Interdisciplinary Neurosurgery: Advanced Techniques and Case Management最新文献

{"title":"Accuracy of Deep brain stimulation (DBS) lead Placement: A Comparative study of bilateral and Four-Lead implantation Techniques","authors":"Patrick Fricke ,&nbsp;Cordula Matthies ,&nbsp;Vera Nickl ,&nbsp;Maria Breun ,&nbsp;Martin M Reich ,&nbsp;Robert C Nickl","doi":"10.1016/j.inat.2025.102042","DOIUrl":"10.1016/j.inat.2025.102042","url":null,"abstract":"<div><h3>Objective</h3><div>Deep Brain Stimulation (DBS) is an established treatment modality for various movement disorders and psychiatric conditions. The effectiveness of DBS largely hinges on the precise placement of electrode leads. However, inaccuracies in electrode positioning can lead to reduced treatment efficacy and adverse side effects.</div></div><div><h3>Methods</h3><div>52 patients with 128 leads, (40 patients, in the bilateral group with 80 leads &amp; 12 in the four-lead group with 48 leads) who received DBS implantations with MER-recordings at the University Hospital of Wuerzburg between 2013 and 2019 were reviewed. Preoperative planning and postoperative imaging were assessed for lead placement accuracy. Clinical outcomes, surgical sequelae, and stimulation parameters were evaluated through patient records.</div></div><div><h3>Results</h3><div>The bilateral group exhibited a mean radial deviation of 1.40 mm from the planned trajectory, with a significant difference in accuracy between the first and second implanted leads. In the four-lead group, while there was an increasing trend in deviation between the first and the fourth electrode, it was not statistically significant.</div></div><div><h3>Conclusions</h3><div>This study contributes novel insights into the complexities of implanting multiple leads in a single DBS session. It highlights the importance of minimizing brain shifts during surgery to improve lead placement accuracy. The findings recommend prioritizing the implantation of the most clinically significant lead first, given the observed decrease in placement accuracy for subsequent leads or a staged procedure. The study represents the largest systematically assessed cohort analyzing electrode placement accuracy in four-lead DBS procedures to date.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102042"},"PeriodicalIF":0.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143881681","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 cavernous malformation of the trigeminal nerve: A case report and pathology highlight","authors":"Thomas Hanks ,&nbsp;Katie Krause ,&nbsp;Hannah Boudreaux ,&nbsp;Steven Ruhoy ,&nbsp;Robert Ryan","doi":"10.1016/j.inat.2025.102041","DOIUrl":"10.1016/j.inat.2025.102041","url":null,"abstract":"<div><h3>Background</h3><div>Cavernous malformations of the cranial nerves are rare, especially of the trigeminal nerve. The following case report highlights the course and treatment of this patient, particularly focusing on the imaging and pathology highlights of the case.</div></div><div><h3>Case Description</h3><div>A 70-year-old male who presented with one year history of decreased sensation on the right side of the face prior to admission, progressed to complete ipsilateral facial numbness, as well as severe ataxia, vertigo, and nausea. Physical exam demonstrated lack of sensation in the V1-3 distribution on the right side, as well as nystagmus and hearing loss on the right side. CTA displayed a cryptic vascular malformation, and MRI demonstrated a lesion with surrounding contrast enhancement. The patient underwent a procedure for microsurgical resection of the hemorrhagic lesion.</div></div><div><h3>Discussion</h3><div>Frozen intraoperative pathology suggested a hyalinized vascular lesion, which was later confirmed to be a cavernous malformation. The patient experienced significant improvement in ataxia and balance following resection but had persistent right sided facial numbness with only mild improvement in sensation. Cavernous malformations of the trigeminal nerve can present with focal neurologic deficits and in some cases, trigeminal neuralgia. This patient uniquely presented with facial numbness and not trigeminal neuralgia, as seen in previous reports.</div></div><div><h3>Conclusion</h3><div>Early removal of cavernous malformations, ideally prior to hemorrhage, can result in improved patient outcomes and improvement of neurologic symptoms.</div><div>1 Background.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102041"},"PeriodicalIF":0.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143886006","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 nuances in the management of pineal region tumors via the occipital transtentorial approach without using brain retractor","authors":"Lingmin Shao,&nbsp;Mohammad Rohul Amin,&nbsp;Jia Liu,&nbsp;Renzhong Liu,&nbsp;Zhihong Jian","doi":"10.1016/j.inat.2025.102026","DOIUrl":"10.1016/j.inat.2025.102026","url":null,"abstract":"<div><h3>Objective</h3><div>Access to the pineal region has always represented a formidable challenge to the neurosurgeons. This study aims to explore the surgical techniques of the occipital transtentorial approach (OTA) without using brain retractor for excision of pineal region tumors based on the author’s experience and literature review.</div></div><div><h3>Methods</h3><div>A retrospective analysis was performed of patients who underwent surgery for pineal tumors via OTA using dynamic retraction at our institution from 2018 to 2022. The clinical data, surgical procedure, and results were examined.</div></div><div><h3>Results</h3><div>Twelve patients underwent surgery via OTA for treatment of pineal tumors. In all cases, it was feasible to complete surgery without using brain retractor. Gross total resection was achieved in 10 cases (83.3 %), while subtotal resection in 2 cases (16.7 %). There were no mortalities. Three patients presented with upper gaze palsy after surgery, 2 of them experienced complete recovery at the third month follow-up. Only one patient had residual neurologic deficit. Two patients reported transit diplopia after surgery. No postoperative hemianopsia was observed in this series.</div></div><div><h3>Conclusion</h3><div>The occipital transtentorial approach is effective for the removal of tumors in the pineal region. Dynamic retraction with handheld instruments and meticulous dissection of arachnoid membrane around the deep veins can provide a sufficient working space.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102026"},"PeriodicalIF":0.4,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143892197","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":"Efficacy and safety of erythropoietin in patients with degenerative lumbar spinal stenosis undergoing multi-level lumbar interbody fusion: A case-control study","authors":"Dong Wang ,&nbsp;Ying Liu ,&nbsp;Shuang Cao ,&nbsp;Ying Wu ,&nbsp;Zhihao Ni ,&nbsp;Rende Ning","doi":"10.1016/j.inat.2025.102031","DOIUrl":"10.1016/j.inat.2025.102031","url":null,"abstract":"<div><div>Study Design.</div><div>Retrospective case-control study.</div></div><div><h3>Objective</h3><div>To assess the efficacy of short-term and high-dose application of erythropoietin (EPO) in patients with degenerative lumbar spinal stenosis (DLSS) undergoing multi-level lumbar interbody fusion (LIF) by assessing mean transfusion volume, transfusion rate, hematologic parameters, postoperative complications, and length of stay.</div><div>Summary of Background Data.</div><div>It has been reported to confirm the efficacy and safety of EPO in major surgeries like neurosurgery, cardiac surgery, and orthopedics. Still, there was little information on the application of EPO in patients with DLSS undergoing multi-level LIF.</div><div>Methods.</div><div>458 DLSS patients between January 2015 and December 2022 were selected and divided into EPO (group A), n = 112, and no EPO (group B), n = 105, according to treatment technique. Evaluation indexes included hemoglobin (Hb), hematocrit (Hct), red blood cells (RBC), postoperative complications, operative time, intraoperative bleeding, drainage volume, mean transfusion volume, transfusion rate, and length of stay.</div><div>Results.</div><div>The mean follow-up time was 21.7 months (18–24 months). Postoperative complications, surgical time, intraoperative bleeding, and drainage volume were not statistically different across groups. The Hb, Hct, and RBC values on postoperative days 1, 3, and 5 were significantly higher in group A than in B, and the difference was statistically significant (P &lt; 0.05). The mean transfusion rate was significantly lower in group A than in B (P &lt; 0.001). The mean transfusion volume was significantly lower in group A than in B (P &lt; 0.001). The length of stay was significantly lower in group A than in B (<em>P</em> &lt; 0.001).</div><div>Conclusion.</div><div>Short-term and high-dose perioperative EPO in DLSS patients undergoing multi-level LIF improves anemia-related hematologic parameters, reduces transfusion requirements, and shortens hospital stay without increasing deep vein thrombosis or wound infection.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102031"},"PeriodicalIF":0.4,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873139","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 management of ruptured intracranial arachnoid cysts in young adults: the role of subduroperitoneal shunt placement","authors":"Fassl Verena ,&nbsp;Sebök Martina ,&nbsp;Fierstra Jorn ,&nbsp;Krayenbühl Niklaus ,&nbsp;Regli Luca ,&nbsp;Velz Julia","doi":"10.1016/j.inat.2025.102023","DOIUrl":"10.1016/j.inat.2025.102023","url":null,"abstract":"<div><h3>Introduction</h3><div>Intracranial arachnoid cysts (IAC) are a common incidental finding on brain MRIs in adults. While IAC rupture, leading to severe intracranial hypertension, is well-documented in children, it is rarely reported in adults. As a result, there is limited guidance on managing ruptured IACs in young adults.</div><div>In particular, there is no data on the benefits of subduroperitoneal (SDP) shunt placement without interposed pressure valves in young adult patients, a treatment often used in pediatric patients.</div></div><div><h3>Methods</h3><div>We present two cases of young adult patients presenting with ruptured IAC with subsequent subdural hematoma/collection and consecutive neurological decline. Based on these sample clinical cases, we will discuss the above-mentioned management strategy and provide an overview of the current available literature.</div></div><div><h3>Results</h3><div>This case series demonstrates the successful management of ruptured IAC in young adults through drainage of subdural fluid collections via burr hole trepanation, combined with SDP shunt placement without interconnected pressure valves.</div></div><div><h3>Conclusion</h3><div>While there is general consensus that surgery is necessary for symptomatic cases following IAC rupture, the optimal approach remains debated. We provide additional evidence that burr hole trepanation combined with SDP shunt placement without interconnected pressure valves, a method commonly used in children, is a safe treatment option for young adults with ruptured IAC.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102023"},"PeriodicalIF":0.4,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873138","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":"Effect of stimulation frequency on quality of speech in individuals with Parkinson’s disease who have undergone sub thalamic nucleus Deep Brain Stimulation surgery","authors":"Radhakrishnan Chella Perumal ,&nbsp;Krishnaswamy Visvanathan ,&nbsp;Sharon Mizpah Prathana Charan","doi":"10.1016/j.inat.2025.102034","DOIUrl":"10.1016/j.inat.2025.102034","url":null,"abstract":"<div><h3>Background</h3><div>Deep Brain Stimulation (DBS) targeting the subthalamic nucleus (STN) has been successful in improving the core motor symptoms, including motor fluctuations and speech systems, even in advanced stages of Parkinson’s Disease (PD). Given that the DBS frequency setting influences speech intelligibility, it is important to determine the ideal frequency setting while programming DBS to minimize reduction in speech quality postoperatively in individuals with PD.</div></div><div><h3>Aim</h3><div>To compare and contrast the effects of stimulation frequency (High, Low, DBS off state) in subthalamic nucleus Deep Brain Stimulation (STN-DBS) on the quality of speech in individuals with PD.</div></div><div><h3>Method</h3><div>Subjective and objective measures of articulation and voice parameters were estimated in low as well as high stimulation frequencies and the DBS-off state for six individuals with PD treated with STN-DBS.</div></div><div><h3>Results</h3><div>Friedman’s Two-way ANOVA yielded significant differences in objective measures of voice (<em>p</em> &lt; 0.05) only, however there was no statistically significant difference between the low, high stimulation frequency and DBS off state on the articulatory and subjective voice parameters.</div></div><div><h3>Conclusion</h3><div>The site of DBS insertion in the STN, the spread of current to adjacent pathways during high-frequency stimulation, the duration of disease, and the dosage of medication post-DBS surgery can cause detrimental effects on the quality of speech compared to motor movements. Low-frequency stimulation can improve speech scores, but it may also lead to a decline in motor function. On the contrary, a high stimulation frequency is effective in controlling tremors and body movements but may result in a decrease in speech scores. The extent of speech deterioration caused by a high stimulation frequency varies among patients, emphasizing the need for individualized programming of deep brain stimulation (DBS) parameters along with holistic rehabilitation for speech to balance motor and speech outcomes.</div></div><div><h3>Key messages</h3><div>Changes in the DBS stimulation frequency can alter speech and motor characteristics in individuals with Parkinson’s disease. Hence, while programming DBS stimulation parameters, it needs to be tailored to the individual patient’s needs, balancing the motor function with speech outcomes.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102034"},"PeriodicalIF":0.4,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873140","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":"Solitary melanoma in the pineal gland: Differentiating primary from metastatic melanoma in the central nervous system","authors":"Denesh Selvarajah ,&nbsp;Hana Angelia Kawatu ,&nbsp;Peter Mews ,&nbsp;Elizabeth C Paver","doi":"10.1016/j.inat.2025.102028","DOIUrl":"10.1016/j.inat.2025.102028","url":null,"abstract":"<div><div>Primary melanoma of the pineal gland is exceedingly rare. Melanoma in the central nervous system (CNS) is far more likely to be a metastasis from a cutaneous primary; however, in a patient with no known history of melanoma, differentiating metastatic from primary CNS melanoma may present a diagnostic challenge. The distinction is important, however, as there are significant differences in tumour biology, prognosis, and responses to treatment. This report describes a rare case of solitary melanoma of the pineal gland in a 75-year-old female with no known history of melanoma and was considered as most likely to be a metastatic melanoma of unknown primary based on molecular testing of the tumour. This case highlights the utility of extended panel molecular testing in differentiating metastatic melanoma of unknown primary from primary CNS melanoma and the scarcity of evidence in the literature to guide the treatment in this setting.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102028"},"PeriodicalIF":0.4,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143855424","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":"Innovative developments in deep brain stimulation devices","authors":"Della Torre Attilio ,&nbsp;La Torre Domenico ,&nbsp;Guzzi Giusy ,&nbsp;Volpentesta Giorgio ,&nbsp;Lavano Angelo","doi":"10.1016/j.inat.2025.102035","DOIUrl":"10.1016/j.inat.2025.102035","url":null,"abstract":"<div><div>Technological advances in DBS hardware and software represent a significant growth area in functional neurosurgery. These advancements have the potential to significantly enhance treatment outcomes and expand the scope of neurological disorders that can be effectively addressed through DBS interventions. The advent of directional deep brain stimulation (DBS) ushers in a new era in neuromodulation, providing enhanced benefits to individuals with Parkinson’s disease, optimizing clinical outcomes more efficiently, and targeting treatment for stubborn symptoms using data-driven approaches. Implementing a multimodal programming strategy and incorporating cutting-edge current fractionation technology and image-guided tools for lead localization and brain sensing reduces reliance on traditional trial-and-error programming methods. This paves the way for a more predictive application of this therapy. These advancements are poised to propel the development of advanced closed-loop stimulation systems that seamlessly integrate continuous data streams, ultimately leading to improved patient care.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102035"},"PeriodicalIF":0.4,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873153","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":"Effectiveness of endoscopic surgery for treating spontaneous cerebrospinal fluid rhinorrhea","authors":"Saleh Rasras ,&nbsp;Soheila Nikakhlagh ,&nbsp;Hosein Safari ,&nbsp;Zahra Cheraghian ,&nbsp;Shohreh Noroozi","doi":"10.1016/j.inat.2025.102033","DOIUrl":"10.1016/j.inat.2025.102033","url":null,"abstract":"<div><h3>Background and Objective</h3><div>Spontaneous Cerebrospinal Fluid (CSF) rhinorrhea is a rare but potentially serious condition characterized by the leakage of CSF through the nasal cavity without an apparent traumatic or iatrogenic cause.</div></div><div><h3>Materials and Methods</h3><div>The current study was a five-year retrospective cross-sectional study on 24 patients with a history of spontaneous Cerebrospinal Fluid (CSF) rhinorrhea who underwent endoscopic surgery. The patients were selected among 90 individuals with CSF leaks.The required information was extracted from their medical records. The collected data included patient demographics, BMI, presenting symptoms, radiologic imaging findings, defect site, materials used for skull base repair, postoperative complications, and the success rate of endoscopic treatment.</div></div><div><h3>Results</h3><div>The patients who experienced spontaneous Cerebrospinal Fluid (CSF) leaks were primarily obese, middle-aged women. All patients presented with intermittent watery rhinorrhea, and 25% experienced positional headaches. Computed Tomography (CT) and magnetic resonance imaging (MRI) identified leak sites in 20 patients (83.3%). In cases where CT and MRI were inconclusive, CT cisternography was used (16.6%). The most common intraoperative defect site was the fovea ethmoidalis (50%). In 30% of patients, a single-layer reconstruction with only a fat graft was performed. Postoperative complications were observed in five patients (20%). Two patients developed meningitis postoperatively, which resolved with antibiotic treatment, and three patients experienced complete and permanent anosmia. Successful primary repair was achieved in 23 patients (96%), with a relapse rate of 4%.</div></div><div><h3>Conclusion</h3><div>Endoscopic surgery had a high success rate (96%) for the repair of spontaneous CSF rhinorrhea, with minimal recurrence (4%). The technique, particularly the multilayer approach, was effective in managing this condition.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102033"},"PeriodicalIF":0.4,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143844406","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":"Growing teratoma syndrome arising from malignant mixed germ cell tumor: Case report and review of literature","authors":"Kazumasa Senju ,&nbsp;Toshiyuki Enomoto ,&nbsp;Hiromasa Kobayashi ,&nbsp;Koichirou Takemoto ,&nbsp;Takashi Morishita ,&nbsp;Mikiko Aoki ,&nbsp;Makoto Hamasaki ,&nbsp;Hiroshi Abe","doi":"10.1016/j.inat.2025.102030","DOIUrl":"10.1016/j.inat.2025.102030","url":null,"abstract":"<div><div>Growing teratoma syndrome (GTS) is a condition in which tumor markers normalize during chemoradiation of germ cell tumors, but metastatic or recurrent lesions increase, and the lesions are histopathologically composed of mature teratomas. The incidence of GTS among intracranial germ cell tumors is estimated to be 5 %, making it a relatively rare condition. Here, we describe the case of an 8-year-old female with GTS 1.5 months after initial surgery. A suprasellar tumor was identified, and an endoscopic biopsy was performed. It was a mixed germ cell tumor, consisting mainly of immature teratomas, germinomas, and choriocarcinomas. After chemotherapy, both alpha-fetoprotein (AFP) and beta human chorionic gonadotropin decreased, but the suprasellar tumor grew rapidly and hydrocephalus developed. A craniotomy was performed, and the tumor was completely removed. Histopathological examination revealed that the tumor was a mature teratoma. A teratoma component has been identified in most biopsy specimens of mixed germ cell tumors that produce GTS. However, in some cases, GTS occurred even when teratomas were not detected in the biopsy specimens. As biopsies do not reflect the entire tumor histology, it is important to consider the possibility of conversion to GTS in cases of elevated AFP levels or imaging findings suspicious for teratoma, even in cases where the specimen does not contain a teratoma.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102030"},"PeriodicalIF":0.4,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143860448","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}