Journal of neurosurgery. Case lessons最新文献

Spinal epidermoid cyst: illustrative case. 脊柱表皮样囊肿：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2026-05-04 DOI: 10.3171/CASE25909

Saarang Patel, Arjit Singh, Jacob Gould, Gavin Touponse, Guan Li, Julian Gendreau, Ronald Sayhouni, Vanessa Goodwill, Nikhil K Murthy

{"title":"Spinal epidermoid cyst: illustrative case.","authors":"Saarang Patel, Arjit Singh, Jacob Gould, Gavin Touponse, Guan Li, Julian Gendreau, Ronald Sayhouni, Vanessa Goodwill, Nikhil K Murthy","doi":"10.3171/CASE25909","DOIUrl":"https://doi.org/10.3171/CASE25909","url":null,"abstract":"Background: Spinal epidermoid cysts are rare, benign lesions accounting for less than 1% of all spinal tumors. They may be congenital or acquired following trauma or spinal procedures. Although slow-growing, their mass effect can cause progressive neurological symptoms. Resection remains the mainstay of treatment, but they may recur when complete removal is limited by adherence to neural structures.Observations: A 71-year-old female with prior lumbar surgery presented with back pain and radiculopathy after multiple falls. MRI revealed a recurrent intradural extramedullary lesion at L1-2. She underwent endoscope-assisted revision laminectomy with gross-total resection. Pathological analysis confirmed an epidermoid cyst. Postoperatively, the patient remained neurologically stable without recurrence at 3 months.Lessons: Endoscope-assisted microsurgical resection provides excellent visualization for safe, effective removal of spinal epidermoid cysts. Despite favorable outcomes, long-term follow-up is essential due to the risk of recurrence. https://thejns.org/doi/10.3171/CASE25909.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"11 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The minimally invasive grid approach for seizure localization: patient series. 癫痫定位的微创网格方法：患者系列。

Journal of neurosurgery. Case lessons Pub Date : 2026-05-04 DOI: 10.3171/CASE25981

Megana Saripella, Hayley A Granberg, Hernan Gonzalez, Sabrina Chriqui, Kareem Khalifeh, Leena Kansal, Hoameng Ung, Shadi Dayeh, David Lee, Jerry J Shih, Arjun Khanna, Sharona Ben-Haim

{"title":"The minimally invasive grid approach for seizure localization: patient series.","authors":"Megana Saripella, Hayley A Granberg, Hernan Gonzalez, Sabrina Chriqui, Kareem Khalifeh, Leena Kansal, Hoameng Ung, Shadi Dayeh, David Lee, Jerry J Shih, Arjun Khanna, Sharona Ben-Haim","doi":"10.3171/CASE25981","DOIUrl":"https://doi.org/10.3171/CASE25981","url":null,"abstract":"Background: Epilepsy surgery continues to advance new minimally invasive techniques for both seizure localization and treatment. Stereo-electroencephalography (sEEG) is increasingly being used; however, some patients continue to require subdural electrodes for neocortical mapping. Traditional subdural grid electrodes involve medium to large craniotomies, relatively large incisions, and can be associated with morbidity. The authors describe a minimally invasive technique using a small, strip-like craniotomy and sequentially placed subdural strips to form a minimally invasive subdural grid (MIG) for seizure localization.Observations: Eight patients underwent electrode placement using a MIG in combination with stereotactic depth electrodes. Small craniotomies, typically positioned several centimeters away from the targeted region, allowed insertion of parallel strip electrodes under stereotactic navigation to create a grid-like array. Postoperative imaging confirmed electrode positioning and allowed for adjustments.Lessons: The MIG technique successfully localized epileptogenic zones without major complications and was effectively used for stimulation-based mapping. No patient developed subdural fluid collection over the grid site, hemorrhage, or significant CSF leakage. The MIG technique significantly minimized the surgical incision and craniotomy size required for equivalent neocortical surface coverage. The MIG technique offers a safe, minimally invasive alternative for seizure localization and mapping while reducing craniotomy size. https://thejns.org/doi/10.3171/CASE25981.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"11 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Contralateral screw loosening of through-and-through fixation following unilateral sacroiliac joint fusion: illustrative case. 单侧骶髂关节融合术后对侧螺钉内固定松动：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2026-05-04 DOI: 10.3171/CASE25668

Rafael Garcia, Cale Hendricks, David W Polly

{"title":"Contralateral screw loosening of through-and-through fixation following unilateral sacroiliac joint fusion: illustrative case.","authors":"Rafael Garcia, Cale Hendricks, David W Polly","doi":"10.3171/CASE25668","DOIUrl":"https://doi.org/10.3171/CASE25668","url":null,"abstract":"Background: Sacroiliac (SI) joint dysfunction is a frequently underrecognized source of low back pain, implicated in 15%-30% of cases across select populations. Unilateral SI joint fusion remains the most commonly performed technique, utilizing either iliosacral screws or, more recently, through-and-through (TNT) screws.Observations: A 65-year-old woman with a history of failed right-sided SI joint fusion underwent revision surgery with bilateral TNT screw fixation due to worsening symptoms. Follow-up imaging confirmed solid right-sided arthrodesis. However, progressive haloing and sclerosis were observed around the left iliac portion of the cephalad screw.Lessons: This case represents the first reported instance of persistent motion and screw haloing using TNT screw fixation when using two spanning screws. These findings highlight a potential limitation of TNT constructs due to load transfer, stress shielding, and asymmetric osseous integration, particularly in patients with a history of prior unilateral SI joint fusion. https://thejns.org/doi/10.3171/CASE25668.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"11 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Differential awakening of the sciatic nerve: illustrative case. 坐骨神经的差异觉醒：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2026-05-04 DOI: 10.3171/CASE251028

William D Chow, Pavlos Texakalidis, Felipe J S Jones, Robert J Spinner

{"title":"Differential awakening of the sciatic nerve: illustrative case.","authors":"William D Chow, Pavlos Texakalidis, Felipe J S Jones, Robert J Spinner","doi":"10.3171/CASE251028","DOIUrl":"https://doi.org/10.3171/CASE251028","url":null,"abstract":"Background: Differential awakening is a well-known, yet poorly understood phenomenon seen in patients with intracranial pathologies. Because acute postoperative neurological decline has many potentially reversible causes, distinguishing differential awakening from other etiologies is critical. To the authors' knowledge, differential awakening has not been reported following peripheral nerve procedures.Observations: A 40-year-old man presented with a 1.5-year history of painful bilateral cervical and right lumbosacral radiculoplexus neuropathy recently associated with bilateral facial and vestibulocochlear neuropathy. He had not responded to treatment trials. A sciatic nerve lesion in the sciatic notch was identified on imaging and an open biopsy of the posterior femoral cutaneous nerve was pursued. Immediately after emergence from anesthesia, he demonstrated a complete inability to dorsiflex or plantar flex the right foot, despite minimal intraoperative manipulation of the sciatic nerve. Over the ensuing hour, motor function progressively returned to baseline. The transient postoperative motor deficit was attributed to differential awakening of the sciatic nerve. Pathological analysis confirmed high-grade B-cell lymphoma.Lessons: Differential awakening may be an underrecognized cause of transient neurological worsening during emergence from anesthesia following peripheral nerve surgery. Further investigation is needed to clarify the underlying mechanisms and define its incidence and risk factors. https://thejns.org/doi/10.3171/CASE251028.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"11 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mycotic aneurysm presenting in a patient with a ventriculoatrial shunt with positive CSF cultures for Cutibacterium acnes: illustrative case. 真菌性动脉瘤表现为脑室房分流术患者脑脊液培养阳性痤疮表皮杆菌：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2026-05-04 DOI: 10.3171/CASE25625

Natalie Amaral-Nieves, Krisztina Moldovan, Valerie Xu, Alexander Acevedo-Jetter, Santos Santos-Fontanez, Cody Doberstein, Belinda Shao, Carlin Chuck, Petra Klinge, Radmehr Torabi, Elias Shaaya, Dylan N Wolman

{"title":"Mycotic aneurysm presenting in a patient with a ventriculoatrial shunt with positive CSF cultures for Cutibacterium acnes: illustrative case.","authors":"Natalie Amaral-Nieves, Krisztina Moldovan, Valerie Xu, Alexander Acevedo-Jetter, Santos Santos-Fontanez, Cody Doberstein, Belinda Shao, Carlin Chuck, Petra Klinge, Radmehr Torabi, Elias Shaaya, Dylan N Wolman","doi":"10.3171/CASE25625","DOIUrl":"https://doi.org/10.3171/CASE25625","url":null,"abstract":"Background: Mycotic aneurysms (MAs) typically present with intracranial hemorrhage but are a rare cause of subdural hematoma (SDH). Although infective endocarditis is the most common etiology, MAs may also result from bacteremia associated with intravenous drug use, meningitis, or poor dentition. Patients with ventriculoatrial shunts (VASs) are at increased risk for shunt-related bacteremia compared to those with ventriculoperitoneal shunts, potentially predisposing them to MA formation.Observations: This is the case of a 61-year-old female with a fusiform distal left middle cerebral artery MA presenting as an acute-on-chronic SDH without endocarditis, but with positive blood cultures and CSF cultures for Cutibacterium acnes from a long-term VAS.Lessons: MAs can rarely present as SDHs and should be considered in the differential diagnosis for patients with a long-standing VAS due to the risk of subacute bloodstream infections. https//thejns.org/doi/10.3171/CASE25625.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"11 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The internal mammary artery as an alternative graft for internal maxillary artery-middle cerebral artery bypass: illustrative case. 乳腺内动脉作为上颌内动脉-大脑中动脉搭桥术的替代移植物：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2026-05-04 DOI: 10.3171/CASE25888

Juan J Ramírez-Andrade, Javier Degollado-García, Benigno Ferreira-Piña, Carlos F Nicolás-Cruz, J Tomás Moncada-Habib, Marco Antonio Muñuzuri-Camacho, Zahira Elizabeth Medina-Felix, Edgar Nathal

{"title":"The internal mammary artery as an alternative graft for internal maxillary artery-middle cerebral artery bypass: illustrative case.","authors":"Juan J Ramírez-Andrade, Javier Degollado-García, Benigno Ferreira-Piña, Carlos F Nicolás-Cruz, J Tomás Moncada-Habib, Marco Antonio Muñuzuri-Camacho, Zahira Elizabeth Medina-Felix, Edgar Nathal","doi":"10.3171/CASE25888","DOIUrl":"https://doi.org/10.3171/CASE25888","url":null,"abstract":"Background: Extracranial-intracranial revascularization has evolved to include bypasses using interposition grafts, most commonly the saphenous vein (SV) or radial artery (RA). These high-flow conduits are essential for treating giant or complex aneurysms, skull base tumors encasing the carotid or middle cerebral arteries, and selected cases of ischemic cerebrovascular disease requiring preservation or augmentation of cerebral blood flow.Observations: This report describes the first case of cerebral revascularization using the internal mammary artery (IMA) as an interposition graft. The patient had previously undergone endovascular treatment of an internal carotid artery aneurysm with a flow diverter and later developed progressive arterial stenosis leading to compromised distal cerebral perfusion.Lessons: To achieve optimal outcomes and long-term patency, graft selection and bypass strategy must be planned meticulously, taking into consideration the patient's anatomy and specific clinical requirements. In the present case, because the RAs and SVs were unsuitable as primary grafts, the IMA was selected as a viable alternative for a high-capacitance internal maxillary artery-middle cerebral artery bypass. The graft was harvested through a minimally invasive thoracoscopic approach. Postoperatively, the patient exhibited significant clinical improvement, and perfusion CT demonstrated restoration of cerebral blood flow. https://thejns.org/doi/10.3171/CASE25888.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"11 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hemodynamic remnant drift after coil embolization: longitudinal silent MRA and computational fluid dynamics analysis of a migratory neck remnant. Illustrative case. 线圈栓塞后的血流动力学残余漂移：纵向沉默MRA和迁移颈部残余的计算流体动力学分析。说明情况。

Journal of neurosurgery. Case lessons Pub Date : 2026-05-04 DOI: 10.3171/CASE26109

Toru Satoh, Kana Murakami, Megumi Sasaki, Yudai Abe

{"title":"Hemodynamic remnant drift after coil embolization: longitudinal silent MRA and computational fluid dynamics analysis of a migratory neck remnant. Illustrative case.","authors":"Toru Satoh, Kana Murakami, Megumi Sasaki, Yudai Abe","doi":"10.3171/CASE26109","DOIUrl":"https://doi.org/10.3171/CASE26109","url":null,"abstract":"Background: Neck remnants after coil embolization are usually attributed to coil compaction or aneurysm regrowth, but their longitudinal spatial behavior has rarely been examined.Observations: The authors report an unruptured posterior communicating artery aneurysm treated with coil embolization, followed by serial silent MR angiography (MRA) and computational fluid dynamics (CFD). Fusion imaging from an intradome perspective showed progressive migration of a small residual cavity, rather than concentric enlargement, along the aneurysm neck plane at 6, 12, and 18 months. CFD demonstrated that remnant location corresponded to temporal changes in inflow targeting, best reflected by the flow rate ratio, whereas wall shear stress magnitude alone did not correlate consistently with remnant evolution. Directional WSS patterns and streamlines suggested shifting hemodynamic guidance of the residual cavity. The authors term this phenomenon a \"migratory neck remnant\" or \"remnant drift.\"Lessons: Serial silent MRA combined with CFD can visualize longitudinal migration of neck remnants. Hemodynamic inflow targeting appears to determine remnant location, whereas blood pressure-related wall stress may govern long-term stability. Recognition of remnant drift may improve prediction of aneurysm recurrence and guide surveillance strategies. https://thejns.org/doi/10.3171/CASE26109.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"11 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

O-arm-assisted endoscopic endonasal decompression for medullary compression caused by a clival osteophyte: illustrative case. o臂辅助内镜下鼻内减压治疗由斜坡骨赘引起的髓质压迫：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2026-05-04 DOI: 10.3171/CASE251039

Yusuke Muramatsu, Kazuhito Takeuchi, Motonori Ishii, Sho Akahori, Yu Yamamoto, Ryuta Saito, Masakazu Takayasu

{"title":"O-arm-assisted endoscopic endonasal decompression for medullary compression caused by a clival osteophyte: illustrative case.","authors":"Yusuke Muramatsu, Kazuhito Takeuchi, Motonori Ishii, Sho Akahori, Yu Yamamoto, Ryuta Saito, Masakazu Takayasu","doi":"10.3171/CASE251039","DOIUrl":"https://doi.org/10.3171/CASE251039","url":null,"abstract":"Background: The craniovertebral junction contains critical structures such as the medulla oblongata, upper cervical spinal cord, and vertebral arteries; therefore, selecting the surgical approach is particularly important given its anatomical complexity. Various anterior approaches have been proposed for this purpose. However, in recent years, endoscopic endonasal decompression has increasingly replaced the traditional transoral approach for the treatment of upper anterior lesions.Observations: The authors encountered a case of ventral medullary compression caused by an inferior clival osteophyte that progressively enlarged after C1-2 fixation. The endoscopic endonasal approach (EEA), which provides the shortest and most direct route to the lesion, was selected for this study. Intraoperative use of the O-arm enabled precise real-time assessment of the extent of bone removal, thereby enabling complete decompression. Mechanical loading following C1-2 fixation is considered a possible contributing factor to osteophyte enlargement.Lessons: Although neuronavigation is commonly used in the EEA, its reliance on preoperative imaging limits its ability to accurately assess decompression. The O-arm, which provides real-time intraoperative imaging, has proven extremely useful in overcoming this limitation. https://thejns.org/doi/10.3171/CASE251039.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"11 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Robot-assisted excision of presacral ganglioneuroma: illustrative case. 机器人辅助骶前神经节神经瘤切除术：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2026-04-27 DOI: 10.3171/CASE25462

Srinath Hariharan, Vivek Sanker, Chelsea Park, Joseph Frantzias, Maria Jose Cavagnaro, Aaron J Dawes, Atman Desai

{"title":"Robot-assisted excision of presacral ganglioneuroma: illustrative case.","authors":"Srinath Hariharan, Vivek Sanker, Chelsea Park, Joseph Frantzias, Maria Jose Cavagnaro, Aaron J Dawes, Atman Desai","doi":"10.3171/CASE25462","DOIUrl":"https://doi.org/10.3171/CASE25462","url":null,"abstract":"Background: Presacral ganglioneuromas are extremely rare tumors, with only 37 documented cases in the literature. For a successful outcome, resection is crucial because it is currently the only effective treatment option. With the advancement in resection techniques, robotic surgery is now being utilized for achieving optimal surgical outcomes, with only 2 previous cases being documented in the literature for the resection of presacral ganglioneuroma. Since ganglioneuromas are benign, radiation therapy and adjuvant chemotherapy are not recommended; however, frequent monitoring is required to detect possible local recurrences early.Observations: The authors present the case of presacral ganglioneuroma in a 62-year-old male who underwent robot-assisted excision. Robot-assisted surgery allowed for a positive surgical outcome, including the absence of intra- or postoperative complications and a decreased length of hospital stay.Lessons: The presacral location poses challenges to resection due to many exiting nerve roots. Robotic surgery facilitates positive patient outcomes for tumors in challenging anatomical locations like the presacral location. https://thejns.org/doi/10.3171/CASE25462.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"11 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793345","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}

引用次数: 0

Lateral recess sphenoid sinus encephaloceles treated via transorbital neuroendoscopic surgery: illustrative case. 经眶神经内窥镜手术治疗外侧隐窝蝶窦脑膨出：一个说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2026-04-27 DOI: 10.3171/CASE26124

Victor R Chavez-Herrera, Oscar E Camacho-Hernandez, Flavio Hernandez-Gonzalez, Ricardo Garcia-Iturbide, Cesar A Valenzuela-Iribe, Rafael Gutierrez-Gomez, Karina Mateos-Diaz, Blas E Lopez-Felix

{"title":"Lateral recess sphenoid sinus encephaloceles treated via transorbital neuroendoscopic surgery: illustrative case.","authors":"Victor R Chavez-Herrera, Oscar E Camacho-Hernandez, Flavio Hernandez-Gonzalez, Ricardo Garcia-Iturbide, Cesar A Valenzuela-Iribe, Rafael Gutierrez-Gomez, Karina Mateos-Diaz, Blas E Lopez-Felix","doi":"10.3171/CASE26124","DOIUrl":"https://doi.org/10.3171/CASE26124","url":null,"abstract":"Background: Lateral recess sphenoid sinus encephaloceles (LRSSEs) are considered a rare condition. Conventional surgical treatments include open approaches and endonasal endoscopy. These approaches are associated with approach-specific comorbidities. Alternatively, transorbital neuroendoscopy surgery (TONES) has been shown to provide a direct, minimally invasive approach to the middle fossa. Only a limited number of publications have reported using TONES as the primary surgical method for LRSSEs.Observations: A 57-year-old female presented to our hospital with a 1-month history of increased quantity and frequency of left nostril rhinorrhea and was found to have a left LRSSE. CT cisternography and MRI confirmed left temporal brain matter entering through the middle fossa floor into a well-pneumatized sphenoid sinus. The patient's LRSSE was successfully repaired using a lateral TONES approach. In addition, a systematic review conducted in accordance with PRISMA guidelines identified 9 patients from 7 studies spanning the years 2016 to 2025.Lessons: This case illustrates that TONES provides a direct, minimally invasive corridor for the surgical treatment of LRSSEs, with minimal comorbidities. An ideally positioned LRSSEs might suggest that TONES is the most suitable choice. https://thejns.org/doi/10.3171/CASE26124.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"11 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793157","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}

引用次数: 0