Journal of Neurological Surgery Reports最新文献

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Corrigendum: Sellar Dermoid Cyst Coexistence with Pituitary Adenoma/Pituitary Neuroendocrine Tumor. 更正:鞍皮样囊肿与垂体腺瘤/垂体神经内分泌瘤共存。
IF 0.7
Journal of Neurological Surgery Reports Pub Date : 2026-04-07 eCollection Date: 2026-01-01 DOI: 10.1055/a-2838-9808
Chi-Man Yip, Chia-Ing Jan
{"title":"Corrigendum: Sellar Dermoid Cyst Coexistence with Pituitary Adenoma/Pituitary Neuroendocrine Tumor.","authors":"Chi-Man Yip, Chia-Ing Jan","doi":"10.1055/a-2838-9808","DOIUrl":"https://doi.org/10.1055/a-2838-9808","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1055/a-2816-7368.].</p>","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"87 1","pages":"e69"},"PeriodicalIF":0.7,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13056435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639761","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}
引用次数: 0
Skull Base Reconstruction after Endonasal Endoscopic Resection of Synchronous Sinonasal Adenoid Cystic Carcinoma and Intracranial Meningioma. 鼻内窥镜同时性鼻窦腺样囊性癌及颅内脑膜瘤切除术后颅底重建。
IF 0.7
Journal of Neurological Surgery Reports Pub Date : 2026-04-07 eCollection Date: 2026-04-01 DOI: 10.1055/a-2837-3442
Martin Jurlina, Boris Kos, Matija Mamić, Ivica Lukšić, Edward C Kuan, Marica Žižić, Krsto Dawidowsky
{"title":"Skull Base Reconstruction after Endonasal Endoscopic Resection of Synchronous Sinonasal Adenoid Cystic Carcinoma and Intracranial Meningioma.","authors":"Martin Jurlina, Boris Kos, Matija Mamić, Ivica Lukšić, Edward C Kuan, Marica Žižić, Krsto Dawidowsky","doi":"10.1055/a-2837-3442","DOIUrl":"https://doi.org/10.1055/a-2837-3442","url":null,"abstract":"<p><p>Synchronous skull base tumors have rarely been reported in the literature. The endoscopic approach has now become standard for most anterior skull base tumors. An open approach is considered in cases when an endoscopic approach is contraindicated or inadequate for full resection. Since tumor resection often results in significant dural defects, dural reconstruction represents critical part of endonasal endoscopic surgery. To prevent serious complications and achieve optimal outcomes, recreation of airtight and watertight barrier between the anterior cranial fossa and the sinonasal cavity and ensuring mechanical support are essential. The free fascia lata graft currently represents the gold standard for endonasal endoscopic dural reconstruction following tumor resection. Other options include free grafts (e.g., free mucosal grafts, free abdominal fat grafts, free temporalis muscle fascia grafts [FTMFG]), vascularized axial flaps (e.g., pericranial flaps, nasoseptal flaps, axial middle turbinate flaps), and synthetic materials. The use of FTMFG for dural reconstruction has anecdotally been reported only in open surgical approaches. In this technically challenging case, FTMFG was used for dural reconstruction following endoscopic resection in a rare case of synchronous extracranial malignant and extensive intracranial benign cranial base tumor. The preexisting communication justified simultaneous resection over skull base preservation. Negative margins were achieved 360 degrees around the defect ( Video 1 ).</p>","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"87 2","pages":"e70"},"PeriodicalIF":0.7,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13056433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639866","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}
引用次数: 0
Metastatic HPV-Related Multiphenotypic Sinonasal Carcinoma: A Case Report and Review of the Literature. 转移性hpv相关多表型鼻窦癌1例报告及文献复习。
IF 0.7
Journal of Neurological Surgery Reports Pub Date : 2026-03-27 eCollection Date: 2026-01-01 DOI: 10.1055/a-2773-6796
Rachel Stemme, Wassim Najjar, Tanguy Y Seiwert, Harry Quon, Lisa M Rooper, Debraj Mukherjee, Nicholas R Rowan
{"title":"Metastatic HPV-Related Multiphenotypic Sinonasal Carcinoma: A Case Report and Review of the Literature.","authors":"Rachel Stemme, Wassim Najjar, Tanguy Y Seiwert, Harry Quon, Lisa M Rooper, Debraj Mukherjee, Nicholas R Rowan","doi":"10.1055/a-2773-6796","DOIUrl":"10.1055/a-2773-6796","url":null,"abstract":"<p><strong>Background: </strong>Human papillomavirus (HPV)-related multiphenotypic sinonasal carcinoma (HMSC) is a rare neoplasm characterized by a paradoxical clinical course. Despite its high-grade histologic features, HMSC exhibits an unexpectedly indolent clinical behavior, marked by frequent local recurrences but limited metastatic potential. We report the first case of HMSC metastasis to the liver with the earliest known distant progression.</p><p><strong>Case report: </strong>A 53-year-old male who presented with unilateral epistaxis was found to have T4aN0M0 HPV35-positive HMSC of the left maxillary sinus, with erosion into the orbital floor. He underwent induction chemotherapy, endoscopic resection with negative margins, and adjuvant chemoradiation. He did well until surveillance PET-CT at 10 months revealed asymptomatic hepatic metastases confirmed by biopsy. He was treated with transarterial chemoembolization and pembrolizumab before developing locoregional recurrence involving the orbital apex and cavernous sinus 5 months later.</p><p><strong>Conclusion: </strong>Several case reports demonstrate HMSC's potential for aggressive behavior, including intracranial extension and rapid recurrence. However, distant metastases (DM) are rare, with only three documented cases of pulmonary metastases and one digital metastasis, occurring years after initial treatment. We present the first reported case of HMSC with metastasis to the liver, marking the earliest known distant recurrence. This case challenges the current paradigm by highlighting HMSC's potential for aggressive systemic progression. Molecularly, this tumor harbored high-risk HPV35, a rarely reported subtype. Despite HMSC's typically indolent course, this case underscores the importance of vigilant surveillance to detect early DM and guide therapeutic management.</p>","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"87 1","pages":"e59-e61"},"PeriodicalIF":0.7,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13030936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575863","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}
引用次数: 0
Primary Intraosseous Meningioma of the Sphenoid-Temporal Bone with Single-Stage, 3D-Planned Cranioplasty: Case Report. 单期3d计划颅骨成形术治疗原发性蝶颞骨骨内脑膜瘤一例报告。
IF 0.7
Journal of Neurological Surgery Reports Pub Date : 2026-03-27 eCollection Date: 2026-01-01 DOI: 10.1055/a-2813-1643
Arthur F de Mattos, Mariana S Shima, Lucas P Chaves, João V M Doro, Paulo Mácio Porto de Melo
{"title":"Primary Intraosseous Meningioma of the Sphenoid-Temporal Bone with Single-Stage, 3D-Planned Cranioplasty: Case Report.","authors":"Arthur F de Mattos, Mariana S Shima, Lucas P Chaves, João V M Doro, Paulo Mácio Porto de Melo","doi":"10.1055/a-2813-1643","DOIUrl":"10.1055/a-2813-1643","url":null,"abstract":"<p><strong>Background: </strong>Primary intraosseous meningiomas (PIM) are rare extradural tumors, representing less than 2% of all meningiomas. They are often slow-growing and may present with nonspecific radiological features, complicating diagnosis.</p><p><strong>Case report: </strong>We report the case of a 48-year-old female with progressive left frontotemporal bulging over 12 months, without neurological deficits. Imaging revealed an osteoblastic lesion in the left sphenoid and temporal bones, causing mild compression of adjacent structures. The patient underwent craniectomy with complete tumor resection and immediate cranioplasty using a preplanned customized prosthesis. Histopathology and immunohistochemistry confirmed a meningothelial meningioma, with tumor cells confined to intertrabecular bone spaces and free surgical margins, consistent with a primary intraosseous origin. Postoperative follow-up demonstrated excellent cosmetic results and no recurrence.</p><p><strong>Conclusion: </strong>PIMs pose diagnostic and therapeutic challenges due to their rarity and nonspecific imaging features. Histopathology remains essential for definitive diagnosis. Preoperative 3D prototyping and customized prosthesis planning can optimize surgical reconstruction, reduce deformities, and improve cosmetic and functional outcomes. This case highlights the importance of integrating clinicoradiological evaluation, histopathology, and modern reconstructive techniques to achieve complete resection and minimize recurrence.</p>","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"87 1","pages":"e62-e68"},"PeriodicalIF":0.7,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13030935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575835","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}
引用次数: 0
Transorbital Approach to Surgical Resection of a Far-Lateral Frontal Sinus Osteoma. 经眶入路手术切除远外侧额窦骨瘤。
IF 0.7
Journal of Neurological Surgery Reports Pub Date : 2026-03-20 eCollection Date: 2026-01-01 DOI: 10.1055/a-2831-9153
Leah T Rosen, Gabriella Schmuter, Sruti Akula, Shanlee Stevens, Celestine Gregerson, Michael J Ye, Abtin Tabaee, Kyle J Godfrey
{"title":"Transorbital Approach to Surgical Resection of a Far-Lateral Frontal Sinus Osteoma.","authors":"Leah T Rosen, Gabriella Schmuter, Sruti Akula, Shanlee Stevens, Celestine Gregerson, Michael J Ye, Abtin Tabaee, Kyle J Godfrey","doi":"10.1055/a-2831-9153","DOIUrl":"10.1055/a-2831-9153","url":null,"abstract":"<p><p>A 21-year-old male presented with chronic left-sided rhinosinusitis and was found to have a left frontal sinus mass on maxillofacial computed tomography (CT). The mass measured approximately 1.9 × 1.3 × 2.3 cm in size and was contiguous with the intrasinus septum and anterior table of the frontal sinus. Imaging features were consistent with osteoma. An endoscopic endonasal approach resulted in subtotal resection of the mass. Eleven months later, the patient underwent a combined left transorbital and endoscopic surgical resection with oculofacial plastic surgery and otolaryngology. The mass was resected in its entirety, and histopathology confirmed an osteoma. This is one of the few reports of a unilateral transorbital frontal sinus osteoma resection and highlights the utility of the transorbital approach for minimally invasive access to the far-lateral frontal sinus.</p>","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"87 1","pages":"e54-e58"},"PeriodicalIF":0.7,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13004659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500102","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}
引用次数: 0
Gyrus Rectus Herniation Following Transsphenoidal Pituitary Adenoma Surgery: A Rare Case Report. 经蝶窦垂体腺瘤手术后发生直回疝1例。
IF 0.7
Journal of Neurological Surgery Reports Pub Date : 2026-03-17 eCollection Date: 2026-01-01 DOI: 10.1055/a-2816-7110
Yusuf Emrullahoğlu, Mustafa Deniz, Şükrü Oral
{"title":"Gyrus Rectus Herniation Following Transsphenoidal Pituitary Adenoma Surgery: A Rare Case Report.","authors":"Yusuf Emrullahoğlu, Mustafa Deniz, Şükrü Oral","doi":"10.1055/a-2816-7110","DOIUrl":"https://doi.org/10.1055/a-2816-7110","url":null,"abstract":"<p><strong>Background: </strong>The gyrus rectus (GR) is located at the base of the anterior cranial fossa, above the prechiasmatic optic nerves and optic chiasm. Herniation of the GR has been reported secondary to idiopathic causes or space-occupying lesions of the frontal lobe. However, GR herniation following transsphenoidal pituitary surgery has not been described previously.</p><p><strong>Case description: </strong>A 51-year-old woman with no comorbidities other than diabetes presented with visual disturbance in the right eye. Imaging revealed a non-functioning pituitary macroadenoma compressing the optic chiasm from below. The patient underwent microscopic transsphenoidal resection of the pituitary adenoma, achieving total removal. Early postoperative recovery was uneventful. Six-month follow-up MRI demonstrated inferior herniation of the GR into the sellar cavity, compressing the optic nerves superiorly. Visual complaints partially improved without further progression.</p><p><strong>Conclusion: </strong>This case represents the first reported instance of GR herniation following transsphenoidal pituitary surgery. Awareness of this rare complication is essential when evaluating persistent or new-onset visual symptoms postoperatively.</p>","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"87 1","pages":"e51-e53"},"PeriodicalIF":0.7,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12995446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147481991","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}
引用次数: 0
Giant Intradiploic Epidermoid Cyst of the Occipital Bone with Posterior Fossa Compression: A Case Report. 后颅窝压迫的枕骨巨大窝内表皮样囊肿1例。
IF 0.7
Journal of Neurological Surgery Reports Pub Date : 2026-03-17 eCollection Date: 2026-01-01 DOI: 10.1055/a-2804-2307
Halit Alioglu, Uğur Can Yılmaz, Mahmoud Osama, Zuhal Kuş Silav, Bulent Guclu
{"title":"Giant Intradiploic Epidermoid Cyst of the Occipital Bone with Posterior Fossa Compression: A Case Report.","authors":"Halit Alioglu, Uğur Can Yılmaz, Mahmoud Osama, Zuhal Kuş Silav, Bulent Guclu","doi":"10.1055/a-2804-2307","DOIUrl":"https://doi.org/10.1055/a-2804-2307","url":null,"abstract":"<p><strong>Background: </strong>Intradiploic epidermoid cysts are rare lesions that account for a small fraction of intracranial tumors with occasional malignant transformation. Occipital involvement is particularly uncommon, and lesions may reach giant dimensions with a risk fossa compression.</p><p><strong>Case presentation: </strong>A 60-year-old woman presented with a 12-month history of progressive headache and vertigo. Magnetic resonance imaging (MRI) revealed a large, diffusion-restricting extra-axial mass arising from the occipital bone and extending into the posterior fossa. She underwent a posterior fossa craniotomy with gross-total resection while preserving dural integrity. Histopathology confirmed an epidermoid cyst. The postoperative course was uneventful, and follow-up MRI showed complete resection with no recurrence.</p><p><strong>Conclusion: </strong>Giant intradiploic epidermoid cysts of the occipital bone, though histologically benign, can cause extensive bone destruction and significant posterior fossa mass effect. Accurate preoperative imaging and meticulous surgical planning are critical to achieving safe gross-total excision and favorable outcomes, particularly in atypical or extensive presentations.</p>","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"87 1","pages":"e46-e50"},"PeriodicalIF":0.7,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12995448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482035","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}
引用次数: 0
Vestibular Dysfunction as a Novel Presentation of Middle Ear Neuroendocrine Tumor. 前庭功能障碍是中耳神经内分泌肿瘤的新表现。
IF 0.7
Journal of Neurological Surgery Reports Pub Date : 2026-03-13 eCollection Date: 2026-01-01 DOI: 10.1055/a-2823-9080
Amor Niksic, Rance Jt Fujiwara, Brandon Isaacson
{"title":"Vestibular Dysfunction as a Novel Presentation of Middle Ear Neuroendocrine Tumor.","authors":"Amor Niksic, Rance Jt Fujiwara, Brandon Isaacson","doi":"10.1055/a-2823-9080","DOIUrl":"10.1055/a-2823-9080","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to contribute to the sparse literature on middle ear neuroendocrine tumors (MeNETs) by detailing a unique case of MeNET-associated cochlear-vestibular dysfunction and outlining diagnostic, therapeutic, and follow-up considerations.</p><p><strong>Design: </strong>A single-patient case report.</p><p><strong>Setting: </strong>A tertiary academic referral center.</p><p><strong>Participant: </strong>A 40-year-old male presenting with profound left sensorineural hearing loss (SNHL), left vestibular hypofunction, and a middle ear mass.</p><p><strong>Main outcome measures: </strong>Histopathologic confirmation of MeNET, radiological identification of residual disease, postoperative symptom progression, and rehabilitation outcome.</p><p><strong>Results: </strong>Clinical evaluation, imaging, and histopathology confirmed the diagnosis of MeNET. Immunohistochemistry revealed positivity for chromogranin, synaptophysin, insulinoma-associated protein 1 (INSM1), cytokeratin mouse monoclonal antibody (CAM 5.2). An endoscopic middle ear exploration with tympanoplasty and canalplasty was performed, followed by vestibular rehabilitation. Surveillance with DOTA-Tyr3-octreotate PET/MRI identified residual disease, leading to a revision mastoidectomy. The patient experienced persistent imbalance postoperatively, requiring vestibular rehabilitation, and profound SNHL, for which a hearing aid evaluation was recommended.</p><p><strong>Conclusions: </strong>This case represents the first report of MeNET-associated cochlear-vestibular dysfunction. The significance of this report lies in the unique clinical presentation, the role of advanced imaging for surveillance, and the need for revision mastoidectomy following an initial endoscopic approach. This report discusses the challenges in achieving complete tumor clearance and emphasizes the need for continued case documentation and research into adjunctive therapies.</p>","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"87 1","pages":"e41-e45"},"PeriodicalIF":0.7,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12987700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463831","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}
引用次数: 0
Sellar Dermoid Cyst Coexistence with Pituitary Adenoma/Pituitary Neuroendocrine Tumor. 鞍皮样囊肿与垂体腺瘤/垂体神经内分泌肿瘤共存。
IF 0.7
Journal of Neurological Surgery Reports Pub Date : 2026-03-09 eCollection Date: 2026-01-01 DOI: 10.1055/a-2816-7368
Chi-Man Yip, Chia-Ing Jan
{"title":"Sellar Dermoid Cyst Coexistence with Pituitary Adenoma/Pituitary Neuroendocrine Tumor.","authors":"Chi-Man Yip, Chia-Ing Jan","doi":"10.1055/a-2816-7368","DOIUrl":"10.1055/a-2816-7368","url":null,"abstract":"<p><strong>Introduction: </strong>Collision tumors are extremely rare in the sellar region, less than 1 to 2% of sellar masses. Intracranial dermoid cyst is a rare, benign, slow-growing lesion accounting for 0.04 to 0.7% of all intracranial tumors. Sellar dermoid cysts are extremely rare; from 1976 to 2024, there were only 59 records of sellar dermoid cyst published in the English language. Coexisting sellar dermoid cyst and pituitary adenoma have not been reported in the literature.</p><p><strong>Case presentation: </strong>A 51-year-old man having medical history of left traumatic optic neuropathy and acute lymphoblastic leukemia posttreatment with complete remission in 2018 suffered from intermittent dizziness and occasional unsteady gait with deviation to the left side for more than 6 months prior to visiting our hospital. His brain magnetic resonance imaging disclosed a mass lesion in the sellar region with suprasellar extension, and his preoperative hormone study showed hypopituitarism. After a thorough preoperative evaluation, he underwent an endoscopic endonasal transsphenoidal approach with the removal of the lesion and skull base reconstruction. The lesion was pathologically diagnosed to be a dermoid cyst with coexisting pituitary adenoma/pituitary neuroendocrine tumor.</p><p><strong>Conclusion: </strong>To our best knowledge, this is probably the first report of sellar dermoid cyst with coexisting pituitary adenoma/pituitary neuroendocrine tumor.</p>","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"87 1","pages":"e36-e40"},"PeriodicalIF":0.7,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436249","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}
引用次数: 0
Transection of the Vestigial Anterior Communicating Artery Limb during Microsurgical Clip Ligation of a Large, Ruptured Anterior Communicating Artery Trifurcation Aneurysm. 显微手术夹结扎大破裂前交通动脉三岔动脉瘤时残存前交通动脉肢体的横断。
IF 0.7
Journal of Neurological Surgery Reports Pub Date : 2026-02-18 eCollection Date: 2026-01-01 DOI: 10.1055/a-2780-4233
Romil Singh, Liam Cullen, Barnabas Obeng-Gyasi, Mokshal Porwal, Michael Meyer, Ethan Fitzgerald, Clementina Aiyudu, Paul Jeong, Evan Luther
{"title":"Transection of the Vestigial Anterior Communicating Artery Limb during Microsurgical Clip Ligation of a Large, Ruptured Anterior Communicating Artery Trifurcation Aneurysm.","authors":"Romil Singh, Liam Cullen, Barnabas Obeng-Gyasi, Mokshal Porwal, Michael Meyer, Ethan Fitzgerald, Clementina Aiyudu, Paul Jeong, Evan Luther","doi":"10.1055/a-2780-4233","DOIUrl":"https://doi.org/10.1055/a-2780-4233","url":null,"abstract":"<p><p>Unrecognized anatomic variants of the anterior communicating artery (AComm) complex can increase periprocedural risk during aneurysm treatment. A trifurcated AComm complex remains rare, with an incidence below 1%. Furthermore, vestigial AComm limbs may be difficult to appreciate on preoperative imaging. This video illustrates the intraoperative identification of a vestigial AComm limb and its transection to visualize and effectively clip a large, ruptured AComm trifurcation aneurysm. A middle-aged female presented with subarachnoid hemorrhage secondary to an 11-mm AComm aneurysm and was also found to have a small left anterior choroidal artery aneurysm. Preoperative imaging confirmed the presence of three A2 segments, but it was unclear if the left and right A1-A2 junctions communicated. Given her young age, aneurysm neck morphology, and the ability to treat both aneurysms through a single approach, microsurgical clip ligation was recommended. Following exposure of AComm complex, a small vestigial limb was identified, obscuring complete visualization of the aneurysm neck. Multiple fenestrated clip constructs were attempted but either occluded the A2 origin involved in the aneurysm neck or resulted in residual dome filling. The vestigial limb was transected, and the uninvolved A1-A2 junction was transposed to visualize the aneurysm neck, allowing for successful clipping fully. Intraoperative indocyanine green and postoperative angiography confirmed complete aneurysm occlusion and patency of all three A2s. Preoperative recognition of anatomic variants and their intraoperative confirmation can obviate complications in aneurysm surgery.</p>","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"87 1","pages":"e34-e35"},"PeriodicalIF":0.7,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12916220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146228952","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}
引用次数: 0
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