Mei-Hua Wang , Wei Chen , Jie Song , Hao-Yue Yuan , Zhuo-Ying Du , Qiang Yuan , Jin Hu , Gang Wu , Lei Yang
{"title":"Evaluation of the efficacy of prone position therapy in patients with acute brain Injury: A prospective observational study","authors":"Mei-Hua Wang , Wei Chen , Jie Song , Hao-Yue Yuan , Zhuo-Ying Du , Qiang Yuan , Jin Hu , Gang Wu , Lei Yang","doi":"10.1016/j.inat.2025.102005","DOIUrl":"10.1016/j.inat.2025.102005","url":null,"abstract":"<div><h3>Background</h3><div>Acute brain injury (ABI) frequently coexists with severe lung injury, leading to significant challenges. This study investigates the impact of prone position (PP) on the patients with ABI.</div></div><div><h3>Methods</h3><div>This prospective observational study was conducted at Huashan Hospital, enrolling patients with ABI requiring mechanical ventilation. ICP and ABP were continuously monitored. PP therapy was initiated based on clinical assessments. We evaluated ICP, CPP, oxygenation, and hemodynamics at three time points: baseline (T0), during therapy (T1), and after therapy (T2). LUS, CT, and ABG were performed. The primary outcomes included imaging results and clinical endpoints, while secondary outcomes focused on complications related to PP.</div></div><div><h3>Results</h3><div>Nine patients with ABI were enrolled, with a total of 13 episodes of PP analyzed. ICP notably elevated (14.8 ± 5.5 mmHg vs. 20.7 ± 6.0 mmHg, P < 0.05). No significant changes in CPP were observed across T0, T1, and T2; however, oxygen saturation significantly improved during PP. LUS decreased significantly from T0 to T2 (8.60 ± 3.50 vs. 20.80 ± 3.71, P < 0.001). Seven patients displayed improved pulmonary imaging. One patient recovered fully, 7 showed improvement, and 1 succumbed. Complications related to PP were recorded in 6 patients, including two cases of ocular complications and five pressure ulcers.</div></div><div><h3>Conclusion</h3><div>This study underscores the efficacy and safety of PP in patients with ABI complicated by severe lung injury. Continuous multimodal monitoring of neurological status during the intervention is crucial. Further research with larger sample is necessary to validate these findings and enhance patient outcomes.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"39 ","pages":"Article 102005"},"PeriodicalIF":0.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143577213","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 , Esmaeil Mohammadi , Nader Akbari Dilmaghani , Elham Paraandavaji , 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 , Patrick Lekgwara , 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 , Abdi Ermolo , Abraham Tadele , Temesgen Wolde , 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":"Hemidystonia improved by intrathecal baclofen infusion therapy: A case report","authors":"Takashi Asahi , Kiyonobu Ikeda , Shiro Horisawa , Taku Nonaka , Yuko Muro , Nobutaka Yamamoto , 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}
Alessio Iacoangeli , Sergio Capelli , Andrea Held , Emidio Procaccini , Davide Luglietto , Matteo Barba , Alessandro De Benedictis , Carlo Gandolfo , Carlo Efisio Marras
{"title":"Surgical management of intracranial hypertension in rickets-related craniosynostosis","authors":"Alessio Iacoangeli , Sergio Capelli , Andrea Held , Emidio Procaccini , Davide Luglietto , Matteo Barba , Alessandro De Benedictis , Carlo Gandolfo , 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 , Yasumasa Kawano , Hironori Fukumoto , Takato Tajiri , Mitsutoshi Iwaasa , Sinichi Morimoto , Yoshito Izutani , Shintaro Yamasaki , Kazuya Yamauchi , Hiroki Hatomoto , Hiroshi Abe , 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/m<sup>2</sup> (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 , Rezida Maratovna Galimova , 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, Yuxin Fan, Tianyong Cai, 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}