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

Staged coiling and flow diversion for a ruptured persistent primitive hypoglossal artery aneurysm: illustrative case. 分阶段盘绕和分流治疗持续性原始舌下动脉瘤破裂：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2026-04-20 DOI: 10.3171/CASE2642

Ryohei Goda, Hideki Hayashi, Shintaro Nakayasu, Kaiji Imanishi, Masaki Maeda, Nozomu Murai

{"title":"Staged coiling and flow diversion for a ruptured persistent primitive hypoglossal artery aneurysm: illustrative case.","authors":"Ryohei Goda, Hideki Hayashi, Shintaro Nakayasu, Kaiji Imanishi, Masaki Maeda, Nozomu Murai","doi":"10.3171/CASE2642","DOIUrl":"10.3171/CASE2642","url":null,"abstract":"Background: A persistent primitive hypoglossal artery (PPHA) is a rare embryonic carotid-vertebrobasilar anastomosis that can serve as the dominant posterior circulation inflow and predispose to aneurysm formation; optimal management remains unsettled.Observations: A 68-year-old woman presented with a World Federation of Neurosurgical Societies grade V subarachnoid hemorrhage resulting from a large, wide-necked aneurysm at the junction of the PPHA and vertebral artery. The contralateral vertebral artery was diminutive, and the anterior inferior cerebellar artery supplied the right posterior inferior cerebellar artery territory. To minimize acute-phase thromboembolic risk and prevent rebleeding, balloon-assisted coiling with hydrogel-coated coils was performed and Raymond-Roy class I occlusion (volume embolization ratio 20.2%) was achieved. The patient recovered to a modified Rankin Scale score of 1. Despite initial stability, recanalization occurred at 1 year. A FRED flow diverter was deployed by simple unsheathing without complications. Follow-up angiography showed complete occlusion at 6 months.Lessons: In the context of PPHA anatomy with high posterior circulation dependence, a staged strategy-acute stentless coiling followed by delayed flow diversion-can balance immediate protection with durable reconstruction. A detailed anatomical evaluation (including perforators, vertebral artery caliber, and vascular variants) and antiplatelet optimization are essential. https://thejns.org/doi/10.3171/CASE2642.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"11 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730975","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 and anatomical characteristics of craniocervical junction arteriovenous fistulas fed from the vertebral artery dural ring: patient series. 颅颈交界动静脉瘘椎动脉硬膜环灌注的临床与解剖学特征：患者系列。

Journal of neurosurgery. Case lessons Pub Date : 2026-04-20 DOI: 10.3171/CASE26142

Hisaaki Uchikado, Takayasu Ando, Takehiro Makizono, Taku Ohkubo, Yukihiko Nakamura, Gosuke Hattori, Motohiro Morioka

{"title":"Clinical and anatomical characteristics of craniocervical junction arteriovenous fistulas fed from the vertebral artery dural ring: patient series.","authors":"Hisaaki Uchikado, Takayasu Ando, Takehiro Makizono, Taku Ohkubo, Yukihiko Nakamura, Gosuke Hattori, Motohiro Morioka","doi":"10.3171/CASE26142","DOIUrl":"10.3171/CASE26142","url":null,"abstract":"Background: Manifestations of craniocervical junction (CCJ) arteriovenous fistulas (AVFs) include bleeding and congestive myelopathy. CCJ AVFs are classified as epidural, dural, radicular, and perimedullary. On diagnostic imaging, differentiation between dural and radicular AVFs is difficult because of the shortness of the feeding artery from the vertebral artery dural ring. Herein, the authors investigated the feeding artery of these AVFs.Observations: Angiographic findings were described for 11 cases of CCJ AVFs (perimedullary, n = 1; radicular, n = 4; dural, n = 4; epidural 2), and direct surgery was performed in 8 patients (perimedullary, n = 1; radicular, n = 3, dural; n = 4). It is important to determine whether the posterior spinal artery branches have an epidural or intradural origin, and 2 cases (25%) of postoperative complications (brainstem ischemia, subarachnoid bleeding) were observed. In direct surgery, perimedullary AVFs must be treated just before the shunt point, and it is important to treat only the refluxing bridging veins in dural AVFs.Lessons: CCJ AVF requires classification of shunt points and understanding of vascular anatomy, including variations of posterior spinal artery. https://thejns.org/doi/10.3171/CASE26142.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"11 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147731073","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

Radiation-induced meningiomas, cerebral aneurysm, and multiple cavernomas 2 decades after radiotherapy for medulloblastoma: illustrative case. 髓母细胞瘤放射治疗20年后放射诱发的脑膜瘤、脑动脉瘤和多发性海绵瘤：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2026-04-20 DOI: 10.3171/CASE25898

Almira A Dayrit, Agos-Gel R Amasula, Dan Philippe C Nicer, Kathleen Joy O Khu, Gerardo D Legaspi

{"title":"Radiation-induced meningiomas, cerebral aneurysm, and multiple cavernomas 2 decades after radiotherapy for medulloblastoma: illustrative case.","authors":"Almira A Dayrit, Agos-Gel R Amasula, Dan Philippe C Nicer, Kathleen Joy O Khu, Gerardo D Legaspi","doi":"10.3171/CASE25898","DOIUrl":"10.3171/CASE25898","url":null,"abstract":"Background: Radiation therapy is a mainstay in the management of medulloblastoma. However, it carries long-term side effects including radiation-induced tumors and vasculopathies. The authors report the first case of the occurrence of radiation-induced meningiomas, an intracranial aneurysm, and multiple cavernomas in a patient with a remote history of medulloblastoma. In addition, this is only the seventh reported radiation-associated superior cerebellar artery (SCA) aneurysm, the first such aneurysm to be associated with external beam RT and the first such aneurysm to be treated with microsurgery.Observations: The patient was diagnosed with medulloblastoma when he was 4 years old and underwent surgery, craniospinal irradiation, and chemotherapy. He was well until 25 years later, when he presented with headache and left-sided weakness. Cranial imaging revealed multiple meningiomas and cavernomas. He underwent surgery to excise the largest meningioma in the right frontotemporal area. Two years later, he underwent another operation for a left frontal meningioma that increased in size. Two months postexcision, he presented with a subarachnoid hemorrhage from a ruptured right SCA aneurysm and underwent clipping. He was discharged well.Lessons: This case highlights the importance of long-term surveillance for patients treated with radiotherapy. However, the ideal follow-up duration and frequency of screening tests have yet to be determined. https://thejns.org/doi/10.3171/CASE25898.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"11 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730963","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 corpus callosotomy for drug-resistant epilepsy due to cerebral folate transporter deficiency: illustrative case. 内窥镜胼胝体切开术治疗脑叶酸转运体缺乏引起的耐药癫痫：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2026-04-20 DOI: 10.3171/CASE25793

Arturo Balaguer Townsend, Mahie Gopalka, David Bieber, Jeffrey S Raskin, Joshua Baker, Anne M McRae, Elysa Widjaja, Sandi K Lam

{"title":"Endoscopic corpus callosotomy for drug-resistant epilepsy due to cerebral folate transporter deficiency: illustrative case.","authors":"Arturo Balaguer Townsend, Mahie Gopalka, David Bieber, Jeffrey S Raskin, Joshua Baker, Anne M McRae, Elysa Widjaja, Sandi K Lam","doi":"10.3171/CASE25793","DOIUrl":"10.3171/CASE25793","url":null,"abstract":"Background: Cerebral folate transporter deficiency (FOLR1-related CFTD, MIM #613068) is a rare, autosomal recessive neurological disease characterized by markedly deficient CSF folate levels arising from impaired transport of folate across the blood-brain barrier. Current research highlights the role of folinic acid in treatment for patients with CFTD. To date, there has been minimal published evidence on seizure management for CFTD patients whose conditions are refractory to folinic acid treatment, and there are no standardized approaches for guiding care in this subset.Observations: The authors report a successful clinical outcome after corpus callosotomy in a patient with drug-resistant epilepsy (DRE) secondary to folinic acid-refractory CFTD.Lessons: This case represents the first documented surgical treatment for DRE in this patient population. Intracranial epilepsy surgery might play an important role for managing DRE in this patient population in the future. https://thejns.org/doi/10.3171/CASE25793.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"11 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729951","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

Isolated cerebellopontine angle neurosarcoidosis mimicking meningioma: a diagnostic pitfall. Illustrative case. 孤立的模拟脑膜瘤的桥小脑角神经结节病：一个诊断缺陷。说明情况。

Journal of neurosurgery. Case lessons Pub Date : 2026-04-20 DOI: 10.3171/CASE2668

Nilay Karaman, Ali H Duzkalir, Ibrahim Kulac, Selcuk Peker

{"title":"Isolated cerebellopontine angle neurosarcoidosis mimicking meningioma: a diagnostic pitfall. Illustrative case.","authors":"Nilay Karaman, Ali H Duzkalir, Ibrahim Kulac, Selcuk Peker","doi":"10.3171/CASE2668","DOIUrl":"10.3171/CASE2668","url":null,"abstract":"Background: Neurosarcoidosis (NS) is a rare inflammatory disease that can mimic intracranial neoplasms. Its presentation as an isolated cerebellopontine angle (CPA) mass is exceedingly uncommon and typically resembles vestibular schwannomas or meningiomas, complicating the diagnostic process.Observations: A 25-year-old man presented with progressive diplopia and hearing loss. MRI revealed a diffusely enhancing lesion in the left CPA. Because the initial workup was inconclusive and intraoperative pathology heavily favored a nonneoplastic inflammatory process, subtotal resection was performed. Histopathological examination revealed a histiocyte-rich inflammatory infiltration with occasional multinucleated giant cells. The patient was treated with high-dose corticosteroids and experienced a good recovery.Lessons: This case underscores the importance of including NS in the differential diagnosis of CPA tumors, particularly in young patients with atypical features. Early consideration and histopathological confirmation are crucial to avoid unnecessary extensive resection and to enable timely initiation of appropriate medical therapy. https://thejns.org/doi/10.3171/CASE2668.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"11 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730403","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

Intraoperative indocyanine green videoangiography of spinal epidural arteriovenous fistula in thoracolumbar lesions: illustrative case. 术中吲哚菁绿血管造影显示胸腰椎硬膜外动静脉瘘：一例说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2026-04-20 DOI: 10.3171/CASE25865

Chihiro Takashima, Hisaaki Uchikado, Taku Ohkubo, Yukihiko Nakamura, Takehiro Makizono, Takayuki Kawano, Motohiro Morioka

{"title":"Intraoperative indocyanine green videoangiography of spinal epidural arteriovenous fistula in thoracolumbar lesions: illustrative case.","authors":"Chihiro Takashima, Hisaaki Uchikado, Taku Ohkubo, Yukihiko Nakamura, Takehiro Makizono, Takayuki Kawano, Motohiro Morioka","doi":"10.3171/CASE25865","DOIUrl":"10.3171/CASE25865","url":null,"abstract":"Background: Compared to dural arteriovenous fistulas (AVFs), the pathogenesis of extradural AVFs is unclear. Furthermore, the outcomes of surgical and endovascular treatments are inferior to those of dural AVFs, and in some cases, there are reports of poor outcomes.Observations: A 74-year-old male hemodialysis patient presented with gradually progressive gait disturbance. MRI showed high T2 signal intensity in the lower spinal cord, and angiography revealed a dural AVF. The patient was referred to the authors' hospital. Multiple small arteries were found to have refluxing veins in the dura at T12-L1 on the right side, and a diagnosis of epidural AVF was made, leading to direct surgery. During exoscopic microsurgery, the venous pouch located on the lateral ventral side was exposed, and intradural and extradural hemodynamics were confirmed using indocyanine green (ICG) videoangiograhy, followed by complete coagulated occlusion. Postoperatively, the patient's symptoms improved.Lessons: There have been few cases of epidural AVF treated with exoscopic ICG videoangiography for intradural and extradural observation and healing. https://thejns.org/doi/10.3171/CASE25865.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"11 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730013","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

Periodontoid pseudotumor with cranial retroclival extension and brainstem compression in a patient with rheumatoid arthritis: illustrative case. 类风湿关节炎患者牙周假瘤伴颅斜后延伸和脑干压迫：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2026-04-20 DOI: 10.3171/CASE26169

Andrea De Rosa, Carmela Palmiero, Giovanni Oliva, Gianpiero Iannuzzo, Veronica Parisi, Roberto Tafuto, Claudio Schonauer

{"title":"Periodontoid pseudotumor with cranial retroclival extension and brainstem compression in a patient with rheumatoid arthritis: illustrative case.","authors":"Andrea De Rosa, Carmela Palmiero, Giovanni Oliva, Gianpiero Iannuzzo, Veronica Parisi, Roberto Tafuto, Claudio Schonauer","doi":"10.3171/CASE26169","DOIUrl":"10.3171/CASE26169","url":null,"abstract":"Background: Periodontoid pseudotumor is a nonneoplastic mass arising around the odontoid process and is most commonly associated with chronic atlantoaxial instability in inflammatory and noninflammatory conditions. Although traditionally managed with direct anterior resection, increasing evidence suggests that posterior stabilization may promote lesion regression by addressing the underlying biomechanical driver.Observations: A 73-year-old male with a history of rheumatoid arthritis was admitted to the authors' institution with a history of gait instability and vertigo. Contrast-enhanced MRI of the cervicomedullary junction revealed a retro-odontoid cystic mass with significant cranial extension into the retroclival region and compression on the lateral recess of the fourth ventricle. The patient underwent a C1-2 arthrodesis with the Magerl technique and decompression of the posterior arch of C1. Marked regression of the periodontoid mass was observed on 3-month postoperative MRI, along with significant cervicomedullary junction decompression.Lessons: In carefully selected patients with radiological evidence of chronic atlantoaxial instability and favorable C1-2 anatomy, posterior stabilization may represent an effective primary strategy for managing periodontoid pseudotumor, even in cases with cranial extension. This approach may mitigate the morbidity associated with anterior mass resection, although its generalizability is limited by the single-case design and short-term follow-up. https://thejns.org/doi/10.3171/CASE26169.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"11 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730892","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

Pediatric cerebral sparganosis mimicking low-grade glioma in a nonendemic region: illustrative case. 儿童脑spargosis模拟低级别胶质瘤在非地方性地区：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2026-04-20 DOI: 10.3171/CASE264

Ege Anil Ucar, Ekin Deniz, Oguz Baran, Goktug Akyoldas, Ozgur Can Eren, Ibrahim Kulac, İhsan Solaroglu

{"title":"Pediatric cerebral sparganosis mimicking low-grade glioma in a nonendemic region: illustrative case.","authors":"Ege Anil Ucar, Ekin Deniz, Oguz Baran, Goktug Akyoldas, Ozgur Can Eren, Ibrahim Kulac, İhsan Solaroglu","doi":"10.3171/CASE264","DOIUrl":"10.3171/CASE264","url":null,"abstract":"Background: Cerebral sparganosis is a rare parasitic infection of the CNS caused by the Spirometra species. Pediatric intracranial involvement is exceptionally uncommon and has been reported predominantly from endemic regions in Asia. Preoperative diagnosis is challenging because clinical and radiological features frequently mimic neoplastic lesions.Observations: An 11-year-old girl presented with new-onset seizures. MRI demonstrated a small, peripherally enhancing lesion in the right parietal lobe with surrounding vasogenic edema and intralesional calcifications, initially interpreted as a pediatric low-grade glioma. The patient underwent supramarginal resection. Histopathological examination revealed inflammatory changes with parasitic structures consistent with Spirometra species. A structured review of the literature identified 77 pediatric cases, showing a modest male predominance, a mean age of 11.01 years, seizures as the most common presenting symptom, a frontal-parietal predominance of lesions, frequent preoperative misdiagnosis, and inconsistent peripheral eosinophilia.Lessons: Pediatric cerebral sparganosis can closely mimic low-grade glioma on neuroimaging, especially in nonendemic regions. Absence of peripheral eosinophilia or a clear exposure history does not exclude the diagnosis. Awareness of this entity is critical to avoid misdiagnosis, and complete excision remains the most effective diagnostic and therapeutic strategy in tumor-like presentations. https://thejns.org/doi/10.3171/CASE264.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"11 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730917","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

Prostate cancer presenting as brain metastasis with concurrent elevation of carcinoembryonic antigen and carbohydrate antigen 19-9 levels: illustrative case. 前列腺癌表现为脑转移，同时癌胚抗原和碳水化合物抗原19-9水平升高：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2026-04-20 DOI: 10.3171/CASE25735

Sosuke Sumiyoshi, Kosuke Fujii, Kazuhiro Kasashima, Masashi Oda, Masaaki Saiki

{"title":"Prostate cancer presenting as brain metastasis with concurrent elevation of carcinoembryonic antigen and carbohydrate antigen 19-9 levels: illustrative case.","authors":"Sosuke Sumiyoshi, Kosuke Fujii, Kazuhiro Kasashima, Masashi Oda, Masaaki Saiki","doi":"10.3171/CASE25735","DOIUrl":"10.3171/CASE25735","url":null,"abstract":"Background: Prostate cancer is a common malignancy in men and usually presents with elevated prostate-specific antigen (PSA) levels and metastases to the bones or lymph nodes. Brain metastases are rare, occurring in less than 1% of cases. Concurrent elevation of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) is also uncommon.Observations: A 61-year-old man presented with left hemiparesis and cognitive decline. Laboratory tests revealed elevated PSA, CEA, and CA19-9 levels. Imaging revealed a cystic frontal lobe mass, lung nodules, pelvic lymphadenopathy, and a prostatic lesion. MRI confirmed a 5-cm right frontal mass with heterogeneous enhancement and edema. A prostate biopsy revealed adenocarcinoma positive for CEA and CA19-9. Endoscopy revealed no gastrointestinal malignancies. Craniotomy and histopathological examination confirmed the diagnosis of adenocarcinoma. Immunohistochemical analysis revealed CEA positivity, partial CA19-9 positivity, strong NKX3.1 positivity, and PSA negativity. Postoperatively, the patient received androgen deprivation therapy with leuprorelin acetate and darolutamide, along with 5 cycles of docetaxel chemotherapy. At the 24-month follow-up, he remains neurologically stable without recurrence.Lessons: Brain metastases from prostate cancer with elevated CEA and CA19-9 are rare. Although these markers often indicate a poor prognosis, this patient achieved a favorable outcome with multimodal treatment. https://thejns.org/doi/10.3171/CASE25735.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"11 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730972","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

Anomalous hemorrhage in myxopapillar ependymoma: illustrative case. 黏液柱室管膜瘤异常出血：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2026-04-20 DOI: 10.3171/CASE25791

Inge J M H Caelers, Ferenc A van Nie, Anouk Y J M Smeets

引用次数: 0