Journal of neurosurgery. Case lessons最新文献

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Supratentorial remote site hemorrhage following elective craniotomy: illustrative case. 选择性开颅术后幕上远端出血:说明性病例。
Journal of neurosurgery. Case lessons Pub Date : 2025-04-21 DOI: 10.3171/CASE2514
Turki H Alzidani, Abdulaziz A Basurrah, Marwa A Aljehani, Saleh S Baeesa
{"title":"Supratentorial remote site hemorrhage following elective craniotomy: illustrative case.","authors":"Turki H Alzidani, Abdulaziz A Basurrah, Marwa A Aljehani, Saleh S Baeesa","doi":"10.3171/CASE2514","DOIUrl":"https://doi.org/10.3171/CASE2514","url":null,"abstract":"<p><strong>Background: </strong>Remote supratentorial hemorrhage (RSH) is a rare condition following elective craniotomy, leading to severe morbidity. This report aims to analyze the incidence and possible pathophysiology of RSH in patients undergoing elective craniotomy and to present the case of RSH following left frontal lobectomy for recurrent oligodendroglioma.</p><p><strong>Observations: </strong>The authors present the case of a 56-year-old male who presented with a recurrence 20 years after resection of a left frontal oligodendroglioma (WHO grade 2). He presented with new-onset expressive dysphasia and right-sided weakness. MRI revealed a recurrent mass in the left frontal lobe. The patient was scheduled for a left frontal lobectomy. Surprisingly, 2 hours after the operation, the patient became neurologically worse and developed general tonic-clonic seizures. Subsequent head CT showed bilateral temporal hemorrhages. No surgical intervention was undertaken, and the patient was discharged from the hospital 2 weeks later in stable condition with near-complete neurological recovery.</p><p><strong>Lessons: </strong>RSH is a rare critical postoperative complication that requires careful monitoring. Early detection and intervention can improve outcomes, emphasizing the need for further research on its etiologies, risk factors, and management strategies. https://thejns.org/doi/10.3171/CASE2514.</p>","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"9 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056077","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
Intramedullary spinal aspergillosis in an immunocompetent host with no extraspinal infection: illustrative case. 无脊髓外感染的免疫正常宿主的髓内脊髓曲菌病:说明性病例。
Journal of neurosurgery. Case lessons Pub Date : 2025-04-21 DOI: 10.3171/CASE24463
Siddhartha Srivastava, Juan P Giraldo, S Harrison Farber, Ahmad Aldeiri, Nima Alan, James J Zhou, Luke K O'Neill, Juan S Uribe
{"title":"Intramedullary spinal aspergillosis in an immunocompetent host with no extraspinal infection: illustrative case.","authors":"Siddhartha Srivastava, Juan P Giraldo, S Harrison Farber, Ahmad Aldeiri, Nima Alan, James J Zhou, Luke K O'Neill, Juan S Uribe","doi":"10.3171/CASE24463","DOIUrl":"https://doi.org/10.3171/CASE24463","url":null,"abstract":"<p><strong>Background: </strong>The only known case report of spinal intramedullary aspergillosis in a patient who had no known immunocompromised status and no extraspinal infection is presented. A subsequent literature review was conducted to compare this case with existing cases in the literature.</p><p><strong>Observations: </strong>After 3 months of a worsening clinical course, the neurosurgery team was consulted to conduct a biopsy of the patient's intramedullary spinal lesion, revealing an invasive aspergillosis infection of the CNS. The patient had experienced significant morbidity and clinical symptoms, including a sensory level at T10, urinary retention, worsening of the sensory level to T6, and lower extremity weakness (2-3/5 strength on the Medical Research Council scale). Infection did not progress after appropriate antifungal treatment and diagnosis. The patient was still alive at a 4-month follow-up visit with the neurology team.</p><p><strong>Lessons: </strong>Invasive aspergillosis is a rare diagnosis that typically arises in immunocompromised patients. This case suggests that this infectious diagnosis should be included in the differential diagnosis even if a patient is immunocompetent and there is no sign of extraspinal infection. https://thejns.org/doi/10.3171/CASE24463.</p>","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"9 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035279","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
Sclerotherapy for the treatment of bilateral mandibular intraosseous arteriovenous malformations: illustrative case. 硬化疗法治疗双侧下颌骨内动静脉畸形:说明性病例。
Journal of neurosurgery. Case lessons Pub Date : 2025-04-21 DOI: 10.3171/CASE24868
Gabriel A Ramos, Nisha Dabhi, M Todd Brandt, Min S Park
{"title":"Sclerotherapy for the treatment of bilateral mandibular intraosseous arteriovenous malformations: illustrative case.","authors":"Gabriel A Ramos, Nisha Dabhi, M Todd Brandt, Min S Park","doi":"10.3171/CASE24868","DOIUrl":"https://doi.org/10.3171/CASE24868","url":null,"abstract":"<p><strong>Background: </strong>Primary intraosseous arteriovenous malformations (AVMs) are rare, especially as intraosseous lesions in the mandible. Resection, with or without embolization, has historically been the treatment of choice. There are few reports in the literature regarding the treatment of these lesions with primary sclerotherapy.</p><p><strong>Observations: </strong>A 13-year-old female presented with significant bleeding from a progressively enlarging alveolar and gingival mass with loosening dentition following a biopsy of a left mandibular lesion. CT angiography of the head diagnosed bilateral Schöbinger stage II intramandibular AVMs. She underwent sclerotherapy using ethanol and coils for both lesions in separate sessions as the primary treatment of the lesions. Posttreatment, the patient showed no complications or recurrence, and her dentition settled into normal occlusion without mobility.</p><p><strong>Lessons: </strong>Primary sclerotherapy using ethanol and coils can be an effective treatment option for low-stage, simple intraosseous AVMs. Further studies are needed to determine the optimal interventional treatment for intraosseous AVMs and to compare the efficacy of different sclerosants. https://thejns.org/doi/10.3171/CASE24868.</p>","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"9 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055957","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
Epidural hematoma associated with a closed capsule in the tumor cavity: illustrative case. 硬膜外血肿伴肿瘤腔内封闭囊:说明性病例。
Journal of neurosurgery. Case lessons Pub Date : 2025-04-21 DOI: 10.3171/CASE24899
Jian Liu, Huan Li, Yanjin Wang
{"title":"Epidural hematoma associated with a closed capsule in the tumor cavity: illustrative case.","authors":"Jian Liu, Huan Li, Yanjin Wang","doi":"10.3171/CASE24899","DOIUrl":"https://doi.org/10.3171/CASE24899","url":null,"abstract":"<p><strong>Background: </strong>The formation of a tumor bed cyst (TBC) is an infrequent complication that can occur following surgery for brain glioma. In this case report, the authors present the first documented occurrence of TBC associated with a postoperative epidural hematoma in a patient who underwent glioma surgery.</p><p><strong>Observations: </strong>A 48-year-old right-handed male with right frontal lobe glioma underwent surgery, and an epidural hematoma was detected on CT 2 hours postcraniotomy. Subsequently, the patient exhibited progressive deterioration of consciousness. Reassessment via CT revealed no significant increase in the epidural hematoma size; however, there was evidence of a TBC within the cavity and aggravated peripheral edema. An urgent evacuation procedure was performed to remove the epidural hematoma, accompanied by an external dura opening to address the TBC. This resulted in a jet overflow of cyst fluid and a rapid reduction in tumor cavity size. After the patient regained consciousness from anesthesia, he exhibited normal motor function and maintained a lucid state of mind.</p><p><strong>Lessons: </strong>The presence of epidural hematoma can contribute to the formation of a TBC. During reoperation for epidural hematoma removal, the compressive effect of the TBC went unnoticed, leading to its nontreatment. https://thejns.org/doi/10.3171/CASE24899.</p>","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"9 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056081","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 vertebral artery transection injury: illustrative case. 外伤性椎动脉横断损伤:说明性病例。
Journal of neurosurgery. Case lessons Pub Date : 2025-04-21 DOI: 10.3171/CASE24557
Chien-Tung Yang, Wei-Liang Chen, Ying-Lin Tseng, Cheng-Di Chiu, Chun-Chung Chen, Der-Yang Cho, Chun-Chieh Liang, Jeng-Hung Guo
{"title":"Traumatic vertebral artery transection injury: illustrative case.","authors":"Chien-Tung Yang, Wei-Liang Chen, Ying-Lin Tseng, Cheng-Di Chiu, Chun-Chung Chen, Der-Yang Cho, Chun-Chieh Liang, Jeng-Hung Guo","doi":"10.3171/CASE24557","DOIUrl":"https://doi.org/10.3171/CASE24557","url":null,"abstract":"<p><strong>Background: </strong>Vertebral artery injury (VAI) is a rare but serious condition, with an incidence of 0.24%-2% following blunt trauma and 1%-6% after penetrating injuries. Often asymptomatic, VAI carries significant risks, including ischemic strokes and severe neurological deficits, with symptoms appearing up to 6 months postinjury.</p><p><strong>Observations: </strong>A 64-year-old man experienced a critical neck injury from rebar penetration, resulting in hemorrhagic shock. Imaging revealed a left C3-4 fracture, vertebral artery (VA) transection, pseudoaneurysm, and arteriovenous fistula. Coil embolization was attempted but failed, necessitating stent placement and balloon dilation to restore VA patency. Postprocedure MRI revealed an epidural hematoma without spinal cord involvement. Surgical decompression and fixation were performed the next day, followed by dual antiplatelet therapy. The patient was discharged on day 13 without neurological deficits, and in-stent stenosis was successfully treated with balloon dilation 1 year later.</p><p><strong>Lessons: </strong>This case highlights the successful treatment of a Denver scale grade V transected VAI using stent placement, emphasizing the importance of VA reconstruction as the primary treatment goal. https://thejns.org/doi/10.3171/CASE24557.</p>","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"9 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039263","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
Solitary intradural extramedullary recurrence of testicular diffuse large B-cell lymphoma mimicking a schwannoma: illustrative case. 模拟神经鞘瘤的睾丸弥漫性大b细胞淋巴瘤的单发硬膜内髓外复发:说明性病例。
Journal of neurosurgery. Case lessons Pub Date : 2025-04-21 DOI: 10.3171/CASE24830
Marli Knox, Lewis Starasoler, Yehuda Herschman
{"title":"Solitary intradural extramedullary recurrence of testicular diffuse large B-cell lymphoma mimicking a schwannoma: illustrative case.","authors":"Marli Knox, Lewis Starasoler, Yehuda Herschman","doi":"10.3171/CASE24830","DOIUrl":"https://doi.org/10.3171/CASE24830","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this case report is to highlight the presentation, radiographic challenges, and clinical decision-making prior to operative intervention in an 84-year-old man with a delayed recurrence of diffuse large B-cell lymphoma (DLBCL) in a rare location of the intradural extramedullary space of the cervical spine.</p><p><strong>Observations: </strong>The authors report the case of a cervical intradural extramedullary neoplasm in an 84-year-old male who presented with ataxic gait and right-sided weakness. The patient has a history of testicular DLBCL. Initial MRI revealed a mass at C6-7 mimicking the appearance of either a schwannoma or a meningioma. He underwent resective surgery of the neoplasm, which proved to be a recurrence of DLBCL by histopathology and immunohistochemistry.</p><p><strong>Lessons: </strong>Diagnosing rare malignancies like lymphoma in the spine requires considering the patient's history, as imaging alone might not allow distinguishing between different tumor types. For patients with a history of lymphoma, malignant recurrence in the spine should be considered in the differential diagnosis of solitary spinal masses, even when imaging suggests more common lesions. https://thejns.org/doi/10.3171/CASE24830.</p>","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"9 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048563","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
Asymptomatic extensive right cerebral hemispheric lesion in an adult with histopathological findings consistent with mild malformation of cortical development with oligodendroglial hyperplasia and epilepsy: illustrative case. 成人无症状的广泛右脑半球病变,组织病理学表现符合轻度皮质发育畸形伴少突胶质细胞增生和癫痫:说明性病例。
Journal of neurosurgery. Case lessons Pub Date : 2025-04-14 DOI: 10.3171/CASE24827
Ryohei Ono, Shunichiro Miki, Takao Koiso, Narushi Sugii, Noriaki Sakamoto, Yosuke Masuda, Masahide Matsuda, Makoto Shibuya, Hajime Miyata, Eiichi Ishikawa
{"title":"Asymptomatic extensive right cerebral hemispheric lesion in an adult with histopathological findings consistent with mild malformation of cortical development with oligodendroglial hyperplasia and epilepsy: illustrative case.","authors":"Ryohei Ono, Shunichiro Miki, Takao Koiso, Narushi Sugii, Noriaki Sakamoto, Yosuke Masuda, Masahide Matsuda, Makoto Shibuya, Hajime Miyata, Eiichi Ishikawa","doi":"10.3171/CASE24827","DOIUrl":"https://doi.org/10.3171/CASE24827","url":null,"abstract":"<p><strong>Background: </strong>A mild malformation of cortical development (MCD) with oligodendroglial hyperplasia and epilepsy (MOGHE) is characterized by increased Olig2-positive atypical cells in the white matter and is associated with drug-resistant intractable epilepsy, typically the frontal and temporal lobes. MOGHE is a newly classified subtype of focal cortical dysplasia associated with epilepsy, according to the latest International League Against Epilepsy guidelines. There have been no reports of MOGHE without epilepsy and associated with extensive lesions.</p><p><strong>Observations: </strong>A 31-year-old man was incidentally diagnosed with an extensive right cerebral hemispheric lesion on MRI. Pathological examination of the biopsy sample showed no evidence of an invasive tumor but revealed an increase in Olig2-positive cells, consistent with MOGHE. Sanger sequencing showed no IDH1/2, histone H3 TERTpromoter, or SLC35A2 mutations. Electroencephalography showed no evidence of epilepsy.</p><p><strong>Lessons: </strong>This case suggests the existence of a condition with similar histological findings to MOGHE but without epilepsy. The authors propose naming this condition \"mild malformation of cortical development with oligodendroglial hyperplasia and no epilepsy.\" https://thejns.org/doi/10.3171/CASE24827.</p>","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"9 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12001064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055953","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
Intracerebellar extension of occipital scalp dermoid after initial resection: illustrative case. 初次切除后枕头皮皮样的小脑内延伸:说明性病例。
Journal of neurosurgery. Case lessons Pub Date : 2025-04-14 DOI: 10.3171/CASE2548
Rishishankar E Suresh, Thomas Eckert, Kyle P Stegmann, Timothy Webb, Brian F Saway, Ramin Eskandari
{"title":"Intracerebellar extension of occipital scalp dermoid after initial resection: illustrative case.","authors":"Rishishankar E Suresh, Thomas Eckert, Kyle P Stegmann, Timothy Webb, Brian F Saway, Ramin Eskandari","doi":"10.3171/CASE2548","DOIUrl":"https://doi.org/10.3171/CASE2548","url":null,"abstract":"<p><strong>Background: </strong>Dermoid cysts are benign ectodermal growths that commonly form at cranial sutures. Although benign, resection is often recommended to prevent intracranial extension as the cyst grows. The prognosis after resection is very good, provided a complete resection is possible.</p><p><strong>Observations: </strong>The authors present the case of a 10-month-old male patient with an occipital scalp dermoid cyst with intracranial extension who underwent subtotal resection and later presented with cerebellar extension.</p><p><strong>Lessons: </strong>Scalp dermoid cysts with intradiploic extension have a significant risk of intracranial extension. Thus, care must be taken to achieve total resection in the first attempt or provide close follow-up before intracranial extension develops. https://thejns.org/doi/10.3171/CASE2548.</p>","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"9 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12001065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059821","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 basal ganglia hemorrhage: illustrative cases. 外伤性基底神经节出血:说明性病例。
Journal of neurosurgery. Case lessons Pub Date : 2025-04-14 DOI: 10.3171/CASE24625
Ermias Fikru Yesuf, Atiklet Zerihun Zewdie, Mestet Yibeltal Shiferaw, Michael Asegid Shimekit, Yidersal Demsie Denberu, Zemed Geleta Eshete, Alemu Adise Mldie, Mengistu Ayele Yigzaw, Bereket Hailu Mekuria, Henok Teshome Molla
{"title":"Traumatic basal ganglia hemorrhage: illustrative cases.","authors":"Ermias Fikru Yesuf, Atiklet Zerihun Zewdie, Mestet Yibeltal Shiferaw, Michael Asegid Shimekit, Yidersal Demsie Denberu, Zemed Geleta Eshete, Alemu Adise Mldie, Mengistu Ayele Yigzaw, Bereket Hailu Mekuria, Henok Teshome Molla","doi":"10.3171/CASE24625","DOIUrl":"https://doi.org/10.3171/CASE24625","url":null,"abstract":"<p><strong>Background: </strong>Traumatic basal ganglia hemorrhage (TBGH) is rare. The most common mechanism of injury is road traffic accidents. In this case series, the authors discuss the clinical course of 5 patients with TBGH with different outcomes.</p><p><strong>Observations: </strong>The internal capsule is the most commonly involved site, which was noted in 3 of the 5 cases reported here. The size of the TBGHs ranged from 1.02 cm to 2.61 cm. All patients had at least 1 additional site of bleeding. One patient had zygomatic, maxillary, and mandibular fractures, while another patient had a mandibular fracture. Two of the 5 patients died. These 2 patients had Glasgow Coma Scale (GCS) scores of 3 and 4, and their pupils were not reactive to light after resuscitation and loading with mannitol.</p><p><strong>Lessons: </strong>CT findings in TBGHs differ from those in spontaneous hemorrhages in that gray-white matter junction contusions and ventral or dorsolateral brainstem contusions are more commonly observed in the former. Compared with other fractures, mandibular fractures are more commonly associated with TBGH. Conservative treatment is a valid approach for managing patients with TBGH. The overall prognosis of patients with TBGH is poor, and the highest mortality rates are seen in patients with low GCS scores and absent pupillary light reactions. https://thejns.org/doi/10.3171/CASE24625.</p>","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"9 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12001058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062350","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
Diagnosis and management of esophageal perforation with necrotizing fasciitis in traumatic cervical spine injuries: illustrative case. 外伤性颈椎损伤后食管穿孔伴坏死性筋膜炎的诊断和治疗:典型病例。
Journal of neurosurgery. Case lessons Pub Date : 2025-04-14 DOI: 10.3171/CASE24720
Arman Kavoussi, Ashley Ricciardelli, Alex Flores, Alexander Brenner, Nelson Eddie Liou, Alexander E Ropper, Cyrus King
{"title":"Diagnosis and management of esophageal perforation with necrotizing fasciitis in traumatic cervical spine injuries: illustrative case.","authors":"Arman Kavoussi, Ashley Ricciardelli, Alex Flores, Alexander Brenner, Nelson Eddie Liou, Alexander E Ropper, Cyrus King","doi":"10.3171/CASE24720","DOIUrl":"https://doi.org/10.3171/CASE24720","url":null,"abstract":"<p><strong>Background: </strong>Esophageal perforation is a rare but deadly complication of cervical spine fractures. Early identification can be difficult but is imperative for proper treatment and prevention of life-threatening infection. Once diagnosed, surgical drainage and broad-spectrum antibiotics can yield positive outcomes. The authors present a successfully managed case of cervical spine fracture with associated esophageal perforation and necrotizing fasciitis as well as an extensive literature review.</p><p><strong>Observations: </strong>An 87-year-old male with a previous cervical laminectomy presented to the emergency department with shortness of breath after a ground-level fall. Initial CT imaging of the cervical spine was noted to have no abnormalities at the time, and the patient was sent home. Eight days later, he presented again with neck pain, spasm, overt hyperextension injury, and fracture of the C7 vertebra, which was seen on CT. Initial surgical fixation was aborted due to the discovery of necrotizing fasciitis resulting from esophageal perforation. After surgical repair, debridement, and antibiotics, the fracture was stabilized via C2-T3 posterior segmental instrumented fusion. Following a complex hospital course, the patient was ultimately discharged following inpatient rehabilitation at his neurological baseline.</p><p><strong>Lessons: </strong>Esophageal perforation and necrotizing fasciitis from cervical spine injuries can be deadly if not diagnosed and managed early. A high level of suspicion should be maintained with disruption of the anterior column of the cervical spine. A combination of surgical and medical management can yield successful treatment. https://thejns.org/doi/10.3171/CASE24720.</p>","PeriodicalId":94098,"journal":{"name":"Journal of neurosurgery. Case lessons","volume":"9 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12001055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060700","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
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