Surgical neurology international最新文献

{"title":"Vascular endothelial cadherin dysfunction: A predictor of hypertensive nonlobar intracerebral hemorrhage.","authors":"Tondi Maspian Tjili, Julius July, Eryati Darwin, Yuliarni Syafrita, Vanessa Angelica Suntoro, Patrick Putra Lukito, Jonathan Setiawan","doi":"10.25259/SNI_20_2025","DOIUrl":"10.25259/SNI_20_2025","url":null,"abstract":"<p><strong>Background: </strong>Endothelial dysfunction plays a key role in intracerebral hemorrhage (ICH), with vascular endothelial cadherin (VE-cadherin) being essential for maintaining blood vessel integrity and the blood-brain barrier. Hypertension increases ICH risk by damaging blood vessel integrity due to inflammatory cascades. Lower VE-cadherin levels in hypertensive patients suggest its potential as an early predictor of ICH risk.</p><p><strong>Methods: </strong>This 12-month study included 40 hypertensive control patients and 40 hypertensive patients with nonlobar ICH. Blood samples were analyzed using enzyme-linked immunosorbent assays to measure VEcadherin, interferon gamma, and interleukin-17 levels. Receiver operating characteristic analysis determined a VE-cadherin cutoff value, and a regression model assessed its association with ICH risk.</p><p><strong>Results: </strong>A VE-cadherin cutoff value of 400.8 pg/dL was identified, with higher levels independently linked to lower odds of nonlobar ICH. VE-cadherin was the only biomarker that remained statistically significant in the regression model. These findings suggest that reduced VE-cadherin levels contribute to ICH development, and its measurement may help identify high-risk patients for early intervention.</p><p><strong>Conclusion: </strong>VE-cadherin dysfunction in hypertension may serve as a predictor of nonlobar ICH risk. Its protective role highlights its potential as a biomarker for risk assessment and prevention strategies in hypertensive patients. These findings may pave the way for targeted interventions in hypertensive populations, warranting further research to confirm its clinical utility.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"268"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628451","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":"Parosteal lipoma of the supra-auricular region.","authors":"Made Ratna Dewi, Christopher Lauren, I Nyoman Gde Wahyudana, Analysa Analysa, Ida Bagus Gede Adiguna Wibawa, I Gusti Ketut Agung Surya Kencana, Tjokorda Gde Bagus Mahadewa","doi":"10.25259/SNI_289_2025","DOIUrl":"10.25259/SNI_289_2025","url":null,"abstract":"<p><strong>Background: </strong>Parosteal lipomas are rare benign soft-tissue tumors that develop in close association with the periosteum. Skull involvement is exceptionally uncommon, with only a few cases reported in the literature.</p><p><strong>Case description: </strong>A 14-year-old female presented with a slowly enlarging, painless lump above her right ear, first noticed at the age of five. Physical examination revealed a firm, well-defined, immobile mass measuring 2.5 × 1.5 cm in the supra-auricular region. A non-contrast computed tomography scan demonstrated a hypodense mass with thickening of the underlying squamous and mastoid bones, along with mastoid air cell enlargement. Surgical excision was performed for cosmetic reasons and histopathological diagnosis. Intraoperatively, the mass was found to be adherent to the periosteum and underlying bone. Histopathological examination confirmed the diagnosis of parosteal lipoma, showing mature adipose tissue, fibrous tissue, and focal lymphocytic aggregates without signs of malignancy. The patient recovered well postoperatively, with no recurrence or complications over 6 months of follow-up.</p><p><strong>Conclusion: </strong>Parosteal lipomas of the skull are exceedingly rare and require clinical suspicion for diagnosis. Imaging aids in preoperative planning, while histopathological assessment confirms the diagnosis. Complete surgical excision is curative, with a favorable prognosis. This case adds to the limited literature on skull-based parosteal lipomas.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"254"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628437","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":"Spontaneous resolution of foramen magnum dural arteriovenous fistula with anticoagulant therapy: A case of antiphospholipid syndrome misdiagnosed as seronegative neuromyelitis optica spectrum disorder.","authors":"Prasert Iampreechakul, Korrapakc Wangtanaphat, Songpol Chuntaroj, Chonlada Angsusing, Sirirat Khunvutthidee, Yodkhwan Wattanasen, Punjama Lertbutsayanukul, Sunisa Hangsapruek, Narupat Suanprasert, Surasak Komonchan, Somkiet Siriwimonmas","doi":"10.25259/SNI_308_2025","DOIUrl":"10.25259/SNI_308_2025","url":null,"abstract":"<p><strong>Background: </strong>Foramen magnum dural arteriovenous fistulas (FMDAVFs) are rare vascular lesions that often present with progressive myelopathy and can mimic inflammatory conditions such as neuromyelitis optica spectrum disorder (NMOSD). While endovascular or surgical treatment is typically required, spontaneous resolution of FMDAVFs is exceptionally rare. This case highlights the importance of considering vascular etiologies in patients with myelopathy and overlapping autoimmune features and explores the potential role of anticoagulant therapy in select cases.</p><p><strong>Case description: </strong>A 34-year-old man initially presented with progressive paraparesis, sensory disturbances, and bowel and bladder dysfunction. He was diagnosed with seronegative NMOSD and treated with immunosuppressive therapy without improvement. Upon referral, spinal imaging revealed findings consistent with a dural arteriovenous fistula (DAVF) at the foramen magnum. Before angiography could be performed, the patient developed deep vein thrombosis and pulmonary embolism, prompting a comprehensive hypercoagulability workup that confirmed antiphospholipid syndrome (APS). He was started on long-term anticoagulation. Follow-up imaging demonstrated progressive resolution of spinal cord congestion and eventual complete angiographic obliteration of the FMDAVF. The patient remained asymptomatic at 1-year follow-up.</p><p><strong>Conclusion: </strong>This case illustrates the potential for spontaneous resolution of FMDAVF in the setting of anticoagulant therapy and underscores the role of thrombosis in the pathogenesis of DAVFs. Careful diagnostic evaluation, including vascular imaging and hypercoagulability testing, is critical in patients with atypical myelopathy. In selected patients with underlying thrombotic conditions such as APS, conservative management with anticoagulation may offer a noninvasive therapeutic alternative.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"252"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628443","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":"Neuroimaging markers of intracranial hypertension in cerebral venous thrombosis: A systematic review and meta-analysis.","authors":"Abdulsalam M Aleid, Abdulmonem A Alhussain, Awn Abdulmohsen Alessa, Ibrahim Alahmed, Abdulmajeed Abdulaziz Aljabr, Hasan A AlAidarous, Loai Albinsaad, Abdulrahman Almoslem, Saud Nayef Aldanyowi, Sami F Almalki","doi":"10.25259/SNI_1037_2024","DOIUrl":"10.25259/SNI_1037_2024","url":null,"abstract":"<p><strong>Background: </strong>Cerebral venous thrombosis (CVT) is commonly associated with intracranial hypertension (IH), though its neuroimaging markers remain less well-defined. This study aims to systematically review and compare neuroimaging markers of IH in CVT and idiopathic IH (IIH) to better understand their diagnostic implications.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. From inception to 2024, we searched PubMed, Web of Science, and Scopus for observational studies and randomized controlled trials focusing on neuroimaging findings in primary IH (i.e., IIH) and IH secondary to CVT. Data were extracted on neuroimaging outcomes, including peri-optic cerebrospinal fluid (CSF) pressure, optic nerve head protrusion, and others.</p><p><strong>Results: </strong>Six studies met the eligibility criteria, comprising three cohort studies and three case-control studies, with a combined total of 301 patients. The results indicated that peri-optic CSF pressure (Odds ratio [OR]: 5.85, <i>P</i> = 0.0002), optic nerve head protrusion (OR: 4.1, <i>P</i> = 0.02), sclera flattening (OR: 2.2, <i>P</i> = 0.04), and empty sella (OR: 3.25, <i>P</i> = 0.03) were observed more frequently in patients with IIH than in those with CVT and IH. However, when comparing CVT with IH to controls, optic nerve tortuosity did not show a significant difference (OR: 2.20, <i>P</i> = 0.18). Increased ventricular volume (Mean difference: 1.76, <i>P</i> < 0.00001) and sclera flattening (OR: 6.68, <i>P</i> = 0.002) were more common in CVT with IH patients compared to the control group.</p><p><strong>Conclusion: </strong>Typical neuroimaging characteristics of IH (e.g., empty sella) are more frequently observed in idiopathic cases (i.e., IIH) than in secondary causes, such as IH resulting from CVT. These differences have the potential to enhance diagnostic precision and facilitate the development of improved imaging protocols.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"257"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628424","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":"Spinal intradural lesion as manifestation of multiple myeloma: Illustrative case and systematic review of literature.","authors":"Kiana Yang Prather, Beste Gülsuna, Kishore Balasubramanian, Hakeem J Shakir, Xiaochun Zhao, Chao Li","doi":"10.25259/SNI_249_2025","DOIUrl":"10.25259/SNI_249_2025","url":null,"abstract":"<p><strong>Background: </strong>Multiple myeloma (MM) typically affects the bone marrow. When it spreads to the central nervous system, it usually presents as intracranial metastasis or extradural spinal lesions. Intradural spinal cord metastases are exceedingly rare.</p><p><strong>Case description: </strong>A 53-year-old male with immunoglobulin A kappa MM presented with a contrast-enhancing lesion at the T3-4 level, consisting of an intradural lesion and an extradural lesion extending through the foramen. The lesion's characteristics suggested a schwannoma, but MM involvement was suspected given the patient's history. Surgical resection and spinal stabilization were performed, and pathological examination confirmed a plasma cell neoplasm. A systematic review of the literature identified 10 cases of intradural spinal lesions associated with MM or solitary plasmacytoma. Most lesions were intradural extramedullary, located primarily in the thoracic spine. Management often included surgery, chemotherapy, and radiotherapy, but the prognosis remained poor, especially with leptomeningeal spread.</p><p><strong>Conclusion: </strong>This case highlights the diagnostic and therapeutic challenges of intradural spinal MM involvement. While surgery can provide symptomatic relief and confirm the diagnosis, the risk of leptomeningeal dissemination requires close monitoring. A multidisciplinary approach is essential for managing these rare and complex cases, and further studies are needed to refine treatment strategies and improve patient outcomes.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"247"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628442","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":"Cerebrospinal fluid analysis in tuberculous meningitis: A literature review.","authors":"Akhmad Imron, Yulius Hermanto, Ahmad Rizal, Vycke Yunivita, Rovina Ruslami","doi":"10.25259/SNI_1131_2024","DOIUrl":"10.25259/SNI_1131_2024","url":null,"abstract":"<p><strong>Background: </strong>Tuberculous meningitis (TBM) is the most common central nervous system infection of <i>Mycobacterium tuberculosis</i> (<i>M.tb</i>). The infection will cause focal neurological deficits and can be fatal, so that it will increase the morbidity and mortality rates. Adequate treatment is needed so that the drug can reach the center of infection. Not all anti-tuberculosis (TB) drugs can effectively cross the blood-brain and blood-cerebrospinal fluid barriers. The use of higher doses is expected to be able to work on the center of infection effectively. However, the use of higher doses will also increase the risk of drug-induced liver injury, which requires temporary discontinuation of the suspected drug.</p><p><strong>Methods: </strong>This scientific work aims to determine the penetration rate of first-line anti-TB drugs that are often used in patients infected with <i>M.tb</i>, especially TBM. Journal searches were performed on PubMed/PMC and BioMed Central/BMC search engines with the appropriate keywords. Critical appraisal analysis was carried out in selected journals. CSF sampling can be done to establish the diagnosis of TBM. CSF characteristics in TBM include lymphocyte pleocytosis, increased protein levels, and decreased glucose levels.</p><p><strong>Results: </strong>The results of CSF analysis depend on the volume of CSF used, the delivery of the sample, and the technical expertise of the clinician. If clinically, a patient is suspected of having TBM even though the results of CSF analysis show negative results for <i>M.tb</i> bacteria, a drug regimen can be given immediately to prevent worsening of the patient's condition. Bacterial cultures may be performed as treatment progresses. Based on the penetration rate of anti-TB drugs in the CSF, isoniazid (INH), pyrazinamide, and fluoroquinolones, especially levofloxacin, are drugs with fairly good CSF penetration.</p><p><strong>Conclusion: </strong>The use of INH is beneficial because it has high bactericidal activity. Gatifloxacin and ciprofloxacin, which are included in the fluoroquinolone class of drugs, are safe to use even though their CSF penetration is not as good as levofloxacin.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"246"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628315","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":"Assessing the predictability of isocitrate dehydrogenase mutational status in glioma patients using imaging features.","authors":"Joao Meira Goncalves, André Miranda, Carolina Silva, Bruno Carvalho, Patricia Polónia, Paulo Linhares","doi":"10.25259/SNI_323_2025","DOIUrl":"10.25259/SNI_323_2025","url":null,"abstract":"<p><strong>Background: </strong>Radiogenomics, the intersection of imaging and genetics, is important in improving glioma diagnosis and treatment. This study aims to correlate imaging features with isocitrate dehydrogenase (IDH) mutation status, providing a non-invasive diagnostic tool to identify the genetic background of gliomas.</p><p><strong>Methods: </strong>In a retrospective sample of 59 patients with either IDH wild-type (WT) or IDH mutant gliomas, the study employed volumetric and morphologic magnetic resonance imaging (MRI) analyses to discern molecular alterations based on radiographic signatures. Key imaging biomarkers, such as the T2/fluid-attenuated inversion recovery mismatch, contrast enhancement patterns, and diffusion/perfusion metrics, were evaluated for their ability to differentiate between IDH-WT and mutant gliomas. Receiver operating characteristic curves were employed to evaluate diagnostic performance, and a logistic regression model was developed for patient classification based on imaging.</p><p><strong>Results: </strong>The results revealed that IDH mutant gliomas frequently exhibited distinct imaging characteristics, such as homogenous hyperintense T2 signals and absence of contrast enhancement. In addition, perfusion and diffusion metrics varied significantly between the IDH-WT and mutant groups, offering potential radiogenomic markers. A logistic regression model was developed to predict IDH status with high accuracy, identifying factors such as tumor enhancement size, presence of central necrosis, peritumoral edema, and patient age.</p><p><strong>Conclusion: </strong>The study's results affirm the significance of radiogenomic correlations in predicting IDH status, resonating findings from prior research. We highlight the necessity of a multimodal approach in MRI analysis to enhance the non-invasive diagnostic accuracy for glioma patients.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"256"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628401","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":"Endoscopic-assisted surgical repair of ear cerebrospinal fluid leakage through a subtemporal craniotomy.","authors":"Ramón López López, Emmanuel González Ruiz, Jesús Ricardo Cazadero Márquez","doi":"10.25259/SNI_155_2025","DOIUrl":"10.25259/SNI_155_2025","url":null,"abstract":"<p><strong>Background: </strong>CSF fistula involves abnormal leakage of cerebrospinal fluid (CSF) from its normal pathways, typically from high- to low-pressure areas at the base of the skull. It requires an osteomeningeal breach, causing discomforts such as headaches and abnormal drainage. Temporal bone CSF leakage often results from trauma or chronic otitis media, and its surgical treatment is often delayed. The application of endoscopes in skull base procedures has become increasingly common, offering new ways to improve visualization during performance. Endoscopic tools provide a broad view, sharp image quality, enhanced magnification, and the advantage of visualizing areas that are typically hard to see directly.</p><p><strong>Methods: </strong>CSF leaks in the temporal bone can be challenging to diagnose, with subtle symptoms that can go undetected for years. Imaging techniques such as computed tomography (CT) and magnetic resonance imaging are used for diagnosis, with CT cisternography being the most reliable. Surgical repair may be necessary in certain cases. Most patients do not require surgery, as conservative management is effective. Surgery is considered for severe symptoms. Absolute contraindications include conditions that prevent general anesthesia, while relative contraindications include vestibular issues and migraines. Endoscopic surgery involves a light source, rigid endoscope, and high-definition camera. The defect is repaired using materials such as bone wax, fat, and fibrin glue. Surgery is performed under general anesthesia with a small incision behind the ear, and the skull base is reconstructed.</p><p><strong>Results: </strong>Once the patient can ambulate and tolerate a diet, they can be discharged (average hospital stay is 2 days) on 60 mg of oral prednisone daily for 2 weeks followed by a 1-week taper. During postoperative course, patient's course was uncomplicated and there was no evidence of CSF leakage at 24 h, nor at the review 2 weeks later in the outpatient clinic.</p><p><strong>Conclusion: </strong>CSF leaks of temporal bone origin are rare and should be considered in patients with non-resolving outer ear effusion or meningitis. Temporal bone CT represents the most valuable imaging modality for diagnosis and preoperative surgical planning. Isolated dural defects of the tegmen tympani may be repaired through subtemporal approach through a craniotomy. Endoscope-assisted surgery leads to an elevated efficacy of defining precisely the site of the bone defect.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"253"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628418","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":"Glioma mimicking a cystic infectious disease: A case report of multifocal, multicentric cystic glioblastoma.","authors":"Daniel Kiss-Bodolay, Marc Weiner, Kristof Egervari, Gilles Eperon, Maria Isabel Vargas, Denis Migliorini, Johannes Lobrinus, Stephan Harbarth, Philippe Bijlenga","doi":"10.25259/SNI_56_2025","DOIUrl":"10.25259/SNI_56_2025","url":null,"abstract":"<p><strong>Background: </strong>Glioblastoma multiforme (GBM) is a highly aggressive malignant tumor known to be a great mimicker. Multicystic metastasis and cystic GBM are not rare but multicystic diffuse GBM was never reported before.</p><p><strong>Case description: </strong>We describe here the clinical course, the radiological characteristics, and the management of a patient with a diffuse cystic brain lesion. Even though the comprehensive bacterial, fungal, and parasitic work-up came back negative twice, the radiological and biological findings of the case presented in this work mislead an experienced multidisciplinary team. In a somewhat unexpected way, the pathological results showed a high-grade glial tumor.</p><p><strong>Conclusion: </strong>The case reported herein is an important reminder of the highly multimorph characteristics of GBM and the challenging differential diagnosis of cystic brain lesions.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"248"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628421","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":"Thoracic spinal epidural angiolipoma presenting with progressive paraparesis in an elderly patient.","authors":"Haydar Gok, Kivanc Yangi, Omar Alomari, Uguray Payam Hacisalihoglu","doi":"10.25259/SNI_389_2025","DOIUrl":"10.25259/SNI_389_2025","url":null,"abstract":"<p><strong>Background: </strong>Spinal epidural angiolipomas (SEALs) are rare, benign tumors composed of mature adipocytes and abnormal vasculature, representing only 0.04-1.2% of spinal tumors. Predominantly located in the thoracic epidural space, they often cause progressive neurological deficits due to spinal cord compression, though acute deterioration may occur from hemorrhage or thrombosis. Misdiagnosis is common, and evidence-based management remains limited.</p><p><strong>Case description: </strong>a 74-year-old woman presented with a 3-month history of progressive paraparesis, gait instability, and left-sided hyperreflexia. Spinal magnetic resonance ımaging revealed an 11 cm posterior epidural mass extending from T3 to T7, causing severe cord compression with myelopathic signal changes. The patient underwent T4-T6 laminectomy with gross total resection of the highly vascular mass. Histopathology confirmed the diagnosis of SEAL. Postoperatively, her symptoms improved, and she was discharged without complications.</p><p><strong>Conclusion: </strong>This case highlights the importance of recognizing SEALs in differential diagnoses of spinal cord compression, emphasizing meticulous surgical excision for favorable outcomes. A literature review underscores the need for standardized management guidelines for these rare lesions.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"251"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628448","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}