Journal of neurosurgery. Case lessons最新文献_第3页

Excision of a supergiant spinal schwannoma: illustrative case. 超大型脊神经分裂瘤切除术：示例病例。

Journal of neurosurgery. Case lessons Pub Date : 2024-11-04 DOI: 10.3171/CASE24224

Tyler C Owens, Weston C de Lomba, Christian B Schroeder, Jennifer Mingrino, Jared Fridley, Adetokunbo A Oyelese, Thomas J Miner, Paul Y Liu, Albert S Woo, Ziya L Gokaslan, Patricia Zadnik Sullivan

{"title":"Excision of a supergiant spinal schwannoma: illustrative case.","authors":"Tyler C Owens, Weston C de Lomba, Christian B Schroeder, Jennifer Mingrino, Jared Fridley, Adetokunbo A Oyelese, Thomas J Miner, Paul Y Liu, Albert S Woo, Ziya L Gokaslan, Patricia Zadnik Sullivan","doi":"10.3171/CASE24224","DOIUrl":"10.3171/CASE24224","url":null,"abstract":"Background: The authors report on a patient who presented with an extremely large presacral schwannoma and subsequent mass effect-induced hydronephrosis and kidney failure. To the authors' knowledge, this case represents the largest radiographically verified spinal schwannoma in the medical literature. The tumor presented here was more than three times as large as a typical giant schwannoma. While smaller presacral schwannomas are usually uncomplicated surgical cases, the supergiant schwannomas described here create significant surgical challenges.Observations: The extremely large size of this nerve sheath tumor introduced a level of surgical complexity not seen in most spinal schwannoma cases. The authors hope that this case informs surgeons regarding the approach to excision of giant spinal schwannomas.Lessons: The resection of giant spinal schwannomas is likely to involve one or more lengthy surgeries, and the resection volume can be limited by excessive bleeding. Physicians approaching these large, benign spinal tumors should be aware of the challenges of surgery duration and hemostasis before approaching a tumor of this kind. https://thejns.org/doi/10.3171/CASE24224.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"8 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577217","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

Intracranial pleomorphic liposarcoma misclassified as a pleomorphic xanthoastrocytoma by a DNA methylation classifier: illustrative case. DNA 甲基化分类器将颅内多形性脂肪肉瘤误分类为多形性黄细胞瘤：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2024-11-04 DOI: 10.3171/CASE24465

Kohichi Go, Yasuhide Makino, Yasuhide Takeuchi, Sachiko Minamiguchi, Shigeki Takada, Noritaka Sano, Masahiro Tanji, Yohei Mineharu, Masato Hojo, Hironori Haga, Yoshiki Arakawa

{"title":"Intracranial pleomorphic liposarcoma misclassified as a pleomorphic xanthoastrocytoma by a DNA methylation classifier: illustrative case.","authors":"Kohichi Go, Yasuhide Makino, Yasuhide Takeuchi, Sachiko Minamiguchi, Shigeki Takada, Noritaka Sano, Masahiro Tanji, Yohei Mineharu, Masato Hojo, Hironori Haga, Yoshiki Arakawa","doi":"10.3171/CASE24465","DOIUrl":"10.3171/CASE24465","url":null,"abstract":"Background: Recently, it has been shown that DNA methylation arrays and German Cancer Research Center (Deutsches Krebsforschungszentrum) methylation classifiers are useful aids in brain tumor diagnosis for cases in which histopathological diagnosis is difficult. However, not enough is known about diagnostic aids for intracranial liposarcoma (LPS).Observations: An 18-year-old woman with a history of natural killer/T-cell lymphoma, which had been treated with a bone marrow transplant and total body irradiation at age 11 years, presented with diplopia. Magnetic resonance imaging revealed a brain tumor in the posterior left temporal lobe, which was removed by craniotomy. The tumor was initially diagnosed as pleomorphic xanthoastrocytoma through histopathological and DNA methylation examination. She also had a soft tissue tumor in her left thigh, which was removed. It contained spindle cells with oval nuclei and highly pleomorphic cells and was diagnosed as radiation-induced LPS. Histopathological re-examination of the brain tumor led to a final diagnosis of pleomorphic LPS.Lessons: In this report, the authors describe the case of a patient with an intracranial pleomorphic LPS that was initially classified as a pleomorphic xanthoastrocytoma by a DNA methylation classifier. Although DNA methylation classifiers are useful as diagnostic aids in cases in which definitive pathology is difficult to determine, there is a risk of misdiagnosis in some types of tumors. https://thejns.org/doi/10.3171/CASE24465.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"8 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577232","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

Two-stage surgical intervention for a rare case of intersected nasoethmoidal encephalocele and open-lip schizencephaly in an infant: illustrative case. 对一例罕见的婴儿鼻乙状颅脑交错症和开唇裂头畸形进行两阶段手术治疗：示例病例。

Journal of neurosurgery. Case lessons Pub Date : 2024-11-04 DOI: 10.3171/CASE24259

Silvia Suarez-Monsalve, Santiago Campos-Fajardo, Raul Ramirez-Grueso, Karen Lorena Jacomussi-Alzate, Julie Franco Rodriguez

{"title":"Two-stage surgical intervention for a rare case of intersected nasoethmoidal encephalocele and open-lip schizencephaly in an infant: illustrative case.","authors":"Silvia Suarez-Monsalve, Santiago Campos-Fajardo, Raul Ramirez-Grueso, Karen Lorena Jacomussi-Alzate, Julie Franco Rodriguez","doi":"10.3171/CASE24259","DOIUrl":"10.3171/CASE24259","url":null,"abstract":"Background: Schizencephaly and encephaloceles are rare developmental birth defects, with the former involving abnormal clefts in the cerebral hemispheres connected to the ventricular system and the latter involving a neural tube defect characterized by the protrusion of brain tissue through an abnormal skull opening. These conditions are individually uncommon, and their simultaneous occurrence in a single patient is exceedingly unusual.Observations: This case report explores the intersection of these two rare congenital malformations in a 2-month-old female patient from an indigenous community in a rural area of Colombia. She presented with open-lip schizencephaly accompanied by a nasoethmoidal encephalocele and additional brain abnormalities, including septum pellucidum agenesis, corpus callosum dysgenesis, and a suspected bilateral optic nerve hypoplasia.Lessons: Management involved a two-step surgical procedure, addressing hydrocephalus with a ventriculoperitoneal shunt and the encephalocele with posterior excision, thereby facilitating optimal cortical gray matter development and enhancing neurological outcomes. https://thejns.org/doi/10.3171/CASE24259.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"8 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577242","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

Utility of the turn-back supporting technique using a steerable intermediate catheter: illustrative case. 使用可转向中间导管的回转支撑技术的实用性：示例。

Journal of neurosurgery. Case lessons Pub Date : 2024-11-04 DOI: 10.3171/CASE24467

Takeshi Hara, Daizo Ishii, Hiroshi Kondo, Masashi Kuwabara, Yusuke Yamamoto, Nobutaka Horie

{"title":"Utility of the turn-back supporting technique using a steerable intermediate catheter: illustrative case.","authors":"Takeshi Hara, Daizo Ishii, Hiroshi Kondo, Masashi Kuwabara, Yusuke Yamamoto, Nobutaka Horie","doi":"10.3171/CASE24467","DOIUrl":"10.3171/CASE24467","url":null,"abstract":"Background: Selective shunt occlusion (SSO) for intracranial dural arteriovenous fistulas (DAVFs) is a safe and effective method that directly intercepts the shunted pouch from the affected sinus with minimal materials. However, it can be challenging to obliterate the shunted pouch if the microcatheter is not supported adequately.Observations: A 68-year-old woman presented with tinnitus and was diagnosed with multiple shunted DAVFs in the right transverse-sigmoid sinus (TSS) and the superior sagittal sinus (SSS). Although the entire sinus packing of the right TSS was performed, a follow-up angiography 7 months later revealed significant cerebral venous reflux due to occlusion of the left TSS and an increasing residual shunt flow in the venous pouch at the confluence of the SSS. A guiding catheter was introduced into the isolated sinus transvenously. Then, a steerable intermediate catheter (SIC) was manually steered into a hairpin shape and hooked on near the pouch prior to navigating a microcatheter into the fistula point. Finally, the fistula pouch was completely obliterated using only two coils under the adequate support of the turned-back intermediate catheter.Lessons: The turn-back supporting technique using an SIC was useful in achieving SSO for DAVFs, providing both adequate support and guidance for the coaxial microcatheter. https://thejns.org/doi/10.3171/CASE24467.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"8 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577246","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

Vertebral endarterectomy combined with endovascular treatment for patients with vertebral artery stenosis and vertebral aneurysm: illustrative case. 椎动脉狭窄和椎体动脉瘤患者的椎动脉内膜切除术联合血管内治疗：示例病例。

Journal of neurosurgery. Case lessons Pub Date : 2024-11-04 DOI: 10.3171/CASE2475

Fan Yang, Shilin Li, Yuanbing Chen, Jiayi Xie, Yi Liu, Fei Peng, Xuge Chen, Jiaxiang Xia, Boya Xu, Zhifei Wang, Jiaode Jiang, Aihua Liu

引用次数: 0

Branching and nonbranching intracranial aneurysms in the presence of a persistent stapedial artery and an aberrant internal carotid artery assessed with computational hemodynamics: illustrative case. 利用计算血液动力学评估存在持续性镫骨动脉和异常颈内动脉的分支和非分支颅内动脉瘤：示例病例。

Journal of neurosurgery. Case lessons Pub Date : 2024-11-04 DOI: 10.3171/CASE24421

Céline Salaud, Tristan Martin, Gilles El Hage, Michel W Bojanowski

{"title":"Branching and nonbranching intracranial aneurysms in the presence of a persistent stapedial artery and an aberrant internal carotid artery assessed with computational hemodynamics: illustrative case.","authors":"Céline Salaud, Tristan Martin, Gilles El Hage, Michel W Bojanowski","doi":"10.3171/CASE24421","DOIUrl":"10.3171/CASE24421","url":null,"abstract":"Background: The mechanisms underlying the initiation and progression of bifurcation versus lateral wall aneurysms are not well understood. Computational fluid dynamics (CFD) can improve the understanding of these mechanisms and can consequently help identify patients at higher risk for developing aneurysms and monitor them more closely.Observations: A 36-year-old man presented with a ruptured anterior communicating artery aneurysm, which was successfully treated with microsurgical clipping. Imaging also revealed a persistent stapedial artery with an elongated and tortuous posterior communicating artery (PComA). Fourteen years later, he was readmitted for a ruptured aneurysm on a PComA loop. CFD helped identify considerable collateral circulation due to the aberrant internal carotid artery (ICA). High flow rates trigger both types of aneurysms, but nuances exist in the hemodynamic mechanisms that drive their growth.Lessons: Berry aneurysms and lateral wall aneurysms initially start due to a high flow rate, a common underlying cause. However, the formation of true sidewall aneurysms is primarily characterized by locally increased wall shear stress, while the development of berry aneurysms is mainly linked to high local blood pressure at arterial bifurcations. An aberrant ICA can lead to supraphysiological compensatory flow in the anterior and posterior circulation, increasing the risk of intracranial aneurysm formation at both branching and nonbranching sites, underscoring the need for lifelong monitoring. https://thejns.org/doi/10.3171/CASE24421.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"8 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577166","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

Efficacy and safety of the contralateral approach to vascular lesions in the vertebral artery: patient series. 用对侧方法治疗椎动脉血管病变的有效性和安全性：患者系列。

Journal of neurosurgery. Case lessons Pub Date : 2024-11-04 DOI: 10.3171/CASE24420

Hiroki Takahashi, Toshinori Matsushige, Masahiro Hosogai, Shinichiro Oku, Nobutaka Horie

{"title":"Efficacy and safety of the contralateral approach to vascular lesions in the vertebral artery: patient series.","authors":"Hiroki Takahashi, Toshinori Matsushige, Masahiro Hosogai, Shinichiro Oku, Nobutaka Horie","doi":"10.3171/CASE24420","DOIUrl":"10.3171/CASE24420","url":null,"abstract":"Background: Endovascular treatment is preferred over microsurgical clipping for intracranial aneurysms in the posterior circulation. However, access to lesions, particularly those in the regions of the vertebral artery (VA) and the posterior inferior cerebellar artery (PICA), is technically challenging in terms of the vessel diameter of the ipsilateral VA or the branching angle of the PICA.Observations: Nine cases of intracranial aneurysms in the region of the PICA, which were endovascularly treated with an approach beyond the vertebrobasilar junction (VBJ) from the contralateral VA in the last 4 years, are described herein. All procedures, namely stent deployment, the use of a balloon catheter, and coiling, were safely performed using the contralateral approach. Neither rebleeding nor ischemic complications occurred. All patients had favorable outcomes and no recurrence.Lessons: All aneurysms were successfully treated using an adjunctive technique with an additional approach beyond the VBJ from the contralateral VA. The combination of both ipsilateral and contralateral approaches to VA-PICA or PICA lesions contributes to safe and effective endovascular treatment. https://thejns.org/doi/10.3171/CASE24420.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"8 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577182","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

Middle meningeal artery embolization and tranexamic acid therapy for subdural hematoma in a patient with hereditary hemorrhagic telangiectasia: illustrative case. 脑膜中动脉栓塞和氨甲环酸治疗遗传性出血性毛细血管扩张症患者硬膜下血肿：示例病例。

Journal of neurosurgery. Case lessons Pub Date : 2024-11-04 DOI: 10.3171/CASE24483

Robert Kushmakov, Ilona Cazorla-Morales, Keith Brenner, David Araten, Maksim Shapiro, Eytan Raz, Dimitris G Placantonakis

{"title":"Middle meningeal artery embolization and tranexamic acid therapy for subdural hematoma in a patient with hereditary hemorrhagic telangiectasia: illustrative case.","authors":"Robert Kushmakov, Ilona Cazorla-Morales, Keith Brenner, David Araten, Maksim Shapiro, Eytan Raz, Dimitris G Placantonakis","doi":"10.3171/CASE24483","DOIUrl":"10.3171/CASE24483","url":null,"abstract":"Background: Subdural hematoma is a rare manifestation of hereditary hemorrhagic telangiectasia (HHT), also known as Osler-Weber-Rendu disease. Here, the authors present a patient with HHT and a large chronic subdural hematoma, for whom nonsurgical management was pursued.Observations: A 49-year-old right-handed male with a history of hypertension and familial HHT presented with complaints of mild confusion and left hemiparesis over several days. Noncontrast head computed tomography images demonstrated a large chronic right hemisphere subdural hematoma compressing the right cerebral hemisphere and causing a 1.3-cm midline shift. Due to concerns about surgical complications arising from hemorrhages of cryptic telangiectasias, the patient was treated conservatively with middle meningeal artery embolization and adjuvant tranexamic acid. There was clinical and radiological resolution several months later.Lessons: This case highlights the rarity of a subdural hematoma as a manifestation of HHT and the nonsurgical treatment strategy as a mechanism to avoid hemorrhagic complications of surgical evacuation. https://thejns.org/doi/10.3171/CASE24483.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"8 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577236","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

Brainstem hemorrhage associated with venous hypertensive myelopathy without dural arteriovenous fistula: illustrative case. 脑干出血伴静脉高压性脊髓病，但无硬脑膜动静脉瘘：示例病例。

Journal of neurosurgery. Case lessons Pub Date : 2024-11-04 DOI: 10.3171/CASE24441

Sho Hanai, Kiyoyuki Yanaka, Ken Akimoto, Aiki Marushima, Kazuhiro Nakamura, Nobuyuki Takahashi, Yuji Matsumaru, Eiichi Ishikawa

{"title":"Brainstem hemorrhage associated with venous hypertensive myelopathy without dural arteriovenous fistula: illustrative case.","authors":"Sho Hanai, Kiyoyuki Yanaka, Ken Akimoto, Aiki Marushima, Kazuhiro Nakamura, Nobuyuki Takahashi, Yuji Matsumaru, Eiichi Ishikawa","doi":"10.3171/CASE24441","DOIUrl":"10.3171/CASE24441","url":null,"abstract":"Background: Venous hypertensive myelopathy (VHM), formerly known as \"Foix-Alajouanine syndrome,\" is a spinal cord dysfunction caused by impaired perfusion of the spinal cord. Most cases are attributed to spinal dural arteriovenous fistulas (dAVFs), but there are scattered reports of VHM without concomitant dAVF. Furthermore, no cases of VHM associated with intracranial hemorrhage exist.Observations: A 68-year-old man with a history of hypertension presented with a sudden headache, proximal paresis of the left upper extremity, impaired pain and temperature sensation in the right upper extremity, dysphagia, and dysarthria. Computed tomography scans showed intraparenchymal hemorrhage in the left medulla oblongata and a linear, continuous high-density area extending from the medulla oblongata to the cervical spinal cord. Magnetic resonance images showed cervical spondylosis at the C5-6 and C6-7 levels, with high signal intensity changes from the medulla oblongata to the lower cervical cord on T2-weighted images. Cerebral angiography showed no abnormal vessels. Conservative treatment gradually improved symptoms and the high signal intensity areas.Lessons: This case highlights intracranial hemorrhage occurring from extracranial causes and the possibility of VHM due to cervical spondylosis. When hemorrhagic lesions of the craniovertebral junction or spinal parenchymal lesions are encountered, the underlying pathology should be investigated thoroughly and systematically. https://thejns.org/doi/10.3171/CASE24441.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"8 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577164","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 unique presentation of trigeminal neuralgia related to a central nervous tissue choristoma along the trigeminal nerve root: illustrative case. 三叉神经痛的独特表现与沿三叉神经根的中枢神经组织绒毛膜瘤有关：示例病例。

Journal of neurosurgery. Case lessons Pub Date : 2024-11-04 DOI: 10.3171/CASE24384

Cagdas Ataoglu, Ufuk Erginoglu, Serhat Aydin, Mehmet Sapanci, Shahriar Salamat, Mustafa K Baskaya

{"title":"A unique presentation of trigeminal neuralgia related to a central nervous tissue choristoma along the trigeminal nerve root: illustrative case.","authors":"Cagdas Ataoglu, Ufuk Erginoglu, Serhat Aydin, Mehmet Sapanci, Shahriar Salamat, Mustafa K Baskaya","doi":"10.3171/CASE24384","DOIUrl":"10.3171/CASE24384","url":null,"abstract":"Background: Trigeminal neuralgia (TNa), or tic douloureux, is characterized by severe facial pain triggered by everyday activities. Recurring and intense TNa pain results from localized demyelination within the affected nerve segment. The primary cause of TNa is typically vascular compression, with the superior cerebellar artery being the most common vessel. Tumors, multiple sclerosis, and infectious diseases such as herpes are less frequent causes of TNa.Observations: The authors present a unique case in which TNa was caused by an aberrant mass resembling a schwannoma during surgery. However, histological examination revealed heterotopic benign central nervous neurons and myelinated axons, which could represent a choristoma in the cisternal segment of the portio major of the trigeminal nerve. Following surgery, the patient's TNa was completely resolved.Lessons: To the best of the authors' knowledge, this is the first documented case of a central nervous tissue choristoma causing TNa and responding positively to surgical intervention, aside from one previous report that did not specifically use the term \"choristoma\" in identifying the lesion. This case highlights the challenges involved in diagnosing and managing a rare TNa presentation, with a particular focus on pathology findings. It underscores the potential role of surgery for patients whose condition is resistant to medical intervention. https://thejns.org/doi/10.3171/CASE24384.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"8 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577180","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