Journal of neurosurgery. Case lessons最新文献_第7页

Language mapping during awake brain surgery in a deaf patient with a brain tumor: illustrative case. 一例伴有脑肿瘤的失聪患者的清醒脑外科手术中的语言映射：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-05-05 DOI: 10.3171/CASE2597

Ene Chibawanye I, Elizabeth Silva, Kyle Noll, Mariana Bradshaw, Katherine Connelly, Ho-Ling Liu, Ravi Tummala, David Ferson, Frederick F Lang, Vinodh A Kumar

{"title":"Language mapping during awake brain surgery in a deaf patient with a brain tumor: illustrative case.","authors":"Ene Chibawanye I, Elizabeth Silva, Kyle Noll, Mariana Bradshaw, Katherine Connelly, Ho-Ling Liu, Ravi Tummala, David Ferson, Frederick F Lang, Vinodh A Kumar","doi":"10.3171/CASE2597","DOIUrl":"https://doi.org/10.3171/CASE2597","url":null,"abstract":"Background: Signed language integrates complex sensorimotor processes involving visual and motor networks. The contribution of language regions such as Broca's and Wernicke's areas during signing is not well established. Here, the authors report the case of a 45-year-old right-handed male with congenital deafness, who communicates using American Sign Language (ASL) and Signed English, presenting with focal seizures. Imaging showed a diffuse infiltrative glioma in the right cerebral hemisphere.Observations: Remarkably, preoperative functional MRI language activations were bihemispheric and overlapped for both traditional language paradigms and sign paradigms, suggesting that the same cortical regions of the brain are used for language processing in this patient. This case is unique because it is the first reported awake craniotomy performed in a deaf patient with a right hemispheric glioma. The authors also found that direct cortical stimulation of the right premotor cortex (Exner's area) resulted in interruption of signing, which has not been previously reported in the literature in a deaf patient.Lessons: Prior to surgery for brain lesions in deaf patients, careful preoperative assessment and intraoperative testing (including the presence of an experienced ASL sign interpreter) is required to understand the distribution of language processing within the brain and to minimize postoperative morbidity. https://thejns.org/doi/10.3171/CASE2597.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"9 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028427","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

Surgical management of spinal intradural hematomas: illustrative cases. 脊柱硬膜内血肿的外科治疗：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-04-28 DOI: 10.3171/CASE25108

Rishishankar E Suresh, Thomas Eckert, Rahim Abo Kasem, Coulter Small, Brian Saway, Zachary Hubbard, Arunprasad Gunasekaran, Nathan Rowland, Abhay Varma, Kamil W Nowicki, Cory C Rosenstein, Roberta Sefcik

{"title":"Surgical management of spinal intradural hematomas: illustrative cases.","authors":"Rishishankar E Suresh, Thomas Eckert, Rahim Abo Kasem, Coulter Small, Brian Saway, Zachary Hubbard, Arunprasad Gunasekaran, Nathan Rowland, Abhay Varma, Kamil W Nowicki, Cory C Rosenstein, Roberta Sefcik","doi":"10.3171/CASE25108","DOIUrl":"https://doi.org/10.3171/CASE25108","url":null,"abstract":"Background: Spinal intradural hematoma (SIH) is a rare condition with potential for permanent neurological deficit. SIH can be managed conservatively with serial imaging or surgically with lumbar drainage or open evacuation. We present 3 SIH cases managed with multiple surgical techniques, including a novel lumbar drainage-and-advancement technique, and review the literature.Observations: Patient 1 was a 35-year-old peripartum female with cauda equina syndrome after epidural analgesia. MRI revealed SIH at L4-5, necessitating urgent L3-S1 laminectomy and hematoma evacuation. Patient 2 was a 47-year-old male with bilateral lower extremity radiculopathy following posterior decompression and fusion for an L5 compression fracture. MRI revealed SIH extending from T3-L5. Focal decompression and lumbar drain placement with cranial advancement were performed for complete evacuation. Patient 3 was a 75-year-old male with urinary retention after restarting anticoagulation 4 days postlaminectomy for resection of a large synovial cyst at L4-5. MRI demonstrated a subdural collection suggestive of hygroma. A focal laminectomy with intrathecal decompression and a lumbar drain were used to completely evacuate the lesion.Lessons: SIH management should be individualized. Focal decompression is effective for localized hematomas, while extensive, multilevel SIH may benefit from a lumbar drain with controlled cranial advancement, irrigation, and decompression. https://thejns.org/doi/10.3171/CASE25108.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"9 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061431","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

Emergency neurosurgical separation of pygopagus conjoined twins in a triplet pregnancy: illustrative case. 紧急神经外科分离三胞胎妊娠中的pygopagus连体双胞胎：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-04-28 DOI: 10.3171/CASE24818

Endris Hussen Ali, Yared Nigusie Abebe, Milena Gebreegziabher Haile, Abera Bayable

{"title":"Emergency neurosurgical separation of pygopagus conjoined twins in a triplet pregnancy: illustrative case.","authors":"Endris Hussen Ali, Yared Nigusie Abebe, Milena Gebreegziabher Haile, Abera Bayable","doi":"10.3171/CASE24818","DOIUrl":"https://doi.org/10.3171/CASE24818","url":null,"abstract":"Background: Conjoined twins are a rare type of congenital malformation. The point of attachment is the primary factor used to classify conjoined twins; typically, this is front to front, with thoracopagus and omphalopagus twins accounting for about 75% of cases and pygopagus twins only between 6% and 19%.Observations: This is a case report of 46-day-old female triplets born to a 37-year-old para 4 mother. Triplets A and B were conjoined at the lumbosacrococcygeal area dorsally. Triplet C was not conjoined. The conjoined triplets had a low birth weight; hence, it was decided to start nutritional management and achieve adequate weight gain before surgical separation. While on nutritional management, at 46 days of age, triplet B developed cardiorespiratory failure. Therefore, the multidisciplinary team decided to proceed with emergency neurosurgical separation surgery, with the primary aim of saving triplet A. Triplet B died 7 hours after the surgery due to irreversible cardiorespiratory failure, and triplet A remained in the hospital for 14 days and was discharged with intact neurological function.Lessons: Most cases of conjoined twins do not require emergency separation surgery and need nutritional support before the separation procedure. Separation surgery requires a multidisciplinary team meeting, planning ahead of time, and preparation. https://thejns.org/doi/10.3171/CASE24818.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"9 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055601","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

S1 pedicle subtraction osteotomy combined with prone lateral lumbar interbody fusion for the correction of major lumbopelvic malalignment: illustrative case. S1椎弓根减截骨联合俯卧侧位腰椎椎体间融合术矫正腰椎骨盆严重错位：说导性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-04-28 DOI: 10.3171/CASE24653

Ashish Patel, Michael R McDermott, Michael Rogers, Alfred-John Bayaton, Rebecca Michna, Steven Mather

{"title":"S1 pedicle subtraction osteotomy combined with prone lateral lumbar interbody fusion for the correction of major lumbopelvic malalignment: illustrative case.","authors":"Ashish Patel, Michael R McDermott, Michael Rogers, Alfred-John Bayaton, Rebecca Michna, Steven Mather","doi":"10.3171/CASE24653","DOIUrl":"https://doi.org/10.3171/CASE24653","url":null,"abstract":"Background: Combining lateral lumbar interbody fusion (LLIF) with open posterior surgery creates a hybrid surgical approach that can restore spinopelvic alignment by simultaneously addressing the anterior and posterior columns. The following is a case report detailing a hybrid prone LLIF with open S1 pedicle subtraction osteotomy (PSO) for correction of a major sagittal imbalance with a pelvic incidence (PI) > 100°.Observations: A 48-year-old female with previous L3-S1 transforaminal interbody fusion presented with severe low back pain and standing imbalance. Imaging revealed significant sagittal malalignment and a PI of 103.1°. The patient underwent revision surgery, including an L2-3 prone LLIF and an S1 PSO. There were no significant complications in the perioperative period, and her first postoperative radiographs showed a reduction in PI (103.1° to 72.1°), lumbar lordosis (LL) (87.4° to 64.2°), PI-LL mismatch (14.5° to 7.9°), and sagittal vertical axis (15.1 cm to 4.9 cm). At 1 year, she reported only minor deficits, ambulating without a cane. She has gone on to successful fusion without adjacent segment pathology.Lessons: The prone LLIF and PSO combination offers a hybrid surgical approach utilizing the anterior and posterior columns to optimize construct and alignment goals for major sagittal deformity correction. https://thejns.org/doi/10.3171/CASE24653.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"9 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062952","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

Functional hemispherectomy for seizure control in encephalocraniocutaneous lipomatosis: illustrative case. 功能半球切除术用于控制脑皮脂肪瘤病的癫痫发作：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-04-28 DOI: 10.3171/CASE2578

Joyce Koueik, David Hsu, Jeffrey Helgager, Raheel Ahmed

{"title":"Functional hemispherectomy for seizure control in encephalocraniocutaneous lipomatosis: illustrative case.","authors":"Joyce Koueik, David Hsu, Jeffrey Helgager, Raheel Ahmed","doi":"10.3171/CASE2578","DOIUrl":"https://doi.org/10.3171/CASE2578","url":null,"abstract":"Background: Encephalocraniocutaneous lipomatosis (ECCL) is a rare neurocutaneous syndrome composed of a spectrum of congenital cutaneous, ocular, and brain anomalies. Principal anomalies include nevus psiloliparus lesions of the scalp, ocular choristomas consisting of dermolipomas, and intracranial lipomas and arachnoid cysts. The hypothesized pathogenic basis in ECCL is a developmental mesenchymal defect involving neural crest cell derivatives. Management is typically focused on treating symptoms, directed at the organ system and supportive neurorehabilitation. Reports to date have only focused on pharmacotherapeutic treatment of drug-refractory epilepsy (DRE), a principal neurological phenotype. Surgical management of medication-refractory epilepsy, which can occur in up to 70% of ECCL subjects, has not been described to date.Observations: The authors present an illustrative case report of a 4-year-old girl with ECCL who developed DRE and underwent a functional hemispherectomy for seizure relief. The clinical course, diagnostic evaluation, and surgical treatment are described, with emphasis on surgical-pathological observations.Lessons: To the authors' knowledge, surgical treatment for hemispheric onset DRE in the context of ECCL has not been reported. Systemic and clinical features on presentation are reviewed to highlight aberrant mesenchymal differentiation as the developmental basis for the syndrome. The authors also underscore the role of functional hemispherectomy in the treatment of DRE in the context of a genetic/developmental syndrome. https://thejns.org/doi/10.3171/CASE2578.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"9 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004084","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

Book craniotomy: modified craniotomy for midline extradural hematoma. Patient series. 书本开颅术：改良开颅术治疗中线硬膜外血肿。病人系列。

Journal of neurosurgery. Case lessons Pub Date : 2025-04-28 DOI: 10.3171/CASE2518

Satya Bhusan Senapati, Abhijit Acharya, Sumirini Puppala, Ashok K Mahapatra

{"title":"Book craniotomy: modified craniotomy for midline extradural hematoma. Patient series.","authors":"Satya Bhusan Senapati, Abhijit Acharya, Sumirini Puppala, Ashok K Mahapatra","doi":"10.3171/CASE2518","DOIUrl":"https://doi.org/10.3171/CASE2518","url":null,"abstract":"Background: An extradural hematoma (EDH) is an acute blood collection between the dura and calvarium in the skull and the spine. The most common cause is traumatic and the most common location is the temporal convexity. A midline or vertex EDH from a venous bleed, most commonly from the midline sinuses, is rare.Observations: The authors present a case series of 9 cases of vertex EDH managed in their department.The common cause was road traffic accidents. Vertex EDH was the most common type. Book craniotomy was considered in all cases. A definite sinus injury was seen in 5 cases. No patients died. Book craniotomy is an innovative method to manage midline EDH when there is a risk of sinus injury.Lessons: A midline EDH is not common and needs special attention. Surgical treatment can lead to profuse blood loss due to an underlying sinus injury and patient morbidity. Book craniotomy is an innovative method to safeguard the sinuses in cases of midline EDH and achieve hemostasis. https://thejns.org/doi/10.3171/CASE2518.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"9 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056463","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

Traumatic basilar artery incarceration following longitudinal clival fracture: illustrative case. 纵向斜坡骨折后外伤性基底动脉嵌顿：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-04-28 DOI: 10.3171/CASE24870

Rose V Zach, Kinsley C Wang, Vladimir Katyshev, Victor Zach

{"title":"Traumatic basilar artery incarceration following longitudinal clival fracture: illustrative case.","authors":"Rose V Zach, Kinsley C Wang, Vladimir Katyshev, Victor Zach","doi":"10.3171/CASE24870","DOIUrl":"https://doi.org/10.3171/CASE24870","url":null,"abstract":"Background: Clival fractures are rare injuries that occur following high-energy blunt trauma. Longitudinal clival fractures can lead to incarceration of the basilar artery within the bone fragments, often leading to stenosis or occlusion of the basilar artery, subsequently causing vascular compromise, significant ischemic events, and neurological deficits. The authors present a case of basilar artery incarceration following craniofacial trauma and review the relevant literature.Observations: The reported case is of a 37-year-old male who presented following a 20-foot fall. CT angiography revealed a longitudinal fracture of the posterior wall of the right sphenoid sinus with basilar artery incarceration. CT of the head revealed pontine infarct with extension to the midbrain, indicating concern for severe shear injury and incarcerated basilar artery. The patient was transitioned to comfort care after discussion with his family.Lessons: A literature search yielded 23 patients with basilar artery incarceration following traumatic head injury, including the presented case. The most common traumatic etiologies included falls, motor vehicle crashes, and impact from a falling beam. A longitudinal clival fracture occurred in 22 patients. Angiography confirmed all cases, most commonly showing basilar artery occlusion. Outcomes were generally poor. This review further identifies the etiologies, clinical course, and radiographic features of basilar artery incarceration following craniofacial trauma. Although rare, clinicians should be aware of this devastating potential complication. https://thejns.org/doi/10.3171/CASE24870.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"9 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059153","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

Improbable discovery of an incidental high-grade AVM: illustrative case. 偶然发现的不可能的高级别AVM：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-04-28 DOI: 10.3171/CASE24850

Max S Fleisher, Hayes H Patrick, Edinson Najera, Walter C Jean

{"title":"Improbable discovery of an incidental high-grade AVM: illustrative case.","authors":"Max S Fleisher, Hayes H Patrick, Edinson Najera, Walter C Jean","doi":"10.3171/CASE24850","DOIUrl":"https://doi.org/10.3171/CASE24850","url":null,"abstract":"Background: The authors discuss the first reported case of a large, high-grade arteriovenous malformation (AVM) in the dominant hemisphere, discovered incidentally after a penetrating nail gun injury.Observations: The patient underwent surgical removal of a nail lodged in the right frontal lobe. A contralateral AVM was diagnosed on his perioperative imaging and was evaluated further with diagnostic cerebral angiography. Because of the location of the AVM within the dominant fronto-opercular region, the patient underwent a super-selective Wada test to evaluate for the risk of expressive language deficit prior to undergoing a successful resection of the AVM. He had an excellent recovery from both surgeries without any neurological deficits.Lessons: This case illustrates the importance of continued suspicion for incidental findings when reviewing imaging, despite the presence of a known and obvious pathology. The observations add nuance to the standard considerations for surgical intervention for penetrating nail gun injuries, and the workup for incidentally found vascular lesions is reviewed. https://thejns.org/doi/10.3171/CASE24850.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"9 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016062","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

Converting "nonlesional" imaging occult epilepsy into a focal lesional entity using advanced imaging techniques: illustrative case. 利用先进的成像技术将“非病变”的隐匿性癫痫成像转化为局灶性病变实体：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-04-28 DOI: 10.3171/CASE24667

Muhammad Usman Khalid, Flavius D Raslau, Valentinos Zachariou, David Powell, Zachary Winder, Ryan Cloyd, Sarah H Thomas, John Kuipers, Rachel Ward Mitchell, Riham El Khouli, Timothy Ainger, Sally Mathias, Farhan A Mirza

{"title":"Converting \"nonlesional\" imaging occult epilepsy into a focal lesional entity using advanced imaging techniques: illustrative case.","authors":"Muhammad Usman Khalid, Flavius D Raslau, Valentinos Zachariou, David Powell, Zachary Winder, Ryan Cloyd, Sarah H Thomas, John Kuipers, Rachel Ward Mitchell, Riham El Khouli, Timothy Ainger, Sally Mathias, Farhan A Mirza","doi":"10.3171/CASE24667","DOIUrl":"https://doi.org/10.3171/CASE24667","url":null,"abstract":"Background: To achieve the best possible outcome in surgical refractory epilepsy, the seizure onset zone must be accurately identified prior to treatment.Observations: A 38-year-old man presented with tonic-clonic and focal seizures 2-3 times per month, refractory to antiseizure medications. Scalp EEG, MRI, PET, ictal SPECT, magnetoencephalography, and stereo-EEG (SEEG) did not provide conclusive seizure onset zone localization. Subsequently, the patient was included in the authors' ongoing postictal arterial spin labeling (ASL) study and additional postprocessing was performed with a morphometric analysis program (MAP) and texture analysis. Using these results, the authors reexamined the original structural MR images, with attention paid to the patient's semiology. A subtle focal cortical dysplasia at the junction of the anterior bank of the right precentral gyrus and the precentral sulcus was identified, confirmed with repeat SEEG, and safely resected without functional deficits. The patient is now seizure free at 2 years.Lessons: Advanced imaging techniques, including ASL, MAP, and texture analysis, can manifest seemingly occult epileptogenic foci. Thorough MRI re-review with updated information and new postprocessing tools may be a necessary step in challenging cases. https://thejns.org/doi/10.3171/CASE24667.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"9 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048571","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

Stereo-electroencephalography in the setting of a preexisting deep brain stimulation device: illustrative case. 在预先存在的深部脑刺激装置设置立体脑电图：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-04-28 DOI: 10.3171/CASE24854

Stephen Jaffee, Navnika Gupta, Dallas Kramer, Dorian M Kusyk, James Valeriano, Amanda Merkley, Trent Kite, Shaifali Arora, Pulkit Grover, Alexander C Whiting

{"title":"Stereo-electroencephalography in the setting of a preexisting deep brain stimulation device: illustrative case.","authors":"Stephen Jaffee, Navnika Gupta, Dallas Kramer, Dorian M Kusyk, James Valeriano, Amanda Merkley, Trent Kite, Shaifali Arora, Pulkit Grover, Alexander C Whiting","doi":"10.3171/CASE24854","DOIUrl":"https://doi.org/10.3171/CASE24854","url":null,"abstract":"Background: Deep brain stimulation (DBS) and responsive neurostimulation are increasingly being used to treat drug-resistant epilepsy (DRE). However, patients who experience partial or limited improvement in seizure control could require additional surgical interventions or refinement of their epilepsy network characterization, including further stereo-electroencephalography (SEEG) investigations. SEEG in the setting of previously implanted hardware demonstrates a myriad of technical challenges. The authors present the first reported demonstration of SEEG electrode implantation with a preexisting DBS device.Observations: The patient was a 36-year-old male with a history of severe DRE with focal impaired awareness seizures beginning at 7 years of age. Despite having a bilateral DBS device for the anterior nucleus of the thalamus, he continued to have 1-2 seizures per day and was offered SEEG. The patient tolerated the surgery well without any morbidity, with a successfully improved definition of his epilepsy network. SEEG allowed the medical team to titrate stimulation settings while following intracranial electrographic response.Lessons: SEEG in the setting of preexisting DBS can be performed safely without damage to functioning hardware, and the authors obtained characterization and localization of the epilepsy network. Further follow-up will be needed to assess the efficacy outcomes of additional intervention in this patient. https://thejns.org/doi/10.3171/CASE24854.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"9 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058466","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