Neurocirugia (English Edition)最新文献

{"title":"Inframeatal intradural retrosigmoid petrosectomy (IIRP): Multicenter experience and anatomical review of an effective approach to the petroclival region","authors":"Pedro Miguel González-Vargas,&nbsp;José Luis Thenier-Villa,&nbsp;Álvaro Martín-Gallego,&nbsp;Pablo Sanromán Álvarez,&nbsp;Antonio Riveiro,&nbsp;Rosa María Martínez Rolán,&nbsp;Juan Pou","doi":"10.1016/j.neucie.2026.500762","DOIUrl":"10.1016/j.neucie.2026.500762","url":null,"abstract":"<div><h3>Introduction</h3><div>Tumorous and infectious lesions of the petrous bone pose a surgical challenge due to their deep location and proximity to critical neurovascular structures. Inframeatal intradural retrosigmoid petrosectomy (IIRP) is an alternative route that allows direct access to the petrous apex with minimal morbidity.</div></div><div><h3>Methods</h3><div>Retrospective study of 11 patients who underwent IIRP between 2015 and 2025 in two hospitals in southern Galicia. Demographic variables, type of lesion, surgical time, degree of resection, complications, and progression-free survival were collected. A descriptive analysis and Kaplan–Meier curve were performed.</div></div><div><h3>Results</h3><div>Eleven patients were included (7 women, 4 men; mean age 48.9 years). Lesions included invasive cholesteatoma (<em>n</em> <!-->=<!--> <!-->4), petroclival meningiomas (<em>n</em> <!-->=<!--> <!-->2), chondrosarcoma (<em>n</em> <!-->=<!--> <!-->1), atypical schwannoma (<em>n</em> <!-->=<!--> <!-->1), squamous cell carcinoma (<em>n</em> <!-->=<!--> <!-->1), breast cancer metastasis (<em>n</em> <!-->=<!--> <!-->1) and an intraosseous abscess due to <em>Actinomyces</em> (<em>n</em> <!-->=<!--> <!-->1). Gross total resection was achieved in 81.8%, with one transient complication (9.1%) and one recurrence. Progression-free survival analysis showed satisfactory recurrence-free survival up to 20 months.</div></div><div><h3>Conclusion</h3><div>IIRP is a safe, effective, and versatile technique for approaching select lesions of the petrous bone. It allows sufficient exposure with low morbidity and is also useful in refractory infectious cases.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"37 4","pages":"Article 500762"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146151357","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":"The global burden and future projections of intracerebral hemorrhage: An analysis of trends from 1990 to 2036.","authors":"Jingyi Xie, Xiang Gao, Songquan Wang, Laizhao Chen","doi":"10.1016/j.neucie.2026.500784","DOIUrl":"10.1016/j.neucie.2026.500784","url":null,"abstract":"<p><strong>Objective: </strong>Intracerebral hemorrhage (ICH) is a severe stroke subtype with high global mortality and morbidity. This study quantifies the global burden and time trend of ICH from 1990 to 2021, and constructs a predictive model for 2036. We focus on health disparities to inform targeted prevention and intervention.</p><p><strong>Methods: </strong>Utilizing Global Burden of Disease data, this study evaluated ICH incidence, prevalence, mortality, and disability-adjusted life years from 1990 to 2021. The study examined global, regional, and national levels. The estimated annual percentage change quantified trends. Frontier analysis examined variations by development. A Bayesian age-period-cohort model projected future burden. These methods provide a more comprehensive and actionable assessment than previous studies.</p><p><strong>Results: </strong>The global burden of ICH increased substantially in absolute numbers from 1990 to 2021, with incident cases and deaths rising by 46.05% and 41.29%, respectively. In 2021, ICH caused 3,308,367 deaths [95% uncertainty interval (UI): 3,021,075-3,594,725]. However, age-standardized rates showed a consistent decline over time, with the age-standardized incidence rate was 40.83 (95% UI: 36.20-45.21) and the mortality rate was 39.09 (95% UI: 35.65-42.25) per 100,000, respectively. The burden of ICH was strongly associated with socio-demographic development. Lower Socio-demographic Index (SDI) regions bearing disproportionately higher mortality and DALY burdens. In contrast, higher SDI regions generally exhibited declining trends in age-standardized rates.</p><p><strong>Conclusions: </strong>ICH remains a critical global public health challenge. Although the overall age-standardized burden has decreased, pronounced disparities persist, especially in less developed regions. Focused public health action, equitable resource distribution, and stronger health systems are critical to closing these gaps.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500784"},"PeriodicalIF":0.0,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148229632","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":"Failed back syndrome or extra-spinal sciatica? Ischiofemoral syndrome as a cause of persistent radicular pain after 4 lumbar spine surgeries","authors":"Andrés Barriga-Martín ,&nbsp;Orlando Paredes-Muñóz ,&nbsp;Miguel Peral-Alarma ,&nbsp;Luis Maria Romero-Muñóz ,&nbsp;Joint Halley Guimbard-Pérez","doi":"10.1016/j.neucie.2025.500737","DOIUrl":"10.1016/j.neucie.2025.500737","url":null,"abstract":"<div><div>Most cases of sciatica are caused by compression of lumbar nerve roots, although some originate from extraradicular structures, such as in ischiofemoral impingement syndrome. We present the case of a 64-year-old man with a 10-year history of right-sided sciatic pain occurring only while seated. He underwent several lumbar surgeries for spinal stenosis (L4-L5, then L3-L4, and later L5-S1 with fusion to S1), as well as multiple infiltrations and pulsed radiofrequency, without improvement. Neurophysiological and imaging studies showed no significant compression, except for oedema at the ischial insertion of the quadratus femoris muscle. A diagnostic local anaesthetic infiltration temporarily resolved the pain, confirming ischiofemoral impingement syndrome. He was treated with osteotomy of the lesser trochanter, achieving complete pain resolution and functional recovery. This case highlights the importance of considering extraradicular causes in patients with persistent sciatic pain after spinal surgery.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"37 3","pages":"Article 500737"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145703071","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":"Haemoclip repair technique: A preliminary evaluation of a safe and practical method for dura mater closure in haemilaminectomy","authors":"Mehmet Aktoklu,&nbsp;Mehmet Orbay Bıyık,&nbsp;Ali Samet Topsakal,&nbsp;Ali Rıza Güvercin,&nbsp;Ertuğrul Çakır,&nbsp;Yağmur Kurak","doi":"10.1016/j.neucie.2025.500730","DOIUrl":"10.1016/j.neucie.2025.500730","url":null,"abstract":"<div><h3>Purpose</h3><div>In the surgical management of spinal tumours, haemilaminectomy is frequently the preferred approach due to its minimal invasive nature and the ability to preserve stability. However, the repair of the dura mater defect is technically very difficult and a challenging problem for neurosurgeons because of the high incidence of complications related to postoperative cerebrospinal fluid (CSF) leakage. This study presents a novel haemoclip-assisted technique that has been developed for the purpose of providing safe and rapid dura repair in spinal tumour surgery involving haemilaminectomy.</div></div><div><h3>Material and methods</h3><div>In 12 patients who underwent haemilaminectomy for spinal intradural extramedullary tumours between 2023 and 2024, dura mater defects were repaired with haemoclips. The technique is to present the results of cases in which the dura edges were closed with non-penetrating haemoclips. The results were evaluated in terms of dura repair time, postoperative complications and presence of CSF leakage.</div></div><div><h3>Results</h3><div>The mean dural repair time was found to be significantly shorter when compared to conventional suture methods. Postoperative cerebrospinal fluid leakage and related complications were not observed in any patient. The technique significantly facilitated surgical practice, especially in the haemilaminectomy window, which provides a limited field of view. Furthermore, the absence of artefacts in magnetic resonance imaging (MRI) appears to be a significant additional criterion in patient follow-up.</div></div><div><h3>Conclusion</h3><div>Haemoclip-assisted dura repair is a safe, fast and practical alternative for spinal tumour surgery with haemilaminectomy. The technique has the potential to reduce complication rates by facilitating dura repair.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"37 3","pages":"Article 500730"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145643743","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":"Timing matters: Influence of vertebral augmentation timing on pain relief, cement leakage, and fracture progression in thoracolumbar vertebral compression fractures","authors":"Raquel Gutiérrez-González ,&nbsp;Teresa Kalantari ,&nbsp;Xavier Santander ,&nbsp;Álvaro Zamarrón ,&nbsp;Ana Royuela","doi":"10.1016/j.neucie.2025.500744","DOIUrl":"10.1016/j.neucie.2025.500744","url":null,"abstract":"<div><h3>Background and aim</h3><div>There is no consensus regarding the best timing of vertebral augmentation (VA) procedures for the treatment of osteoporotic thoracolumbar fractures. This study aims to determine if early VA (performed during the first 2 weeks of evolution) show an advantage over delayed surgery in terms of efficacy and safety outcomes, and to evaluate the role of different modifiable therapeutic variables on the same outcomes.</div></div><div><h3>Material and methods</h3><div>Single-center retrospective study including all patients aged &gt;50 years who underwent VA for thoracolumbar osteoporotic fracture from 2010 to 2023. Patients with two events in less than 3 months or incomplete follow-up were excluded. Pain relief, fracture progression and cement extravasation were assessed with regression analyses.</div></div><div><h3>Results</h3><div>One hundred fifty-four procedures were analyzed, with no significant difference in pain relief according to the timing of surgery. Early VA (1–14 days after symptoms onset) was associated with higher risk of fracture progression compared to intermediate (15–60 days; OR 15.2, <em>p</em> <!-->=<!--> <!-->0.001) and delayed (&gt;60 days; OR 16.2, <em>p</em> <!-->=<!--> <!-->0.013) procedures; higher risk of cement leakage into the disc or vascular space (OR 3.2, <em>p</em> <!-->=<!--> <!-->0.025); but lower risk of spinal canal cement leakage (OR 0.16, <em>p</em> <!-->=<!--> <!-->0.027). No differences were observed between vertebroplasty and kyphoplasty.</div></div><div><h3>Discussion</h3><div>Early VA showed equivalent but earlier effect on pain relief and reduced risk of spinal canal leakage when compared with delayed procedures, despite a non-clinically significant increased risk of fracture progression and cement leakage into the disc or drainage vessels. Thus, it was identified as the most effective strategy for balancing analgesic efficacy and procedural safety.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"37 3","pages":"Article 500744"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145656546","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":"Semisitting position in neurosurgery: A 20-year experience in a tertiary center","authors":"Duygu Dolen Burak ,&nbsp;Cafer Ikbal Gulsever ,&nbsp;Merve Erguven ,&nbsp;Alperen Poyraz ,&nbsp;Ilyas Dolas ,&nbsp;Pulat Akin Sabanci","doi":"10.1016/j.neucie.2025.500734","DOIUrl":"10.1016/j.neucie.2025.500734","url":null,"abstract":"<div><h3>Introduction</h3><div>The semisitting position offers surgical advantages for posterior fossa and pineal region procedures but remains controversial due to potential complications such as venous air embolism (VAE) and tension pneumocephalus. This study reviews a 20-year single-center experience to assess its safety, complication profile, and clinical outcomes under a standardized monitoring protocol.</div></div><div><h3>Materials and methods</h3><div>This retrospective cohort study included all consecutive patients undergoing neurosurgical procedures in the semisitting position at our tertiary center from January 2004 to December 2024. Patients were monitored using a standardized protocol including precordial Doppler ultrasonography, end-tidal CO₂ monitoring, and central venous catheter placement. Patient demographics, surgical details, perioperative complications, and clinical outcomes were systematically analyzed. Venous air embolism (VAE) and other significant adverse events were specifically documented. Statistical analyses included univariate and multivariate logistic regression analyses to identify potential risk factors for complications.</div></div><div><h3>Results</h3><div>A total of 244 patients underwent surgery in the semisitting position, with a mean age of 43.8<!--> <!-->±<!--> <!-->18.4 years. The most common surgical localizations were the parietal and occipital regions, followed by the posterior fossa. The incidence of VAE was 4.5% (<em>n</em> <!-->=<!--> <!-->11), including one fatal cerebral infarction. Other complications occurred in 3.6% of cases, including tension pneumocephalus (1.6%), neurological deficit, cerebrospinal fluid leakage, postoperative seizure, myocardial infarction, and ischemic infarction (each 0.4%). Multivariate analysis did not identify significant predictors of complications.</div></div><div><h3>Conclusions</h3><div>The semisitting position remains a safe and effective neurosurgical approach when executed with rigorous protocols and vigilant monitoring. With careful management, these risks can be effectively mitigated, underscoring their continued utility in suitable cases, particularly for surgeries involving the posterior fossa and pineal region.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"37 3","pages":"Article 500734"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145590149","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":"The experimental laboratory in the development and evolution of neurosurgery—Historical perspective in tribute to Professor G. Yasargil","authors":"Giancarlo Mattos Piaggio,&nbsp;Emilio González Martínez,&nbsp;David Santamarta Gómez,&nbsp;Javier Ibáñez Plágaro,&nbsp;José García-Cosamalón","doi":"10.1016/j.neucie.2025.500727","DOIUrl":"10.1016/j.neucie.2025.500727","url":null,"abstract":"<div><div>The experimental laboratory has been of paramount importance in the development and evolution of neurosurgery. In that research environment, many neurosurgical techniques were designed and the classics approaches to different regions of the brain were refined, until turning neurological surgery into atraumatic procedure, fulfilling one of the founding axioms of this speciality, that of delicate treatment on brain tissue, advocated by Harvey Cushing and later optimized by Professor Gazy Yasargil. The scenarios, their main characters, and the contributions they made to the development and progress of neurosurgery have all been analyzed in this article from a historical standpoint.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"37 3","pages":"Article 500727"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145703189","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":"Early postoperative quality of life in glioma patients – A prospective cohort study","authors":"João Meira Gonçalves ,&nbsp;Jorge Moutinho ,&nbsp;Paulo Linhares ,&nbsp;Bruno Carvalho","doi":"10.1016/j.neucie.2025.500741","DOIUrl":"10.1016/j.neucie.2025.500741","url":null,"abstract":"<div><h3>Background</h3><div>Since gliomas have no cure, the quality of life (QoL) reported by patients assumes utmost importance in the therapeutic strategy. However, few studies have provided longitudinal data about how surgical resection impacts QoL as reported by patients, and even fewer have included preoperative assessments. The aim of this pilot study was to assess how glioma patients’ QoL changes in the early postoperative period of glioma resection, at 1 month and 6 months, compared to preoperative.</div></div><div><h3>Methods</h3><div>Patients undergoing surgical resection of low-grade glioma (LGG) or high-grade glioma (HGG) were prospectively included from January 2022 to December 2022. To analyze patient-reported QoL we used EORTC QLQ-C30 and BN20 questionnaires applied preoperatively and at 1 and 6 months after surgery.</div></div><div><h3>Results</h3><div>We evaluated 34 patients (LGG-9; HGG-25). There were no differences in QoL at all evaluation time points between LGG and HGG groups. Within the LGG patients, QoL scores remained stable throughout 1- and 6-month evaluations. In patients with HGG, when compared to baseline, there were no meaningful variations in QoL at 1 month, but a clinically and statistically significant improvement (<em>p</em> <!-->=<!--> <!-->0.035) was found at 6 months. Total resection was associated with improved QoL in HGG patients at 6 months (<em>p</em> <!-->=<!--> <!-->0.025). At individual level, considering a minimum clinically significant value of 10, most HGG patients improved their QoL, while most LGG patients remained stable. Regarding subdomain analysis, a clinically and statistically significant improvement in future uncertainty was found in both LGG (<em>p</em> <!-->=<!--> <!-->0.042) and HGG (<em>p</em> <!-->=<!--> <!-->0.024) patients at 6 months.</div></div><div><h3>Conclusions</h3><div>Contrarily to previous studies that revealed a deterioration in HGG patients at 6 months, our preliminary data suggest an improvement in the QoL of these patients at 6 months. Additionally, total resection seems to be beneficial, as it was not associated with QoL deterioration, and can even improve QoL.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"37 3","pages":"Article 500741"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145656550","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":"A systematic review of intradural disk herniation: A neurosurgeon's perspective","authors":"Alberto Morello,&nbsp;Enrico Lo Bue,&nbsp;Ayoub Saaid,&nbsp;Stefano Colonna,&nbsp;Alessandro Pesaresi,&nbsp;Federica Bellino,&nbsp;Marco Ajello,&nbsp;Alessandro Fiumefreddo,&nbsp;Diego Garbossa,&nbsp;Fabio Cofano","doi":"10.1016/j.neucie.2025.500743","DOIUrl":"10.1016/j.neucie.2025.500743","url":null,"abstract":"<div><div>Intradural disk herniation (IDH) refers to the protrusion of the nucleus pulposus into the dural sac. While disk herniation is a relatively frequent condition, the intradural variant is exceptionally rare. Patients diagnosed with IDH often exhibit more pronounced clinical symptoms compared to those with extradural herniations. Establishing a definitive preoperative diagnosis remains challenging, as the pathophysiology and radiological features are not yet fully understood. Differentiating IDH from other intradural extramedullary pathologies, including schwannomas, neurofibromas, meningiomas, or metastatic lesions, can be complex.</div><div>A systematic review was conducted on the diagnosis and treatment of cervical, thoracic and lumbar IDH, following PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and retrieving potentially relevant literature from PubMed and Embase. The search strategy included combinations of the terms “transdural” OR “intradural” AND “disc” AND “herniation”. Age, sex, symptoms, herniated disk level, history of trauma, location of disk mass, imaging examination, pre- or intraoperative diagnosis and clinical outcomes were studied through the medical records. The type of surgery, the ventral dural defect management and the postoperative leakage of cerebrospinal fluid were also evaluated.</div><div>One hundred and sixty-one articles involving 285 patients were selected. Cases of IDHs occurred at the lumbar (64.3%), thoracic (21.9%) and cervical (13.8%) levels. The most common level IDH was located at L4–L5 (27.6%). 49 patients exhibited cauda equina syndrome. Only 44 patients (15.4%) were diagnosed as having IDH preoperatively, while most patients were diagnosed intraoperatively. Neurological functions improved variably according to cervical, thoracic and lumbar locations (respectively 2.5%, 5.6% and 21.7%).</div><div>IDH mostly involves the lumbar spine. Patients with IDH generally experience more severe symptoms than those with extradural disk herniation and have incomplete recovery of postoperative neurological functions. Diagnosing IDH remains challenging given its clinical presentations and radiographic features, and it is likely an underdiagnosed and underestimated condition.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"37 3","pages":"Article 500743"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145656564","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":"Intraoperative biopsy challenges: Cavernous sinus meningioma mimic","authors":"Antonio Pérez Serena ,&nbsp;Daisy Paola Martínez Betancourt","doi":"10.1016/j.neucie.2025.500739","DOIUrl":"10.1016/j.neucie.2025.500739","url":null,"abstract":"<div><div>We report the case of a 56-year-old female patient with controlled Human Immunodeficiency Virus (HIV) who presented with binocular diplopia and a known sixth cranial nerve palsy. Imaging revealed a lesion centered in the right cavernous sinus (CS) causing mass effect and displacement of adjacent structures. Progressive cranial nerve involvement led to surgical intervention. Intraoperative biopsy yielded inconclusive results, with initial suspicion pointing toward meningioma. Definitive diagnosis was only possible after paraffin-embedded histopathology confirmed a CS hemangioma. Postoperative management included pain control and corticosteroid tapering. The patient remains stable under multidisciplinary follow-up. This case underscores the diagnostic challenges of CS lesions and the limitations of intraoperative biopsy in differentiating vascular tumors from meningiomas and other CS neoplasms such as schwannomas should be taken into account.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"37 3","pages":"Article 500739"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145656531","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}