinetic and postural tremor. MRI showed a large multiseptal cystic lesion within the left cerebral peduncle and left part of the midbrain. The patient underwent surgical fenestration of the cyst via a left supracerebellar infratentorial approach in the semi-sitting position. The postoperative course was uneventful with significant reduction of tremor and hemiparesis on the second postoperative day. Follow-up MRI at 3 and 12 months showed reasonable reduction in the size of the cystic lesion and restoration of brainstem anatomy. The patient’s tremor decreased by 70 % according to the Tremor Research Group Essential Tremor Rating Scale<!--> <!-->(TETRAS scale).</div></div><div><h3>Conclusion</h3><div>In cases of intraparenchymal cystic lesions presenting with neurological abnormalities, surgical exploration and fenestration of the lesion may be a safe treatment option with a good functional outcome.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"39 ","pages":"Article 101994"},"PeriodicalIF":0.4,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143378780","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 case report of abdominal implantation and metastasis caused by transventricular peritoneal drainage tube after radiotherapy for intracranial pituitary tumor","authors":"Chao Ma,&nbsp;Yuxin Fan,&nbsp;Tianyong Cai,&nbsp;Zheyong Li","doi":"10.1016/j.inat.2025.101996","DOIUrl":"10.1016/j.inat.2025.101996","url":null,"abstract":"<div><h3>Introduction and importance</h3><div>This article reports the diagnosis and treatment of a patient with a malignant pituitary tumor who underwent transtumoral ventriculo-abdominal drainage and multiple radiotherapies.</div></div><div><h3>Case presentation</h3><div>The patient exhibited intraperitoneal metastasis and was admitted due to abnormal menopause. Diagnostic examination revealed pituitary gland space occupation, leading to cranial brain surgery. Cerebrospinal fluid was sampled during the operation for cytological examination to consider germinoma. However, the complete removal of the pituitary tumor was hindered by severe cerebral edema, necessitating the temporary placement of a ventriculo-abdominal drainage tube. Following the operation, the patient received 23 sessions of directed radiotherapy, resulting in tumor disappearance as confirmed by pituitary MRI review. Three years later, the patient returned to the hospital due to abdominal pain and anorexia, revealing a substantial abdominal cavity mass. Active surgical intervention was conducted, and postoperative pathology confirmed a secondary malignant tumor in the abdominal cavity originating from dysgerminoma. Following treatment, the patient’s condition improved, and they were discharged. However, intra-abdominal tumor recurrence ensued due to delayed chemotherapy administration, ultimately resulting in death from extensive cerebral infarction.</div></div><div><h3>Clinical discussion</h3><div>When encountering such patients in the future, if surgery is necessary, how can we select patients who require postoperative maintenance treatment? Which regimen offers greater benefits compared to radiotherapy or chemotherapy? In cases where patients are unable to tolerate chemotherapy and radiotherapy, how can we provide a more specialized treatment plan for them?</div></div><div><h3>Conclusion</h3><div>Analysis of this report underscores the potential enhancement of clinical treatment strategies for such cases.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"39 ","pages":"Article 101996"},"PeriodicalIF":0.4,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143421445","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}