Journal of Neurological Surgery Reports最新文献

{"title":"Overcoming Challenging Vascular Anatomy in Chronic Subdural Hematoma: Direct Carotid Bulb Access and Contralateral Middle Meningeal Artery Embolization.","authors":"Saarang Patel, Zachary Hoglund, Chandrasekhar Palepu, Kyle W Scott, Visish M Srinivasan","doi":"10.1055/a-2603-9286","DOIUrl":"10.1055/a-2603-9286","url":null,"abstract":"<p><strong>Background: </strong>Middle meningeal artery (MMA) embolization is an emerging intervention for subdural hemorrhage. Few cases discuss the utility of contralateral MMA embolization due to challenging ipsilateral MMA anatomy for this indication.</p><p><strong>Case presentation: </strong>A 90-year-old male presented after 6 days of slurred speech and severe headache. A head computed tomography (CT) revealed a left-sided 13-mm subdural hemorrhage, and neck CT angiography revealed left internal carotid artery stenosis at 50%. The carotid stenosis was treated with a standard carotid endarterectomy at the carotid bulb. Despite direct catheterization of the external carotid artery, selective catheterization of the MMA was not feasible. Instead, coils were placed in the left internal maxillary artery spanning the left MMA origin, and the right MMA was selectively embolized using a standard transradial approach. Postoperative CT showed a reduction in subdural hematoma (SDH) size, and the patient was discharged in stable condition on postoperative day 6.</p><p><strong>Conclusion: </strong>This case presents a rescue or salvage maneuver for MMA embolization for SDH with a favorable safety profile and outcome.</p>","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"86 2","pages":"e116-e121"},"PeriodicalIF":0.6,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209774","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":"Reply to Comment: Sinonasal Plasmablastic Lymphoma: A Systematic Review.","authors":"Sophia Chen, Haidee Chen, Sophie Song, Marilene B Wang","doi":"10.1055/a-2596-0018","DOIUrl":"https://doi.org/10.1055/a-2596-0018","url":null,"abstract":"","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"86 2","pages":"e113"},"PeriodicalIF":0.6,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12116043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162648","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":"Comment: Sinonasal Plasmablastic Lymphoma: A Systematic Review.","authors":"Nosaibah Razaqi, Rachana Mehta, Shubham Kumar, Ranjana Sah","doi":"10.1055/a-2564-1141","DOIUrl":"10.1055/a-2564-1141","url":null,"abstract":"","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"86 2","pages":"e112"},"PeriodicalIF":0.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121191","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":"Endoscopic Resection of Right Petrous Meningioma Causing Trigeminal Neuralgia: \"The Double Crush\" Phenomenon.","authors":"Mazen Zaher, Pedro Aguilar-Salinas, Amna Hussein, Peter Nakaji","doi":"10.1055/a-2599-4419","DOIUrl":"10.1055/a-2599-4419","url":null,"abstract":"<p><p>Trigeminal neuralgia (TN) is typically caused by neurovascular compression (NVC) at the root entry zone, often involving the superior cerebellar artery. Occasionally, TN may be secondary to cerebellopontine angle (CPA) tumors, such as meningiomas, vestibular schwannomas, or epidermoid cysts. When both a tumor and a vascular loop contribute to nerve compression, the resulting, as we refer to the \"double crush\" phenomenon, complicates surgical management and necessitates a more comprehensive therapeutic strategy. Literature indicates that a simultaneous approach targeting both the tumor and the NVC is crucial to achieving optimal outcomes. Microvascular decompression (MVD) alone may be insufficient for patients with tumor-associated TN, as the residual mass effect can persist. The literature suggests that combining MVD with tumor resection provides superior pain relief and reduces recurrence rates. An endoscopic retrosigmoid craniotomy offers enhanced visualization and maneuverability, allowing complete tumor resection and effective nerve decompression with excellent clinical results. We present the case of a 55-year-old female with right-sided TN due to a petrous meningioma and an adjacent superior cerebellar artery loop compressing the trigeminal nerve. The patient underwent endoscopic tumor resection and MVD, resulting in significant pain relief and improved facial sensation. This case emphasizes the need to address both compressive etiologies in TN cases associated with CPA tumors to achieve the best clinical outcomes.</p>","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"86 2","pages":"e114-e115"},"PeriodicalIF":0.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162641","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":"Spontaneous Shrinking and Growing Skull Base Chordoma.","authors":"Esmée M Bosman, Max E Keizer, Jasper van Aalst, Martinus P G Broen, Alida A Postma, Astrid I P Vernemmen, Henricus P M Kunst, Yasin Temel","doi":"10.1055/a-2587-6573","DOIUrl":"https://doi.org/10.1055/a-2587-6573","url":null,"abstract":"<p><strong>Background: </strong>Chordomas are rare slow-growing tumors occurring in the axial skeleton and can demonstrate local aggressive behavior, typically extending from the median axis, compressing surrounding tissue. Complete surgical resection and adjuvant radiotherapy are the preferred treatments. We present an unusual case of a spontaneously shrinking and growing off-midline petroclival chordoma.</p><p><strong>Case description: </strong>A 23-year-old woman presented with right abducens nerve palsy. Computed tomography and magnetic resonance imaging (MRI) revealed an off-midline petroclival lesion compressing the abducens nerve with characteristics of a chondrosarcoma. Preoperative MRI indicated spontaneous lesion regression, and the abducens nerve showed clinical improvement. Hence, the planned surgery was canceled. During the wait-and-scan period, abducens nerve palsy recurred. MRI confirmed lesion growth and showed an intratumoral linear structure indicative of blood. Even though preoperative MRI again demonstrated shrinkage, the lesion was surgically removed. Despite the unusual presentation, histopathological examination diagnosed a conventional chordoma. A second surgery was required to remove the residual tumor, after which the patient received high-dose photon beam therapy.</p><p><strong>Conclusion: </strong>This article discusses the uncommon presentation and behavior of a petroclival chordoma, showing fluctuating cycles of off-midline growth and spontaneous regression. While intratumoral hemorrhage is hypothesized to explain this tumor behavior, the exact etiology needs further investigation. The case presented here emphasizes the importance of considering chordoma in the differential diagnosis despite an atypical disease course.</p>","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"86 2","pages":"e107-e111"},"PeriodicalIF":0.6,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020462","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 Mechanism of HDAC2 Inhibitors on Chronic Pancreatitis Pain.","authors":"Xiang-Tian Zeng, Wen-Hui Chen, Ding-Wen Zhong, Qi-Xin Dai, Yong He, Rong-Qiang Ye, Xiu-Lin Xiao, Yong-Hui Liao","doi":"10.1055/a-2561-8065","DOIUrl":"https://doi.org/10.1055/a-2561-8065","url":null,"abstract":"<p><strong>Background: </strong>Chronic pancreatitis (CP) is marked by persistent inflammation and fibrosis of the pancreas, often causing severe abdominal pain. The pain mechanism involves complex interactions between pancreatic inflammation and spinal nerve activity. Histone deacetylase 2 (HDAC2) is implicated in neural processes and pain modulation, making it a potential target for CP pain management.</p><p><strong>Aim: </strong>This study investigates HDAC2's role in CP pain and evaluates the effects of its inhibition in a CP rat model.</p><p><strong>Methods: </strong>CP was induced in male Sprague-Dawley rats using dibutyltin dichloride (DBTC). HDAC2 expression in spinal and pancreatic tissues was assessed through western blotting, quantitative Real-Time PCR, and enzyme-linked immunosorbent assay (ELISA). Pain sensitivity was evaluated using paw withdrawal tests. Co-cultures of AR42J pancreatic acinar cells and F11 spinal neurons were used to explore pancreatic-neural interactions. Chromatin immunoprecipitation (ChIP) and promoter assays examined HDAC2 transcriptional regulation.</p><p><strong>Results: </strong>HDAC2 expression was significantly elevated in CP rats, which also displayed increased pain sensitivity and higher inflammatory markers (interleukin [IL]-1β [IL-1β], tumor necrosis factor-α [TNF-α], IL-6, and chemokine ligand 2 [CCL-2]). HDAC2 inhibition reduced pain sensitivity and pancreatitis. Co-culture experiments revealed that pancreatic inflammatory mediators upregulate HDAC2 in neurons. ChIP identified Sp1 as a regulatory factor for HDAC2, with the extracellular signal-regulated kinase-Specific protein 1 (ERK-Sp1) pathway critical for its expression.</p><p><strong>Conclusion: </strong>HDAC2 is crucial in CP pain sensitization and inflammation. Its inhibition reduces pain and inflammation, offering potential for targeted pain management in CP.</p>","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"86 2","pages":"e99-e106"},"PeriodicalIF":0.6,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014646","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":"Circulating Tumor DNA Testing for Detection and Surveillance of Sinonasal HPV-Associated Cancers.","authors":"Avraham E Adelman, Kartik Motwani, Nikita Chapurin","doi":"10.1055/a-2576-7496","DOIUrl":"https://doi.org/10.1055/a-2576-7496","url":null,"abstract":"<p><strong>Background: </strong>The incidence of human papilloma virus (HPV)-mediated head and neck (H/N) cancers has risen dramatically. While most HPV-associated H/N cancers are oropharyngeal squamous cell carcinoma (OPSCC), sinonasal squamous cell carcinoma (SNSCC) is the second most common. Recent studies highlight an increasing incidence of HPV-positive SNSCC. Circulating tumor HPV DNA (ctDNA) is a noninvasive tool that has become increasingly utilized to detect high-risk HPV genotypes in the setting of OPSCC, with recent studies reporting high sensitivity and specificity in both pretreatment detection and posttreatment surveillance in OPSCC. Only one study exists reporting its use for SNSCC and nasopharyngeal carcinoma, which was successful in pretreatment detection and identification of recurrence posttreatment.</p><p><strong>Case reports: </strong>We report two cases demonstrating the utility of ctDNA in HPV-mediated sinonasal malignancies. Case 1: 60-year-old male who presented with a large nasal cavity cancer. Pretreatment ctDNA testing yielded a positive tumor tissue modified viral (TTMV)-HPV DNA Score of 67, reflective of the normalized tumor tissue modified viral-HPV DNA fragments/mL of plasma, and pathology confirmed HPV+ SNSCC. Posttreatment surveillance with HPV ctDNA and endoscopy has shown no evidence of disease. Case 2 involves a 64-year-old male with HPV+ neuroendocrine carcinoma who developed recurrence. ctDNA testing, previously negative following initial treatment, scored 35 at recurrence, prompting salvage surgery and adjuvant chemoradiation.</p><p><strong>Conclusion: </strong>These cases, along with prior studies, underscore the potential of ctDNA as a diagnostic and surveillance tool for sinonasal malignancies. Further multi-institutional prospective trials with larger cohorts are needed to validate its role in detection and surveillance.</p>","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"86 2","pages":"e89-e91"},"PeriodicalIF":0.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12031431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052756","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":"<b>Recurrent Glioblastoma Resection with Microvascular Free Flap Reconstruction and Associated GammaTile Implantation: A Personalized Approach with Oncologic and Reconstructive Integration</b>.","authors":"Russel T Wagner, Jacopo Berardinelli, Amin B Kassam, Julian E Bailes, Melanie B Fukui, George C Bobustuc, Sammy Khalili, Neil S Mundi","doi":"10.1055/a-2576-7559","DOIUrl":"https://doi.org/10.1055/a-2576-7559","url":null,"abstract":"<p><strong>Background: </strong>Glioblastoma multiforme (GBM), despite aggressive multimodal treatment comprising surgery followed by chemoradiation, is almost uniformly associated with inevitable recurrence and poor outcomes. In this clinical context, local radiation therapy-an emerging approach-has gained considerable attention over time for its potential to address the limitations of traditional treatment options for GBM. Multiple surgeries and adjuvant chemoradiation therapy can negatively impact the integrity of the scalp soft tissues and can compromise the ability to achieve primary closure over the surgical site. In these circumstances, complex reconstruction with free tissue transfer may be necessary.</p><p><strong>Methods: </strong>We report the case of a 37-year-old female patient with recurrent GBM and associated wound healing complications who underwent single-stage GammaTile surgically targeted radiation therapy combined with microvascular free flap scalp reconstruction.</p><p><strong>Results: </strong>Immediate free flap reconstruction over the site of GammaTile implantation did not result in any wound healing complications and did not compromise the viability of the transplanted tissue. This approach also provided immediate and localized radiation, possibly enhancing patient progression-free survival while reducing the likelihood of radiation-induced adverse effects.</p><p><strong>Conclusion: </strong>We report the first case of GammaTile implantation with immediate reconstruction of the overlaying soft tissue defect with a free flap. Despite the immediate local radiation produced by the tiles abutting the deep surface of the free flap, there were no complications noted in the vascularity of the transplanted tissue. This finding provides preliminary evidence supporting the safety of using free tissue transfer alongside GammaTile implantation for complex reconstruction.</p>","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"86 2","pages":"e92-e97"},"PeriodicalIF":0.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12031433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049120","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":"Use of a Septal Stapler to Secure a Septal Free Mucosal Graft to the Nasoseptal Flap Donor Site Following Endoscopic Endonasal Resection of a Pituitary Adenoma.","authors":"Jessa E Miller, Jakob L Fischer, Marilene B Wang","doi":"10.1055/a-2531-6140","DOIUrl":"https://doi.org/10.1055/a-2531-6140","url":null,"abstract":"<p><p>There are multiple techniques that can be utilized to reconstruct skull base defects following endoscopic endonasal pituitary surgery. The nasoseptal flap (NSF) is a vascularized reconstructive option that is commonly used to repair skull base defects. There are several factors that must be considered when deciding to perform a NSF. If a NSF is harvested from one side, the posterior septal mucosa on the contralateral side is often sacrificed and wasted during the posterior septectomy for the endoscopic endonasal pituitary approach. Harvesting a NSF from one side and a posterior septal free mucosal graft (FMG) from the contralateral side affords the surgeon multiple reconstructive options depending on the size of the defect and the presence of a CSF leak at the end of the tumor resection. After a NSF is performed, patients often have significant crusting along the exposed anterior cartilaginous septum that results from delayed remucosalization. If a contralateral posterior septal FMG is harvested, this can be secured to the caudal septal NSF donor site to help minimize postoperative sinonasal symptoms, principally caudal septal crusting which can result in nasal obstruction. In this operative video, we demonstrate the use of a septal stapler to secure a FMG to the anterior NSF donor site following endoscopic endonasal resection of a pituitary adenoma. The staples are dissolvable, and the septal stapler technique is more efficient than performing a quilting suture.</p>","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"86 2","pages":"e98"},"PeriodicalIF":0.6,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12132704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217194","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":"Application of Augmented Reality Navigation in Craniofacial Surgery for Fibrous Dysplasia.","authors":"Will C Kaiser, Sanaa Hameed, Fauziyya Muhammad, David Barkyoumb, Christian El Amm, Zachary A Smith","doi":"10.1055/a-2547-5400","DOIUrl":"https://doi.org/10.1055/a-2547-5400","url":null,"abstract":"<p><strong>Introduction: </strong>Fibrous dysplasia of the craniofacial bones, or craniofacial dysplasia (CFD), involves the replacement of normal bone with fibrous osseous tissue, resulting in asymmetry and distortion of the overlying soft tissue and irregular bone deposition. Treatment primarily involves surgical resection, and achieving symmetry by matching the contralateral unaffected side is crucial. However, surgical correction is challenging due to the lack of visualization of the normal contralateral structures and the need to precisely control resection depth. Although the application of an augmented reality navigation (ARN) system for CFD surgery has been documented, to our knowledge its specific use in identifying key neurovascular structures has not been reported.</p><p><strong>Methods: </strong>We present the application of an ARN system for the surgical management of an 18-year-old woman with CFD. The virtual plan was designed to visualize the extent of tumor, identify normal and abnormal vasculature, and guide the reconstruction of a normal anatomical contour.</p><p><strong>Results: </strong>ARN was successfully integrated into the surgical workflow and optimized operative planning, identification of tumor margins, avoidance of neurovascular structures, reconstruction, and symmetric recontouring. The ability to visualize structures in real time proved to be especially beneficial for making intraoperative adjustments.</p><p><strong>Conclusion: </strong>ARN has significant applications for CFD surgery by providing real-time, three-dimensional simulation, and precise overlay of patient-specific anatomy and pathology, facilitating safe resection, and providing a useful reconstruction guide. To our knowledge, this report presents the first detailed description of its utility in visualizing critical neurovascular structures, offering significant potential to enhance surgical safety and patient outcomes.</p>","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"86 2","pages":"e83-e88"},"PeriodicalIF":0.6,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037843","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}