Surgical neurology international最新文献

{"title":"Orbital leiomyoma mimicking a cavernous hemangioma.","authors":"Meriem Kajeou, Israe Almaghribi, Yasser Arkha","doi":"10.25259/SNI_201_2025","DOIUrl":"10.25259/SNI_201_2025","url":null,"abstract":"<p><strong>Background: </strong>Orbital leiomyoma is a rare benign tumor of the smooth muscles of the orbit with intraconal or extraconal location. The tumor affects twice as many men as women, with an average age of 30 years.</p><p><strong>Case description: </strong>A 38-year-old female presented with proptosis: Axile, nonpulsatile, painless, nonreducible, Grade III, with impairment of oculomotricity, associated with a decrease in visual acuity on the affected side with an AV at 03/10, and fundus: Grade I papilledema. The computed tomography scan showed a solitary, tissue mass, well-limited, encapsulated, and usually homogeneous, with homogeneous enhancement after contrast injection. The magnetic resonance imaging showed a rounded, homogeneous lesion, isointense on T1 and hyperintense on T2, with homogeneous enhancement after gadolinium injection. Suggestive of an intraorbital cavernous hemangioma. The patient underwent surgery via a subfrontal approach, with macroscopically complete resection. Histopathological examination was in favor of an orbital leiomyoma.</p><p><strong>Conclusion: </strong>Although very rare, orbital leiomyoma should be considered in the differential diagnosis of patients with orbital tumors.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"233"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628436","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":"Chiari I malformation with syringomyelia: Exploring novel dermatological markers in pediatrics.","authors":"Soumi Kundu, Pradosh Kumar Sarangi, Firdaus Bano, Sarthak Das, Saroj Kumar Tripathy","doi":"10.25259/SNI_244_2025","DOIUrl":"10.25259/SNI_244_2025","url":null,"abstract":"<p><strong>Background: </strong>Chiari I malformation (CM1) and syringomyelia can present a wide spectrum of symptoms and signs in children, often varying with age. However, the association of CM1 with dermatographia and alopecia is exceedingly rare and, to our knowledge, has not been previously reported in the pediatric population.</p><p><strong>Case description: </strong>We present the case of a 7-year-old boy who exhibited an unusual constellation of findings, including Horner's syndrome, dermatographia, and patchy alopecia. Magnetic resonance imaging revealed CM1 with holocord syringomyelia.</p><p><strong>Conclusion: </strong>This case highlights the importance of considering CM1 in the differential diagnosis of pediatric patients with unexplained dermatological and neurological findings. Early diagnosis and a multidisciplinary approach are crucial to achieving favorable outcomes.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"226"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628317","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 endonasal approach for the resection of a clival meningioma: Two-dimensional operative video.","authors":"Marco Antonio Munuzuri-Camacho, Marcos V Sangrador-Deitos, Jorge Alanis-Mendizabal, Luis Alberto Rodriguez-Hernandez, J Tomas Moncada-Habib, Victor Alcocer-Barradas","doi":"10.25259/SNI_276_2025","DOIUrl":"10.25259/SNI_276_2025","url":null,"abstract":"<p><strong>Background: </strong>The endoscopic endonasal approach for the resection of clival meningiomas involves navigating through the nasal cavity and sphenoid sinus to access the clivus. This minimally invasive technique provides enhanced visualization and precision, allowing for effective tumor resection while minimizing damage to surrounding structures and shortening recovery time.</p><p><strong>Case description: </strong>We present the case of a 43-year-old male who experienced intermittent headaches and dysphagia. Neurological examination revealed right-sided hemiparesis and abolition of the gag reflex. An initial computed tomography scan identified hydrocephalus, which was managed with a ventriculoperitoneal shunt. Subsequent magnetic resonance imaging demonstrated a well-defined extra-axial lesion at the clivus with homogeneous contrast enhancement, a dural tail extending toward the clivus, and brainstem displacement, suggestive of a clival meningioma. Given the tumor's location and characteristics, a minimally invasive endoscopic approach was selected as the preferred surgical strategy. This technique provides several advantages over traditional transcranial methods, including direct tumor visualization, preservation of glandular function, reduced cranial nerve manipulation, and improved control of the posterior fossa's vascular structures.</p><p><strong>Conclusion: </strong>Although the endoscopic endonasal approach offers significant benefits in clival meningioma resection, it requires specialized training to optimize outcomes and minimize complications. This video abstract aims to provide a step-by-step guide to the endonasal corridor leading to the clival region, emphasizing key vascular structures and the transposition of the pituitary gland to facilitate safe and effective tumor removal.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"230"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628404","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":"Purely cystic intraosseous meningioma of the skull: A radiologic conundrum and histologic challenge.","authors":"Diego Rojas, Arman Kavoussi, Ashley Rose Ricciardelli, Alex Flores, Sricharan Gopakumar, Luis Carrete, Hsiang-Chih Lu, Alex W Brenner, Akash J Patel","doi":"10.25259/SNI_34_2025","DOIUrl":"10.25259/SNI_34_2025","url":null,"abstract":"<p><strong>Background: </strong>Intraosseous meningiomas and cystic meningiomas are two rare subtypes of meningiomas. Meningiomas can develop with characteristics encompassing both cystic and intraosseous, termed intraosseous cystic meningiomas, that pose a diagnostic challenge.</p><p><strong>Case description: </strong>We report the case of a 41-year-old woman with a history of hearing loss presented with a left frontal mass that had been present for 12 years. Her history of hearing loss was in the setting of ear infections bilaterally since she was a teenager and was being evaluated by ear, nose, and throat specialists at the time. Initial cranial computed tomography (CT) identified a skull lesion characterized as a benign arachnoid cyst. At that time, no further intervention was deemed necessary. During a future visit with her primary care physician, the patient expressed concern about the potential growth of the mass and a new symptom. This prompted further CT and magnetic resonance imaging (MRI) studies of the brain, and a benign etiology such as an intra-diploic arachnoid cyst was suspected, but the patient was referred to neurosurgery for further evaluation. The patient and neurosurgeon came to the shared decision for surgery, given ongoing symptoms and pursuit of diagnosis. On the day of the operation, a left parietal craniectomy was performed using stereotactic navigation. At follow-up, the patient noted improvement in headache symptoms and was scheduled for a follow-up MRI.</p><p><strong>Conclusion: </strong>This case provides our rare example of a patient presenting with intraosseous cystic meningioma and current reported cases in the literature. The exact natural history of this pathology is not well described, and further research is needed.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"221"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628439","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 national survey of on-call responsibilities and night float systems at neurological surgery residency programs.","authors":"Mustafa Motiwala, Nicholas Behymer, Kara A Parikh, Emal Lesha, David Griffin Laird, Deke Blum, Barrett Schwartz, L Madison Michael Ii, Nickalus R Khan, Paul Klimo, William Mangham","doi":"10.25259/SNI_85_2025","DOIUrl":"10.25259/SNI_85_2025","url":null,"abstract":"<p><strong>Background: </strong>In 2003, the Accreditation Council for Graduate Medical Education instituted work-hour requirements for residents, and since that time, the response from the academic neurosurgical community has been varied. To meet these requirements, some neurosurgical training programs have implemented night float systems, but the scope of these changes remains undefined.</p><p><strong>Methods: </strong>We conducted a nationwide survey of neurosurgical residency training programs to evaluate the on-call structure and responsibilities of neurosurgery residents to elucidate a better understanding of the demands faced by trainees and programs alike.</p><p><strong>Results: </strong>Seventy-four neurosurgery residency training programs (67.28%) comprising 1,107 residents were represented in our data; 23 (31.08%) of these programs reported having a night float system. Compared to programs with a traditional call system, those with a night float system had a significantly higher number of residents (17.74 vs. 13.71; <i>P</i> = 0.0079) and covered a significantly greater number of hospitals on call (3.07 vs. 2.21; <i>P</i> = 0.0150). There was no significant difference in the presence of a night float system between programs with advanced practice provider support on call (<i>P</i> = 0.177), Level I trauma center coverage (<i>P</i> = 1.000), and pediatric hospital coverage (<i>P</i> = 0.507).</p><p><strong>Conclusion: </strong>Across the country, larger neurosurgical training programs with greater hospital demands have more readily adopted night float systems. The integration of advanced practice providers to enhance resident education and ensure the continuity of care emerges as a prominent trend that programs are utilizing to adapt to a changing healthcare landscape.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"223"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628395","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":"Extradural cervical spinal meningioma without myelopathy.","authors":"Mohamad El Houshiemy, Ibrahim Murad, Wael Ali Shouman, Rayyan Sakr, Sarah Kawtharani, Marwan Najjar","doi":"10.25259/SNI_373_2025","DOIUrl":"10.25259/SNI_373_2025","url":null,"abstract":"<p><strong>Background: </strong>Only 2.5-3.5% of all spinal meningiomas are extradural.</p><p><strong>Case description: </strong>A 45-year-old female presented with chronic neck pain and bilateral arm numbness but was otherwise neurologically normal. The cervical magnetic resonance (MR) imaging revealed a right-sided extradural extramedullary lesion extending from C5 to C7. Through a C4-C7 laminectomy, the patient underwent subtotal tumor excision; the intracanalicular portion of the tumor was excised, leaving behind some extraforaminal components. The histopathology was consistent with a typical meningioma (i.e., containing meningothelial cells and psammomatous calcifications).</p><p><strong>Conclusion: </strong>Extradural cervical spinal meningiomas are rare. Following MR studies, patients may undergo routine dorsal resection of the intracanalicular components of the meningioma, leaving behind extraforaminal extension if warranted. Early recognition and treatment lead to the most favorable outcomes.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"219"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628419","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":"Transient diabetes insipidus triggered by propofol infusion during brain surgery.","authors":"Firas Kalai, Sarra Sammari, Lotfi Rebai, Sabrine Ben Brahem, Olfa Faten, Ichraf Ardhaoui","doi":"10.25259/SNI_377_2025","DOIUrl":"10.25259/SNI_377_2025","url":null,"abstract":"<p><strong>Background: </strong>Diabetes insipidus (DI) is a rare entity in neuroanesthesia, most often encountered in the context of hypothalamic-pituitary surgeries. Its occurrence during the intraoperative period, outside of any manipulation of this region, is exceptional and may delay diagnosis.</p><p><strong>Case description: </strong>We report the case of a 54-year-old female patient who underwent surgery for a cerebellopontine angle schwannoma and developed signs of DI early during the intraoperative period, even before any surgical incision. No usual contributing factors were identified. The favorable outcome following cessation of propofol infusion suggests a probable role of this agent in the development of this disorder.</p><p><strong>Conclusion: </strong>This case illustrates an atypical but important complication to be aware of in anesthesia. The sudden onset of polyuria during surgery, even outside of hypothalamic-pituitary procedures, should prompt consideration of DI, especially in the presence of potentially triggering pharmacological agents.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"228"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628449","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":"Discrepancy between preoperative noninvasive evaluation and intraoperative electrical cortical stimulation for motor function assessment in diffuse cortical dysplasia.","authors":"Ryo Onoda, So Fujimoto, Kota Bokuda, Toshio Shimizu, Takeshi Matsuo","doi":"10.25259/SNI_931_2024","DOIUrl":"10.25259/SNI_931_2024","url":null,"abstract":"<p><strong>Background: </strong>Evaluating residual motor function and functional compensation is essential before performing hemispherotomy. We have been evaluating hand motor function using transcranial magnetic stimulation (TMS), which cannot confirm the lower limb functions.</p><p><strong>Case description: </strong>A male teenager with a huge arachnoid cyst in the right frontotemporal region and extensive polymicrogyria and gyral dysplasia in the adjacent lobes experienced focal to bilateral tonic-clonic seizures. We performed functional magnetic resonance imaging (MRI) and electrical cortical stimulation in addition to TMS. Functional MRI and TMS-motor-evoked potential (MEP) results suggested that the left primary motor cortex elicited the bilateral motor response, while intraoperative cortical stimulation MEPs revealed that the primary motor areas of each lower limb were controlled contralaterally. Consequently, we performed a total callosotomy instead of a hemispherotomy.</p><p><strong>Conclusion: </strong>The results suggest that a preoperative diagnosis of complete hemispheric damage based on noninvasive examinations is not sufficient in some cases to determine the operative strategy. A combination of pre- and intraoperative examinations may be required to prevent unexpected neurological complications.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"231"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628323","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 endonasal drainage of a foreign body-associated brain abscess.","authors":"Jesús Eduardo Falcón Molina, Isauro Lozano Guzmán, Victor Ramzes Chavez Herrera, Eduardo Ichikawa Escamilla, Nelmy Lourdes Pérez Elizondo, Emanuel Alejandro Suárez Ramírez, Salomón Waizel Haiat, Gerardo Yoshiaki Guinto-Nishimura","doi":"10.25259/SNI_90_2025","DOIUrl":"10.25259/SNI_90_2025","url":null,"abstract":"<p><strong>Background: </strong>Although brain abscesses (BA) are uncommon, they represent a significant clinical challenge due to their potential for high morbidity and mortality. When combined with the presence of foreign bodies (FB), such as those resulting from penetrating craniofacial trauma, the management of BA becomes even more complex. Although craniotomy is the most frequent route described for resolution, endoscopic approaches for BA drainage or FB removal have not been widely documented.</p><p><strong>Case description: </strong>A 29-year-old female with the antecedent of an assault two months before her referral to our hospital underwent cranial computed tomography (CT) and magnetic resonance imaging (MRI) revealing a penetrating FB through the left maxillary sinus to the anterior skull base associated with a left frontal abscess. The patient underwent a combined endonasal endoscopic and sublabial transmaxillary approach for FB extraction and navigation-guided abscess drainage using needle aspiration. A multilayer technique was employed for anterior skull base repair. The patient received an antibiotic scheme for six weeks and recovered without any neurological deficit. The control MRI showed complete resolution of BA.</p><p><strong>Conclusion: </strong>Coexisting BA and penetrating FB represent a challenge for neurosurgical management. When indicated, endoscopic endonasal surgery is a useful tool for FB extraction and allows the resolution of associated complications, such as drainage of a BA.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"229"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628417","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":"Distal intracranial artery pseudoaneurysm causing subdural hematoma: An illustrative case and a systematic review.","authors":"Kautilya R Patel, William E Thorell, Nicholas Borg, Daniel L Surdell, Uyen Tran, Cynthia M Schmidt, Sahara J Cathcart, Mithun G Sattur","doi":"10.25259/SNI_186_2025","DOIUrl":"10.25259/SNI_186_2025","url":null,"abstract":"<p><strong>Background: </strong>Pseudoaneurysm arising from the distal segment of an intracranial artery is a rare cause of subdural hematoma (SDH). We report a patient diagnosed with a pseudoaneurysm of a cortical branch of the distal anterior cerebral artery (ACA) during planned middle meningeal artery embolization for SDH and present a systematic review to summarize the present literature.</p><p><strong>Methods: </strong>A systematic literature search was conducted across EMBASE, MEDLINE, CINAHL, the Cochrane Library, and Scopus to identify studies reporting SDH due to pseudoaneurysms in the terminal intracranial artery segments. Details regarding clinical presentation, management, and outcomes were extracted.</p><p><strong>Results: </strong>Twenty patients from the 18 retrospective studies and the patient from the present report were included in the review. The mean age of the patients was 49.4 years; 80.9% of the patients were males. A history of nonpenetrating head trauma was present in 11 (52.4%) patients. The most common presenting symptoms were hemiparesis and altered mental status. Catheter angiography established the diagnosis in the majority of the patients (85.7%). Angiography was performed due to a clinical/radiological suspicion for a pseudoaneurysm in 6 (28.5%) patients. In the majority of the patients (66.7%), angiography was performed for a different indication. Middle cerebral artery (15 patients, 71.4%) was the most common location of the pseudoaneurysm, followed by ACA, posterior cerebral artery, and posterior inferior cerebellar artery. Pseudoaneurysm was treated surgically in 14 patients (66.7%) and by endovascular modalities in 5 patients (23.8%). One patient undergoing endovascular treatment required surgical evacuation of SDH. The majority of the patients in both treatment groups (surgical - 72.7%, endovascular - 80%) recovered without severe disability (modified Rankin Scale ≤ 4).</p><p><strong>Conclusion: </strong>Pseudoaneurysms of distal segments of intracranial arteries are a very rare cause of SDH. A high index of suspicion is required for their identification. While a definitive diagnosis requires catheter angiography, indications to perform angiography in SDH are unclear. Pseudoaneurysms with SDH can be treated safely with both microsurgical and endovascular modalities. Microsurgery has the advantage of draining SDH at the same time. The relative efficacy of different treatment approaches and the indications for each are not yet defined.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"224"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628324","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}