Journal of neurosurgery. Case lessons最新文献_第6页

Traumatic durotomy and entrapment of neural elements in a lumbar burst and laminar fracture diagnosed on preoperative imaging: illustrative case. 术前造影诊断为腰椎爆裂性骨折和板层骨折的外伤性穹隆切开术和神经元嵌顿：示例病例。

Journal of neurosurgery. Case lessons Pub Date : 2024-10-21 DOI: 10.3171/CASE24455

Ian J Jarin, Yigal Samocha, John K Houten, Merritt D Kinon

{"title":"Traumatic durotomy and entrapment of neural elements in a lumbar burst and laminar fracture diagnosed on preoperative imaging: illustrative case.","authors":"Ian J Jarin, Yigal Samocha, John K Houten, Merritt D Kinon","doi":"10.3171/CASE24455","DOIUrl":"10.3171/CASE24455","url":null,"abstract":"Background: Traumatic dural lacerations can be caused by thoracolumbar burst fractures and, infrequently, can be associated with the entrapment of neural elements within a laminar fracture. The diagnosis of both is difficult to make on preoperative imaging, as the conditions are typically appreciated during surgical exploration. The authors present a case of traumatic durotomy with entrapment of neural elements in a laminar fracture that they believed could be appreciated on preoperative magnetic resonance imaging (MRI).Observations: A young male involved in a motor vehicle collision presented to the authors' trauma center with a lumbar burst and laminar fracture. Preoperative MRI demonstrated epidural hemorrhage and entrapment of neural elements within the laminar fracture, which was confirmed intraoperatively. The patient underwent a successful decompression, release of nerve roots, fusion, and recovery.Lessons: Traumatic durotomy and entrapment of neural elements can occur after a traumatic spinal fracture, and a diagnosis made upon preoperative MRI can allow for effective preoperative planning. Clinicians should have a high index of suspicion for these pathologies when encountering certain fracture patterns and could therefore tailor the surgical approach to avoid further neurological injury during surgery. https://thejns.org/doi/10.3171/CASE24455.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"8 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11505926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484322","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

Sphenoclival fibrous dysplasia with cyst formation causing abducens nerve palsy in an older patient: illustrative case. 一名老年患者的眼眶纤维发育不良伴囊肿形成导致外展神经麻痹：示例病例。

Journal of neurosurgery. Case lessons Pub Date : 2024-10-14 DOI: 10.3171/CASE24424

Masayuki Nakamura, Hirotaka Hasegawa, Yoichi Yasunaga, Yudai Nakai, Motoyuki Umekawa, Nobuhito Saito

引用次数: 0

Primary jugular foramen fibrous dysplasia: surgically nuanced video of extradural infratemporal transjugular approach. Illustrative case. 原发性颈静脉孔纤维发育不良：硬膜外颞下经颈静脉入路手术视频。示例病例。

Journal of neurosurgery. Case lessons Pub Date : 2024-10-14 DOI: 10.3171/CASE24396

Carlos Eduardo da Silva, Ana Clara Thibes, Tamara Vidaletti

{"title":"Primary jugular foramen fibrous dysplasia: surgically nuanced video of extradural infratemporal transjugular approach. Illustrative case.","authors":"Carlos Eduardo da Silva, Ana Clara Thibes, Tamara Vidaletti","doi":"10.3171/CASE24396","DOIUrl":"https://doi.org/10.3171/CASE24396","url":null,"abstract":"Background: Fibrous dysplasia of the bone is a disease caused by a somatic GNAS mutation that affects craniofacial bones and can have a mass effect on different neurovascular structures. The authors present the first case of primary jugular foramen fibrous dysplasia with occlusion of the transverse and sigmoid sinuses.Objective: A 33-year-old man presented with a history of dizziness and occasional dysphagia over the past year. Magnetic resonance imaging showed a uniform enhanced mass in the left jugular foramen, with complete blockage of the adjacent transverse and sigmoid sinuses. The computed tomography scan revealed a cystic bone lesion of the jugular foramen. The patient underwent a gross-total removal of the tumor through an infratemporal transjugular approach with complete preservation of the lower cranial nerves.Lessons: This first reported case of primary jugular foramen fibrous dysplasia highlights the importance of considering this diagnosis when evaluating jugular fossa lesions. Understanding the anatomy of the infratemporal and jugular fossae, along with proficiency in microsurgical techniques, is essential for removing such tumors while preserving cranial nerve functions and the patient's quality of life. https://thejns.org/doi/10.3171/CASE24396.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"8 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11488373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484390","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

Transcarotid flow reversal for proximal control during cerebral aneurysm clip reconstruction: illustrative case. 经颈动脉血流逆转用于脑动脉瘤夹重建过程中的近端控制：示例病例。

Journal of neurosurgery. Case lessons Pub Date : 2024-10-14 DOI: 10.3171/CASE24330

Nicole M Wenger, Matthew Hentschel, Ting I Wang, Kevin T Kim, Nicholas Caffes, Jacob Cherian

{"title":"Transcarotid flow reversal for proximal control during cerebral aneurysm clip reconstruction: illustrative case.","authors":"Nicole M Wenger, Matthew Hentschel, Ting I Wang, Kevin T Kim, Nicholas Caffes, Jacob Cherian","doi":"10.3171/CASE24330","DOIUrl":"https://doi.org/10.3171/CASE24330","url":null,"abstract":"Background: Paraclinoid aneurysms can pose an operative challenge during clip reconstruction, given the complex surrounding anatomy and the aneurysmal tendency to maintain turgor despite standard approaches to proximal control. This report demonstrates the use of intraoperative retrograde arteriovenous shunting with the transcarotid artery revascularization (TCAR) system to assist in the safe clip reconstruction of an irregular paraclinoid aneurysm.Observations: A 33-year-old woman presented with perimesencephalic subarachnoid hemorrhage and was found to have an incidental 9-mm ophthalmic aneurysm. Coil embolization was not successful. During microsurgical clip reconstruction, the left common carotid artery was exposed to allow for proximal control as well as transcarotid arterial sheath placement. Flow reversal was instituted throughout the aneurysm dissection and clipping, with a visible softening of the aneurysm. Intraoperative angiography confirming successful clip reconstruction was performed utilizing the TCAR sheath. The case was complicated by the development of cerebrospinal fluid rhinorrhea postoperatively, requiring surgical repair. The patient has since made a complete recovery.Lessons: Transcarotid flow reversal utilizing the TCAR system has potential for use in the surgical treatment of paraclinoid aneurysms, as it may aid in softening the aneurysm for safer dissection and clip reconstruction, protect against aneurysm-associated emboli, and provide an avenue for intraoperative angiography. https://thejns.org/doi/10.3171/CASE24330.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"8 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11488372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484319","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

Spinal subdural empyema in an immunocompetent patient: illustrative case. 免疫功能正常患者的脊髓硬膜下积液：典型病例。

Journal of neurosurgery. Case lessons Pub Date : 2024-10-14 DOI: 10.3171/CASE24464

Shreyas Thiruvengadam, Boyuan Khoo, Snigdha Saha

引用次数: 0

Minimally invasive management of a spinal arachnoid cyst with ultrasound-assisted catheter placement: illustrative case. 用超声辅助导管置入法微创治疗脊髓蛛网膜囊肿：示例病例。

Journal of neurosurgery. Case lessons Pub Date : 2024-10-14 DOI: 10.3171/CASE24461

Andrew L DeGroot, Randall W Treffy, Mohamad Bakhaidar, Peter Palmer, Mahmudur Rahman, Saman Shabani

{"title":"Minimally invasive management of a spinal arachnoid cyst with ultrasound-assisted catheter placement: illustrative case.","authors":"Andrew L DeGroot, Randall W Treffy, Mohamad Bakhaidar, Peter Palmer, Mahmudur Rahman, Saman Shabani","doi":"10.3171/CASE24461","DOIUrl":"https://doi.org/10.3171/CASE24461","url":null,"abstract":"Background: Spinal arachnoid cysts are cerebrospinal fluid-filled sacs that are frequently located within the thoracic spine and can lead to symptoms due to direct compression of the thoracic spinal cord. These lesions are typically treated with laminectomy and fenestration of the cyst, with or without shunting. However, with recurrence, treatment is often more complex and sometimes requires re-exposure and fenestration or shunting.Observations: Here, the authors describe a 57-year-old female with a thoracic intradural arachnoid cyst that recurred despite extensive and initially successful fenestration. Given the failure of fenestration, the authors instead attempted to place a cystoperitoneal shunt. Given how extensive her laminectomy was, the authors elected to perform the procedure under ultrasonic guidance to avoid the large incision required for open shunt placement. The procedure was successful, with gradual improvement in the size of the arachnoid cyst as well as symptomatic improvement.Lessons: Here, the authors present a unique minimally invasive technique to treat recurrent spinal arachnoid cysts. They successfully demonstrated the feasibility and safety of this approach in shunting the cyst while avoiding the extensive re-exposure often required in such complex cases. https://thejns.org/doi/10.3171/CASE24461.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"8 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11488369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484388","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 Response. 致编辑的信的回复。

Journal of neurosurgery. Case lessons Pub Date : 2024-10-14 DOI: 10.3171/CASE24356

Erik F Hauck, Joel C Morgenlander

引用次数: 0

Letter to the Editor. Seizure activity may cause early venous drainage in the absence of an arteriovenous fistula or malformation. 致编辑的信。在没有动静脉瘘或畸形的情况下，癫痫发作活动可能会导致早期静脉引流。

Journal of neurosurgery. Case lessons Pub Date : 2024-10-14 DOI: 10.3171/CASE24303

Josef Finsterer

引用次数: 0

Intrathecal baclofen obviating the need for bladder stimulator use in a patient with secondary dystonia: illustrative case. 继发性肌张力障碍患者无需使用膀胱刺激器的鞘内巴氯芬：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2024-10-14 DOI: 10.3171/CASE24364

Ryan K Wang, Victoria Jane Horak, Sunny Abdelmageed, Melissa A LoPresti, Maryam N Shahin, Benjamin Katholi, Jeffrey S Raskin

引用次数: 0

Endoscope-assisted treatment for delayed cystic radiation necrosis after stereotactic radiosurgery for metastatic brain tumors: illustrative cases. 内窥镜辅助治疗转移性脑肿瘤立体定向放射外科手术后延迟性囊肿放射坏死：病例说明。

Journal of neurosurgery. Case lessons Pub Date : 2024-10-14 DOI: 10.3171/CASE24250

Kenji Shoda, Takayuki Nishiwaki, Tetsuya Yamada, Noriyuki Nakayama, Naoyuki Ohe

{"title":"Endoscope-assisted treatment for delayed cystic radiation necrosis after stereotactic radiosurgery for metastatic brain tumors: illustrative cases.","authors":"Kenji Shoda, Takayuki Nishiwaki, Tetsuya Yamada, Noriyuki Nakayama, Naoyuki Ohe","doi":"10.3171/CASE24250","DOIUrl":"https://doi.org/10.3171/CASE24250","url":null,"abstract":"Background: Cystic formation due to radiation necrosis in metastatic brain tumors is a rare condition. Surgical intervention is necessary if symptoms develop. Additionally, excising radiation necrosis lesions within the cyst is essential to prevent recurrence. Neuroendoscopic surgery is a minimally invasive method suitable for treating cystic diseases and accessing deep lesions in the brain. The authors herein present a method for removing radiation necrotic tissue from deep lesions of cystic radiation necrosis using neuroendoscopy.Observations: Endoscopic surgery was performed in two patients with symptomatic cystic radiation necrosis. Both cases involved multilocular cysts, with radiation necrosis located deep within the cyst. The authors performed a small craniotomy of approximately 3 cm and opened the cyst. After removing its contents, an endoscope was used to closely observe the interior of the cyst. Removal of the septum within the cyst allowed the endoscope to be inserted deeply. The authors identified and excised the nodular lesion diagnosed as radiation necrosis in the deep tissue. Following the surgery, the cyst shrank rapidly, and symptoms disappeared. Both patients showed no recurrence of the lesions.Lessons: The authors performed minimally invasive surgery and achieved good outcomes. Endoscopic surgery was considered beneficial for treating cystic radiation necrosis. https://thejns.org/doi/10.3171/CASE24250.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"8 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11488374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484384","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