Journal of Neurological Surgery Reports最新文献

{"title":"From Balloon to Brain Ballooning: A Case of Obstructive Hydrocephalus in a Child.","authors":"Shachar Zion Shemesh, Noa Rennert, Paz Kelmer, Zeev Feldman, Lior Ungar","doi":"10.1055/a-2803-4470","DOIUrl":"https://doi.org/10.1055/a-2803-4470","url":null,"abstract":"<p><strong>Background: </strong>Intraventricular simple cysts, often termed intraventricular arachnoid cysts, are rare benign intracranial lesions in children and are usually asymptomatic. When they become symptomatic, the presentation is typically related to obstructive hydrocephalus or seizures. Clear clinical triggers for abrupt decompensation are not well defined.</p><p><strong>Observations: </strong>A previously healthy 6.9-year-old boy presented in stupor with acute obstructive hydrocephalus. The only notable antecedent event was repetitive, forceful balloon inflation the night before, followed by early-morning headache and vomiting. Examination showed papilledema, nuchal rigidity, and positive Kernig and Brudzinski signs without focal deficits. CT revealed triventricular hydrocephalus with a normal fourth ventricle. Cerebrospinal fluid (CSF) and blood studies were unrevealing for infection. Worsening hydrocephalus prompted emergent frontal ventriculostomy. MRI confirmed supratentorial obstructive hydrocephalus with trans-ependymal CSF seepage. Endoscopic third ventriculostomy through the ventriculostomy tract exposed a thin, transparent, vascularized cyst bridging the right lateral ventricle and third ventricle near the foramen of Monro. Endoscopic cauterization and fenestration of the cyst wall restored CSF flow, and the child recovered fully without deficit.</p><p><strong>Lessons: </strong>This case suggests that repetitive, forceful Valsalva-like maneuvers during excessive balloon inflation can acutely raise intracranial pressure and precipitate decompensation in children harboring an unrecognized intraventricular arachnoid cyst, resulting in acute obstructive hydrocephalus.</p>","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"87 1","pages":"e30-e33"},"PeriodicalIF":0.7,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12909072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146214513","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":"Pitch Perfect: Clinical Research Primer on the Art of Pitching Projects for Medical Students.","authors":"Parth Patel, Jennifer Day, Tressie Stephens, Michael Feldman, Ian F Dunn, Andrew Bauer, Christopher S Graffeo","doi":"10.1055/a-2780-5559","DOIUrl":"https://doi.org/10.1055/a-2780-5559","url":null,"abstract":"<p><p>Research is a crucial skill for undergraduate medical students, especially those aspiring to a career in competitive, academic fields such as neurosurgery. The first and perhaps least explicated step is the development of an idea suitable to a clinical project. While medical students may face challenges during all parts of the research process, learning how to efficiently pitch a research project can reduce barriers to publishing research. Several steps can be taken by medical students to find projects that are conducive to completion. First, medical students should focus on finding project ideas they find interesting, suitable mentors, targeted questions, and projects which can be completed in a reasonable timeframe. Second, medical students should think through the entire project early on to determine if their proposed project has any major hurdles. This involves thinking through any possible problems that may arise for the proposed project's target population, data collection, variables, outcomes, and study design. While these tasks may initially seem like extra work, being able to avoid problematic project ideas can result in more efficient research output and increase research satisfaction. To date, the process of creating and pitching a potential project idea for research has yet to be satisfactorily explained at a medical student level. Therefore, the goal of this paper is to detail any relevant steps necessary to pitch a research project for medical students.</p>","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"87 1","pages":"e19-e23"},"PeriodicalIF":0.7,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12909078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146214454","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 Unique Case of an Arrow-Related Penetrating Spinal Cord Injury in Kenya and a Comprehensive Literature Review.","authors":"Filippos S Chelmis, Fani C Papacharalampous, Iliana N Sorotou, Paraskevas Pakataridis, Hugh Williams, Josephat Mburu, Emmanuel Wekesa, Alexandru Budu","doi":"10.1055/a-2798-9778","DOIUrl":"https://doi.org/10.1055/a-2798-9778","url":null,"abstract":"<p><strong>Background: </strong>Penetrating spinal cord injuries from arrows are rare. Arrowhead extraction can be challenging due to proximal critical neurovascular structures and tip variation. Our study highlights the most appropriate management plan based on our experience and current literature.</p><p><strong>Methods: </strong>Literature search on PubMed and Google Scholar was performed. This review examines optimal surgical management strategies, mean arterial pressure (MAP) evaluation, antibiotic protocols, and recovery timelines. Additionally, we investigate spinal cord decompression, focusing on its potential to reduce edema and accelerate recovery. Our study includes one case of a 32-year-old cervical penetrating spine injury caused by an arrow.</p><p><strong>Results: </strong>Literature recommends maintaining an MAP of 85 to 90 mm Hg for 7 days following blunt spinal cord injury. Evidence for penetrating injuries is limited and suggests no improvement with MAP augmentation. Prophylactic broad-spectrum antibiotics, for 48 hours, appear effective in preventing infection and early surgical intervention. Our patient had an incomplete spinal cord injury with preserved motor function in the right (dominant) hand and decreased motor function (3/5) in the left C8-T1 level. Careful planning must consider the shape of the arrow and the anatomy. Removal of the arrow tip requires proximal control, with additional consideration for dural repair.</p><p><strong>Conclusion: </strong>This case underscores the rarity and challenges of treating arrow-induced spinal cord injuries, particularly in resource-limited settings. Unlike blunt trauma, insufficient evidence supports elevated MAP or decompression for penetrating injuries. The primary management goal remains the safe, timely removal of the arrow and prophylactic antibiotics. Further research is needed to develop a standardized management protocol.</p>","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"87 1","pages":"e24-e29"},"PeriodicalIF":0.7,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12909079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146214456","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":"Understanding the Translabyrinthine Approach for Neurosurgery Residents: Operative and Educational Video.","authors":"Beste Gülsuna, Xiaochun Zhao, Alexander G Bien, Jeffrey A Zuccato, Christopher S Graffeo","doi":"10.1055/a-2780-4133","DOIUrl":"10.1055/a-2780-4133","url":null,"abstract":"<p><p>Vestibular schwannomas are benign tumors of the vestibular division of the eighth cranial nerve, with an incidence of 1 to 2 per 100,000 annually. Large tumors (>3 cm) may cause disabling symptoms such as progressive hearing loss, vestibulopathy, or trigeminal nerve dysfunction, often necessitating microsurgical resection. This video demonstrates the translabyrinthine resection of a 3.2-cm left-sided vestibular schwannoma in a 67-year-old woman with worsening sensorineural hearing loss and new-onset lip numbness ( Video 1 ). The procedure was performed at a tertiary center with continuous intraoperative neurophysiological monitoring of cranial nerves V, VI, VII, X, and XI, as well as somatosensory and motor evoked potentials. Near-total resection (∼99%) was achieved, with a small residual adherent to the cisternal segment of the facial nerve near the superior petrosal vein to maximize functional preservation. Postoperatively, the patient experienced transient House-Brackmann (HB) grade 2 facial palsy, which improved within 5 weeks to HB 1, and no nodular enhancement was observed on follow-up magnetic resonance imaging. The translabyrinthine approach provides direct exposure of the internal auditory canal with minimal brainstem retraction, making it particularly advantageous for large tumors in patients with nonserviceable hearing. Beyond its operative illustration, this video emphasizes step-by-step surgical anatomy, technique, and intraoperative decision-making, offering neurosurgery residents an educational framework for understanding indications, technical nuances, and complication avoidance strategies.</p>","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"87 1","pages":"e17-e18"},"PeriodicalIF":0.7,"publicationDate":"2026-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12904753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203221","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":"Postspinal Surgery Hydrocephalus, Intraventricular Hemorrhage, and Multidrug-Resistant Ventriculitis: A Fatal Cascade.","authors":"Zeinab El Mawla, Abbas Shoeib, Zahraa Shamas, Ahmad Awde, Ali Raad","doi":"10.1055/a-2798-9840","DOIUrl":"10.1055/a-2798-9840","url":null,"abstract":"<p><strong>Background: </strong>Hydrocephalus, intraventricular hemorrhage (IVH), and ventriculitis are rare but devastating complications following spinal surgery. Their coexistence significantly worsens prognosis, especially when multidrug-resistant pathogens are involved.</p><p><strong>Case presentation: </strong>A 59-year-old man with a C7 fracture and complete paraplegia underwent anterior and posterior cervical spine surgeries complicated by cerebrospinal fluid (CSF) leakage. He later developed hydrocephalus and IVH, requiring external ventricular drainage. Shortly thereafter, fever and altered consciousness occurred, and pus was observed in the drain. CSF analysis confirmed carbapenem-resistant <i>Enterobacteriaceae</i> (CRE) ventriculitis, specifically caused by <i>Escherichia coli</i> . Treatment with intravenous meropenem, vancomycin, and escalation to intrathecal colistin and tigecycline achieved microbiological clearance. Despite this, neurological recovery was poor, and the patient succumbed 27 days after readmission.</p><p><strong>Conclusion: </strong>This report emphasizes the interplay of mechanical and infectious complications after spinal surgery, highlighting the need for early recognition, aggressive combined therapy, and preventive strategies to improve outcomes.</p>","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"87 1","pages":"e13-e16"},"PeriodicalIF":0.7,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12885763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158734","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 Intracranial Extension of Ethmoidal Sinus Juvenile Psammomatoid Ossifying Fibroma.","authors":"Sagar Gawali, Shubham Goyal, Naren Nayak","doi":"10.1055/a-2779-6238","DOIUrl":"10.1055/a-2779-6238","url":null,"abstract":"<p><p>Juvenile psammomatoid ossifying fibroma (JPOF) is a type of fibro-osseous lesion in which normal bone is replaced by fibrous tissue. Most commonly, it involves the nasal sinuses or orbital bone. It is very important to differentiate it from other fibro-osseous lesions because these lesions have overlapping clinical features. Even though it is a benign condition, it is locally aggressive and rarely extends intracranially. A complete surgical resection is the key to avoid recurrence. We are presenting a case of JPOF in a 16-year-old boy with a large tumor involving the ethmoidal sinuses with large intracranial component.</p>","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"87 1","pages":"e6-e12"},"PeriodicalIF":0.7,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12823220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146031183","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":"Intracranial Retrograde Cerebrospinal Fluid Dissemination of H3 K27-altered Glioma.","authors":"Parth Patel, James Battiste, Kar-Ming Fung, Ian F Dunn, Christopher S Graffeo","doi":"10.1055/a-2780-4173","DOIUrl":"10.1055/a-2780-4173","url":null,"abstract":"<p><strong>Introduction: </strong>Diffuse midline glioma, H3 K27-altered (DMGHA), is an uncommon malignant primary brain tumor associated with a grave prognosis and limited treatment options. We report a unique case of an elderly woman who was initially treated for a right cerebellar DMGHA. She subsequently developed a distal recurrence at the septum pellucidum, hypothesized to be a result of retrograde cerebrospinal fluid (CSF) dissemination.</p><p><strong>Case history: </strong>A 72-year-old woman initially presented with headache and dizziness. The subsequent workup revealed a right cerebellar mass. A diagnosis of DMGHA was confirmed by histological studies and molecular profiling, and she was treated with gross total resection followed by protocol-based chemoradiation. At 12 months after surgery and treatment, surveillance imaging showed a new isolated enhancing mass in the septum pellucidum. She underwent another gross total resection with an anterior interhemispheric approach. Pathology confirmed a diagnosis of DMGHA.</p><p><strong>Conclusion: </strong>We report a novel case of recurrent distal spread of a right cerebellar DMGHA to the septum pellucidum. Although several putative mechanisms may be hypothesized to account for the very unique pattern of disease spread including simple multifocal disease, retrograde CSF dissemination may be the most likely mechanism. This is due to the lack of radiographic evidence for subcortical or hematogenous spread, and the interface between both enhancing masses and the CSF compartment.</p>","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"87 1","pages":"e1-e5"},"PeriodicalIF":0.7,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12795630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967563","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":"Microsurgical Resection of a Diaphragma Sellae Meningioma via Extradural Clinoidectomy with Preservation of Superior Hypophyseal Arteries.","authors":"Umid Sulaimanov, Jiyang An, Ufuk Erginoglu, Cagdas Ataoglu, Yerkebulan Serikkanov, Abdullah Keles, Mustafa K Baskaya","doi":"10.1055/a-2765-5582","DOIUrl":"10.1055/a-2765-5582","url":null,"abstract":"<p><p>Diaphragma sellae meningiomas are rare suprasellar tumors often misidentified as tuberculum sellae meningiomas. Their association with the optic nerve, chiasm, pituitary stalk, internal carotid, and superior hypophyseal arteries presents unique surgical challenges. These tumors are classified into three types based on dural attachment with precise subtype identification. We present a Type A diaphragma sella meningioma, located anterior to the pituitary stalk, managed via a pterional craniotomy with extradural anterior clinoidectomy and optic unroofing. Posterior attachment with ICA adhesion and multiple SHA involvement favored a transcranial route, with clinoidectomy and optic unroofing widening the optico-carotid triangle for safe resection.</p>","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"86 4","pages":"e260-e262"},"PeriodicalIF":0.7,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12705240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145769361","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":"Transformation Versus Ascertainment Bias of a Suprasellar Lesion: A Histopathologic Conundrum of BRAF V600E Positive Papillary Craniopharyngioma Versus Rathke's Cleft Cyst with Squamous Metaplasia: A Systematic Review.","authors":"Hailey Mattheisen, Samon Tavakoli, Edward Kelly Mrachek, Stephanie Cheok, Nathan Zwagerman","doi":"10.1055/a-2751-8340","DOIUrl":"10.1055/a-2751-8340","url":null,"abstract":"<p><strong>Background: </strong>Differentiating craniopharyngiomas (CPs) from Rathke's cleft cysts (RCCs) is challenging due to overlapping features. RCCs with squamous metaplasia (SM) may represent a transition to CPs, complicating diagnosis. This study presents a recurrent RCC later confirmed as papillary CP, prompting a systematic review to identify early diagnostic markers. The goal is to improve RCC and CP differentiation, preventing radical resection of true RCCs, and predicting recurrence or transformation to CPs.</p><p><strong>Methods: </strong>A systematic review was performed with adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Using the PubMed/Medline databases, a search string was created with the keywords \"RCC transformation or (RCC and CP) or (RCC to CP) or (RCC to CP) or (Rathke's and CP).\" The initial search yielded 489 papers, narrowed by key data points including RCC recurrence with histologic CP confirmation.</p><p><strong>Results: </strong>The final review included five studies, which detailed cases of initial pathological diagnosis of RCC that were later diagnosed as a CP upon repeat surgery and tissue sampling. Histological examination of primary and secondary surgical resections revealed RCC recurrence with transformation to CPs (two adamantinomatous CPs, two papillary CPs, and one ciliated CP).</p><p><strong>Conclusion: </strong>RCCs and CPs share overlapping features, complicating preoperative diagnosis and treatment. RCC recurrence with subsequent CP is rare, as our review identified only five recorded cases. Definitive diagnosis requires pathology, though sampling bias poses challenges. Advanced imaging (contrast-enhanced 3D T2-FLAIR MRI) and biomarkers (BRAF V600E, beta-catenin, p53, Ki-67) show promise in improving diagnosis, predicting recurrence, and guiding treatment.</p>","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"86 4","pages":"e253-e259"},"PeriodicalIF":0.7,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12695434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145744956","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":"Aggressive Clinical Course and Malignant Transformation of a Meningeal Melanocytoma of the Pontomedullary Region: Diagnostic and Therapeutic Implications.","authors":"Oyku Ozturk, Mehmet A Inan, Muammer M Sahin, Emrah Celtikci","doi":"10.1055/a-2753-9601","DOIUrl":"10.1055/a-2753-9601","url":null,"abstract":"<p><strong>Background: </strong>Primary melanocytic tumors of the central nervous system (CNS) are rare neoplasms that range from benign melanocytomas to aggressive malignant melanomas. Although meningeal melanocytomas are generally considered indolent lesions, malignant transformation and distant metastasis can occur.</p><p><strong>Case description: </strong>We report the case of a 33-year-old male with a bulbopontine meningeal melanocytoma who developed systemic metastases, culminating in a fatal outcome. Despite initial histopathologic features of benignity and absence of BRAF mutation, the lesion showed aggressive behavior.</p><p><strong>Conclusion: </strong>This case underscores the diagnostic pitfalls associated with primary CNS melanocytic tumors and highlights the importance of long-term vigilance, even for histologically benign lesions.</p>","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"86 4","pages":"e249-e252"},"PeriodicalIF":0.7,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12674948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679142","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}