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

Placement of cesium-131 permanent brachytherapy seeds in periventricular high-grade gliomas: case report highlighting a novel technique to prevent seed migration. Illustrative cases. 在脑室周围高级别胶质瘤中放置铯-131永久近距离治疗种子：病例报告强调了一种防止种子迁移的新技术。说明情况。

Journal of neurosurgery. Case lessons Pub Date : 2025-07-07 DOI: 10.3171/CASE25176

A Gabriella Wernicke, Julianna Cavallaro, Faina Ablyazova, Ching-Ling Teng, Anurag Sharma, Jake McDermott, John A Boockvar

{"title":"Placement of cesium-131 permanent brachytherapy seeds in periventricular high-grade gliomas: case report highlighting a novel technique to prevent seed migration. Illustrative cases.","authors":"A Gabriella Wernicke, Julianna Cavallaro, Faina Ablyazova, Ching-Ling Teng, Anurag Sharma, Jake McDermott, John A Boockvar","doi":"10.3171/CASE25176","DOIUrl":"10.3171/CASE25176","url":null,"abstract":"Background: Reirradiation of recurrent high-grade gliomas (HGGs) with external beam radiation therapy is limited by the risk of radiation necrosis (RN). Intraoperative brachytherapy offers a localized radiation approach that minimizes RN risk while maintaining tumor control. However, seed migration has historically limited its use in periventricular regions. The authors present 3 cases of recurrent periventricular HGG (2 IDH-wildtype, MGMT promoter-methylated, EGFR-amplified WHO grade 4 glioblastoma and 1 WHO grade 3 astrocytoma) in which a three-layered barrier was created between the ventricular lining and tumor cavity to prevent seed migration, enabling successful brachytherapy.Observations: Following maximal safe resection, a three-layered patch separated the resection cavity from the ventricle prior to cesium-131 (131Cs) brachytherapy. Patient 1 received suture-stranded 131Cs (20 seeds), while patients 2 and 3 received 131Cs GammaTile (6 tiles, 4 seeds per tile). A three-layered barrier was formed using Gelfoam, Surgicel, and Adherus. At a median 22-month (range 11-24 months) follow-up, MRI confirmed no seed migration and seeds remained in the cavity. There were no complications associated with the barrier placement.Lessons: This study highlights the novel use of this technique in preventing 131Cs seed migration in intraoperative brachytherapy, serving as a proof-of-concept study. https://thejns.org/doi/10.3171/CASE25176.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585924","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

Magnetic resonance-guided focused ultrasound thalamotomy as a viable option for essential tremor after deep brain stimulation explantation: illustrative case. 磁共振引导的聚焦超声丘脑切开术作为深部脑刺激手术后特发性震颤的可行选择：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-07-07 DOI: 10.3171/CASE25240

Daniel N de Souza, Caroline C Folz, Andreas Seas, Aurea Michael, Lynne Todd, Stephen C Harward

{"title":"Magnetic resonance-guided focused ultrasound thalamotomy as a viable option for essential tremor after deep brain stimulation explantation: illustrative case.","authors":"Daniel N de Souza, Caroline C Folz, Andreas Seas, Aurea Michael, Lynne Todd, Stephen C Harward","doi":"10.3171/CASE25240","DOIUrl":"10.3171/CASE25240","url":null,"abstract":"Background: Essential tremor (ET) has limited pharmacological treatments, and deep brain stimulation (DBS) has emerged as an effective surgical intervention. DBS, although effective and safe, is inherently invasive. Patients at high risk for surgery or who experience complications with DBS are left with limited treatments for medically refractory ET. Magnetic resonance-guided focused ultrasound (MRgFUS) is a less invasive and effective option for these patients.Observations: A 67-year-old right-handed male with a 37-year history of refractory ET underwent DBS of the bilateral ventral intermediate nuclei. His postoperative course was complicated by infection requiring device explantation and tremor recurrence. The patient subsequently elected to undergo left MRgFUS thalamotomy. Postoperative imaging illustrated overlap of the left thalamic MRgFUS lesion with the decussating and nondecussating dentato-rubro-thalamic tracts, while avoiding the medial lemniscus and corticospinal tract. The postoperative lesion was slightly posterior and superior to the original DBS lead trajectory. The patient reported 90% tremor reduction 3 months posttreatment, and his Clinical Rating Scale for Tremor score dropped from 47 to 11 with significant quality of life improvement.Lessons: While MRgFUS is not a replacement for DBS, it is an effective and less invasive option for patients with medically refractory ET at high risk for surgery or who fail treatment with DBS. https://thejns.org/doi/10.3171/CASE25240.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585923","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

Posterior column osteotomy for spinal realignment in patients with prior lumbar fusion: illustrative case. 后柱截骨术治疗腰椎融合术患者脊柱复位：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-07-07 DOI: 10.3171/CASE25251

Barnabas Obeng-Gyasi, Anoop Chinthala, Michael J Visconti, Ahmed M Belal, Gordon Mao

{"title":"Posterior column osteotomy for spinal realignment in patients with prior lumbar fusion: illustrative case.","authors":"Barnabas Obeng-Gyasi, Anoop Chinthala, Michael J Visconti, Ahmed M Belal, Gordon Mao","doi":"10.3171/CASE25251","DOIUrl":"10.3171/CASE25251","url":null,"abstract":"Background: Iatrogenic flat back syndrome following prior posterolateral fusion without interbody support is challenging, especially with adjacent segment stenosis. While pedicle subtraction osteotomy (PSO) offers strong correction, it is associated with higher morbidity. Alternative techniques with reduced risk are needed.Observations: The authors present the case of a 71-year-old woman with a 25-year-old L4-S1 fusion and severe sagittal deformity who underwent a Schwab grade 2 posterior column osteotomy (PCO) through the L4-5 fusion mass, with insertion of interbody cages of varying heights and lordotic angles. Preoperative parameters included C7 sagittal vertical axis (SVA) +10 cm, pelvic incidence (PI) 65°, lumbar lordosis (LL) -13°, PI-LL mismatch 79°, and pelvic tilt (PT) 43°. Postoperative improvements were C7 SVA +5.7 cm, LL 41°, PI-LL mismatch 24°, and PT 35°. The 285-minute surgery had an estimated blood loss of 1100 mL. At 1 month, the patient could walk a one-quarter mile, compared with < 50 feet before surgery.Lessons: This modified PCO technique provides effective decompression and substantial sagittal correction for iatrogenic flat back syndrome while potentially reducing morbidity compared with PSO. By distributing correction across multiple levels, this approach offers a valuable alternative for patients with moderate to severe sagittal imbalance and concurrent stenosis above prior fusion constructs-avoiding a three-column osteotomy. https://thejns.org/doi/10.3171/CASE25251.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585925","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

Rapid response to BRAF/MEK inhibitor therapy within 2 weeks for high-grade glioma with leptomeningeal metastasis: illustrative case. 2周内BRAF/MEK抑制剂治疗对伴有脑膜轻脑膜转移的高级别胶质瘤的快速反应：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-07-07 DOI: 10.3171/CASE25247

Yuki Kawaguchi, Taijun Hana, Hirotaka Hasegawa, Chiaki Murakami, Morihiro Higashi, Shunya Hanakita

{"title":"Rapid response to BRAF/MEK inhibitor therapy within 2 weeks for high-grade glioma with leptomeningeal metastasis: illustrative case.","authors":"Yuki Kawaguchi, Taijun Hana, Hirotaka Hasegawa, Chiaki Murakami, Morihiro Higashi, Shunya Hanakita","doi":"10.3171/CASE25247","DOIUrl":"10.3171/CASE25247","url":null,"abstract":"Background: High-grade gliomas, particularly isocitrate dehydrogenase-wildtype glioblastomas (GBMs), are highly aggressive brain tumors with limited treatment options and poor outcomes. A subset of these tumors, including epithelioid GBM, can harbor the BRAF V600E mutation, which drives tumor growth via persistent activation of the RAS/MAPK signaling pathway. Recently, the combination of dabrafenib (BRAF inhibitor) and trametinib (MEK inhibitor) has been approved for treating inoperable solid tumors with this mutation.Observations: The authors present the case of a 51-year-old man with epithelioid GBM harboring the BRAF V600E mutation who developed early leptomeningeal metastasis (LMM) following standard therapy with surgery, temozolomide, and radiotherapy. Owing to disease progression, he was treated with dabrafenib and trametinib. Remarkably, the patient showed rapid clinical and radiographic improvement within 2 weeks of treatment initiation. MR images demonstrated significant reduction in tumor-associated edema and contrast enhancement. At the 28-week follow-up, the patient achieved near-complete radiographic remission without notable adverse effects.Lessons: This case highlights the potential of BRAF/MEK inhibitor therapy to significantly improve outcomes in patients with aggressive gliomas and LMM, conditions typically associated with extremely poor prognosis. Further studies are needed to validate the long-term efficacy and safety of this targeted therapeutic approach in similar cases. https://thejns.org/doi/10.3171/CASE25247.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585926","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

Simultaneous craniotomy for resection and placement of responsive neurostimulation for treatment of medically refractory epilepsy: illustrative cases. 同时开颅切除和放置反应性神经刺激治疗难治性癫痫：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-07-07 DOI: 10.3171/CASE24895

Catherine A Gwinn, Shahin Hakimian, Kurt E Weaver, Adriel Barrios-Anderson, Andrew L Ko, Benjamin Grannan

{"title":"Simultaneous craniotomy for resection and placement of responsive neurostimulation for treatment of medically refractory epilepsy: illustrative cases.","authors":"Catherine A Gwinn, Shahin Hakimian, Kurt E Weaver, Adriel Barrios-Anderson, Andrew L Ko, Benjamin Grannan","doi":"10.3171/CASE24895","DOIUrl":"10.3171/CASE24895","url":null,"abstract":"Background: In cases of medically refractory epilepsy that is multifocal or involving eloquent cortex, a combined resection and neuromodulatory approach may offer greater seizure reduction than resection alone. Here the authors describe indications, technical considerations, and outcomes of patients in whom resection and responsive neurostimulation (RNS) device implantation were performed in the same operation.Observations: Three patients met inclusion criteria for this study. Preoperative sEEG demonstrated multifocal or eloquent cortex-involving seizure onset zones in all patients. In 2 patients, one depth electrode in the contralateral hippocampus and a cortical strip electrode ipsilateral to the resection were implanted. One patient received bilateral hippocampal depth electrodes and resection. Technical considerations include prioritization of stereotactic accuracy, avoidance of pulse generator discharge, and distant implantation of the generator relative to the resection site. At 1 year, 2 patients achieved Engel class IIIA, and 1 patient achieved class IIB.Lessons: The authors suggest consideration of this combined approach of simultaneous RNS device implantation and craniotomy for resection when intracranial data indicate a role for resection but it is unlikely to achieve seizure freedom alone. https://thejns.org/doi/10.3171/CASE24895.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585927","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

Endoscopic endonasal surgery using indocyanine green fluorescence endoscope for Cushing's disease caused by mixed intrasellar gangliocytoma and adrenocorticotropin adenoma: illustrative case. 吲哚菁绿荧光内镜下鼻内手术治疗混合鞍内神经节细胞瘤和促肾上腺皮质激素腺瘤所致库欣病：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-06-30 DOI: 10.3171/CASE25237

Yuefei Wang, Haixia Cheng, Wenqiang He, Qilin Zhang, Shun Yao, Zhengyuan Chen, Zengyi Ma, Xuefei Shou, Ming Shen, Yongfei Wang

{"title":"Endoscopic endonasal surgery using indocyanine green fluorescence endoscope for Cushing's disease caused by mixed intrasellar gangliocytoma and adrenocorticotropin adenoma: illustrative case.","authors":"Yuefei Wang, Haixia Cheng, Wenqiang He, Qilin Zhang, Shun Yao, Zhengyuan Chen, Zengyi Ma, Xuefei Shou, Ming Shen, Yongfei Wang","doi":"10.3171/CASE25237","DOIUrl":"10.3171/CASE25237","url":null,"abstract":"Background: Mixed gangliocytoma-adenoma (MGA) is an uncommon tumor found in the sellar region, characterized by both gangliocytic and pituitary adenomatous components. Preoperative differentiation of these mixed tumors from typical pituitary adenomas can be challenging, making thorough histological examination following resection essential for accurate diagnosis. However, the presence of the neural component in the gangliocytoma does not seem to affect its aggressiveness or recurrence risk after surgery.Observations: In the present study, the authors report a case of Cushing's disease secondary to a mixed pituitary adrenocorticotropin adenoma coexisting with an intrasellar gangliocytoma. Innovative preoperative C-X-C chemokine receptor type 4 (CXCR4)-targeted positron emission tomography (PET)/MRI and an intraoperative indocyanine green (ICG) fluorescence endoscope were used to localize the pathology. Biochemical remission was achieved after gross-total resection.Lessons: Gross-total resection of the tumor is a curative management strategy for MGAs. MGA should be suspected if the intraoperative frozen section shows gliosis with ganglion-like neurons but not adenomas. Preoperative CXCR4-targeted PET/MRI can help to localize the pathology causing Cushing's disease. An intraoperative ICG fluorescence endoscope can be used to differentiate the pathology from normal gland tissue. https://thejns.org/doi/10.3171/CASE25237.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"9 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532062","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

Ipsilateral tumor-side-down approach to mesial parietal and occipital gliomas: patient series. 同侧肿瘤侧下入路治疗内侧顶骨和枕部胶质瘤：患者系列。

Journal of neurosurgery. Case lessons Pub Date : 2025-06-30 DOI: 10.3171/CASE25305

Mahmoud M Elguindy, John M Bernabei, Jacob S Young, Mitchel S Berger

{"title":"Ipsilateral tumor-side-down approach to mesial parietal and occipital gliomas: patient series.","authors":"Mahmoud M Elguindy, John M Bernabei, Jacob S Young, Mitchel S Berger","doi":"10.3171/CASE25305","DOIUrl":"10.3171/CASE25305","url":null,"abstract":"Background: Patient positioning is important for optimizing the window for tumor resection while minimizing complications. Mesial posterior parietal and occipital gliomas pose unique challenges due to their relationship with optic radiations, visual cortex, and cerebral sinuses. For these lesions, the authors propose placing the patient in the lateral decubitus position with the tumor side down to take advantage of gravity and minimize the need for retraction. They describe the unique surgical corridor this approach enables.Observations: The authors identified 6 glioma patients who underwent resection of mesial parieto-occipital tumors through an ipsilateral tumor-side-down approach. Gravity-assisted retraction of the ipsilateral occipital lobe creates a safe corridor into the mesial parieto-occipital lobe for tumor resection. Gross-total resection was achieved in 5 patients. Three patients had stable visual field assessments, and 3 had worsened visual deficits postoperatively. There were no additional surgical complications in any patient.Lessons: The ipsilateral tumor-side-down approach to mesial parieto-occipital gliomas is an effective technique for tumor resection, allowing for gravity-assisted retraction while minimizing resection of adjacent normal brain tissue to gain access to the lesion. While the goal for glioma surgery is safe maximal resection, the risk of a new or worsening visual field deficit, although minimized with this approach, may still occur. https://thejns.org/doi/10.3171/CASE25305.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"9 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532066","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

Intravenous cangrelor infusion for the treatment of traumatic intracranial internal carotid artery dissection: illustrative case. 静脉输注康瑞洛治疗外伤性颅内颈内动脉夹层：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-06-30 DOI: 10.3171/CASE2559

Aliana N Rao, Erin K M Graves, Meghan Vallejo, Eric T Quach

{"title":"Intravenous cangrelor infusion for the treatment of traumatic intracranial internal carotid artery dissection: illustrative case.","authors":"Aliana N Rao, Erin K M Graves, Meghan Vallejo, Eric T Quach","doi":"10.3171/CASE2559","DOIUrl":"10.3171/CASE2559","url":null,"abstract":"Background: Antithrombotic initiation in patients with traumatic arterial dissections is weighed against the risk of bleeding complications. Cangrelor is a direct P2Y12 receptor blocker with rapid onset and reversibility. As such, its usage in polytrauma cases such as these, in which patients have both an elevated bleeding risk and an acute need for thromboembolic prevention, is advantageous.Observations: This case details cangrelor usage in a patient with a traumatic left cavernous internal carotid artery dissection as well as acute intracranial hemorrhage and other systemic injuries. No hemorrhagic or thromboembolic complications occurred during cangrelor therapy, which was eventually transitioned to oral aspirin. Outpatient follow-up angiography revealed successful healing of the carotid dissection.Lessons: The authors present a case demonstrating the clinical utility of cangrelor therapy to treat traumatic arterial dissections and prevent thrombus formation while also maintaining the ability to achieve rapid reversal if bleeding were to occur or urgent surgical procedures were needed. https://thejns.org/doi/10.3171/CASE2559.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"9 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532065","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. Multifaceted approaches for the treatment of stroke and venous thrombosis in PMM2-congenital glycosilation disorder. 给编辑的信。pmm2先天性糖基化障碍卒中和静脉血栓形成的多途径治疗。

Journal of neurosurgery. Case lessons Pub Date : 2025-06-30 DOI: 10.3171/CASE25142

Josef Finsterer

引用次数: 0

Infected aneurysm of middle meningeal artery causing intracerebral hemorrhage: illustrative case. 脑膜中动脉感染动脉瘤引起脑出血：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-06-30 DOI: 10.3171/CASE25214

Mana Suzuki, Taichi Ishiguro, Yoshihiro Omura, Kostadin Karagiozov, Keita Yoshida, Tadao Nakazawa, Tadasuke Tominaga, Nobuhiko Momozaki, Masahiko Nishitani, Takakazu Kawamata

{"title":"Infected aneurysm of middle meningeal artery causing intracerebral hemorrhage: illustrative case.","authors":"Mana Suzuki, Taichi Ishiguro, Yoshihiro Omura, Kostadin Karagiozov, Keita Yoshida, Tadao Nakazawa, Tadasuke Tominaga, Nobuhiko Momozaki, Masahiko Nishitani, Takakazu Kawamata","doi":"10.3171/CASE25214","DOIUrl":"10.3171/CASE25214","url":null,"abstract":"Background: Middle meningeal artery (MMA) aneurysms are rare and typically associated with trauma. Nontraumatic MMA aneurysms are very rare, and their rupture can lead to intracranial hemorrhage.Observations: The authors present a case of a ruptured MMA aneurysm causing intracranial hemorrhage in the temporal lobe, for which immediate hematoma evacuation and aneurysm resection were performed. Pathological examination revealed severe inflammatory infiltration and destruction of the aneurysm wall, consistent with an infected aneurysm. Additionally, they conducted a systematic search and literature review of previously reported cases of nontraumatic MMA aneurysms to identify their characteristics. Data from 33 published cases were extracted and summarized. Nontraumatic MMA aneurysms are rare, with sporadic reports linking them to hemodynamic stress. There were only a few cases linked to infectious etiologies. In the illustrative case, inflammation from periodontal disease likely spread to the MMA, leading to aneurysm formation and rupture. This case underscores the potential for devastating outcomes in infected MMA aneurysms and highlights the need for prompt diagnosis and treatment.Lessons: Although nontraumatic MMA aneurysms are extremely rare, their rupture necessitates immediate medical intervention due to the risk of fatal intracranial hemorrhage. https://thejns.org/doi/10.3171/CASE25214.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"9 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532063","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