Journal of Neurological Surgery Reports最新文献

{"title":"Triple Stentriever \"Bouquet\" Deployment with Zoom 88 Large-Bore Aspiration and Walrus Balloon-Guide Catheter for the Definitive Thrombectomy of a Carotid Free-Floating Thrombus.","authors":"Jessica K Campos, Benjamen M Meyer, Muhammad W Khan, David A Zarrin, Jonathan C Collard de Beaufort, Gizal Amin, Li-Mei Lin, Alexander L Coon","doi":"10.1055/s-0044-1778695","DOIUrl":"10.1055/s-0044-1778695","url":null,"abstract":"<p><p>Formation of a carotid free-floating thrombus (CFFT) is a rare and life-threatening condition without an optimal management plan. A 78-year-old woman with a history of prior right internal carotid artery (ICA) mechanical thrombectomy and antiplatelet noncompliance presented with transient ischemic attacks secondary to a recurrent CFFT in the right ICA. Given her symptoms and recurrent CFFT, endovascular mechanical thrombectomy was performed. A balloon guide-catheter (BGC) and a Zoom 88 distal access catheter were brought into the right distal common carotid artery and proximal ICA bulb, respectively. Three 0.021-inch microcatheters, each loaded with a unique stentriever, were navigated beyond the thrombus into the upper cervical ICA and deployed in a bouquet fashion. The BGC was inflated to achieve flow arrest, and the Zoom 88 aspiration catheter was tracked over the three bouquet stentrievers to ingest the thrombus. Follow-up angiography demonstrated recanalization of the proximal cervical ICA without evidence of residual thrombus. Twenty-four-hour postoperative computed tomography imaging did not reveal any evidence of new infarction. The patient was discharged home with an intact neurological examination, compliant on aspirin and apixaban. We demonstrate a novel technique utilizing a large-bore catheter with a triple stentriever \"bouquet\" to thrombectomize a CFFT.</p>","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"85 1","pages":"e17-e22"},"PeriodicalIF":0.6,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10861319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139724388","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":"Pituitary Adenoma Coexistent with Sellar Clear Cell Meningioma Unattached to the Dura: Case Report and Treatment Considerations.","authors":"Grégoire P Chatain, Keanu Chee, Meghan Driscoll, B K Kleinschmidt-DeMasters, Kevin O Lillehei","doi":"10.1055/s-0043-1777792","DOIUrl":"10.1055/s-0043-1777792","url":null,"abstract":"<p><p>Collision tumors involving the sella are rare. Intrasellar collision tumors are most commonly composed of a combination of pituitary adenomas and pituitary neuroendocrine tumors; however, collision tumors consisting of a pituitary adenoma and intrasellar meningioma are exceedingly rare. The authors present the case of a 47-year-old man who presented with progressive right eye vision loss. Magnetic resonance imaging showed a large, heterogeneously enhancing sellar mass with suprasellar extension. Using a transcranial approach with a right subfrontal craniotomy, near-total resection of the mass was achieved. Histologic analysis confirmed a diagnosis of a gonadotroph adenoma with concomitant clear cell meningioma (CCM). This patient was discharged with improvement in visual acuity and no signs of diabetes insipidus. Given the indistinguishable radiographic characteristics of pituitary adenoma and CCM, a preoperative diagnosis of a collision tumor was difficult. This case was uniquely challenging since the CCM component lacked the classic dural attachment that is associated with meningiomas on neuroimaging. CCMs are classified as central nervous system (CNS) World Health Organization (WHO) grade 2 tumors and tend to behave more aggressively, therefore warranting close surveillance for signs of tumor recurrence. This is the first case to report a collision tumor consisting of pituitary adenoma and CCM.</p>","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"85 1","pages":"e1-e10"},"PeriodicalIF":0.5,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10776412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139425685","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":"Multidisciplinary Management of Total Anterior Skull Base Osteoradionecrosis","authors":"Aatin K. Dhanda, Sean P McKee, David Z. Allen, Omar G. Ahmed, Kurt Yaeger, Laura M Kim, J. J. Kain","doi":"10.1055/a-2236-6162","DOIUrl":"https://doi.org/10.1055/a-2236-6162","url":null,"abstract":"Cases of delayed osteoradionecrosis (ORN) of the anterior skull base have unique management considerations. A 59-year-old woman with a history of basaloid squamous cell carcinoma of the sinonasal cavity with intracranial extension through the anterior skull base developed delayed radiation sequelae of anterior skull base ORN. She underwent an initial endoscopic resection in 2011 with persistent disease that required an anterior craniofacial resection with left maxillectomy in 2012 followed by adjuvant chemoradiotherapy. She subsequently developed an intracranial abscess in 2021 along the anterior skull base that required a craniotomy and endoscopic debridement. Despite aggressive surgical and medical therapy, she had persistent intracranial infections and evidence of skull base osteoradionecrosis. She ultimately underwent a combined open bifrontal craniotomy and endoscopic resection of the necrotic frontal bone and dura followed by an anterolateral thigh free flap reconstruction with titanium mesh cranioplasty. The patient recovered well from a microvascular free-tissue reconstruction without concern for cerebrospinal fluid leak. Anterior skull base reconstruction with free tissue transfer is a commonly utilized method for oncologic resections. Here, an anterolateral free flap was effectively used to treat an anterior skull base defect secondary to a rare indication of skull base osteoradionecrosis.","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"7 12","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139145378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decision-Making in Clival Mass Lesions: Risk Factors for Malignant Disease and an Illustrative Case Example.","authors":"Matthew P Baier, Daniel A Cheong, Helen H Shi, Jo Elle G Peterson, Kar-Ming Fung, Ian F Dunn, Kibwei A McKinney, Christopher S Graffeo","doi":"10.1055/a-2215-0974","DOIUrl":"10.1055/a-2215-0974","url":null,"abstract":"<p><p><b>Introduction</b>  Clival tumors are rare and heterogeneous. Although some benign prototypical sellar lesions may present as clival tumors, the likelihood of malignant disease is higher. Here we define a novel algorithm for the workup and management of clival masses through an illustrative case of colorectal adenocarcinoma metastasis to the clivus. <b>Methods</b>  In this case report, the best practice guidelines for managing clival masses are described through a literature review and refined by senior author consensus. We conducted a focused systematic review to characterize the present case in the context of clival metastasis from gastrointestinal malignancy. <b>Results</b>  An 83-year-old woman presented with 4 weeks of headaches and blurry vision. Examination revealed partial right abducens and left oculomotor palsies. Magnetic resonance imaging (MRI) identified a large, weakly enhancing sellar and clival mass with sphenoid sinus extension. An aggressive subtotal endoscopic endonasal resection was performed with removal of all sphenoid, clival, and sellar disease without cavernous sinus wall resection. Pathology confirmed colorectal adenocarcinoma; computed tomography (CT) imaging identified an ascending colon mass with metastases to the liver and mesenteric nodes. Palliative oncologic therapies were recommended, but she elected hospice, and died 3 months after initial presentation. Gastrointestinal clival metastases are exceedingly rare among sellar and clival pathologies, with eight prior cases reported, most of which presented with diplopia from abducens nerve involvement. <b>Conclusion</b>  Clival masses are uncommon skull base lesions that are associated with more aggressive diseases. We present a consolidated framework for decision-making in these challenging patients, alongside an unusual case example that illustrates the importance of increased suspicion for malignant clinical entities in this setting.</p>","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"84 4","pages":"e156-e162"},"PeriodicalIF":0.6,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10733071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138832127","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":"Multifocal Ectopic Recurrence of a C2 Chordoma.","authors":"Maikerly Reyes, Allison Kayne, Sarah Collopy, Giyarpuram Prashant, Patrick Kelly, James J Evans","doi":"10.1055/s-0043-1777073","DOIUrl":"https://doi.org/10.1055/s-0043-1777073","url":null,"abstract":"<p><p><b>Background</b>  Chordomas are histologically benign but locally aggressive tumors with a high propensity to recur. Our case highlights the importance of long-term vigilance in patients who have undergone chordoma resection. <b>Case Report</b>  We report the case of a 47-year-old man with a cervical chordoma who developed multiple musculoskeletal ectopic recurrences in the left supraclavicular region, the proximal right bicep, and the left submandibular region without recurrence in the primary tumor site. Primary tumor resection was achieved via a combination of surgery, adjuvant radiation therapy, and imatinib. All recurrences were successfully resected and confirmed via pathology to be ectopic chordoma. <b>Discussion</b>  Ectopic recurrence of cervical chordoma is rare and lung is the most common site of distant spread. Chordoma recurrence in skeletal muscle is particularly rare, with only 10 cases described in the literature. A plausible mechanism of distant metastatic disease in chordoma patients suggests that tumor cells escape the surgical tract via a combination of cytokine release, vasodilation, and microtrauma induced during resection. <b>Conclusion</b>  Cervical chordoma with ectopic recurrence in skeletal muscle has not been previously described in the literature. Skull base surgeons should be aware of the phenomenon of chordoma ectopic recurrence in the absence of local recurrence.</p>","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"84 4","pages":"e146-e155"},"PeriodicalIF":0.5,"publicationDate":"2023-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10673705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138463377","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":"Repeat Surgery for Vestibular Schwannomas: An Institutional Case Series.","authors":"Khizar R Nandoliya,&nbsp;Emily J Winterhalter,&nbsp;Constantine L Karras,&nbsp;Rushmin Khazanchi,&nbsp;Mark W Youngblood,&nbsp;Pavlos Texakalidis,&nbsp;James P Chandler,&nbsp;Stephen T Magill","doi":"10.1055/s-0043-1776124","DOIUrl":"https://doi.org/10.1055/s-0043-1776124","url":null,"abstract":"<p><p><b>Introduction</b>  Vestibular schwannomas (VSs) are treated with microsurgery and/or radiosurgery. Repeat resection is rare, and few studies have reported postoperative outcomes. The objective of this study was to describe clinical characteristics and outcomes in patients undergoing repeat surgery for VS. <b>Methods</b>  All adult (≥ 18 years) patients undergoing VS resection between 2003 and 2022 at our institution were retrospectively reviewed to identify patients who underwent repeat surgery of an ipsilateral VS following prior gross-total (GTR) or subtotal resection. Patient, radiographic, and clinical characteristics were reviewed. Primary outcomes were postoperative tumor volume, extent of resection, postoperative cranial nerve deficits, and time to further tumor progression. <b>Results</b>  Of 102 patients undergoing VS resection, 6 (5.9%) had undergone repeat surgery. Median (range) follow-up was 20 (5-117) months. Three patients were female. Median age was 56 (36-60) years. Median pre- and postoperative tumor volumes were 8.2 (1.8-28.2) cm ³ and 0.4 (0-3.8) cm ³ . GTR was achieved in two patients. Four patients had higher House-Brackmann scores at last follow-up, but none had tumor progression. <b>Conclusion</b>  In this small cohort of patients, repeat resection of recurrent or progressive VS can effectively reduce tumor volume with acceptable perioperative outcomes.</p>","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"84 4","pages":"e140-e143"},"PeriodicalIF":0.5,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10611534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71414648","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":"Proton Therapy for Chondrosarcoma","authors":"Dennis M. Tang, Raffaello Cutri, Arthur Wu, Chirag Patil, Zachary Zumsteg","doi":"10.1055/a-2192-5775","DOIUrl":"https://doi.org/10.1055/a-2192-5775","url":null,"abstract":"Chondrosarcoma is a type of an endochondral bone malignancy which is primarily treated surgically with radiation therapy used in the adjuvant setting or in cases of unresectable disease. Proton therapy has potential advantages compared to traditional photon therapy for treatment of tumors in close proximity to critical structures due to the theoretic lower exit dose. Studies have shown improved survival in patients with skull base chondrosarcoma who undergo proton therapy. However, there is a lack of randomized data. Further studies are needed to define the role of proton therapy in treatment of skull base chondrosarcoma.","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136142468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CIC-DUX4 Sarcoma Involving the Skull Base: A Rare Presentation and Review of the Literature.","authors":"Sara B Hobday,&nbsp;Leila J Mady,&nbsp;Alec M Jacobson,&nbsp;Christopher H Rassekh","doi":"10.1055/a-2166-5688","DOIUrl":"10.1055/a-2166-5688","url":null,"abstract":"<p><p><b>Background</b>  CIC-DUX4 sarcoma is a rare, aggressive tumor that is difficult to diagnose. Although it is closely related to Ewing's sarcoma, each is a distinct pathologic entity and both have been previously reported in the skin, lymph nodes, and viscera. We report the first description of CIC-DUX4 involving the posterior cranial fossa and review the distinctive symptomatology, morphology, immunoprofile, and genetic signature that differentiate this rare tumor. <b>Case Report</b>  A 32-year-old man presented with an enlarging right lateral neck mass, progressive hoarseness, and orofacial pain. Biopsy revealed a high-grade undifferentiated malignant neoplasm. Imaging demonstrated an 8-cm mass in the right neck extending to the skull base and abutting the carotid sheath, in addition to pulmonary nodules and pelvic lymphadenopathy. Despite initial response to chemotherapy, he experienced disease progression and underwent surgical resection, radical neck dissection, and brachytherapy. Definitive pathologic diagnosis was achieved with next-generation sequencing. Within weeks of treatment, he developed symptoms reflecting progression of disease involving the neck, posterior cranial fossa, and lung. Adjuvant chemotherapy was planned, but the patient succumbed to his disease prior to initiation of further therapy. <b>Conclusion</b>  CIC-DUX4 sarcomas are uncommon and can progress rapidly. Diagnosis requires either fluorescence in situ hybridization or next-generation sequencing. Due to its rarity, there is no standard-of-care treatment for this tumor and further investigations are needed to understand disease behavior and develop targeted therapeutic modalities.</p>","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"84 4","pages":"e124-e128"},"PeriodicalIF":0.5,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/62/73/10-1055-a-2166-5688.PMC10575739.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41239697","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":"Anterior Skull Base Osteoradionecrosis in the Age of Intensity-Modulated Radiation Therapy: A Case Series.","authors":"Nikitha Kosaraju,&nbsp;Huan Zhang,&nbsp;Sharon Qi,&nbsp;Robert Chin,&nbsp;Marilene B Wang","doi":"10.1055/a-2164-8637","DOIUrl":"https://doi.org/10.1055/a-2164-8637","url":null,"abstract":"<p><p><b>Background</b>  Despites advances in radiation technology, skull base osteoradionecrosis (ORN) continues to be a rare, devastating, and hard to treat complication of radiotherapy. We present three cases of anterior skull base ORN in a cohort treated with intensity-modulated radiation therapy (IMRT). <b>Case Series</b>  Three patients developed anterior skull base ORN after receiving at least one round of IMRT. ORN was diagnosed through either nasal endoscopy or imaging findings. The first was a 59-year-old woman with a sinonasal squamous cell carcinoma. Her chemoradiation history was notable for reirradiation and a high dose of radiation (143.3 Gy). The second was a 55-year-old man with recurrent nasopharyngeal carcinoma, whose history was notable for a high dose of radiation (∼140 Gy) and for being reirradiated. The final patient was a 37-year-old woman with an unremarkable history who received radiotherapy (65.0 Gy) for an esthesioneuroblastoma. One patient was asymptomatic and did not receive ORN-specific therapy. The other two were treated with a combination of medical and surgical intervention with successful short-term outcomes (no evidence of infection). <b>Conclusion</b>  Anterior skull base ORN can be treated through conservative and surgical means to achieve successful short-term outcomes. Further investigation of long-term outcomes is warranted.</p>","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"84 3","pages":"e109-e112"},"PeriodicalIF":0.5,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cc/ba/10-1055-a-2164-8637.PMC10533358.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41137371","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 Primary Intraosseous Meningioma: A Rare Case of Malignancy with High Proliferative Ability.","authors":"Yoshiki Sato,&nbsp;Koichi Mitsuya,&nbsp;Yuko Kakuda,&nbsp;Takuma Oishi,&nbsp;Shoichi Deguchi,&nbsp;Takashi Sugino,&nbsp;Yasuto Akiyama,&nbsp;Takeshi Nagashima,&nbsp;Kenichi Urakami,&nbsp;Yuji Shimoda,&nbsp;Keiichi Ohshima,&nbsp;Nakamasa Hayashi,&nbsp;Ken Yamaguchi","doi":"10.1055/a-2161-7710","DOIUrl":"10.1055/a-2161-7710","url":null,"abstract":"<p><p>Primary intraosseous meningioma (PIM) is a rare tumor that arises in the skull. Histopathologically, it is generally described as a slow-growing, benign lesion. However, on rare occasions, PIM presents as a malignancy with high proliferative ability, which requires maximal resection, adjuvant radiotherapy, and subsequent careful follow-up. Because of the rarity of such cases, they present a diagnostic challenge with unusual pathological findings. Herein, we report a case of a primary intraosseous anaplastic meningioma with extensive invasion inside and outside the skull, along with the results of whole-genome analysis. Histopathological diagnosis was a World Health Organization grade 3 anaplastic meningioma. In the literature, only two cases of anaplastic PIM have been reported, so its characteristics and treatment are poorly understood. Our patient was successfully treated with tumor resection, followed by intensity-modulated radiation therapy. Follow-up imaging studies revealed no recurrence or distant metastasis, including to lung, liver, and bone, at 8 months after the surgery.</p>","PeriodicalId":44256,"journal":{"name":"Journal of Neurological Surgery Reports","volume":"84 1","pages":"e103-e108"},"PeriodicalIF":0.5,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10611535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43550925","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}