Interdisciplinary Neurosurgery: Advanced Techniques and Case Management最新文献

{"title":"Triple anticoagulation therapy in neuroendovascular interventions − Is there a safe point?","authors":"Gabriel Henrique Simoni , Leticia Simoni , Giovanna Susin , Alef Perini , Mariana Simoni , Marcio Ferreira , Bipin Chaurasia","doi":"10.1016/j.inat.2025.102100","DOIUrl":"10.1016/j.inat.2025.102100","url":null,"abstract":"","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102100"},"PeriodicalIF":0.4,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144695271","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":"Complete resection of fungal brain abscess in a patient with chronic active Epstein-Barr virus infection using intraoperative MRI: A case report","authors":"Takuma Kodama,&nbsp;Ryo Miyahara,&nbsp;Shinichiro Teramoto,&nbsp;Yuzaburo Shimizu,&nbsp;Mario Suzuki,&nbsp;Akihide Kondo,&nbsp;Osamu Akiyama","doi":"10.1016/j.inat.2025.102098","DOIUrl":"10.1016/j.inat.2025.102098","url":null,"abstract":"<div><h3>Background</h3><div>Chronic active Epstein-Barr virus (CAEBV) infection is a rare, life-threatening disease for which the only curative treatment is allogeneic hematopoietic stem cell transplantation (HSCT). Here, we report a case of a brain abscess caused by a CAEBV infection. Brain abscesses can be surgically treated using craniotomy or aspiration. The advantage of craniotomy over aspiration is that it enables complete removal of the suppurative material and surrounding abscess sacs, allowing for more reliable and rapid treatment, potentially reducing the duration of antibiotic therapy and the need for additional treatment. Intraoperative magnetic resonance imaging (MRI), a powerful brain imaging tool, allows visualization of the resection of intraparenchymal lesions and should be used when more accurate removal is needed.</div><div>Case Description: A 28-year-old man presented with a brain abscess caused by CAEBV. Before allogeneic HSCT was performed, total excision of the abscess was necessary to avoid aggravation of the infection. A craniotomy was performed using intraoperative MRI to achieve complete and reliable resection and confirm total resection of the abscess. No postoperative complications occurred, and postoperative MRI showed no recurrence of the abscess.</div></div><div><h3>Conclusion</h3><div>Although the role of craniotomy is limited by advances in minimally invasive surgery, such as stereotactic aspiration, it should be considered to achieve total removal of an abscess. Intraoperative MRI is useful for confirming complete resection of the abscess in a specific case.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102098"},"PeriodicalIF":0.4,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144695270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new type of glioneuronal tumor: A case report","authors":"M.J.F. Landers-Wouters ,&nbsp;G.J.M. Rutten ,&nbsp;J.W. Kooij ,&nbsp;J.M. Kros ,&nbsp;H. Ardon","doi":"10.1016/j.inat.2025.102085","DOIUrl":"10.1016/j.inat.2025.102085","url":null,"abstract":"<div><div>Glioneuronal tumors are rare and mostly consist of gangliogliomas. These tumors are usually benign and total resection is usually curative. We report on a new type of tumor in an adolescent with first onset of epilepsy. MRI showed a small contrast-enhancing lesion with minimal perilesional edema. The radiological diagnosis was compatible with ganglioglioma. Awake surgery was performed and total resection could be achieved. The diagnosis of glioneuronal tumor with PATZ1 gene fusion was made. This recently described tumor entity has not yet been included in the WHO classification of tumors of the central nervous system (fifth edition, 2021).</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102085"},"PeriodicalIF":0.4,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144623647","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":"Treatment of a unruptured distal anterior cerebral artery (DACA) aneurysm with pipeline-shield technology: A case report","authors":"Zhu Song ,&nbsp;Haifeng Yang","doi":"10.1016/j.inat.2025.102096","DOIUrl":"10.1016/j.inat.2025.102096","url":null,"abstract":"<div><div>A 59 year old female was found to have an aneurysm in the A3 segment of the left anterior cerebral artery during a health examination with using high-resolution magnetic resonance. Oral dual antiplatelet therapy (DAPT) during the perioperative. The third generation Flow diverter of Medtronic Pipeline Flex Embolization Device with Shield Technology (PED-Shield) was implanted into the parent artery for endovascular therapy (EVT). Postoperative instant radiography shows that only the contrast agent is retained at the neck of the aneurysm. Two months after the treatment, the patient stopped taking clopidogrel on their own due to multiple patchy bruises on the skin and used aspirin alone. Four months after the treatment, the patient began to feel intermittent tightness and swelling in the head. Four and a half months after the treatment. DSA showed moderate to severe stenosis in the proximal of the stent, the neck and partial body of aneurysm were visualized, contrast agent retention. We consider it to be stent thrombosis (or excessive intimal hyperplasia) and poor healing of the aneurysm. Our report provides a reference for the feasibility of using PED-Shield to treat distal anterior cerebral artery aneurysms in China; The shaping of the stent catheter sometimes plays a decisive role when PED-Shield used to treat distal aneurysms with large curvature of the parent artery; Also provides evidence that the stent catheter (Phenom 21) unable match the PED-Shield. This also provides case evidence for early Oral dual antiplatelet therapy switched to individual antiplatelet therapy leading to stent thrombosis in PED-Shield.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102096"},"PeriodicalIF":0.4,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144623367","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":"Early surgical outcome of petroclival meningiomas: a single-center case series from Vietnam","authors":"Huy Ngoc Pham ,&nbsp;He Van Dong ,&nbsp;Ha Dai Duong ,&nbsp;Manh Huy Bui ,&nbsp;Tuan Anh Le ,&nbsp;Van Dinh Tran ,&nbsp;Nguyen Cong Tien Anh","doi":"10.1016/j.inat.2025.102086","DOIUrl":"10.1016/j.inat.2025.102086","url":null,"abstract":"<div><h3>Objective</h3><div>Petroclival meningiomas have been regarded as among the most difficult skull base lesions to operate. This study evaluated the early surgical outcome of petroclival meningiomas at one of the largest neurosurgery centers in Vietnam.</div></div><div><h3>Methods</h3><div>A series of 38 patients (28 females and 10 males) with petroclival meningiomas operated as the primary treatment from January 2021 to January 2023 were prospectively studied. Data was collected during patient hospitalization period and follow-ups at one month and six months after discharge.</div></div><div><h3>Results</h3><div>The mean preoperative Karnofsky Performance Scale (KPS) score was 75.53 and 26/38 (68.4 %) patients presented with cranial nerve deficits. The mean tumor equivalent diameter was 34.5 mm and 6 (15.8 %) cases demonstrated extensions into adjacent regions. Gross total resection (GTR) was achieved in 36.8 % of patients. Hyperintensity on MRI T2-weighted images was associated with a higher rate of GTR. 12/38 (31.6 %) patients had postoperative complications with 3 (7.9 %) hospital mortalities. Complications included 2 (5.3 %) intracranial hemorrhage, 1 (2.6 %) brainstem infarction, 1 (2.6 %) diffuse brain edema, 1 (2.6 %) newly developed hydrocephalus, 2 (5.3 %) cerebrospinal fluid leak, 2 (5.3 %) meningitis, 1 (2.6 %) surgical site infection, 3 (7.9 %) pneumonia and 6 (15.8 %) underwent tracheotomy. Headache, dizziness, limb weakness, ataxia, sensory disturbance, and sphincter dysfunction showed remarkable improvement, whereas CN dysfunction exhibited varying pattern of progression. 14/35 (40 %) patients developed new or exacerbation of preoperative neuropathies which mainly involved cranial nerves VI (14.3 %), VII (22.9 %), and VIII (14.3 %). The mean KPS score decreased to 69.21 at the 1-month follow-up and then improved to 74.47 six months after surgery. Follow-up MRI demonstrated one case with tumor recurrence after total resection and another case with lesion progression following subtotal resection.</div></div><div><h3>Conclusions</h3><div>Petroclival meningiomas remain as surgically challenging lesions. Despite limited resectability, surgery offers early favorable results. Hyperintensity on MRI T2-weighted image facilitates gross total resection.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102086"},"PeriodicalIF":0.4,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653691","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":"Clinical outcome of high-grade aneurysmal acute subarachnoid hemorrhage: Hunt and Hess grade 4 survivors may have a good long-term functional outcome","authors":"Rose Fluss,&nbsp;Adisson Fortunel,&nbsp;Deepak Khatri","doi":"10.1016/j.inat.2025.102095","DOIUrl":"10.1016/j.inat.2025.102095","url":null,"abstract":"<div><h3>Introduction</h3><div>Patients with high-grade aneurysmal subarachnoid hemorrhage (SAH) have classically been known to have poor functional outcomes. However, recent reports vary widely in citing the morbidity and mortality for these patients, with some studies citing that the majority of high-grade SAH will gain independent function. The authors sought to clarify functional outcomes expected of high-grade SAH through its own retrospective review as well as a review of the literature.</div></div><div><h3>Methods</h3><div>A retrospective review was conducted of patients with high-grade SAH managed at a single institution between May 2015 and April 2020. High-grade SAH was defined using the Hunt-Hess (HH) scale 4 or 5 at admission. The primary outcome measures were functional outcome at discharge and at 90 days after discharge, defined using the modified Rankin Scale (mRS). Poor functional outcome was defined as mRS &gt; 3. Additionally, a PubMed search was performed to identify functional outcomes expected of high-grade SAH patients.</div></div><div><h3>Results</h3><div>Thirty-eight out of the total 229 (16.59 %) SAH patients treated at our center were included in this study. This included 24 (63.16 %) HH grade 4 patients and 14 (36.84 %) HH grade 5 patients. 22 out of 38 patients (57.9 %) survived during the initial admission and were successfully discharged from the hospital. A large majority (n = 20/22, 90.9 %) of patients had poor functional outcomes at the time of discharge, including four patients with mRS 4 and 16 patients with mRS 5. However, two patients (9.1 %) had favorable functional outcomes (mRS 3) at the time of discharge<strong>.</strong> Notably, 47.1 % of HH4 survivors with poor discharge mRS (8 of 17 patients) improved to mRS ≤ 3 during follow-up. Among the HH grade 5 patients (n = 14), only five patients survived the acute clinical course and subsequently got discharged from the hospital (n = 5/14, 35.7 %).</div></div><div><h3>Conclusion</h3><div>This investigation provides support that functional outcomes remain poor in high-grade SAH patients. However, there is a large lack of consistency of functional outcomes reported for high-grade SAH among the literature. Of those high-grade SAH that do survive, there is evidence to suggest improvement in functional outcome over time. Longitudinal investigations tracking high grade SAH are warranted.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102095"},"PeriodicalIF":0.4,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144611681","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":"IgG4 related disorders of the CNS – A neurosurgeons perspective","authors":"Nikhil Reddy ,&nbsp;Jishnu Nair ,&nbsp;K. Visvanathan ,&nbsp;V. Vivek ,&nbsp;Archana ,&nbsp;Lawrence D’cruz ,&nbsp;K. Ganesh","doi":"10.1016/j.inat.2025.102094","DOIUrl":"10.1016/j.inat.2025.102094","url":null,"abstract":"<div><div>IgG4-related diseases (IgG4-RD) are immune-mediated fibro-inflammatory conditions that can mimic various other diseases and affect multiple organs, including the central nervous system (CNS). This case series examines five patients with diverse CNS manifestations of IgG4-RD. A 30-year-old man presented with spinal cord compression and was diagnosed with IgG4-related spinal pachymeningitis following surgical excision and elevated serum IgG4 levels. A 16-year-old girl with bitemporal hemianopia and panhypopituitarism was initially diagnosed with hypophysitis but later found to have IgG4-related sellar disease upon positive immunostaining despite normal serum IgG4 levels. A 40-year-old man with recurrent orbital pseudo-tumour and vision loss was ultimately identified as having IgG4-related orbital disease, complicated by active tuberculosis, and treated with a combination of anti-tuberculous therapy and Rituximab. A 37-year-old woman with post-COVID visual symptoms and suspected fungal infection was diagnosed with IgG4-related pachymeningitis and treated with cyclophosphamide and Rituximab. Lastly, a 21-year-old woman with drug-resistant epilepsy and a frontal brain lesion was diagnosed with IgG4-related intraparenchymal disease, responding well to corticosteroid therapy. This series highlights the varied presentations and diagnostic challenges of IgG4-RD in the CNS.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102094"},"PeriodicalIF":0.4,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144623368","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 novel treatment approach for esophageal perforation post-anterior cervical discectomy and fusion: A case report","authors":"Kent Sabatose ,&nbsp;Suzan De Feo ,&nbsp;Erinc Akture ,&nbsp;Wissam Elfallal","doi":"10.1016/j.inat.2025.102084","DOIUrl":"10.1016/j.inat.2025.102084","url":null,"abstract":"<div><div>Anterior cervical discectomy and fusion (ACDF) is a common spinal surgery performed in the United States to achieve spinal cord and nerve root decompression. Our case presentation describes a rare presentation of esophageal perforation post-ACDF requiring repair with a novel surgical approach. A 59-year-old male with intractable cervicalgia and evidence of C7 radiculopathy supported by cervical MRI showing moderate to severe left neural foraminal narrowing at C6-C7 underwent ACDF at an outside institution without intraoperative complications. On postoperative day four, the patient reported to the emergency department due to a 3-day history of fever, encephalopathy, purulent drainage from the incision site, and erythema with tenderness over the incision site down to the anterior chest wall. Cervical MRI and CT confirmed extensive cellulitis/fasciitis and large-volume subcutaneous soft tissue emphysema. CT esophagram showed a right posterior esophageal leak at C6-C7 with esophagocutaneous fistula. Multidisciplinary treatment included neurosurgical washout and drain placement followed by esophageal repair via esophagogastroduodenoscopy (EGD) utilizing over-the-scope clip (OTSC) to repair the esophagocutaneous fistula. Early identification and treatment of esophageal perforation is critical, as mediastinitis and cardiopulmonary collapse with high mortality may result despite current treatment regimens. We describe a successful novel approach to treating esophageal perforation with surgical washout and primary fistula closure through EGD with OTSC. Further research is needed to investigate potential risk factors and treatment strategies for esophageal perforation following ACDF.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102084"},"PeriodicalIF":0.4,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144587603","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":"Ultrasound measurement of optic nerve sheath diameter for intracranial pressure monitoring","authors":"Jiukun Jiang ,&nbsp;Xiujing Xie","doi":"10.1016/j.inat.2025.102091","DOIUrl":"10.1016/j.inat.2025.102091","url":null,"abstract":"<div><div>Changes in optic nerve sheath diameter reflect intracranial pressure (ICP) variations and can serve as indicators for noninvasive ICP measurements. This review explores the literature on the anatomical foundations of changes in the optic nerve sheath diameter in response to ICP fluctuations, diagnostic threshold for elevated ICP and conversion formula, covers advances in research on monitoring the optic nerve sheath diameter in primary neurological conditions, primary non-neurological conditions, and the perioperative period, and discusses the procedure, benefits, and future research directions for ultrasound examination of the optic nerve sheath diameter, aiming to promote clinical study and application.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102091"},"PeriodicalIF":0.4,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144587604","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":"Globus pallidus internus-deep brain stimulation for Lance Adams syndrome post-COVID-19: A case report and systematic review","authors":"Amir Reza Bahadori ,&nbsp;Parisa Javadnia ,&nbsp;Mohammad Amin Fathollahi ,&nbsp;Afshan Davari ,&nbsp;Sajad Shafiee ,&nbsp;Aidine Omidvar ,&nbsp;Sara Mohammadian ,&nbsp;Sara Ranji ,&nbsp;Abbas Tafakhori","doi":"10.1016/j.inat.2025.102090","DOIUrl":"10.1016/j.inat.2025.102090","url":null,"abstract":"<div><div>Objects: Lance Adams syndrome (LAS) is a chronic post-hypoxic myoclonus that predominantly arises following successful cardiopulmonary resuscitation; however, there are so rare instances following respiratory failure.</div></div><div><h3>Method</h3><div>This report discusses a 42-year-old female patient who developed myoclonus after COVID-19 and was diagnosed with LAS. She received globus pallidus internus-deep brain stimulation (Gpi-DBS). A systematic review following PRISMA guidelines was also conducted across multiple databases for post-hypoxic myoclonus patients who underwent DBS until November 30.</div></div><div><h3>Result</h3><div>The systematic review comprised eight studies focusing on post-hypoxic myoclonus, four explicitly diagnosed with LAS. All but one underwent Gpi-DBS. Improvement in myoclonus scores following DBS treatment was noted in all cases. In our case, not only were myoclonus symptoms significantly improved, but there was also an enhancement in the patient’s quality of life assessments.</div></div><div><h3>Conclusion</h3><div>DBS should be considered a safe and effective therapeutic strategy for patients diagnosed with LAS who resist conventional pharmacotherapy.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102090"},"PeriodicalIF":0.4,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144570268","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}