Journal of neurosurgery. Case lessons最新文献_第2页

Fatal vertebral artery pseudoaneurysm following intracranial migration of an odontoid screw: illustrative case. 齿状突螺钉颅内移位后致死性椎动脉假性动脉瘤：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-09-29 DOI: 10.3171/CASE25538

Mohsen Rostami, Phillip M Johansen, Elliot Pressman, Gersham Rainone, Anjali Pradhan, Natalie Bales, Srujan Kopparapu, Puya Alikhani

{"title":"Fatal vertebral artery pseudoaneurysm following intracranial migration of an odontoid screw: illustrative case.","authors":"Mohsen Rostami, Phillip M Johansen, Elliot Pressman, Gersham Rainone, Anjali Pradhan, Natalie Bales, Srujan Kopparapu, Puya Alikhani","doi":"10.3171/CASE25538","DOIUrl":"10.3171/CASE25538","url":null,"abstract":"Background: Intracranial migration of odontoid screws is an exceedingly rare complication following anterior odontoid fixation. When such migration involves vital neurovascular structures, the consequences can be catastrophic. Although anterior odontoid screw fixation (AOSF) is generally well tolerated and biomechanically favorable, hardware failure leading to vertebral artery (VA) injury is sparsely reported.Observations: The authors present the case of a 79-year-old man who previously underwent AOSF for a type II odontoid fracture. He presented with acute neck pain after lifting a heavy object and was found to have cranial migration of the odontoid screw into the foramen magnum, causing mass effect on the right VA and a premedullary subarachnoid hemorrhage. After multidisciplinary evaluation, the patient underwent successful removal of the screw with anterior cervical exposure, followed by intraoperative detection and embolization of a right V4 segment VA pseudoaneurysm using overlapping flow diverter stents. Despite initial neurological stability, he developed respiratory decline and sepsis and ultimately died of multiorgan failure.Lessons: This case highlights the importance of long-term surveillance following spinal instrumentation, the value of multidisciplinary coordination in managing complex neurovascular complications, and the fact that procedural success does not always guarantee favorable clinical outcomes in older, comorbid patients. https://thejns.org/doi/10.3171/CASE25538.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194381","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

A novel surgical strategy for trigeminal neuralgia associated with vertebrobasilar dolichoectasia: nerve rerouting via the anterior transpetrosal approach. Illustrative case. 一种治疗三叉神经痛伴椎基底动脉宽缩症的新手术策略：经前肋经入路神经改道。说明情况。

Journal of neurosurgery. Case lessons Pub Date : 2025-09-29 DOI: 10.3171/CASE25474

Koki Nakazato, Masanori Aihara, Yutaro Itabashi, Tomoko Kunitomi, Naoto Mukada, Soichi Oya

{"title":"A novel surgical strategy for trigeminal neuralgia associated with vertebrobasilar dolichoectasia: nerve rerouting via the anterior transpetrosal approach. Illustrative case.","authors":"Koki Nakazato, Masanori Aihara, Yutaro Itabashi, Tomoko Kunitomi, Naoto Mukada, Soichi Oya","doi":"10.3171/CASE25474","DOIUrl":"10.3171/CASE25474","url":null,"abstract":"Background: Microvascular decompression for trigeminal neuralgia (TN) caused by vertebrobasilar dolichoectasia is challenging due to severe arteriosclerosis of the offending vessel, and is often associated with poor improvement of the symptoms, recurrence, and increased risk of complications. The authors describe a novel method of treatment: rerouting the trigeminal nerve and not manipulating the offending vessels.Observations: A 50-year-old male presented with a 7-year history of TN. MRI showed that the anterior inferior cerebellar artery (AICA) was strongly compressing the trigeminal nerve from the inferomedial direction. Given the severe dolichoectatic changes, mobilization of the offending vessels was considered extremely risky. Therefore, decompression was performed by mobilizing the trigeminal nerve instead of manipulating the offending vessels. The surgery was performed via an anterior transpetrosal approach. Meckel's cave was opened to allow sufficient mobilization of the trigeminal nerve. A GORE-TEX sling was used to lift and decompress the trigeminal nerve by separation from the AICA. The patient's facial pain completely disappeared immediately after surgery, and no new neurological deficits were observed.Lessons: The relative mobility of the trigeminal nerve allows rerouting by opening Meckel's cave. This technique may help reduce surgical risk by avoiding direct manipulation of severely atherosclerotic arteries. https://thejns.org/doi/10.3171/CASE25474.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194371","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

X-configuration Pipeline Flex embolization device for complex anterior communicating artery aneurysm: illustrative case. x位管道Flex栓塞装置治疗复杂前交通动脉瘤：举例说明。

Journal of neurosurgery. Case lessons Pub Date : 2025-09-29 DOI: 10.3171/CASE25415

Hao Zhu, Yang Wang, Yunpei Liu, Yingang Wu, Ge Gao

引用次数: 0

Filum terminale schwannoma with new onset of severe low back pain and radiculopathy: illustrative case. 末丝神经鞘瘤伴新发严重腰痛和神经根病：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-09-29 DOI: 10.3171/CASE25333

Justin N Passman, Emily H Stack, Robert S Kleyner, John Servider, Emily Bellow, Roberta Seidman, Harry Mushlin

{"title":"Filum terminale schwannoma with new onset of severe low back pain and radiculopathy: illustrative case.","authors":"Justin N Passman, Emily H Stack, Robert S Kleyner, John Servider, Emily Bellow, Roberta Seidman, Harry Mushlin","doi":"10.3171/CASE25333","DOIUrl":"10.3171/CASE25333","url":null,"abstract":"Background: Schwannomas are CNS WHO grade 1 benign peripheral nerve sheath tumors. They can occur anywhere in the body where there are peripheral nerves, but they are most common in the vestibular system. To the authors' knowledge, there has been only one previous report of their presentation in the filum terminale.Observations: The author present the case of a 36-year-old man who presented to the emergency department with acute-on-chronic right low back pain and shooting pain to his right groin with radiation to his knee. He was found to have an L1-2 intradural extramedullary lesion on MRI abutting the conus. His preoperative neurological examination was otherwise unremarkable, and he was promptly taken for L1-2 laminectomy and resection of the lesion. Final pathological diagnosis was intradural extramedullary cellular schwannoma, CNS WHO grade 1, of the filum terminale. Postoperative MRI demonstrated gross-total resection. The patient had new urinary fullness and constipation, which resolved by the 2-month follow-up, and otherwise recovered well with resolution of his back and leg pain.Lessons: This case illustrates a rare presentation of an intradural extramedullary cellular schwannoma at the filum terminale, emphasizing the importance of a broad differential diagnosis. Resection of these neoplasms offers a definitive and safe treatment. https://thejns.org/doi/10.3171/CASE25333.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194331","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

Delayed onset of pneumocephalus 14 years after ventriculoperitoneal shunt placement: illustrative case. 脑室腹腔分流器放置后14年延迟发作的脑气：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-09-29 DOI: 10.3171/CASE25118

Saori Ueda, Katsuya Ueno, Haruna Isozaki, Yi Li, Junichi Takeda, Masahiro Nonaka

{"title":"Delayed onset of pneumocephalus 14 years after ventriculoperitoneal shunt placement: illustrative case.","authors":"Saori Ueda, Katsuya Ueno, Haruna Isozaki, Yi Li, Junichi Takeda, Masahiro Nonaka","doi":"10.3171/CASE25118","DOIUrl":"10.3171/CASE25118","url":null,"abstract":"Background: Pneumocephalus is a known complication of trauma or head surgery, typically occurring within 48 hours of injury. However, delayed-onset pneumocephalus has been rarely documented in the literature. Here, the authors report a case of pneumocephalus that developed 14 years after ventriculoperitoneal (VP) shunt placement for posttraumatic hydrocephalus.Observations: A 16-year-old girl with a history of skull base fracture, including a left petrous bone fracture, diffuse brain injury, and subarachnoid hemorrhage caused by a traffic accident at 2 years of age, underwent VP shunt placement for posttraumatic hydrocephalus 1 month after the injury. Fourteen years after the shunt surgery, she developed a sudden headache and was diagnosed with pneumocephalus. CT imaging revealed significant left-sided pneumocephalus. Although the exact point of air entry was not identified, her condition improved following adjustments to the Strata II shunt valve pressure settings. Eventually, the shunt was removed to prevent further infections. No CSF leakage was observed, and the patient experienced no recurrence of symptoms.Lessons: Patients with a VP shunt and a history of skull base fracture may develop pneumocephalus even after a prolonged period. https://thejns.org/doi/10.3171/CASE25118.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194374","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

Embolization of the middle meningeal artery for acute epidural hematoma: illustrative case. 急性硬膜外血肿的脑膜中动脉栓塞：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-09-29 DOI: 10.3171/CASE25521

Kenji Fukutome, Sung-Ho Kim, Junji Fukumori, Taigi Fujita, Motoki Fukunaga, Yuki Shiraishi, Atsuko Shimotsuma, Rinsei Tei, Shuta Aketa, Yasushi Motoyama

{"title":"Embolization of the middle meningeal artery for acute epidural hematoma: illustrative case.","authors":"Kenji Fukutome, Sung-Ho Kim, Junji Fukumori, Taigi Fujita, Motoki Fukunaga, Yuki Shiraishi, Atsuko Shimotsuma, Rinsei Tei, Shuta Aketa, Yasushi Motoyama","doi":"10.3171/CASE25521","DOIUrl":"10.3171/CASE25521","url":null,"abstract":"Background: Acute epidural hematoma (AEDH) is a life-threatening traumatic brain injury typically managed with emergency craniotomy. Endovascular embolization of the middle meningeal artery (MMA) is effective in controlling hemorrhage and preventing epidural hematoma evacuation. In previous studies, concomitant surgical interventions have been commonly applied for other intracranial lesions. Transarterial embolization (TAE), the only definitive treatment that can completely eliminate the need for surgery in all associated intracranial pathologies, is rarely performed.Observations: Here, the authors present the case of a 24-year-old female patient with AEDH who exhibited a leakage sign on CT angiography, which was indicative of active bleeding and possible hematoma expansion. Immediate MMA embolization was performed. Hemostasis was achieved using coils, without the need for surgical interventions. The patient had favorable outcomes, including resolution of headache, absence of neurological deficits, and complete hematoma regression at 1 month. Craniotomy was not performed, and the patient had high satisfaction in terms of cosmetic outcomes.Lessons: TAE can be a safe and effective primary treatment for AEDH in some patients. In particular, it can completely prevent surgery and its associated morbidities. Early endovascular intervention for leakage signs should be promptly considered to achieve rapid hemostasis and prevent hematoma expansion, even with limited surgical access. https://thejns.org/doi/10.3171/CASE25521.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194373","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

Staged bilateral microsurgical rhizotomy for treatment of bilateral glossopharyngeal neuralgia: illustrative case. 分阶段双侧显微外科神经根切断术治疗双侧舌咽神经痛：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-09-29 DOI: 10.3171/CASE25359

Megan M J Bauman, Semirra L Bayan, Maria Peris Celda

{"title":"Staged bilateral microsurgical rhizotomy for treatment of bilateral glossopharyngeal neuralgia: illustrative case.","authors":"Megan M J Bauman, Semirra L Bayan, Maria Peris Celda","doi":"10.3171/CASE25359","DOIUrl":"10.3171/CASE25359","url":null,"abstract":"Background: Glossopharyngeal neuralgia (GPN) is a rare disorder characterized by severe, episodic pain along the sensory distribution of cranial nerve (CN) IX. Bilateral GPN presents unique challenges for consideration of microsurgical treatment due to potential risks of postoperative dysphagia and cardiac arrhythmias associated with resection of bilateral CN IX/X. Here, the authors describe successful staged bilateral microsurgical rhizotomy of CN IX and upper CN X rootlets to treat bilateral GPN.Observations: A 54-year-old female presented with right GPN and underwent a right retrosigmoid craniotomy with rhizotomy, resulting in complete resolution of pain. During the following year, the patient developed left GPN and was considered for the same surgical intervention. However, prior to pursuing surgical intervention, evaluation of her swallowing function was conducted to stratify her risk of pharyngeal sensory denervation or dysphagia, and to confirm her suitability for left-sided rhizotomy. Given the patient's normal oropharyngeal swallowing function on videofluoroscopic swallow study, she underwent left retrosigmoid craniotomy with rhizotomy. At the 3-month follow-up, the patient described complete resolution of pain and normal swallowing function.Lessons: With the use of comprehensive patient evaluation between surgical stages, staged bilateral microsurgical rhizotomy is a feasible and safe treatment option for carefully selected patients with bilateral GPN. https://thejns.org/doi/10.3171/CASE25359.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194376","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

First documented case of solitary cerebellar Schistosoma japonicum neuroschistosomiasis confirmed by real-time polymerase chain reaction of the lesion: illustrative case. 第一例记录的孤立小脑型日本血吸虫神经血吸虫病，通过病变的实时聚合酶链反应确诊：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-09-29 DOI: 10.3171/CASE25282

Edmund John B Cayanong, Natalie Roxanne B Nisce, John Carlo B Reyes, Jeanne Mara M Gopeng, Mary Angeline Luz U Hernandez, Kathleen Joy O Khu

{"title":"First documented case of solitary cerebellar Schistosoma japonicum neuroschistosomiasis confirmed by real-time polymerase chain reaction of the lesion: illustrative case.","authors":"Edmund John B Cayanong, Natalie Roxanne B Nisce, John Carlo B Reyes, Jeanne Mara M Gopeng, Mary Angeline Luz U Hernandez, Kathleen Joy O Khu","doi":"10.3171/CASE25282","DOIUrl":"10.3171/CASE25282","url":null,"abstract":"Background: Neuroschistosomiasis is a rare manifestation of Schistosoma infection, typically affecting the spinal cord and supratentorial brain regions. Cerebellar involvement is exceedingly uncommon and often presents with multiple enhancing lesions on imaging, mimicking neoplastic processes. Solitary cerebellar lesions are even more unusual. The authors present the first reported case of solitary cerebellar neuroschistosomiasis confirmed via real-time polymerase chain reaction (RT-PCR) on brain tissue caused by Schistosoma japonicum.Observations: A 33-year-old man from an endemic region presented with a 3-month history of progressive headache, vomiting, and imbalance. Imaging showed a solitary right cerebellar lesion with obstructive hydrocephalus. A ventriculoperitoneal shunt was placed, followed by tumor resection. Intraoperative and histopathological findings revealed schistosomal ova. RT-PCR on formalin-fixed paraffin-embedded tissue confirmed S. japonicum. The patient was treated with praziquantel and dexamethasone and remained asymptomatic at the 6-month follow-up. Unlike previous reports, this case involved a solitary lesion and a prolonged symptom course, with RT-PCR confirming the diagnosis directly from brain tissue.Lessons: Solitary cerebellar neuroschistosomiasis can mimic tumors and should be considered in endemic areas. RT-PCR on brain tissue offers a valuable diagnostic tool. Timely surgical and medical management can lead to full recovery, emphasizing the importance of considering parasitic infections in atypical intracranial lesions. https://thejns.org/doi/10.3171/CASE25282.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194354","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

Basilar artery vasospasm following transsphenoidal resection of recurrent pituitary macroadenoma: illustrative case. 经蝶窦切除复发性垂体大腺瘤后基底动脉血管痉挛：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-09-29 DOI: 10.3171/CASE25453

Luke R Jackson, Joshua Miles Diamond, Prashant Chittiboina

{"title":"Basilar artery vasospasm following transsphenoidal resection of recurrent pituitary macroadenoma: illustrative case.","authors":"Luke R Jackson, Joshua Miles Diamond, Prashant Chittiboina","doi":"10.3171/CASE25453","DOIUrl":"10.3171/CASE25453","url":null,"abstract":"Background: Cerebral vasospasm is a rare yet serious complication of transsphenoidal surgery (TSS). While its etiology is incompletely understood, early detection is critical for proper management.Observations: The authors report the case of a 35-year-old female with acromegaly who underwent TSS for resection of somatotroph macroadenoma. The adenoma was completely removed with its pseudocapsule, and no CSF leakage was encountered. Postoperative imaging was notable for blood products in the interpeduncular cistern. A week after surgery, she presented to the clinic with dysarthria, right-sided ataxia, and right eye exotropia. CT angiography identified vasospasm at the basilar tip, with subsequent MRI demonstrating an infarction of the midbrain. The patient was admitted, underwent aggressive fluid resuscitation, and then discharged after vitals had stabilized and ambulation and speech had improved. Incomplete right eye convergence resolved by the 3-month follow-up.Lessons: The authors present a rare case of cerebral vasospasm following transsphenoidal resection of a pituitary macroadenoma and discuss the effect on midbrain tracts involved in vergence. https://thejns.org/doi/10.3171/CASE25453.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194357","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

Endovascular treatment for a symptomatic dissecting ophthalmic artery aneurysm occurring in the orbit: illustrative case. 眼眶出现症状性夹层性眼动脉瘤的血管内治疗：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-09-29 DOI: 10.3171/CASE25483

Kohei Izumihara, Jun Haruma, Kenji Sugiu, Fukiko Baba, Juntaro Fujita, Yuichi Hirata, Yuta Sotome, Masato Kawakami, Ryu Kimura, Masafumi Hiramatsu, Shota Tanaka

{"title":"Endovascular treatment for a symptomatic dissecting ophthalmic artery aneurysm occurring in the orbit: illustrative case.","authors":"Kohei Izumihara, Jun Haruma, Kenji Sugiu, Fukiko Baba, Juntaro Fujita, Yuichi Hirata, Yuta Sotome, Masato Kawakami, Ryu Kimura, Masafumi Hiramatsu, Shota Tanaka","doi":"10.3171/CASE25483","DOIUrl":"10.3171/CASE25483","url":null,"abstract":"Background: Peripheral ophthalmic artery aneurysms (POAAs) arising from the main trunk or branches of the ophthalmic artery (OphA) are extremely rare. However, their epidemiology and optimal management remain poorly understood. The authors report a rare case of a symptomatic POAA caused by arterial dissection that was successfully treated using endovascular therapy, leading to favorable visual recovery.Observations: A 77-year-old woman presented with sudden-onset visual impairment in the right eye. Ophthalmological examination revealed a defect in the right visual field. CT angiography revealed a fusiform aneurysm in the right intraorbital OphA. Digital subtraction angiography revealed a pearl and string sign, consistent with a dissecting aneurysm. A balloon test occlusion (BTO) of the OphA origin confirmed collateral circulation from the external carotid artery. Internal trapping of the OphA was performed under general anesthesia. Postoperatively, the patient's visual function gradually improved, and complete recovery was achieved within 3 months.Lessons: Although POAAs are exceptionally rare, they may lead to significant visual dysfunction owing to optic nerve compression. When visual symptoms are present, prompt intervention may reverse the symptoms. Preoperative assessment of collateral circulation using BTO is essential for treatment planning. Internal trapping may be an effective strategy when sufficient collateral flow is confirmed. https://thejns.org/doi/10.3171/CASE25483.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194379","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