Interdisciplinary Neurosurgery: Advanced Techniques and Case Management最新文献

{"title":"Concomitant Vestibular Schwannoma and Pituicytoma: A case report and review of the literature","authors":"Aaron Lerch ,&nbsp;Anthony Minh Tien Chau ,&nbsp;Kym M. Rae ,&nbsp;Benjamin Sly ,&nbsp;James Bowman ,&nbsp;David Wong ,&nbsp;Eloise House ,&nbsp;Martin Wood ,&nbsp;Damian Amato","doi":"10.1016/j.inat.2025.102017","DOIUrl":"10.1016/j.inat.2025.102017","url":null,"abstract":"<div><h3>Background</h3><div>Vestibular schwannomas co-occurring with other intracranial tumours, particularly pituitary tumours, are exceptionally rare. Our review revealed only 48 cases documented in the literature. We additionally present a unique case of synchronous vestibular schwannoma and pituicytoma, a combination not previously reported.</div></div><div><h3>Case report</h3><div>A 51-year-old healthy male presented with rapid-onset sensorineural hearing loss and tinnitus. Diagnostic imaging revealed a vestibular schwannoma and incidental pituitary tumour, later confirmed histologically as a pituicytoma. Surgical management involved a staged resection utilising translabyrinthine and transsphenoidal approaches for tumour removal. At 18 months postoperatively, the patient remains asymptomatic, with complete resolution of his presenting symptoms.</div></div><div><h3>Conclusions</h3><div>To our knowledge, this is the first reported case of synchronous vestibular schwannoma and pituicytoma. We highlight the multidisciplinary approach that contributed to the favourable clinical outcome, underscoring the importance of collaborative management in complex cases involving multiple intracranial pathologies.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102017"},"PeriodicalIF":0.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143759548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare but serious case of subdural hematoma following transsphenoidal surgery for a pituitary adenoma","authors":"Mehdi Mahmoodkhani ,&nbsp;Narjes Koohi ,&nbsp;Alireza Motamedi ,&nbsp;Sam Rahimi ,&nbsp;Fatemeh Abbasi","doi":"10.1016/j.inat.2025.102016","DOIUrl":"10.1016/j.inat.2025.102016","url":null,"abstract":"<div><div>Transsphenoidal endoscopy is a prevalently performed surgical procedure aimed at removing pituitary lesions. This procedure can lead to various complications, including CSF leakage, tension pneumocephalus, and hypernatremia following the removal of a pituitary adenoma. In this particular case, we present a patient with a pituitary adenoma who unexpectedly got a spontaneous subdural hematoma (ASDH), nine days after undergoing transsphenoidal surgery, despite having a minor CSF leak. We speculate that this complication was linked to severe hypernatremia and a sudden decrease in consciousness level, necessitating immediate surgical intervention for hematoma removal. this case represents the first reported instance of ASDH associated with severe hypernatremia and negligible CSF leakage.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102016"},"PeriodicalIF":0.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143696687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The safe surgical strategy using preoperative embolization for cervical dumbbell tumor with large vertebral body Involvement: A case report","authors":"Nobuaki Tadokoro ,&nbsp;Masaaki Shiomi ,&nbsp;Shuhei Mizobuchi ,&nbsp;Katsuhito Kiyasu ,&nbsp;Masahiko Ikeuchi ,&nbsp;Motohiro Kawasaki ,&nbsp;Tomohiro Matsumoto ,&nbsp;Takuji Yamagami","doi":"10.1016/j.inat.2025.102015","DOIUrl":"10.1016/j.inat.2025.102015","url":null,"abstract":"<div><h3>Background</h3><div>The resection of a cervical spine dumbbell tumor extending into the vertebral body with vertebral artery encasement is a surgical challenge in terms of safe tumor resection with minimal intraoperative blood loss.</div></div><div><h3>Case presentation</h3><div>A seventy-six female patient suffering from left arm pain and progressive myelopathy presented with a cervical spine dumbbell tumor mainly located at the left C3-4 foramen with large C3 and C4 vertebral body involvement and encasement of the left vertebral artery. Because en-bloc tumor resection was difficult due to extensive tumor localization, piecemeal tumor resection by posterior and anterior approach was planned. To reduce intraoperative blood loss and complexity of surgical procedures, she underwent preoperative embolization and staged posterior and anterior surgery. The total tumor resection and spinal reconstruction were successfully carried out with minimal intraoperative blood loss.</div></div><div><h3>Conclusion</h3><div>Although complex tumor resection and reconstruction surgery should be planned on an individualized, case-by-case basis, preoperative embolization is reserved as an option for surgical strategies.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102015"},"PeriodicalIF":0.4,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143698131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case of ectopic pituitary adenoma originating from the third ventricle floor: Surgical approach and outcomes","authors":"Guive Sharifi ,&nbsp;Elham Paraandavaji ,&nbsp;Shahin Naghizadeh ,&nbsp;Yalda Nilipour ,&nbsp;Mohammad Ali Kazemi ,&nbsp;Mahbube Ebrahimpur ,&nbsp;Ali Jafari ,&nbsp;Farzad Taghizadeh-Hesary","doi":"10.1016/j.inat.2025.102014","DOIUrl":"10.1016/j.inat.2025.102014","url":null,"abstract":"<div><h3>Introduction</h3><div>Ectopic pituitary adenomas (EPAs) are uncommon tumors originating outside the sella turcica, posing diagnostic challenges due to varied presentations. We report the third documented case of an EPA arising from the third ventricle floor (3VF), who was successfully treated surgically.</div></div><div><h3>Case presentation</h3><div>A 70-year-old male presented with visual impairment. Visual field tests addressed compressive optic neuropathy. Imaging revealed a well-defined mass arising from 3VF compressing the optic chiasm, confirmed as a nonfunctional EPA through histopathological and hormonal analyses. The patient underwent a lateral subfrontal translamina terminalis approach for tumor resection, ensuring maximal preservation of adjacent neurovascular structures. The procedure involved meticulous debulking of the tumor, careful preservation of the optic chiasm and hypothalamus, and watertight dural closure to minimize postoperative complications. Surgical intervention resulted in complete tumor resection without complications, leading to improved visual and endocrine function postoperatively.</div></div><div><h3>Conclusions</h3><div>This technique emphasized minimal brain manipulation and optimal preservation of neural integrity, contributing to the patient’s successful recovery following surgery. This surgical technique can be applied in similar 3VF cases, ensuring successful outcomes with minimal complications.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102014"},"PeriodicalIF":0.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid recovery in degenerative cervical myelopathy: A case report highlighting neuroplasticity following surgical decompression","authors":"Wilson David Campos Figueredo ,&nbsp;Raul Ramirez Grueso ,&nbsp;Maria Paola Barrero Medina ,&nbsp;Paula Andrea Arenas ,&nbsp;José Corredor Santos ,&nbsp;Luisa Jaimes","doi":"10.1016/j.inat.2025.102013","DOIUrl":"10.1016/j.inat.2025.102013","url":null,"abstract":"<div><h3>Introduction</h3><div>Degenerative cervical myelopathy (DCM) causes progressive compression of the spinal cord, leading to permanent and sometimes irreversible nerve damage if left untreated or not promptly treated. The nerve damage is associated with impaired sensory and motor function below the spinal cord injury (SCI) level, leading to a functional disability that affects the patient and the patient’s family quality of life. Early surgical decompression of the spinal canal remains one of the preferred options among physicians. Neuronal plasticity (NP) can take place after the initial injury and has been shown to be a complex process where the neurons use different adaptive strategies to regain their functions.</div></div><div><h3>Case report</h3><div>In this article, we present a case of a 65-year-old male with a history of obesity and rheumatologic disease, who, without prior medical monitoring, presented with posterior cervical pain, right-sided hemicranial headache, and progressive right hemiparesis that advanced to severe quadriparesis. Magnetic resonance imaging (MRI) and computed tomography (CT) revealed a narrowed cervical canal with evidence of compressive myelopathy. During the second surgical intervention, Intraoperative Neurophysiological Monitoring (IONM) was performed, showing Motor Evoked Potentials (MEP) in the right hemibody following decompression. The patient experienced an early and successful recovery, regaining sensory and motor functions sooner than expected after the second decompression.</div></div><div><h3>Conclusion</h3><div>Spinal cord injury (SCI) in adults is believed to cause definitive and non-treatable damage to the neurons. However, the presence of early MEP during the IONM and the rapid recovery of the patient after the surgical decompression demonstrated the potential for neuroplasticity and the opportunity to enhance it with different therapy strategies.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102013"},"PeriodicalIF":0.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143714680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multispecialty view on the management of basal transethmoidal encephaloceles and meningoceles in the neonate","authors":"Rose Fluss ,&nbsp;Anne Lally ,&nbsp;Jinu Kim ,&nbsp;Andrew J. Kobets","doi":"10.1016/j.inat.2025.102006","DOIUrl":"10.1016/j.inat.2025.102006","url":null,"abstract":"<div><div>Basal encephaloceles, and their subtype transethmoidal encephaloceles, are an extremely rare congenital abnormality. They commonly present with ocular anomalies and congenital dyscrasias. Similarly, meningoceles are unusual lesions associated with midfacial anomalies and hypertelorism. We report a case of a preterm newborn who was suspected to have a transethmoidal encephalocele who was operated on day 15 of life due to its expanding nature and concern for cerebrospinal fluid leak. Intraoperatively the lesion was isolated and noted to be devoid of brain tissue thus diagnosing her with a transethmoidal meningocele. Discussed here are the challenges faced with a neonatal repair of a transethmoidal meningocele and the multidisciplinary approach used involving neuroanesthesia, neurosurgery, plastic and reconstructive surgery, as well as otolaryngology teams.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102006"},"PeriodicalIF":0.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683210","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":"Should neurosurgeons ‘chase the dragon’? A case report","authors":"Rick H.G.J. van Lanen ,&nbsp;Christianne M.C. Hoeberigs ,&nbsp;Verona C.A. Gerardu ,&nbsp;Roel H.L. Haeren","doi":"10.1016/j.inat.2025.102012","DOIUrl":"10.1016/j.inat.2025.102012","url":null,"abstract":"<div><h3>Purpose</h3><div>“Chasing the dragon” originally referred to the inhalation of vaporized heroin or opium, but it has since expanded to describe a condition affecting the brain. The term is associated with severe neurological complications, notably toxic leukoencephalopathy. Patients may present with acute neurological symptoms, including lowered consciousness and significant deficits.</div></div><div><h3>Case</h3><div>A 23-year-old male presented with a Glasgow Coma Scale score of E1M1V1 after prolonged unresponsiveness. Imaging showed cerebellar hypodensities, initially diagnosed as infarction with herniation. Immediate decompression of the posterior fossa was performed. Nevertheless, his clinical condition worsened and follow-up imaging revealed toxic leukoencephalopathy which was contributed to abuse of alcohol, quetiapine, 3-methylmethcathinone, cocaine and oxycodone, mimicking abnormalities seen in “chasing the dragon” syndrome. Additionally, severe systemic effects with multi-organ failure ensued, and treatment was withdrawn due to poor prognosis, resulting in the patient’s death.</div></div><div><h3>Conclusions</h3><div>“Chasing the dragon” −like toxic leukoencephalopathy is associated with severe neurological complications, resulting from widespread white matter damage. Our case showed typical imaging findings of drug-induced leukoencephalopathy after polysubstance abuse. Despite undergoing neurosurgical decompression, the outcome was fatal. This highlights the limited effectiveness of surgical intervention in such severe cases, emphasizing that neurosurgeons should not “chase the dragon”. It is essential to consider the differential diagnosis of CHANTER, where neurosurgical intervention, can play a role in improving outcomes.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102012"},"PeriodicalIF":0.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683211","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":"Bertolotti Syndrome: Does it really exist? systematic review","authors":"Acevedo-Gonzalez Juan Carlos ,&nbsp;Delgado-Caicedo Mónica Gabriela ,&nbsp;Lacouture-Silgado Isabella","doi":"10.1016/j.inat.2025.102008","DOIUrl":"10.1016/j.inat.2025.102008","url":null,"abstract":"<div><h3>Study Design</h3><div>systematic review.</div></div><div><h3>Objectives</h3><div>Bertolotti syndrome is described as the association between low back pain and transitional abnormalities of the lumbosacral spine. This association is nonspecific and does not justify surgical procedures on this anomaly, even percutaneous or minimally invasive. We consider that congenital variations of the lumbosacral junction are elements that modify the normal biomechanics of the spine and favor the development of other painful pathologies already known. This work is a systematic review that aims to determine whether Bertolotti Syndrome should be considered as an independent etiology of low back pain or only as a risk factor (Lumbosacral transitional vertebrae) for developing biomechanical alterations that produce pain.</div></div><div><h3>Methods</h3><div>The search used the following terms (PubMed, Embase, Cochrane library and clinical trials): Bertolotti syndrome, low back pain, lumbosacral transitional vertebrae. The search covered the last 21 years (2013 to 2024). The “Rayyan” program was used to gather information and facilitate the analysis process. Each author reviewed the abstract of the articles found. Inclusion: Systematic reviews, clinical trials, observational studies, and case series. Exclusion: Theoretical articles, narrative reviews, and articles in languages other than English.</div></div><div><h3>Results</h3><div>Initial analysis: 285 articles were selected (PubMed-115, Scopus-76, Embase-94), 238 articles were excluded (due to duplicated articles or titles not meeting inclusion/exclusion criteria). 47 articles were selected (25 retrospective clinical studies, 12 case series, 3 randomized clinical trial, and 7 systematic reviews; <em>meta</em>-analyses were not found). The PRISMA checklist was applied, and each article were assessed using the STROBE and CONSORT checklists.</div></div><div><h3>Conclusions</h3><div>Low back pain in patients with congenital abnormalities of the lumbosacral junction requires extensive clinical and radiological evaluation to determine the cause of the source of symptoms. Transitional anomaly is only a risk factor that modifies the normal biomechanics of the lumbosacral spine and not the therapeutic target. Bertolotti syndrome is an anecdotal but not objective association of the origin of pain.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102008"},"PeriodicalIF":0.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143642465","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":"Transoral extrusion of ventriculoperitoneal shunt distal segment: A case report of very rare complication","authors":"Seare Halefom Kahsay ,&nbsp;Samson Yibalih Gebregergisse ,&nbsp;Yirgalem Teklebirhan Gereziher ,&nbsp;Berihu Tadishu Gebre","doi":"10.1016/j.inat.2025.102010","DOIUrl":"10.1016/j.inat.2025.102010","url":null,"abstract":"<div><h3>Background</h3><div>Ventriculoperitoneal shunts (VPS) are a widely utilized neurosurgical intervention for managing hydrocephalus of diverse etiologies. While generally a safe and well-established treatment approach, VPS procedures are not without potential complications. The most frequently reported issues include infection, obstruction, disconnection or fracture of the shunt hardware, as well as skin erosion and overdrainage and tip migration. Migration of VPS tip through various body cavities and openings is a rare but serious complication. Transoral extrusion of the distal segment of a VPS is an exceedingly uncommon complication with only 43 case reports in the literature.</div></div><div><h3>Observation</h3><div>We report a case of 2-year-old male pediatric patient presented with the extrusion of VPS distal tip through the oral cavity. The patient underwent thorough investigation including shunt series. The patient was optimized and empiric broad-spectrum antibiotic administration and was subsequently taken to the operating room for shunt revision. The patient had favorable surgical outcome.</div></div><div><h3>Conclusion</h3><div>Transoral migration of the distal VPS component is an uncommon yet serious complication following VPS placement. This complication is primarily observed in pediatric patients within the first year after the initial VPS procedure. Most instances can be addressed by removing the distal segment, either through the oral cavity or the abdomen. Subsequent management involves monitoring the patient for signs of peritonitis, central nervous system infection, and progression of the underlying hydrocephalus. Prompt antibiotic treatment is required for any identified infections, and the hydrocephalus is managed by either inserting a new VPS or replacing only the distal segment.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102010"},"PeriodicalIF":0.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143629953","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":"Posttraumatic spinal cord herniation: A case report","authors":"Maryam Khaleghi Ghadiri,&nbsp;Özer Tokzös,&nbsp;Laura Horstick,&nbsp;Walter Stummer","doi":"10.1016/j.inat.2025.102011","DOIUrl":"10.1016/j.inat.2025.102011","url":null,"abstract":"<div><div>Spinal cord herniation (SCH) remains challenging to diagnose, and the progression of the disease is often poorly understood. This case report details a rare instance of posttraumatic SCH occurring 35 years after a severe traffic accident. The patient, a 51-year-old woman, presented with left leg paresis, altered temperature sensation, muscle spasticity, and thoracic pain. MRI revealed a pronounced herniation at the T1/T2 level. The surgical intervention involved adhesiolysis and dural repair, resulting in immediate clinical improvement, including enhanced gait and reduced pain. Postoperative MRI confirmed correct spinal cord relocating, with the patient showing ongoing recovery after nine months. This case represents the importance of recognizing delayed SCH as a potential long-term complication of spinal trauma and points out the benefits of surgical intervention for optimal recovery.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102011"},"PeriodicalIF":0.4,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143629954","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}