Journal of neurosurgery. Case lessons最新文献_第10页

Successful surgical management of a recurrent thrombosed vertebral artery aneurysm following cardiopulmonary arrest induced by parent artery occlusion after flow diversion: illustrative case. 血流转移后由母动脉闭塞引起的心肺骤停后复发性血栓性椎动脉动脉瘤的成功手术治疗：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-08-11 DOI: 10.3171/CASE25383

So Ozaki, Taisuke Akimoto, Takahiro Moro, Takafumi Kawasaki, Masaki Sonoda, Jun Suenaga, Yasunobu Nakai, Katsumi Takizawa, Tetsuya Yamamoto

{"title":"Successful surgical management of a recurrent thrombosed vertebral artery aneurysm following cardiopulmonary arrest induced by parent artery occlusion after flow diversion: illustrative case.","authors":"So Ozaki, Taisuke Akimoto, Takahiro Moro, Takafumi Kawasaki, Masaki Sonoda, Jun Suenaga, Yasunobu Nakai, Katsumi Takizawa, Tetsuya Yamamoto","doi":"10.3171/CASE25383","DOIUrl":"10.3171/CASE25383","url":null,"abstract":"Background: The management of large thrombosed unruptured vertebral artery (VA) aneurysms is complex and remains a significant clinical challenge.Observations: A 46-year-old man presented with a headache and was diagnosed with a thrombosed 28-mm aneurysm in the right VA. The initial treatment with a Pipeline flow diverter stent was followed by parent artery occlusion with coils after the aneurysm had enlarged to 40 mm. Subsequently, the patient experienced cardiopulmonary arrest owing to brainstem compression-induced respiratory failure. A surgical approach involving a thrombectomy via a lateral suboccipital craniotomy was used, resulting in significant clinical improvement. The patient was eventually transferred to a rehabilitation facility with a modified Rankin Scale score of 1 and continued to recover with time.Lessons: Although endovascular treatments are less invasive, they may be insufficient in cases with significant mass effects. Direct surgical intervention, including thrombectomy and coagulation of the vasa vasorum, can be an effective strategy to reduce the mass effect and halt aneurysm growth. Timely surgical intervention before the onset of severe symptoms is recommended to optimize outcomes. https://thejns.org/doi/10.3171/CASE25383.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12337978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823527","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

Letter to the Editor. Ventral CSF leak repair via an anterior cervical discectomy and fusion approach. 给编辑的信。颈前椎间盘切除术融合入路修复腹侧脑脊液漏。

Journal of neurosurgery. Case lessons Pub Date : 2025-08-11 DOI: 10.3171/CASE25259

Peyton L Nisson, Wouter Schievink

引用次数: 0

Sudden spinal cord injury after cervicothoracic manipulation therapy: illustrative case. 颈胸手法治疗后突发性脊髓损伤：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-08-11 DOI: 10.3171/CASE25304

Simone Grannò, Alexandre Lavé, Granit Molliqaj, Gianpaolo Jannelli, Karl Schaller, Enrico Tessitore, Aria Nouri

{"title":"Sudden spinal cord injury after cervicothoracic manipulation therapy: illustrative case.","authors":"Simone Grannò, Alexandre Lavé, Granit Molliqaj, Gianpaolo Jannelli, Karl Schaller, Enrico Tessitore, Aria Nouri","doi":"10.3171/CASE25304","DOIUrl":"10.3171/CASE25304","url":null,"abstract":"Background: Traumatic spinal cord injury is a devastating condition resulting in significant functional impairment. It is known that spinal manipulation therapy, often used as complementary treatment for presumed muscular neck pain, may rarely precipitate spinal cord compression and injury in patients with undiagnosed cervical canal stenosis.Observations: The authors report the case of a 68-year-old woman who presented to the emergency department with right scapular-paravertebral pain and right upper limb paresthesia, initially attributed to muscular causes without imaging. Spinal manipulation therapy was administered in the emergency department, causing sudden bilateral lower limb sensory loss and right lower limb motor deficit. No imaging or neurosurgical consultation was undertaken until she returned the next day with progressive weakness, hypoesthesia, and burning dysesthesia. Subsequently, MRI revealed a large acute C6-7 disc extrusion with underlying chronic multilevel stenosis, requiring anterior fusion and posterior decompression. Postoperatively, she partially improved, but a partial motor deficit, lower limb hypoesthesia, and neuropathic pain persisted.Lessons: This case highlights the importance of thorough clinical and radiological assessment prior to administering spinal manipulation in the cervical spine, particularly in patients with signs of sensory or motor dysfunction. Torticollis and muscular contractions in the limbs may be presenting signs of cervical stenosis and degenerative cervical myelopathy, thus requiring further neurological investigation before patients are considered for spinal manipulation therapy. https://thejns.org/doi/10.3171/CASE25304.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12337983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823550","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

Successful use of electrosurgery in an occipitocervical fusion procedure in a patient with an established cochlear implant: illustrative case. 成功使用电外科手术在一个建立人工耳蜗患者枕颈融合术：说明性案例。

Journal of neurosurgery. Case lessons Pub Date : 2025-08-11 DOI: 10.3171/CASE25167

M Kathryn McIntosh, Murray Hong, David P Morris, P Daniel McNeely, Simon Walling, Sean D Christie

{"title":"Successful use of electrosurgery in an occipitocervical fusion procedure in a patient with an established cochlear implant: illustrative case.","authors":"M Kathryn McIntosh, Murray Hong, David P Morris, P Daniel McNeely, Simon Walling, Sean D Christie","doi":"10.3171/CASE25167","DOIUrl":"10.3171/CASE25167","url":null,"abstract":"Background: Neurotechnology is rapidly evolving, challenging surgeons to expand their expertise in managing patients with implanted devices. More than 700,000 persons use cochlear implants. Many others have implanted pacemakers and neuromodulation devices. Understanding electrosurgical interactions is critical for patient safety, yet the literature on this remains limited. Conventional electrosurgery, which uses high-frequency alternating current for hemostasis, is contraindicated in cochlear implant users due to the risk of electromagnetic interference (EMI). EMI can cause heating, component malfunction, or device failure. Despite shielding, induction currents and voltage surges may exceed device tolerance, posing risks.Observations: While PlasmaBlade safety is documented in cardiac surgery, its use in neurosurgery is underreported. The authors present a case demonstrating its safe application during an occipitocervical fusion in a 17-year-old with an established cochlear implant. The PlasmaBlade enabled exposure without affecting implant integrity or auditory function.Lessons: As neurotechnology becomes increasingly prevalent, using innovative safety strategies, including monitoring electromagnetic fields, and adopting refined technologies like the PlasmaBlade will be impactful. These advancements have the potential to improve patient outcomes and ensure safer care for individuals with implanted devices. https://thejns.org/doi/10.3171/CASE25167.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12337984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823528","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

Occipital artery-vertebral artery anastomosis visualized by cerebral angiography due to progression of internal carotid artery stenosis: illustrative case. 由于颈内动脉狭窄进展，脑血管造影显示枕动脉-椎动脉吻合：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-08-11 DOI: 10.3171/CASE25187

Natsuki Akaike, Hiroyuki Ikeda, Takuya Osuki, Minami Uezato, Masanori Kinosada, Yoshitaka Kurosaki, Masaki Chin

{"title":"Occipital artery-vertebral artery anastomosis visualized by cerebral angiography due to progression of internal carotid artery stenosis: illustrative case.","authors":"Natsuki Akaike, Hiroyuki Ikeda, Takuya Osuki, Minami Uezato, Masanori Kinosada, Yoshitaka Kurosaki, Masaki Chin","doi":"10.3171/CASE25187","DOIUrl":"10.3171/CASE25187","url":null,"abstract":"Background: An occipital artery-vertebral artery (OA-VA) anastomosis is rarely observed on cerebral angiography. The authors present a case of posterior circulation infarction during carotid artery stenting (CAS) due to an OA-VA anastomosis.Observations: A 73-year-old male presented with mild right internal carotid artery (ICA) stenosis, which progressed to near occlusion over 18 months. Cerebral angiography revealed anterograde flow from the external carotid artery (ECA) to the vertebrobasilar system via the OA-VA anastomosis, which was not recognized by the surgeons before treatment. CAS using a flow reversal technique was performed to prevent distal embolization in the ICA. MRI the day after CAS revealed cerebral infarcts in both cerebellar hemispheres and on the right side of the pons, possibly due to emboli that migrated via the OA-VA anastomosis into the ECA during CAS.Lessons: As ICA stenosis progresses, an OA-VA anastomosis that was initially invisible on cerebral angiography may become apparent. Since this anastomosis can serve as a pathway for embolic migration during CAS, which can lead to posterior circulation infarction, it is essential to perform CAS in a manner that prevents embolic migration into the ECA in patients with OA-VA anastomoses. https://thejns.org/doi/10.3171/CASE25187.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12337987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823525","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

An atypical visual presentation in a setting of a critically thinned optic nerve compressed between a Rathke's cleft cyst and anterior cerebral artery: illustrative case. 在Rathke裂隙囊肿和大脑前动脉之间出现视神经严重变薄的不典型视觉表现：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-08-11 DOI: 10.3171/CASE25334

Rayford Hazunga, Satoru Oshino, Yuji Onoda, Hidekazu Nakata, Noriyuki Kijima, Haruhiko Kishima

{"title":"An atypical visual presentation in a setting of a critically thinned optic nerve compressed between a Rathke's cleft cyst and anterior cerebral artery: illustrative case.","authors":"Rayford Hazunga, Satoru Oshino, Yuji Onoda, Hidekazu Nakata, Noriyuki Kijima, Haruhiko Kishima","doi":"10.3171/CASE25334","DOIUrl":"10.3171/CASE25334","url":null,"abstract":"Background: A superior temporal visual field defect is the first sign of a chiasmal disorder by a suprasellar mass lesion. Some lesions may present with atypical visual deficits.Observations: The authors present the case of a 71-year-old woman who presented with inferior temporal hemianopia of the left eye in the setting of a Rathke's cleft cyst (RCC). During transsphenoidal surgery, they found the optic nerve was compressed by the anterior cerebral artery (ACA) and appeared translucent. Preoperative MRI revealed that the left optic nerve was compressed between the ACA and RCC, corresponding to surgical findings. Postoperative imaging showed optic nerve thinning and notching on its surface.Lessons: In patients with visual field impairment by sellar mass lesion, attention should be paid not only to upward compression by the mass lesion but also to downward compression by the ACA. https://thejns.org/doi/10.3171/CASE25334.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12337989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823518","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

Intratumoral hemorrhage from brain metastases following nivolumab therapy for malignant melanoma: illustrative case. 恶性黑色素瘤纳武单抗治疗后脑转移瘤内出血：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-08-11 DOI: 10.3171/CASE2581

Takahiro Iinuma, Hiroki Yamada, Shota Kusuhara, Shinsuke Funakoshi, Shigemichi Hirose, Satoshi Terao

{"title":"Intratumoral hemorrhage from brain metastases following nivolumab therapy for malignant melanoma: illustrative case.","authors":"Takahiro Iinuma, Hiroki Yamada, Shota Kusuhara, Shinsuke Funakoshi, Shigemichi Hirose, Satoshi Terao","doi":"10.3171/CASE2581","DOIUrl":"10.3171/CASE2581","url":null,"abstract":"Background: Malignant melanoma is a highly aggressive type of cancer that frequently causes brain metastases, leading to poor outcomes. Immune checkpoint inhibitors (ICIs), such as nivolumab, play a crucial role in treating metastatic melanoma, yet intracranial hemorrhage (ICH) is a rare but serious complication. Although pseudoprogression and hyperprogressive disease are recognized phenomena associated with ICIs, the precise mechanisms connecting ICIs to ICH are not yet fully understood.Observations: The authors report the case of a 75-year-old man with stage IV malignant melanoma who experienced an ICH 5 days after starting nivolumab monotherapy. Imaging revealed a hemorrhagic brain metastasis in the left temporal lobe, necessitating a craniotomy. Histopathology confirmed melanoma metastasis without signs of pseudoprogression or hyperprogressive disease. The patient received whole-brain radiation therapy after surgery but continued to exhibit persistent aphasia and cognitive decline deficits.Lessons: Early-phase intratumoral hemorrhage can occur shortly after ICI therapy, presenting diagnostic and management challenges. While this complication may result from the tumor's inherent hemorrhagic potential or ICI-induced changes such as pseudoprogression, hyperprogressive disease, or tumor lysis, its precise cause often remains unclear. Close monitoring during ICI treatment is essential to promptly address these potentially life-threatening events. https://thejns.org/doi/10.3171/CASE2581.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12337988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823520","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

Proximal occlusion for infectious carotid-cavernous fistula caused by invasive fungal sinusitis: illustrative case. 侵袭性真菌性鼻窦炎致感染性颈动脉-海绵窦瘘近端闭塞治疗：一例说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-08-04 DOI: 10.3171/CASE25336

Akihiro Okada, Takeshi Kawauchi, Yukinori Terada, Kenji Hashimoto

{"title":"Proximal occlusion for infectious carotid-cavernous fistula caused by invasive fungal sinusitis: illustrative case.","authors":"Akihiro Okada, Takeshi Kawauchi, Yukinori Terada, Kenji Hashimoto","doi":"10.3171/CASE25336","DOIUrl":"10.3171/CASE25336","url":null,"abstract":"Background: Thirteen cases of fungal cavernous-carotid aneurysms (CCAs) attributable to invasive fungal sinusitis have been reported in the literature. These reports included only 1 case of carotid-cavernous fistula (CCF). In this report, the authors present a case of CCF attributable to the rupture of an infected CCA caused by invasive fungal sinusitis that required proximal occlusion for treatment.Observations: A 56-year-old man with poorly controlled diabetes experienced a sudden loss of vision in his left eye. Cranial imaging revealed invasive sphenoid sinusitis and CCF attributable to a ruptured infected CCA, as well as an unruptured infected supraclinoid internal carotid artery (ICA) aneurysm. After 3 weeks of medical treatment, the patient developed sudden impairment of higher function. MRI revealed occlusion of the distal ICA attributable to thrombosis of the supraclinoid ICA aneurysm. The anterior circulation was perfused from the contralateral side via the anterior communicating artery. Proximal occlusion with coils was performed, leading to ablation of the CCF.Lessons: This is the first reported case of spontaneous thrombosis of an infected distal cerebral aneurysm, and proximal occlusion with coils was necessary to treat CCF caused by the rupture of a fungal CCA. This case could help guide future treatment. https://thejns.org/doi/10.3171/CASE25336.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786213","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

Life-threatening pneumocephalus from middle ear defect causing cerebrospinal fluid leakage into the eustachian tube: illustrative case. 中耳缺损致脑脊液漏入咽鼓管致危及生命的脑气脑病：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-08-04 DOI: 10.3171/CASE24834

Hailey Mattheisen, Abigail Peterson, Brandon Laing, Nathan T Zwagerman, Michael S Harris, Stephanie Cheok

{"title":"Life-threatening pneumocephalus from middle ear defect causing cerebrospinal fluid leakage into the eustachian tube: illustrative case.","authors":"Hailey Mattheisen, Abigail Peterson, Brandon Laing, Nathan T Zwagerman, Michael S Harris, Stephanie Cheok","doi":"10.3171/CASE24834","DOIUrl":"10.3171/CASE24834","url":null,"abstract":"Background: Spontaneous pneumocephalus is a rare, but potentially serious condition often secondary to a CSF leak. This egress of CSF causes an inward movement of air to replace the lost volume. CSF leaks are typically posttraumatic and present as rhinorrhea or otorrhea. Locating the bony defect and herniating contents through imaging is crucial for planned surgical intervention. In this report, the author present the case of a patient with progressive spontaneous pneumocephalus with an apparent but unidentifiable CSF leak.Observations: A 76-year-old female presented to the authors' institution with rapidly progressing spontaneous pneumocephalus. This case is unique in that the patient's pneumocephalus continued to expand without any radiological indication of extracranial CSF, leading us to believe that the CSF was intermittently leaking through the eustachian tube and passing down the patient's oropharynx. Given the presumed pathway, an initial conservative surgical approach was chosen for this patient's spontaneous pneumocephalus instead of the traditional middle cranial fossa or transmastoid approach.Lessons: To repair the leak, the authors attempted a more conservative approach involving closure of the external acoustic meatus and obliteration of the eustachian tube. A few studies using a similar procedure reported a lower risk of complications and reduction in postoperative CSF leaks. https://thejns.org/doi/10.3171/CASE24834.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786211","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

Clinical characteristics and outcomes of patients with traumatic brain injury transferred from ultra-high-altitude areas: patient series. 超高海拔地区转移的外伤性脑损伤患者的临床特征和预后：患者系列。

Journal of neurosurgery. Case lessons Pub Date : 2025-08-04 DOI: 10.3171/CASE24823

Wenyan Li, Chuan Lan, Yi Zheng, Yi Yin, Binbin Tan, Jishu Xian, Rong Hu, Hua Feng, Tunan Chen, Fei Li

{"title":"Clinical characteristics and outcomes of patients with traumatic brain injury transferred from ultra-high-altitude areas: patient series.","authors":"Wenyan Li, Chuan Lan, Yi Zheng, Yi Yin, Binbin Tan, Jishu Xian, Rong Hu, Hua Feng, Tunan Chen, Fei Li","doi":"10.3171/CASE24823","DOIUrl":"10.3171/CASE24823","url":null,"abstract":"Background: Traumatic brain injury (TBI) patients transferred from high-altitude areas present with unique challenges that complicate the treatment of these patients. This study aims to summarize the clinical characteristics and treatment experience of TBI patients transferred to the authors' center from ultra-high-altitude areas.Observations: The authors conducted a retrospective case series analysis of 10 TBI cases admitted to their center between January 2021 and December 2023. These patients were airlifted from areas > 3500 m above sea level. On admission and at specified intervals up to 30 days postadmission, patients underwent head CT scans, laboratory tests, and posttraumatic stress disorder (PTSD) assessments. Self-care ability scores and psychological assessments were obtained at various time points postdischarge. With a precise and proactive treatment strategy, there was a significant reduction in intracranial hematoma volume, hemoglobin levels, D-dimer, procalcitonin, and serum sodium by the 30th day. The incidence of PTSD was markedly reduced at 6 months postdischarge compared with initial assessments within the 1st week.Lessons: TBI patients transferred from high-altitude areas exhibited persistent intracerebral hematoma, elevated intracranial pressure, relative anemia, hypercoagulation, etc., and thus a precise and proactive treatment would benefit these patients. https://thejns.org/doi/10.3171/CASE24823.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786208","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