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

Identification of small distant glioblastoma lesions using 18F-fluciclovine positron emission tomography: illustrative case. 使用18f荧光正电子发射断层识别小的远处胶质母细胞瘤病变：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-09-01 DOI: 10.3171/CASE25398

Yohei Kagami, Mitsuto Hanihara, Ryu Saito, Hirofumi Kazama, Hideyuki Yoshioka

{"title":"Identification of small distant glioblastoma lesions using 18F-fluciclovine positron emission tomography: illustrative case.","authors":"Yohei Kagami, Mitsuto Hanihara, Ryu Saito, Hirofumi Kazama, Hideyuki Yoshioka","doi":"10.3171/CASE25398","DOIUrl":"10.3171/CASE25398","url":null,"abstract":"Background: Multicentric glioblastoma is a rare and aggressive brain tumor involving multiple, noncontiguous lesions. Its prognosis is generally poor due to the tumor's invasive nature and the challenges associated with achieving complete resection. Although contrast-enhanced MRI is currently the gold standard for diagnosis, it has limitations in visualizing the full extent of tumor infiltration. Recent studies have suggested that positron emission tomography (PET) using 18F-fluciclovine is superior to MRI in detecting tumor spread beyond the contrast-enhanced areas and potentially contributes to the diagnosis and management of glioblastoma.Observations: Here, the authors report the case of a patient with a small distant lesion detected by 18F-fluciclovine PET but not by contrast-enhanced MRI. A 62-year-old man presented with aphasia and apraxia. Initial gadolinium-enhanced MRI revealed a multilobular tumor in the left parietal lobe. At the same time, 18F-fluciclovine PET was performed and revealed an additional small lesion in the right cingulate gyrus, which was not visible on the initial MRI. Considering tumor multicentricity, the patient underwent stereotactic biopsy, which confirmed glioblastoma.Lessons: 18F-fluciclovine PET can be a valuable tool for detecting distant lesions, early diagnosis, and surgical and radiation planning in multicentric glioblastoma. https://thejns.org/doi/10.3171/CASE25398.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984220","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

Brain tumors linked to Chernobyl radiation exposure: a case study and historical perspective. Illustrative cases. 与切尔诺贝利辐射暴露有关的脑肿瘤：个案研究和历史观点。说明情况。

Journal of neurosurgery. Case lessons Pub Date : 2025-09-01 DOI: 10.3171/CASE25272

Brianna Suffren, Zoey Croft, Souvik Singha, Marcio Yuri Ferreira, Laura Mittelman, Iuliia Lakhina, Omer Eshkol, James Duehr, Aruuke Sulaimanova, Saeed Asiry, Jared Knopman, John A Boockvar

{"title":"Brain tumors linked to Chernobyl radiation exposure: a case study and historical perspective. Illustrative cases.","authors":"Brianna Suffren, Zoey Croft, Souvik Singha, Marcio Yuri Ferreira, Laura Mittelman, Iuliia Lakhina, Omer Eshkol, James Duehr, Aruuke Sulaimanova, Saeed Asiry, Jared Knopman, John A Boockvar","doi":"10.3171/CASE25272","DOIUrl":"10.3171/CASE25272","url":null,"abstract":"Background: Brain tumors associated with the 1986 Chernobyl nuclear explosion are rarely reported compared with thyroid malignancies. Studies have drawn a strong correlation between CNS tumor development and ionizing radiation, especially given age and level of exposure. However, extensive latency periods prompt misrepresentation and difficult diagnosis. Herein, the authors report 2 brain tumor cases in a family with proximity to Chernobyl and a simultaneous exposure period. They explore the potential linkage to brain tumor formation and excessive radiation released.Observations: Decades after exposure each patient developed distinct brain tumors, a WHO grade I meningioma and a SMARCB1-deficient sinonasal carcinoma. Following craniotomies for resection and adjuvant therapy, only 1 patient's tumor progressed. Literature revealed radiation exposure analogous for these tumor's etiologies and identified various Chernobyl exposure groups parallel to these patients like cleanup workers, evacuees, and residents of highly contaminated areas and their descendants.Lessons: Brain tumors linked to Chernobyl radiation exposure may represent a rare but clinically significant long-term complication, manifesting years afterward. Further research into these tumors' mechanisms is essential given the millions exposed. This report provides insights that identifies index cases, emphasizes needs for investigation, and raises caution to mitigate risk. https://thejns.org/doi/10.3171/CASE25272.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984199","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 landmine during cranioplasty: unusual rupture of a previously undiagnosed aneurysm. Illustrative case. 颅骨成形术中的地雷：先前未确诊的动脉瘤异常破裂。说明情况。

Journal of neurosurgery. Case lessons Pub Date : 2025-09-01 DOI: 10.3171/CASE25431

Aaron Miller, Julio Isidor, Liz Iglesias, Isaiah Miller, Aimee Weber, Ricardo Domingo, Alejandro Spiotta

{"title":"A landmine during cranioplasty: unusual rupture of a previously undiagnosed aneurysm. Illustrative case.","authors":"Aaron Miller, Julio Isidor, Liz Iglesias, Isaiah Miller, Aimee Weber, Ricardo Domingo, Alejandro Spiotta","doi":"10.3171/CASE25431","DOIUrl":"10.3171/CASE25431","url":null,"abstract":"Background: Spontaneous rupture of an undiagnosed aneurysm during a neurosurgical procedure not aimed at treating it is exceedingly rare, although multiple intraoperative factors can contribute to this situation.Observations: A patient in his 20s with a history of a 60-cm3 left intraparenchymal hematoma treated via decompressive craniectomy in November 2024 presented in March 2025 with a first-time seizure. Keppra was initiated, and the patient was admitted for cranioplasty. During the procedure, the previously sunken brain suddenly developed severe edema, herniating through the craniectomy defect. Intraoperative ultrasound was negative for hematoma but showed a thick subarachnoid hemorrhage (SAH) in the sylvian fissure. Postoperative CT revealed diffuse SAH and hydrocephalus; an external ventricular drain was urgently placed. Angiography identified and aided in coiling of an ophthalmic aneurysm.Lessons: Several factors can precipitate intraoperative aneurysm rupture. Osmotic agents like mannitol can cause rapid intravascular fluid shifts, increasing hemodynamic stress across the aneurysm dome. Atmospheric pressure changes due to intraoperative manipulation can also alter extravascular forces on the aneurysm. Based on this experience, especially in young patients with prior unexplained hemorrhage, the authors advise careful use of mannitol and surgical technique. Surgeons should consider these risks in patients with known or suspected aneurysms to prevent catastrophic rupture. https://thejns.org/doi/10.3171/CASE25431.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984217","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

Upfront use of temporal myofascial flap for repair of traumatic injury and prevention of CSF leaks: illustrative cases. 颞肌筋膜瓣在外伤性损伤修复及预防脑脊液渗漏中的应用：具有说明意义的病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-09-01 DOI: 10.3171/CASE25412

Aliana N Rao, Samuel L Ricci, Sami Pathak, Theodore Hannah, Robert Ziechmann, Philip Villanueva

{"title":"Upfront use of temporal myofascial flap for repair of traumatic injury and prevention of CSF leaks: illustrative cases.","authors":"Aliana N Rao, Samuel L Ricci, Sami Pathak, Theodore Hannah, Robert Ziechmann, Philip Villanueva","doi":"10.3171/CASE25412","DOIUrl":"10.3171/CASE25412","url":null,"abstract":"Background: Traumatic brain injury involving destruction of the mastoid bone leading to a large defect in the middle fossa floor or posterior fossa dura can necessitate delayed or multistep repairs or reconstruction of the middle fossa floor because of a CSF leak and rhinorrhea. Delayed repair may be associated with CNS infection. Reconstruction using a temporalis myofascial flap has been described in delayed reconstruction cases with CSF leak. The authors report a novel concept of upfront repair.Observations: Two patients with gunshot wound injuries involving the mastoid and middle fossa floor or posterior fossa dura underwent decompression and simultaneous early reconstruction with a temporalis myofascial flap sutured to the middle fossa dura. Both patients avoided prolonged CSF leak and had no complications from this approach.Lessons: Upfront repair of traumatic defects of the middle fossa floor or posterior fossa dura involving the mastoid air cells may avoid a prolonged CSF leak and its complications. https://thejns.org/doi/10.3171/CASE25412.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984232","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

First report of adult Taenia solium in human brain with neurocysticercosis: illustrative case. 首例成人脑带绦虫伴神经囊虫病报告：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-08-25 DOI: 10.3171/CASE25370

Giorgi Sekania, Giorgi Svanishvili, Irakli Chelishvili, Velodi Gakharia

{"title":"First report of adult Taenia solium in human brain with neurocysticercosis: illustrative case.","authors":"Giorgi Sekania, Giorgi Svanishvili, Irakli Chelishvili, Velodi Gakharia","doi":"10.3171/CASE25370","DOIUrl":"10.3171/CASE25370","url":null,"abstract":"Background: This report presents the first documented case of a live, adult Taenia solium tapeworm discovered within the human brain-a finding that challenges the conventional understanding of neurocysticercosis (NCC), a parasitic disease typically caused by larval cysts.Observations: A 54-year-old woman with a history of breast cancer presented with seizures, headaches, and photophobia. Initial suspicion of a metastatic brain tumor led to serial MRI studies, which revealed a migrating lesion in the right temporal lobe. During craniotomy, a motile helminth was surgically excised from the brain parenchyma. Histopathological analysis confirmed that the organism was an adult T. solium tapeworm, with taeniid eggs identified within the specimen, marking the first evidence of intracranial adult taeniasis and ectopic cerebral oviposition. The patient's prior oncological treatments, including mastectomy and postoperative therapies, raise hypotheses about immune or anatomical changes facilitating parasitic neuroinvasion.Lessons: The discovery underscores critical gaps in diagnostics, as the lesion mimicked metastatic cancer radiologically, and therapeutics, as standard cysticidal drugs target larval stages, not adult worms. This report highlights the urgent need to investigate interactions between parasitic infections and oncological interventions. It calls for updated clinical guidelines to address this novel pathogenic mechanism and emphasizes the importance of integrating parasitological expertise into neurological care. https://thejns.org/doi/10.3171/CASE25370.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984286","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

Atypical intramedullary spinal cord melanocytic neoplasm with hemorrhagic features in a child: illustrative case. 非典型脊髓髓内黑素细胞肿瘤伴出血性特征：一例说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-08-25 DOI: 10.3171/CASE25279

Emad M Babateen, Abdullah Alatar, Fahad B AlBadr, Amro Amer, Ahmad Almotairi, Amro Al-Habib

{"title":"Atypical intramedullary spinal cord melanocytic neoplasm with hemorrhagic features in a child: illustrative case.","authors":"Emad M Babateen, Abdullah Alatar, Fahad B AlBadr, Amro Amer, Ahmad Almotairi, Amro Al-Habib","doi":"10.3171/CASE25279","DOIUrl":"10.3171/CASE25279","url":null,"abstract":"Background: Intramedullary spinal cord melanocytic neoplasm (IMSCMN) with hemorrhagic features is rare, and it is even rarer in children. The authors present a pediatric case of an IMSCMN involving the thoracic segment of the spinal cord.Observations: An 11-year-old previously healthy girl experienced intermittent low back pain for 5 months, followed by left foot drop, limb weakness, and abnormal gait. MRI revealed an intramedullary hemorrhagic spinal cord lesion at T9-11, with a long syrinx and cord edema. An MRI study of the brain and the remaining spinal cord was unremarkable. The patient underwent laminectomy and near-total resection of the tumor. Histopathological analysis confirmed the diagnosis of an atypical melanocytic neoplasm. Dermatological; ear, nose, and throat; and ophthalmological assessments, as well as a positron emission tomography study, were conducted to identify other neoplasms, which yielded unremarkable findings.Lessons: This case highlights the diagnostic challenges of IMSCMN in children because of its rarity and nonspecific imaging features. IMSCMN should be considered in pediatric hemorrhagic spinal cord lesions with MRI findings of T1 hyperintensity, T2 hypointensity, and an associated syrinx. https://thejns.org/doi/10.3171/CASE25279.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984302","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

Increased systemic venous pressure leading to intracranial hypertension in a patient with a ventriculoatrial shunt: illustrative case. 脑室-心房分流术患者全身静脉压升高导致颅内高压：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-08-25 DOI: 10.3171/CASE25226

Nicolas H Norager, Casper S Riedel, Tina N Munch, Jesper Kelsen, Marianne Juhler

{"title":"Increased systemic venous pressure leading to intracranial hypertension in a patient with a ventriculoatrial shunt: illustrative case.","authors":"Nicolas H Norager, Casper S Riedel, Tina N Munch, Jesper Kelsen, Marianne Juhler","doi":"10.3171/CASE25226","DOIUrl":"10.3171/CASE25226","url":null,"abstract":"Background: Ventriculoatrial (VA) shunt placement is an alternative treatment for hydrocephalus when ventriculoperitoneal shunt placement is not feasible. While shunt obstruction and infection are well-known complications, elevated systemic venous pressure is likely an underrecognized cause of dysfunction. Elevated right atrial pressure can reduce the pressure gradient for CSF drainage, leading to intracranial hypertension despite a mechanically functional shunt.Observations: A 19-year-old female with a VA shunt developed refractory intracranial hypertension despite multiple valve adjustments and a mechanically functional shunt. Venography with pressure measurement revealed elevated systemic venous pressure, with jugular venous pressures elevated to 12-13 mm Hg. Shunt revision confirmed high outflow resistance at the atrial end (20 cm H2O = approximately 15 mm Hg), suggesting impaired CSF drainage due to elevated right atrial pressure. Nitroglycerin reduced intracranial pressure but was discontinued due to headache exacerbation. Subsequently, acetazolamide provided symptomatic relief.Lessons: Elevated systemic venous pressure can impair VA shunt function and cause intracranial hypertension. Preoperative central venous pressure measurement may help identify patients at risk. Nitroglycerin may serve as a diagnostic tool for VA shunt dysfunction related to elevated venous pressure. Awareness of increased systemic venous pressure as a factor in VA shunt dysfunction is warranted. https://thejns.org/doi/10.3171/CASE25226.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984295","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

Intradural extramedullary solitary plasmacytoma originating in the cervical spine in the setting of refractory multiple myeloma: illustrative case. 硬膜内髓外孤立性浆细胞瘤起源于难治性多发性骨髓瘤背景下的颈椎：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-08-25 DOI: 10.3171/CASE24731

Elaina J Wang, Giovanni Kozel, Carlin C Chuck, Michael Punsoni, Patricia Z Sullivan

{"title":"Intradural extramedullary solitary plasmacytoma originating in the cervical spine in the setting of refractory multiple myeloma: illustrative case.","authors":"Elaina J Wang, Giovanni Kozel, Carlin C Chuck, Michael Punsoni, Patricia Z Sullivan","doi":"10.3171/CASE24731","DOIUrl":"10.3171/CASE24731","url":null,"abstract":"Background: Multiple myeloma (MM) and plasmacytoma metastases to the spine are extremely rare, with 9 cases reported in the literature. Only 2 describe cases of solitary plasmacytoma (SP) specifically in the cervical spine, both in patients without known histories of MM. Therefore, the natural history of MM recurrence as SP in the cervical spine remains unknown.Observations: The authors describe the case of a 67-year-old woman with a history of MM after stem cell transplant and chemotherapy in remission for a year who presented with progressive cervical myelopathy found to have an intradural extramedullary solitary lesion at C2-3 on MRI of the whole spine. The patient underwent C1-3 laminectomies for decompression and intradural biopsy of the lesion, with pathology consistent with plasmacytoma. The patient's motor examination improved significantly postoperatively.Lessons: SP should be included in the differential diagnosis for intradural extramedullary lesions found in the spine, particularly in patients with a history of MM and tumor resistance to radiotherapy. Despite plasmacytoma's classically radiosensitive nature, it is possible to have residual tumor after radiation therapy. In these cases, patients may benefit greatly from surgical biopsy and decompression followed by adjuvant radiotherapy. https://thejns.org/doi/10.3171/CASE24731.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984225","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

Distal and proximal embolization for penetrating vertebral artery injury: illustrative case. 远端和近端栓塞治疗穿透性椎动脉损伤：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-08-25 DOI: 10.3171/CASE25435

Natsuki Akaike, Hiroyuki Ikeda, Haruki Yamashita, Minami Uezato, Masanori Kinosada, Yoshitaka Kurosaki, Masaki Chin

{"title":"Distal and proximal embolization for penetrating vertebral artery injury: illustrative case.","authors":"Natsuki Akaike, Hiroyuki Ikeda, Haruki Yamashita, Minami Uezato, Masanori Kinosada, Yoshitaka Kurosaki, Masaki Chin","doi":"10.3171/CASE25435","DOIUrl":"10.3171/CASE25435","url":null,"abstract":"Background: When treating a penetrating vertebral artery (VA) injury, blindly removing a foreign object that has pierced the artery can lead to distal embolism due to thrombus formation at the penetration site and uncontrollable hemorrhage during foreign object removal.Observations: A 68-year-old man was impaled in the posterior neck by a 7-cm metal rod during brush cutting. Neither neurological deficits nor active bleeding was observed. CT revealed that the metal rod had penetrated between the left C1 and C2 transverse foramina, and CT angiography showed occlusion at the V2 segment of the left VA. Retrograde distal embolization via a contralateral approach was performed, followed by proximal embolization to achieve complete occlusion before rod removal. No arterial bleeding occurred during rod removal. Postoperative MRI revealed a small infarct in the left cerebellum, but no neurological deficits were present.Lessons: In cases of penetrating VA injury with a retained foreign object, vascular evaluation and embolization should be considered before foreign object removal. Retrograde distal embolization via a contralateral approach, combined with proximal embolization, may be an effective strategy for preventing distal embolism and controlling hemorrhage. https://thejns.org/doi/10.3171/CASE25435.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984246","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

Improved intraoperative tidal volume during deformity correction in a 16-year-old with spina bifida, severe kyphoscoliosis, and thoracic insufficiency syndrome: illustrative case. 16岁脊柱裂、严重脊柱后凸和胸功能不全综合征患者术中潮汐量的改善：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-08-25 DOI: 10.3171/CASE25379

Christopher H Sollenberger, Alex Vaz, Brendan F Judy, Ali K Ozturk, Timothy Gooldy, Gregory Heuer, Patrick J Cahill, Adam J Kundishora

{"title":"Improved intraoperative tidal volume during deformity correction in a 16-year-old with spina bifida, severe kyphoscoliosis, and thoracic insufficiency syndrome: illustrative case.","authors":"Christopher H Sollenberger, Alex Vaz, Brendan F Judy, Ali K Ozturk, Timothy Gooldy, Gregory Heuer, Patrick J Cahill, Adam J Kundishora","doi":"10.3171/CASE25379","DOIUrl":"10.3171/CASE25379","url":null,"abstract":"Background: Severe kyphoscoliosis in spina bifida patients can result in thoracic insufficiency syndrome, which significantly compromises pulmonary function. While traditional clinical measures for spina bifida focus primarily on bladder function and motor strength, this case highlights pulmonary function as an essential additional indicator.Observations: The authors report on the case of a 16-year-old male with spina bifida and severe thoracic kyphoscoliosis presenting with progressive respiratory difficulty limiting ambulation. Imaging revealed a thoracic curve of approximately 107° and markedly reduced thoracic spine height (13.4 cm). During definitive posterior spinal fusion and deformity correction surgery, intraoperative tidal volumes were continuously monitored. As spinal correction progressed, tidal volumes increased substantially, achieving approximately 20% improvement. Postoperatively, radiographic assessment showed correction of the thoracic scoliosis to approximately 40°, with thoracic height improving to 23.4 cm. Clinically, the patient reported subjective improvement in breathing and demonstrated increased ambulation endurance.Lessons: This case illustrates real-time intraoperative tidal volume monitoring as a potential physiological marker correlating directly with deformity correction efficacy and thoracic volume restoration. These findings suggest that pulmonary function may serve as an intraoperative adjunct to guide the surgical management of severe spinal deformities alongside conventional functional indicators. Further studies may establish a standardized formula that reliably predicts pulmonary function following deformity correction. https://thejns.org/doi/10.3171/CASE25379.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984291","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