Surgical neurology international最新文献

{"title":"Increased levels of tumor necrosis factor-alpha in rat with traumatic brain injury after NeuroAid (MLC 901) administration.","authors":"Rohadi, Bambang Priyanto, Andi Asadul Islam, Mochammad Hatta, Agussalim Bukhari, Rozikin, I Wayan Gede Artawan Eka Putra, Lalu Muhammad Abdurrosid, Krisna Tsaniadi Prihastomo","doi":"10.25259/SNI_301_2025","DOIUrl":"10.25259/SNI_301_2025","url":null,"abstract":"<p><strong>Background: </strong>Tumor necrosis factor-alpha (TNF-α) is an inflammatory cytokine produced by macrophages in acute inflammatory processes and plays roles in cell signaling that cause necrosis and apoptosis. This study aimed to show whether there was an effect of Neuroaid (MLC 901) on TNF-α levels in rats with traumatic brain injury (TBI) measured using the Enzyme-linked immunosorbent assay in the peripheral blood.</p><p><strong>Methods: </strong>A total of 10 Sprague-Dawley rats were divided into two groups, one group was given MLC 901 (<i>n</i> = 5), and the other group was not given MLC 901 (NaCl 0.9%) (<i>n</i> = 5). All groups were treated with brain injury using the modified Marmarou model. The measurements of TNF-α were performed at 30 min and 6 weeks after brain injury.</p><p><strong>Results: </strong>At 30 min after brain injury, the TNF-α level in the MLC 901 group was higher (3564.8) than the 0.9% NaCl group (3453.6), but it was not statistically significant (<i>P</i> = 0.830). At 6 weeks of treatment, the TNF-α level in the MLC 901 group (2576.6) was higher than the 0.9% NaCl group (1383.4) and statistically significant (<i>P</i> = 0.001). This study showed that the administration of MLC 901 could increase TNF-α levels at 6 weeks after treatment.</p><p><strong>Conclusion: </strong>MLC 901 increases TNF-α levels in rats with TBI, with a significant rise observed at 6 weeks, suggesting a sustained inflammatory response.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"259"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628422","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}

{"title":"Carotid artery stenting for a carotid web revealed by shape change after adherent thrombus resolution following conservative treatment.","authors":"Seigo Kimura, Norihiro Fukawa, Masahiro Hayashi, Daiji Ogawa, Keiichi Yamada, Hirokatsu Taniguchi, Masahiko Wanibuchi","doi":"10.25259/SNI_461_2025","DOIUrl":"10.25259/SNI_461_2025","url":null,"abstract":"<p><strong>Background: </strong>The carotid web (CW) is a shelf-like defect located on the posterior wall at the origin of the internal carotid artery. Abnormal blood flow in the CW causes thrombus formation, making it difficult to diagnose. Some reports have indicated that CWs become detectable only after thrombus resolution. We report a case of a patient who underwent carotid artery stenting (CAS) for a previously undetected CW with the resolution of an adherent thrombus resulting in a favorable outcome.</p><p><strong>Case description: </strong>A 39-year-old male presented with the left hemiparesis rushed to our hospital. Magnetic resonance imaging and angiography revealed a cerebral infarction caused by occlusion of the right middle cerebral artery. Initial cerebral angiography showed a mobile contrast defect in the posterior wall of the right cervical internal carotid artery. The patient was treated conservatively with medical therapy and rehabilitation. Follow-up angiography 1 month later revealed a shelf-like defect at the posterior wall of the origin of the internal carotid artery, which was different from the initial cerebral angiography. CAS was performed for the CW with a resolution of the adherent thrombus.</p><p><strong>Conclusion: </strong>A CW may present with varying imaging findings depending on the nature of the adherent thrombus. In cases where such adherent thrombus hamper diagnosis or in the absence of adherent thrombus, the imaging finding of the pooling of the blood flow may help in diagnosing a CW.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"264"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628403","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}

{"title":"Feasibility of redo endoscopic microvascular decompression for recurrent trigeminal neuralgia: An illustrative case.","authors":"Shayakhmet Makhanbetkhan, Fuminari Komatsu, Marat Sarshayev, Mynzhylky Berdikhojayev, Yoko Kato","doi":"10.25259/SNI_262_2025","DOIUrl":"10.25259/SNI_262_2025","url":null,"abstract":"<p><strong>Background: </strong>Trigeminal neuralgia (TN) is often treated with microvascular decompression (MVD), providing long-term pain relief for most patients. However, a subset experiences recurrence requiring reoperation. Endoscopic MVD techniques have gained traction due to enhanced visualization and potentially lower morbidity, yet their feasibility for redo procedures - particularly in complex cases with dense adhesions - remains uncertain.</p><p><strong>Case description: </strong>We report the case of a 63-year-old male who initially presented with Barrow Neurological Institute (BNI) grade V TN in the V2-V3 distribution. After an endoscopic MVD, the patient achieved immediate pain relief (BNI I) but developed recurrent symptoms 10 months later (BNI III), controlled by carbamazepine. A subsequent escalation (BNI IV) prompted surgical re-exploration. Imaging revealed no residual or new neurovascular conflict. Instead, intraoperative findings demonstrated dense adhesions tethering the trigeminal nerve to the tentorium, causing nerve tension. Careful endoscopic dissection restored nerve mobility and resulted in complete symptom resolution.</p><p><strong>Conclusion: </strong>This case highlights the feasibility and effectiveness of a fully endoscopic redo MVD in recurrent TN where dense adhesions, rather than persistent vascular compression, were the primary mechanism of recurrence. Further investigation is warranted to optimize endoscopic techniques, reduce adhesion formation, and improve long-term outcomes in redo MVD cases.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"260"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628420","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}

{"title":"Posterior cage migration after transforaminal lumbar interbody fusion: Risk factors and treatment.","authors":"Juliano Nery Navarro, Nuno Rodolfo Colaço Aguiar, Allison Roxo Fernandes, Vinicius Santos Baptista, Matheus Galvão Valadares Bertolini Mussalem Bertolini, Aécio Rubens Dias Pereira Filho","doi":"10.25259/SNI_496_2025","DOIUrl":"10.25259/SNI_496_2025","url":null,"abstract":"<p><strong>Background: </strong>Here, we reviewed the clinical, radiological, and neurological sequelae and treatment when transforaminal lumbar interbody fusion (TLIF) cages migrate into the lumbar spinal canal.</p><p><strong>Case description: </strong>A 46-year-old female underwent a TLIF L3-L4. Five months later, she presented with cauda symptoms/signs of dorsal cage migration that warranted surgical removal.</p><p><strong>Conclusion: </strong>TLIF can be associated with delayed dorsal cage migration into the spinal canal. This adverse event should be clinically recognized, radiologically documented, and appropriately surgically treated to minimize short/long-term neurological sequelae.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"266"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628438","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}

{"title":"A rare cause of obstructive hydrocephalus: Cerebral aspergillosis presenting as an intracranial space-occupying lesion in an immunocompetent adult.","authors":"Festus Ayobami Oshunpidan, Valerie Nkechi Martins, Olalekan Sherif Adebiyi, Adekunbi Omowumi Oshunpidan, Oluwatobi David Kunle-Ajagbe, James Ayokunle Balogun","doi":"10.25259/SNI_997_2024","DOIUrl":"10.25259/SNI_997_2024","url":null,"abstract":"<p><strong>Background: </strong>Cerebral aspergillosis (CA) is a rare fungal infection and life-threatening disease often associated with immunocompromised patients but can occasionally be present in immunocompetent individuals, mimicking an intracranial neoplasm. CA is highly linked to reduced immunity and is commonly seen in patients with background immunodeficiency, such as acquired immunodeficiency syndrome, chemotherapy, organ transplant patients on immunosuppressive therapy, and those with long-term steroid use. Diagnosis and management of CA can be quite challenging in immunocompetent individuals due to its unusual presentation, non-specific symptoms, and resemblance to tumors in imaging, the necessity of invasive procedures for diagnosis confirmation, complex surgical management, and the need for prolonged antifungal treatment with possible side effects.</p><p><strong>Case description: </strong>The case of a 36-year-old immunocompetent male who presented with a 2-year history of recurrent headaches, vomiting, seizures, inability to walk, and altered sensorium, with no history of immunosuppression. Clinical examination revealed a chronically ill patient with multiple cranial nerve palsies, and magnetic resonance imaging revealed a fourth ventricular mass with pan ventriculomegaly causing obstructive hydrocephalus. Initial management of the patient included a ventriculoperitoneal shunt followed by a midline suboccipital craniectomy and excision of the mass lesion 5 days later. Histopathology confirmed CA diagnosis, and the patient was treated with intravenous voriconazole, after which improvement in his clinical status was observed.</p><p><strong>Conclusion: </strong>This case emphasizes the importance of early detection of unusual CA in immunocompetent individuals and the importance of combining surgical intervention with antifungal therapy. The patient presented with a rare form of CA as an intracranial mass causing obstructive hydrocephalus, which initially mimicked a tumor. Early diagnosis and effective management, including surgery and antifungal treatment with voriconazole, led to significant improvement despite incomplete mass removal. Multidisciplinary care and long-term monitoring are crucial for managing such complex cases.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"258"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628397","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}

{"title":"The real-time brain tissue oxygen saturation monitoring using a versatile red-green-blue camera in cerebrovascular surgery.","authors":"Shinji Sato, Yasuaki Kokubo, Kenshi Sano, Izumi Nishidate, Yukihiko Sonoda","doi":"10.25259/SNI_253_2025","DOIUrl":"10.25259/SNI_253_2025","url":null,"abstract":"<p><strong>Background: </strong>Intraoperative monitoring plays a crucial role in reducing complications during neurosurgical procedures. However, effective methods to detect brain tissue viability changes due to blood flow alterations remain unsolved. Electrophysiological techniques, such as motor evoked potentials (MEPs), and fluorescent angiography using indocyanine green, are the primary methods for intraoperative assessment. Real-time intraoperative monitoring is essential for ensuring safe neurosurgical interventions. This study aims to develop a non-contact imaging system for brain tissue surface tissue oxygen saturation (StO2) using red-green-blue (RGB) imaging based on diffuse reflectance spectroscopy.</p><p><strong>Methods: </strong>Twelve patients with cerebrovascular diseases who underwent craniotomy were included. Six patients had Moyamoya disease, while the remaining six had unruptured cerebral aneurysms. StO2 was monitored in all patients using an RGB camera during surgery.</p><p><strong>Results: </strong>In Moyamoya disease cases, superficial temporal artery (STA)-middle cerebral artery bypass and encephalo-myo-synangiosis were performed. A significant increase in StO2 was observed after STA release, correlating with cerebral hyperperfusion syndrome as evaluated by ¹⁵O-Positron Emission Tomography scans 1 day post-surgery. In cerebral aneurysm cases, StO2 alterations were noted during internal carotid artery temporary occlusion, potentially impacting MEP outcomes. The effects of various intraoperative parameters on StO2 were evaluated.</p><p><strong>Conclusion: </strong>Real-time monitoring of StO2 using a highly versatile RGB camera mounted on the side scope of any surgical microscope, regardless of model, is a promising approach for enhancing the safety and efficacy of neurosurgical interventions. By capturing real-time changes in tissue oxygenation, this method may aid in predicting postoperative complications and preventing ischemic events.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"261"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628447","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}

{"title":"A rare case of postpartum paraplegia due to spinal intradural hematoma.","authors":"Anmol Singh Randhawa, Swarjith Nimmakayala, Pankaj Gupta, Bhawani Shanker Sharma, Rohin Bhatia, Yogesh Agrawal, Jitendra Singh Verma","doi":"10.25259/SNI_413_2025","DOIUrl":"10.25259/SNI_413_2025","url":null,"abstract":"<p><strong>Background: </strong>Spinal intradural hematomas rarely occur following spinal anesthesia. In this case, a 34-year-old postpartum female developed conus-cauda paraplegia (T12/L1-L5) due to an acute subdural hematoma after spinal anesthesia.</p><p><strong>Case description: </strong>Four-day postpartum, a 34-year-old female presented with severe paraplegia (1/5 motor power), complete T12-L1 sensory loss, and bowel incontinence. The lumbar magnetic resonance imaging (MRI) revealed a subacute subdural hematoma extending from the L1 to L5 levels. An urgent L1-L5 laminectomy was performed for clot evacuation. Within 3 postoperative months, she regained 4+/5 motor strength bilaterally and full bowel/bladder control.</p><p><strong>Conclusion: </strong>Spinal anesthesia may cause acute/subacute subdural hematomas. Here, 4-day postpartum, a 34-year-old female became paraplegic due to a subacute T12-L5 subdural hematoma documented on an MRI scan. She underwent emergent decompression, and within 3 postoperative months, regained nearly normal function.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"267"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628396","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}

{"title":"An extremely rare case of epithelioid hemangioendothelioma presumed metastasis to the pineal body.","authors":"Kyota Miyauchi, Akihiro Inoue, Teruyuki Ono, Satoshi Suehiro, Hideaki Watanabe, Riko Kitazawa, Takeharu Kunieda","doi":"10.25259/SNI_330_2025","DOIUrl":"10.25259/SNI_330_2025","url":null,"abstract":"<p><strong>Background: </strong>Epithelioid hemangioendothelioma (EHE) is a rare malignant endothelial tumor of blood and lymph vessels composed of epithelioid cells within a distinctive myxohyaline stroma. Its predilection sites are soft tissues, bone, lung, and liver, and intracranial metastases are extremely rare. We describe a case of EHE in an elderly patient with pineal body metastasis.</p><p><strong>Case description: </strong>An 84-year-old man presented to our hospital with disturbance of consciousness. Neuroimaging showed hydrocephalus and pineal tumor with hemorrhage on computed tomography and gadolinium enhancement on T1-weighted magnetic resonance imaging. Cerebral angiography showed no obvious tumor staining. ¹⁸F-fluorodeoxyglucose (FDG)-positron emission tomography demonstrated accumulations of FDG consistent with the pineal tumor and in the vessel wall and muscle throughout the body. Various tumor markers in the blood and cerebrospinal fluid were negative. Endoscopic biopsy was performed to confirm the diagnosis and to treat the hydrocephalus by endoscopic third ventriculostomy. Histological examination revealed large epithelioid perivascular cells with abundant pale eosinophilic cytoplasm and cytoplasmic vacuolation. Immunohistochemical studies showed positive results for CD34, CD31, cytokeratin AE1/AE3, and calmodulin binding transcription activator 1, and EHE was therefore diagnosed. Because of poor general condition and progressive tumor growth, radiotherapy was administered 7 days after surgery. At 21 days after surgery, endoscopy performed for progressive anemia revealed metastases in the stomach. The lesions continued to grow and the patient died 2 months after surgery.</p><p><strong>Conclusion: </strong>We present an extremely rare case of EHE presumed metastasis presenting as an isolated pineal region tumor. If a tumor with hemorrhage is found in the pineal body in an elderly patient, EHE should be considered in the differential diagnosis, even if it is a single tumor lesion.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"265"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628399","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}

{"title":"The neurosurgeon's paradox: Preparing for war while pursuing peace in the operating room.","authors":"Luxwell Jokonya","doi":"10.25259/SNI_386_2025","DOIUrl":"10.25259/SNI_386_2025","url":null,"abstract":"","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"263"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628445","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}

{"title":"Trigeminal radicular arteriovenous fistula presenting as trigeminal neuralgia treated with endovascular therapy.","authors":"Akiko Hasebe, Ichiro Nakahara, Fuminari Komatsu, Kenichi Haraguchi, Jun Tanabe, Yasuhiro Yamada, Riki Tanaka, Kento Sasaki, Shiho Tanaka, Koutarou Kihara, Tomoka Katayama, Mai Okubo, Yoko Kato","doi":"10.25259/SNI_364_2025","DOIUrl":"10.25259/SNI_364_2025","url":null,"abstract":"<p><strong>Background: </strong>This report presents a rare case of trigeminal neuralgia (TN) caused by a radicular arteriovenous fistula (AVF).</p><p><strong>Case description: </strong>A 58-year-old woman presented with severe pain in the right lower jaw, typical of TN. Magnetic resonance imaging showed a vascular signal near the trigeminal nerve. Direct surgery revealed tortuous vessels on the dorsal surface of the nerve, with no offending vessels identified at the root entry zone. Digital subtraction angiography (DSA) confirmed a radicular AVF fed by the trigeminocerebellar artery, with venous drainage into the superior petrosal sinus through the petrosal vein. Endovascular embolization with n-butyl cyanoacrylate resulted in complete obliteration of the fistula and symptom resolution. Although a small pontine infarction occurred, no long-term deficits were observed. Follow-up DSA confirmed no recurrence.</p><p><strong>Conclusion: </strong>To the best of our knowledge, this represents the first documented case of a trigeminal radicular AVF, highlighting the importance of recognizing vascular anomalies and efficacy of endovascular treatment in managing TN.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"262"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628450","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}