Journal of neurosurgery. Case lessons最新文献_第8页

Jugular foramen dural arteriovenous fistula with bridging vein at the foramen magnum level successfully treated by surgery: illustrative case. 颈静脉硬膜孔动静脉瘘伴枕骨大孔水平桥静脉的手术治疗成功：一例说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-08-25 DOI: 10.3171/CASE25477

Mai Tanimura, Hiroyuki Ikeda, Yoshitaka Kurosaki, Makoto Wada, Minami Uezato, Masanori Kinosada, Masaki Chin

{"title":"Jugular foramen dural arteriovenous fistula with bridging vein at the foramen magnum level successfully treated by surgery: illustrative case.","authors":"Mai Tanimura, Hiroyuki Ikeda, Yoshitaka Kurosaki, Makoto Wada, Minami Uezato, Masanori Kinosada, Masaki Chin","doi":"10.3171/CASE25477","DOIUrl":"10.3171/CASE25477","url":null,"abstract":"Background: In dural arteriovenous fistulas, bridging veins are connecting vessels that drain venous blood from the surface of the brain to the surrounding dural sinus. It is rare for the fistulous point and the bridging vein to be at different levels.Observations: A 71-year-old man presented with progressive spinal symptoms of 8 months' duration. Angiography showed that the jugular branch of the ascending pharyngeal artery was the feeding artery, with the fistulous point at the jugular foramen and the bridging vein at the foramen magnum level, draining into the spinal vein. Direct surgery was performed via a transcondylar fossa approach, allowing visualization of both the fistulous point and the bridging vein, and successful venous outflow occlusion was achieved. The surgery was completed without complications, and the patient's spinal symptoms gradually improved over time.Lessons: For jugular foramen dural arteriovenous fistulas with a bridging vein at the foramen magnum level, a direct surgical approach via the transcondylar fossa, which allows visualization of both the fistulous point and the bridging vein, was useful for achieving a safe and definitive occlusion. https://thejns.org/doi/10.3171/CASE25477.","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/PMC12377173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983472","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

Multidisciplinary management of cervical disc herniation in pregnancy: illustrative case. 妊娠期颈椎间盘突出症的多学科治疗：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-08-25 DOI: 10.3171/CASE25458

Divine C Nwafor, David Asuzu, Abhishek S Bhutada, Thomas Pajewski, Kristin Atkins, Juan Pablo Sardi

{"title":"Multidisciplinary management of cervical disc herniation in pregnancy: illustrative case.","authors":"Divine C Nwafor, David Asuzu, Abhishek S Bhutada, Thomas Pajewski, Kristin Atkins, Juan Pablo Sardi","doi":"10.3171/CASE25458","DOIUrl":"10.3171/CASE25458","url":null,"abstract":"Background: Cervical disc herniation during pregnancy is a rare but clinically significant condition. While conservative management is generally preferred, progressive neurological symptoms may necessitate surgical intervention. When conservative management fails, a multidisciplinary approach is needed when considering surgical intervention to minimize risk to the mother and fetus.Observations: The authors present the case of a woman in her mid-30s at 24 weeks of gestation, conceived via in vitro fertilization, who developed progressively worsening left C7 radiculopathy refractory to conservative therapies. After comprehensive multidisciplinary evaluation, she underwent successful anterior cervical discectomy and fusion with placement of a stand-alone interbody cage. Perioperative planning incorporated anesthetic modifications, fetal monitoring strategies, and minimization of radiation exposure. The patient experienced immediate postoperative relief, rapid functional recovery, and an uncomplicated pregnancy course.Lessons: This case illustrates that elective spine surgery during pregnancy can be performed safely when medically indicated, particularly during the 2nd trimester. Meticulous multidisciplinary planning, surgical adaptations to minimize fetal risk, and individualized patient counseling are critical for optimizing maternal and fetal outcomes. This case emphasizes the importance of patient-centered care in managing spinal pathology during pregnancy. https://thejns.org/doi/10.3171/CASE25458.","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/PMC12377179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983733","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

MRI-guided focused ultrasound thalamotomy for neuropathic pain in an adolescent with cranial metastases: illustrative case. mri引导下聚焦超声丘脑切开术治疗青少年颅脑转移性神经性疼痛：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-08-25 DOI: 10.3171/CASE25221

Sarah G Van Winkle, Danika L Paulo, Ashwin Viswanathan, Daniel Curry, Nisha Gadgil

{"title":"MRI-guided focused ultrasound thalamotomy for neuropathic pain in an adolescent with cranial metastases: illustrative case.","authors":"Sarah G Van Winkle, Danika L Paulo, Ashwin Viswanathan, Daniel Curry, Nisha Gadgil","doi":"10.3171/CASE25221","DOIUrl":"10.3171/CASE25221","url":null,"abstract":"Background: Neuropathic cancer pain (NCP) is a debilitating condition that is often refractory to conventional medical management. MRI-guided focused ultrasound (MRgFUS) central lateral thalamotomy (CLT) is an incisionless neurosurgical option for neuropathic pain palliation, but its use in pediatric patients and those with cranial metastases, a relative contraindication to MRgFUS, remains largely unexamined.Observations: A 16-year-old male with metastatic rhabdomyosarcoma (RMS) with numerous cranial metastases experienced severe, diffuse, refractory NCP. The patient underwent bilateral CLT with MRgFUS. After the procedure, the patient experienced complete and durable resolution of his neuropathic pain. He only reported occasional somatic pain at sites of visible tumor growth. His pain remained well controlled until his death 1.5 months later due to disease progression.Lessons: MRgFUS CLT appears to be a feasible and efficacious option for adolescent cancer patients with atypical cranial anatomy due to metastatic disease. This case highlights the potential for durable pain control in refractory NCP and suggests MRgFUS as a valuable palliative tool, warranting further investigation in pediatric patients and unique anatomical scenarios. https://thejns.org/doi/10.3171/CASE25221.","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/PMC12377172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983653","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

Long-term follow-up after cervical en bloc resection as salvage surgery of spinal chondrosarcoma: illustrative case. 颈椎整体切除作为脊柱软骨肉瘤补救性手术后的长期随访：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-08-25 DOI: 10.3171/CASE25317

Stefanie Ott, Malte Schroeder, Karl-Heinz Frosch, Nils Hansen-Algenstaedt

{"title":"Long-term follow-up after cervical en bloc resection as salvage surgery of spinal chondrosarcoma: illustrative case.","authors":"Stefanie Ott, Malte Schroeder, Karl-Heinz Frosch, Nils Hansen-Algenstaedt","doi":"10.3171/CASE25317","DOIUrl":"10.3171/CASE25317","url":null,"abstract":"Background: Chondrosarcomas are rare malignancies arising from the bone, primarily from the mobile spine. Multimodal treatment is the standard of care, with surgery as a cornerstone for local control since incomplete resection is the main driving factor for progression and disease-related mortality.Observations: Here, the authors present the case of a patient who underwent an initial subtotal resection and adjuvant proton beam radiation therapy. Subsequent salvage surgery with aggressive resection was planned in an interdisciplinary setting, resulting in complete resection without recurrence. Despite incomplete resection initially, this case represents an example for reconsidering salvage surgery in an interdisciplinary setting and center of expertise even for cases with residual tumor burden.Lessons: By highlighting the current literature and setting this clinical case in this context, the authors present a case with a 10-year long-term follow-up, showing that surgical salvage therapy is a possible treatment path with predictable surgery-related morbidity in patients with spinal chondrosarcomas. https://thejns.org/doi/10.3171/CASE25317.","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/PMC12377175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983581","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

Delayed herniation of cauda equina root through occult dural tear following unilateral biportal endoscopic decompression: illustrative case. 单侧双门静脉内窥镜减压后隐匿硬脑膜撕裂导致马尾根迟发性突出：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-08-18 DOI: 10.3171/CASE25438

Keitaro Matsukawa, Kanehiro Fujiyoshi, Yoshiomi Kobayashi, Takahiro Kitagawa, Yoshiyuki Yato

{"title":"Delayed herniation of cauda equina root through occult dural tear following unilateral biportal endoscopic decompression: illustrative case.","authors":"Keitaro Matsukawa, Kanehiro Fujiyoshi, Yoshiomi Kobayashi, Takahiro Kitagawa, Yoshiyuki Yato","doi":"10.3171/CASE25438","DOIUrl":"10.3171/CASE25438","url":null,"abstract":"Background: Incidental dural tears are a well-known but potentially serious complication of spinal surgery. The authors present a unique case of delayed cauda equina herniation through an occult dural tear without any evident CSF leakage, emphasizing diagnostic challenges and preventive measures specific to unilateral biportal endoscopy (UBE).Observations: A 60-year-old man underwent UBE decompression for lumbar canal stenosis and experienced immediate symptom relief. However, 3 weeks postoperatively, he developed acute severe radicular pain, initially presumed to be caused by disc herniation. Despite repeated decompression, his symptoms progressively worsened. MRI findings remained nonspecific, without CSF leakage. Exploratory surgery ultimately revealed herniation of the cauda equina through an occult dural tear. Surgical repair led to rapid symptom relief and complete recovery without neurological deficits.Lessons: This case highlights the importance of considering dural pathology as a potential cause of intractable postoperative radicular pain, even when perioperative findings are inconclusive. Continuous irrigation can compress the dura, mask small dural tears, or tamponade minor leaks, delaying recognition. Surgeons should be aware that UBE's technical environment carries a risk of undetected dural injuries. Prompt recognition and repair of dural defects are essential to prevent rare but serious complications like cauda equina herniation. https://thejns.org/doi/10.3171/CASE25438.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144877650","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

Prenatal diagnosis and conservative management of a congenital cavernous sinus infantile hemangioma: illustrative case. 先天性海绵窦婴儿血管瘤的产前诊断和保守治疗：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-08-18 DOI: 10.3171/CASE25274

Xavier Roberge, Nalla Silva Baticam, Stéphanie Vairy, Mireille Dubé, Niina Kleiber, Thai Hoa Tran, Louis Crevier, Samuele Renzi

{"title":"Prenatal diagnosis and conservative management of a congenital cavernous sinus infantile hemangioma: illustrative case.","authors":"Xavier Roberge, Nalla Silva Baticam, Stéphanie Vairy, Mireille Dubé, Niina Kleiber, Thai Hoa Tran, Louis Crevier, Samuele Renzi","doi":"10.3171/CASE25274","DOIUrl":"10.3171/CASE25274","url":null,"abstract":"Background: Infantile hemangiomas (IHs) are the most common benign vascular tumors of infancy, although intracranial IHs remain exceedingly rare. Diagnosis is typically postnatal, with some cases requiring medical or surgical intervention. Here, the authors report the first case of a congenital cavernous sinus IH diagnosed via prenatal imaging and managed conservatively with successful spontaneous regression.Observations: A 28-year-old female underwent routine fetal ultrasound at 32 weeks' gestation, revealing a 1.8-cm perithalamic lesion. Fetal MRI at 33 weeks confirmed an extra-axial mass in the right middle fossa with a dural attachment. Postnatal MRI on day 1 of life demonstrated imaging features consistent with an IH. Given the neonate's asymptomatic status, conservative management was pursued. Serial MRI at 10 weeks and 6 months showed progressive lesion regression, with near-complete resolution. The infant remained asymptomatic with normal neurodevelopmental progress.Lessons: This case highlights the potential for spontaneous regression of congenital intracranial IHs diagnosed prenatally. Despite the risk of bleeding, conservative management with close clinical and radiological follow-up may be a viable option in select asymptomatic cases, particularly in the neonatal period when surgical risks are significant. https://thejns.org/doi/10.3171/CASE25274.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144877654","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

S3 sacral-alar iliac screws application in partial sacral resection for an aneurysmal bone cyst: illustrative case. S3骶翼髂螺钉在动脉瘤性骨囊肿部分骶骨切除术中的应用：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-08-18 DOI: 10.3171/CASE25267

Hudin N Jackson, Thomas Hamre, David F Bauer

{"title":"S3 sacral-alar iliac screws application in partial sacral resection for an aneurysmal bone cyst: illustrative case.","authors":"Hudin N Jackson, Thomas Hamre, David F Bauer","doi":"10.3171/CASE25267","DOIUrl":"10.3171/CASE25267","url":null,"abstract":"Background: Sacropelvic fixation is used in the management of deformity, neoplasms, and fractures. S2-alar-iliac (S2AI) screws have evolved as a technique for sacropelvic fixation to address disadvantages associated with traditional iliac screws. In select patients, S2AI screw placement is not feasible due to patient anatomy, trauma, or osteolytic lesions.Observations: A 15-year-old girl presented with a 3-month history of right S1-2 radicular pain and right dorsiflexion and plantar flexion weakness. Imaging revealed a right sacral alar aneurysmal bone cyst. The patient underwent right S1-3 hemilaminectomies and partial resection of the S2 and S3 vertebral bodies. Following adequate bony decompression, tumor debulking was performed. Bilateral L4-S1 pedicle screws and left S2AI screws were then placed using neuronavigation guidance. Due to right S1-2 sacral resection, S2AI screw placement was unfeasible. Right-S3 alar-iliac (S3AI) screw placement was performed, and good sacropelvic fixation was demonstrated. Herein, the authors describe the first clinical application of S3AI screw placement in a pediatric patient. After surgery, the patient experienced an improvement in symptoms before later tumor recurrence, which required adjuvant therapy. Long term follow-up revealed solid fusion with stable spinal alignment.Lessons: In select patients in whom S2AI screw placement is not an option, S3AI screw placement is a feasible, safe, alternative for sacropelvic fixation. https://thejns.org/doi/10.3171/CASE25267.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144877656","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

Dynamic imaging evaluation of the positional relationship between the elongated styloid process and the carotid artery stent using cone-beam CT: illustrative case. 锥形束CT对颈动脉支架与茎突之间位置关系的动态成像评价：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-08-18 DOI: 10.3171/CASE25260

Natsuki Akaike, Hiroyuki Ikeda, Arisa Sato, Toshio Fujiwara, Minami Uezato, Masanori Kinosada, Yoshitaka Kurosaki, Masaki Chin

{"title":"Dynamic imaging evaluation of the positional relationship between the elongated styloid process and the carotid artery stent using cone-beam CT: illustrative case.","authors":"Natsuki Akaike, Hiroyuki Ikeda, Arisa Sato, Toshio Fujiwara, Minami Uezato, Masanori Kinosada, Yoshitaka Kurosaki, Masaki Chin","doi":"10.3171/CASE25260","DOIUrl":"10.3171/CASE25260","url":null,"abstract":"Background: Eagle syndrome is a condition in which mechanical stimulation of an elongated styloid process causes internal carotid artery (ICA) dissection.Observations: The patient presented with partial right hemiparesis and dysarthria and was diagnosed with left ICA occlusion due to dissection with horizontal segmental patency of the middle cerebral artery, for which carotid artery stenting was performed. The tip of the styloid process was at the same level as the entry of the dissected segment, suggesting mechanical stimulation of the styloid process as the cause of dissection. Dynamic evaluation of the positional relationship between the tip of the styloid process and the carotid artery stent during head rotation was performed with cone-beam CT. The distance between the tip of the styloid process and the carotid artery stent was shortest in the neutral position and increased with head rotation. Repeated head rotation while swinging a golf club was thought to be the cause of the ICA dissection in this patient.Lessons: The greater the range of motion of the styloid process during head rotation, the greater the likelihood of mechanical stimulation of an elongated styloid process to the ICA. https://thejns.org/doi/10.3171/CASE25260.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144877651","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

Inferior vena cava division with venous-venous bypass during en bloc lumbar spondylectomy for malignant peripheral nerve sheath tumor: illustrative case. 恶性周围神经鞘肿瘤腰椎切除术中下腔静脉分流静脉-静脉旁路术：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-08-18 DOI: 10.3171/CASE25151

Yang Xia, Shreyas Thiruvengadam, Boyuan Khoo, Mark Lam, Joe Hockley, Shirley Jansen

{"title":"Inferior vena cava division with venous-venous bypass during en bloc lumbar spondylectomy for malignant peripheral nerve sheath tumor: illustrative case.","authors":"Yang Xia, Shreyas Thiruvengadam, Boyuan Khoo, Mark Lam, Joe Hockley, Shirley Jansen","doi":"10.3171/CASE25151","DOIUrl":"10.3171/CASE25151","url":null,"abstract":"Background: Malignant peripheral nerve sheath tumors are a rare, aggressive form of soft tissue sarcoma with a dismal prognosis. Little progression has been made in understanding their pathogenesis, natural history, clinical management, and outcomes over the last few decades. The cornerstone of treatment is cytoreduction in the form of surgery. However, when in the lumbar region, the inferior vena cava poses a limitation for executing anterior approaches. Although performed in other operations, elective caval division for access purposes has not been described as an approach to anterior column resection in spinal operations.Observations: The authors present the first documented case of planned division and mobilization of the vena cava supported by venous-venous bypass in order to achieve gross-total resection of a lower lumbar malignant peripheral nerve sheathe tumor as part of a two-stage procedure.Lessons: Inferior vena cava division and reanastomosis is a novel technique that can be used to widen surgical corridors in anterior approaches to the lumbar spine, and one that proves useful in en bloc resections. Venous-venous bypass can minimize impact on right heart filling during prolonged surgery. https://thejns.org/doi/10.3171/CASE25151.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144877652","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

Airtight compartmentalization of the anterior skull base reconstructed using a pedicled pericranial periosteal flap: illustrative case. 用带蒂颅周围骨膜瓣重建前颅底密闭区隔：说明性病例。

Journal of neurosurgery. Case lessons Pub Date : 2025-08-18 DOI: 10.3171/CASE25422

Shunya Kashiwagi, Motoaki Fujimoto, Shuya Otsuki, Hideki Ogata, Takahiko Kamata, Naohito Seki, Shoichi Tani

{"title":"Airtight compartmentalization of the anterior skull base reconstructed using a pedicled pericranial periosteal flap: illustrative case.","authors":"Shunya Kashiwagi, Motoaki Fujimoto, Shuya Otsuki, Hideki Ogata, Takahiko Kamata, Naohito Seki, Shoichi Tani","doi":"10.3171/CASE25422","DOIUrl":"10.3171/CASE25422","url":null,"abstract":"Background: Anterior skull base surgery to address tumor, trauma, or infection causing extensive bony destruction is associated with rhinorrhea and infection as potentially life-threatening complications. When performing anterior skull base reconstruction, watertight dural closure and airtight closure of the nasal cavity mucosa are essential for preventing these complications.Observations: The authors describe the case of a patient with a mixed olfactory neuroblastoma and adenocarcinoma who underwent resection. The procedure involved a multilayer reconstruction of the skull base, combining fascia lata from the thigh, a pedicled pericranial periosteal flap, and a pedicled nasoseptal flap. Specifically, the authors achieved airtight compartmentalization by carefully suturing the pedicled pericranial periosteal flap to the normal dura mater.Lessons: This suture technique for placing a pedicled pericranial periosteal flap from the frontal bone in the epidural space might support the goal of achieving a watertight and airtight closure. https://thejns.org/doi/10.3171/CASE25422.","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"10 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144877648","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