Surgical neurology international最新文献

{"title":"Intradural T12-L1 disc herniation in a patient with achondroplasia: A case report.","authors":"Edgar G Ordonez-Rubiano, Jorge Alberto Romo, Juan Torres, Santiago José Troncoso, Javier Patiño","doi":"10.25259/SNI_347_2024","DOIUrl":"https://doi.org/10.25259/SNI_347_2024","url":null,"abstract":"<p><strong>Background: </strong>There are very few reports of intradural disc herniations associated with achondroplasia described in the literature.</p><p><strong>Case description: </strong>A patient with achondroplasia presented with progressive paraparesis attributed to a magnetic resonance-documented intradural disc herniation at the T12-L1 level occupying more than 90% of the spinal canal. It was successfully removed through a T12 laminectomy with durotomy; note a laminectomy would have been contraindicated if this had been an extradural anterior/anterolateral disc. Postoperatively, the patient progressively improved and, within 6 months, had 4/5 proximal/distal function and full sphincter control.</p><p><strong>Conclusion: </strong>A patient with achondroplasia and an intradural T12/L1 disc herniation (i.e., unlike an extradural anterior/anterolateral thoracic disc) successfully underwent a decompressive laminectomy with near full resolution of their preoperative paraparesis.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"15 ","pages":"369"},"PeriodicalIF":0.0,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635263","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":"Intracranial pressure monitoring and treatment practices in severe traumatic brain injury between low-and middle-income countries and high-income countries: Data or dogma?","authors":"Uchenna Ajoku, Gregory Hawryluk, Marcel Kullmann","doi":"10.25259/SNI_251_2024","DOIUrl":"https://doi.org/10.25259/SNI_251_2024","url":null,"abstract":"<p><strong>Background: </strong>Traumatic brain injury (TBI) is a major cause of morbidity and mortality worldwide. Intracranial pressure (ICP) monitoring forms the cornerstone of most severe TBI (sTBI) management guidelines, yet treatment practices vary between high income countries (HIC) and low/middle-income countries (LMICs). We sought to find the reasons for variation in ICP monitoring and treatment practices between neurosurgeons in low- and high-income countries.</p><p><strong>Methods: </strong>We developed a 34-item anonymous survey questionnaire on ICP monitoring and treatments, which was emailed to neurosurgeons of various neurosurgical societies (Africa, Asia, Europe, and North America) who manage TBI.</p><p><strong>Results: </strong>One hundred and six respondents from 23 countries completed the questionnaire. Sixty-nine were from Africa, 16 were from North America, 12 were from Western Europe, and 8 were from Asia. About 48.72% of respondents from LMICs versus 96.43% from HICs have had training on ICP use. Among practitioners who monitor ICP invasively in <50% of patients that need it, 41.6% and 37.5% from LMIC cited availability and cost as the major constraints, versus 3.3% and 6.67%, respectively, in HIC. Only 7 (8.97%) from LMIC follow Brain Trauma Foundation guidelines all the time compared to 17.86% from HIC. When asked about their knowledge of randomized controlled trial(RCT), 78.57% of respondents from HIC versus 11.54% from LMIC knew about RCTs that tested the role of ICP monitoring in sTBI.</p><p><strong>Conclusion: </strong>Significant differences exist in ICP monitoring and treatment in patients with sTBI between high and LMICs. Cost and availability are the main determinants of ICP monitor usage. Practice pattern among the respondents was not completely supported by evidence.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"15 ","pages":"368"},"PeriodicalIF":0.0,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635258","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":"Cerebellopontine angle pilocytic astrocytoma in adults: A systematic review.","authors":"Placido Bruzzaniti, Giovanni Pennisi, Pierfrancesco Lapolla, Pietro Familiari, Vincenza Maiola, Claudia Quintiliani, Pierluigi Alò, Michela Relucenti, Biagia La Pira, Giancarlo D'Andrea","doi":"10.25259/SNI_539_2024","DOIUrl":"https://doi.org/10.25259/SNI_539_2024","url":null,"abstract":"<p><strong>Background: </strong>In adults, the cerebellopontine angle (CPA) pilocytic astrocytoma (PA) is very rare. This tumor has radiological features similar to those of a vestibular schwannoma in the few cases reported in the literature.</p><p><strong>Methods: </strong>In this study, we conducted a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol and scrutinized all original studies pertaining to pontocerebellar angle PA in adult patients. We conducted an analysis of the clinical, radiological, and molecular components of all eligible articles. We have also reported a case involving a 67-year-old male individual in whom the PA exhibited radiological characteristics similar to an epidermoid cyst.</p><p><strong>Results: </strong>After the screening phase, we found four cases of PA of the pontocerebellar angle. Three cases were identified that resembled vestibular schwannoma; however, in our case, the tumor resembled an epidermoid cyst. These uncommon tumors exhibit distinctive histological patterns and molecular characteristics (adenosine triphosphate dependent helicase (ATP- dependent helicase)+, Isocitrate dehydrogenase 1-), rendering them a potential differential diagnosis for glioblastoma (GBM).</p><p><strong>Conclusion: </strong>The CPA PA has rarely been found in adult patients and should be considered in the differential diagnosis of vestibular schwannoma and epidermoid cysts. In these rare cases, the histological characteristics of PA are significant for the differential diagnosis of GBM.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"15 ","pages":"363"},"PeriodicalIF":0.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635534","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":"Epstein-Barr virus flare: A multiple sclerosis attack.","authors":"Ali Naser Msheik, Zeinab Al Mokdad, Faten Hamed, Farah Assi, Ali Jibbawi, Jean-Pierre Saad, Rami Mohanna, Anthony Khoury, Mhamad Farhat, Rami Atat","doi":"10.25259/SNI_457_2024","DOIUrl":"https://doi.org/10.25259/SNI_457_2024","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Multiple sclerosis (MS)-Epstein-Barr virus (EBV) relation is similar to doing a complicated puzzle: it consists of many pieces that become more and more clear as the issue is viewed from different sides. Based on the research findings, there is powerful evidence that EBV and MS have a strong relation where high levels of EBV DNA are able to be shown in all the spinal cord and the blood of the MS patients, but these are shown during disease relapses, and this implies a role in these illnesses. It kind of narrows the choices that you have to look for, just like how gathering evidence can lead to finding the missing person. In the analysis, new ways of EBV participation in MS progression are expected to be installed, and even new therapeutics are expected to be made.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A comprehensive literature search of PubMed was conducted until November 2023 to identify studies investigating the association between Epstein-Barr virus (EBV) infection and multiple sclerosis (MS). Only articles that met stringent criteria, including validation of EBV infection through laboratory testing, were included in the analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 16 articles were identified as applicable for the background review, and this conformed with the discovery that the initiation of EBV/IM was consistent across various studies, namely, retrospective, cross-sectional, or prospective. The statistics reveal a glimpse into the need for prolonged research in studying the pattern of this link between EBV and MS. Novel treatment approaches targeting EBV, including adoptive T-cell therapy and gene-based immunotherapy, show promise in mitigating MS progression by targeting EBV-infected cells.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Clinical trials investigating antiviral therapies and vaccination strategies are underway, aiming to translate these findings into effective treatments for MS. Despite promising advances, challenges remain in developing EBV-targeted therapies for MS, including safety concerns and the multifactorial nature of MS pathogenesis. Advance treatment options that focus on EBV, such as adoptive T-cell therapy and gene-based immunotherapy, are shown to be effective in the improvement of MS management that targets the viral-infected cell. The clinical trials for antiviral drugs and vaccination tactics are going on to benefit from these findings and eventually to invent effective therapeutics for MS. While these new therapeutic directions may offer great promise, challenges remain in these approaches as safety concerns and complex factors that underlie MS pathology need to be taken care of. The ethical aspects linked to picking the patients and giving informed consent make the progress of EBV-related treatments are even more difficult. Future research is recommended so that the primary mechanisms through which EBV contributes to MS development will be elucidated; in addition, the main MS subtype s","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"15 ","pages":"355"},"PeriodicalIF":0.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634082","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 clinical spectrum and management outcome of adult-onset aqueductal stenosis: Insight from South-West Nigeria.","authors":"Edward Oluwole Komolafe, Chizowa Okwuchukwu Ezeaku, Gabriel Owoicho Ejembi, Christopher Obinna Anele, Simon Adewale Balogun","doi":"10.25259/SNI_635_2024","DOIUrl":"https://doi.org/10.25259/SNI_635_2024","url":null,"abstract":"<p><strong>Background: </strong>Adult-onset aqueductal stenosis (AOAS) is an uncommon cause of hydrocephalus in adults. Its etiopathogenesis is poorly understood, with various proposed mechanisms, spectrum of presentation, and management. Very little has been reported on this anomaly in African literature. This study aimed to describe the pattern of presentation, clinical spectrum, and early outcomes following the shunt procedure in our population practice setting.</p><p><strong>Methods: </strong>This was a retrospective case series of patients with non-tumoral AOAS managed between 2008 and 2023 in a tertiary center in South-West Nigeria. Relevant demographic, clinical-radiologic, and outcome data were retrieved and analyzed.</p><p><strong>Results: </strong>There were seven males and one female. Their age ranged from 18 to 50 years. The duration of symptoms ranged from 3 to 120 months. All patients admitted having headaches; however, visual deterioration (<i>n</i> = 5) was the most common presenting symptom. Features of endocrinopathy (<i>n</i> = 1), cerebellar dysfunction (<i>n</i> = 2), cognitive deficit (<i>n</i> = 2), spontaneous cerebrospinal fluid leak (<i>n</i> = 1), and sphincteric dysfunction (<i>n</i> = 1) were also observed. The mean Evan's index at the presentation was 0.43. Ventriculoperitoneal shunt (VPS) insertion was performed in seven patients with good outcomes. One patient opted for a referral. One patient had shunt revision 6 years later on account of shunt disconnection.</p><p><strong>Conclusion: </strong>AOAS is an infrequent cause of hydrocephalus in our setting, with most patients seeking medical consultation following visual deterioration. Proper evaluation of adults with long-standing headaches and associated features is advocated to avert total visual loss in this subgroup. VPS insertion is a viable treatment option with a good outcome.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"15 ","pages":"360"},"PeriodicalIF":0.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635215","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":"Comparative efficacy of transcranial and endoscopic surgery for craniopharyngioma: A systematic review and meta-analysis of contemporary literature.","authors":"I Wayan Weda Wisnawa, Irwan Barlian Immadoel Haq","doi":"10.25259/SNI_399_2024","DOIUrl":"https://doi.org/10.25259/SNI_399_2024","url":null,"abstract":"<p><strong>Background: </strong>Craniopharyngiomas pose a significant clinical challenge due to their complex anatomical location and potential for neurological sequelae. Surgical management options include transcranial and endoscopic approaches, each with its advantages and limitations. This systematic review and meta-analysis aims to comprehensively compare the outcomes of transcranial and endoscopic surgery for craniopharyngioma, integrating the latest evidence from ten pertinent journal articles.</p><p><strong>Methods: </strong>A systematic search of electronic databases, including Google Scholar, PubMed, MEDLINE, and Embase, was conducted to identify relevant studies published between 2010 and 2022. A total of eight articles comparing outcomes of transcranial and endoscopic surgery for craniopharyngioma were included in the study. Data extraction and quality assessment were performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.</p><p><strong>Results: </strong>The transcranial approach was less effective in achieving gross total resection (odds ratio [OR] = 0.47, 95% confidence interval [CI] = 0.32-0.70) compared to the endoscopic approach, with low heterogeneity (I² = 41%). However, both approaches had similar odds for near-total resection, subtotal resection, and partial resection. The transcranial approach was associated with lower odds of total neurological complications (OR = 0.6, 95% CI = 0.4-0.9), higher odds of tumor recurrence (OR = 1.86, 95% CI = 1.12-3.09), and lower odds of visual improvement (OR = 0.43, 95% CI = 0.32-0.58) compared to the endoscopic approach. There was no significant difference in mortality rate between the two approaches.</p><p><strong>Conclusion: </strong>Our meta-analysis comparing the efficacy of transcranial and endoscopic surgery for craniopharyngioma reveals that the endoscopic approach is preferred for managing specific conditions due to its higher likelihood of achieving complete resection and potentially better postsurgery outcomes, minimizing neurological complications.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"15 ","pages":"356"},"PeriodicalIF":0.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635545","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":"Incidence of pediatric traumatic brain injury (TBI) during the working hours of parents and caregivers in Saudi Arabia: A survey study.","authors":"Sami Fadhel Almalki, Abdulelah Saleh Almousa, Rawan Ahmed Alturki, Ghadi Ali Shamakhi, Fatimah Ahmed Alghirash, Turki Fahhad Almutairi","doi":"10.25259/SNI_60_2024","DOIUrl":"https://doi.org/10.25259/SNI_60_2024","url":null,"abstract":"<p><strong>Background: </strong>Traumatic brain injury (TBI) is a common result of external physical forces that damage the brain, affecting over 50 million people annually, with a higher prevalence in males. Children aged 0-4 years are the most susceptible, particularly in low-and middle-income countries, where 90% of TBI-related deaths occur. TBI significantly affects children's quality of life. This study aimed to estimate the incidence of pediatric TBI during working hours among parents and caregivers in Saudi Arabia.</p><p><strong>Methods: </strong>A questionnaire-based cross-sectional survey was conducted over 2 months, from July to August 2023. The survey data were electronically gathered using a questionnaire sent over social media channels. It includes working as a caregiver for children in Saudi Arabia.</p><p><strong>Results: </strong>Involving 395 respondents, the primary focus was on child head injuries occurring during the working hours of parents and caregivers. Most respondents were in the 36-45 age bracket, predominantly female (66.1%) and married (81.8%). The age of the child at the time of injury was significantly associated with head injuries during parents' and caregivers' working hours, with the highest incidence among children aged 7-14 years (83.1%). The severity of the injury, hospital admission, need for intensive care, and surgical intervention were significantly associated with child injuries during these hours.</p><p><strong>Conclusion: </strong>In this study, we found a significantly higher incidence of head injuries in children during the working hours of both parents and caregivers. Factors such as longer work hours, the presence of a nanny, more children, male gender, and older child age were associated with this risk.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"15 ","pages":"358"},"PeriodicalIF":0.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634966","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":"Interictal gamma oscillation regularity analysis and susceptibility-weighted imaging on focal epilepsy cases with alcohol use disorders.","authors":"Yoshihito Tsuji, Yosuke Sato","doi":"10.25259/SNI_991_2023","DOIUrl":"https://doi.org/10.25259/SNI_991_2023","url":null,"abstract":"<p><strong>Background: </strong>There has been no clear consensus on the clinical markers to distinguish alcohol-related seizures (ARSs) from epileptic seizures. We have reported the usefulness of gamma oscillation (30-70 Hz) regularity (GOR) analysis using interictal electroencephalography (EEG) data to evaluate epileptogenic focus. We conducted interictal GOR analysis using scalp EEG and susceptibility-weighted imaging (SWI) to visualize the epileptogenic focus in two cases initially suspected to have ARS.</p><p><strong>Case description: </strong>In each case, a significantly high GOR area suggestive of epileptogenic focus was detected and that area was consistent with that where SWI showed hemosiderin deposit. In one patient, seizures were well controlled with the introduction of anti-seizure medication (ASM). In another patient, ASM was introduced but is refractory, and epilepsy surgery is being considered in the future.</p><p><strong>Conclusion: </strong>The interictal GOR analysis and SWI can successfully contribute to identify the patients suspected to have ARS who may have epileptogenic focus and can be treated with ASM and epilepsy surgery.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"15 ","pages":"361"},"PeriodicalIF":0.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142636151","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":"Double trouble: Concurrent ossification of ligamentum flavum with infective spondylodiscitis in the thoracic spine resulting in paraplegia: A case report.","authors":"Akshay Vasant Mohite, Tushar Narayan Rathod, Deepika Jain, Bhushan Hadole, Rushikesh Shahade, Chitranshu Shrivastava","doi":"10.25259/SNI_583_2024","DOIUrl":"https://doi.org/10.25259/SNI_583_2024","url":null,"abstract":"<p><strong>Background: </strong>Thoracic ossification of the ligamentum flavum (OLF) and tuberculous infective spondylodiscitis rarely combine to cause paraplegia. Here, a 48-year-old female with both thoracic OLF and tuberculous spondylodiscitis experienced the acute onset of paraplegia successfully managed with a T8-L1 laminectomy with fusion.</p><p><strong>Case description: </strong>A 48-year-old female presented with the acute onset of paraplegia attributed to magnetic resonance-documented thoracic OLF and infective spondylodiscitis. Imaging revealed spinal cord compression (i.e., occupying >50% of the spinal canal) from D8 to D10 level and infective spondylodiscitis at the D10-D11 level. Surgery included a D8-L1 laminectomy with instrumented fusion. Histology and cultures revealed the presence of tuberculosis, and anti-tubercular therapy was administered. Both surgery and continued antibiotic therapy contributed to neurological improvement.</p><p><strong>Conclusion: </strong>Thoracic OLF combined with tuberculous spondylodiscitis may be effectively treated with decompression, fusion, and appropriate anti-tubercular therapy.</p><p><strong>Keywords: </strong>Dorsal spine, Infective spondylodiscitis, Koch's, Neurological deficit, Ossified ligamentum flavum (OLF), Paraplegia, Tuberculosis spine instability score (TSIS).</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"15 ","pages":"362"},"PeriodicalIF":0.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633171","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":"Meningiomas of the parieto-occipital convexity mimicking a hematoma: A case report in a third-world country.","authors":"Fatou Sène, Ebrima Kalilu Manneh, Job Manneh, Fansu F N Jatta, Fatoumatta S Jallow, John Nute Jabang","doi":"10.25259/SNI_410_2024","DOIUrl":"https://doi.org/10.25259/SNI_410_2024","url":null,"abstract":"<p><strong>Background: </strong>Meningiomas are benign, slow-growing tumors of the central nervous system (CNS) that arise from the arachnoid matter. It comprises one of the most common primary tumors of the CNS, occurring mostly in and after the fifth decade of life with a female gender predilection. Diagnosis is facilitated by imaging computed tomography (CT) or magnetic resonance imaging (MRI); however, atypical forms exist which augments the risk of missing the diagnosis. This is a case of a meningioma that mimics a hematoma on imaging, the diagnosis of which was only confirmed following histopathology.</p><p><strong>Case description: </strong>A 36-year-old patient presented with a 9-month history of intermittent moderate-intensity headaches associated with photophobia, tinnitus, and dizziness. There was no previous history of trauma. There were no focal neurological deficits on examination. Both contrast-enhanced and noncontrast-enhanced brain CT scans showed features suggestive of an intraparenchymal hematoma. She had a control CT scan 2 months and 9 months later due to the persistence of symptoms despite remaining stationary, which revealed no changes in the lesion as seen in the previous CT scans. The patient did not benefit from an MRI scan due to the socioeconomic status of the country and the patient herself. A decision to operate was made, and the sample was sent for histopathology. Histopathology confirmed the lesion to be a psammomatous meningioma.</p><p><strong>Conclusion: </strong>Although CT findings of meningiomas are quite often typical, it is important to note that atypical forms exist as well. Knowledge of the atypical forms, such as lesions that look like an intraparenchymal hemorrhage initially but remain unchanged over a period of time, would decrease the risk of missing the diagnosis in such instances.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"15 ","pages":"365"},"PeriodicalIF":0.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635278","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}