Surgical neurology international最新文献

{"title":"Posterior fossa hemorrhagic complication after tuberculum sellae meningioma surgery through transcranial corridor: A proposed hypothesis.","authors":"Guive Sharifi, Esmaeil Mohammadi, Ali Jafari","doi":"10.25259/SNI_177_2025","DOIUrl":"10.25259/SNI_177_2025","url":null,"abstract":"","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"193"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228135","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":"Road map to enhanced recovery protocol for endonasal endoscopic approach to pituitary adenomas: Surgical short-term outcome and experience of a single ENT/neurosurgery collaboration.","authors":"Mohamed M Arnaout, Mansour A Makia, Ahmed A Bessar, Ismail Elnashar, Magdy O ElSheikh","doi":"10.25259/SNI_726_2024","DOIUrl":"10.25259/SNI_726_2024","url":null,"abstract":"<p><strong>Background: </strong>The endoscopic endonasal transsphenoidal approach has become standard for the management of pituitary adenomas. This approach has been shown to facilitate early recovery and discharge from the hospital. The early recovery protocol has many advantages for both patients and the healthcare system in terms of patient satisfaction and cost-effectiveness.</p><p><strong>Methods: </strong>Forty-seven patients with pituitary adenomas who underwent a trans-nasal endoscopic approach at our institution, operated by one neurosurgeon and one ENT surgeon, were retrospectively studied. Enhanced recovery protocols entailed preoperative, intraoperative, and postoperative protocols. The standard care included 1 day postoperative intensive care unit admission plus 1 or 2 days in the ward. Patient satisfaction was measured in terms of resolution of chief complaint, and a questionnaire survey was conducted at discharge and the 3-month follow-up.</p><p><strong>Results: </strong>There was a significant decrease in the length of hospital stay with a mean of 2.7 days (standard deviation = 0.74). Patient satisfaction was better at the 3-month follow-up than in the early postoperative period. Most of our patients improved in terms of biochemical cure (18 out of 25 functioning adenomas [72%]) and experienced resolution of the chief complaint. The death occurred in only one patient due to pulmonary embolism.</p><p><strong>Conclusion: </strong>Our study supports the benefits of early recovery protocols for endoscopic endonasal surgery for pituitary adenoma resection. The procedure is both safe and efficacious and improves overall patient satisfaction. Cerebrospinal fluid leaks remain a challenge but may improve with the use of fat, fascia lata, or middle turbinate flaps for large defects.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"192"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228159","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":"Cavernoma of the left ventral striatum, anatomical and microsurgical implications of the ipsilateral transcallosal transrostral pathway.","authors":"Alejandro Benjamin Romero Leguina, Luis Ángel Canache Jiménez, Mariano Teyssandier, Álvaro Rodrigo Quiñones Céspedes, Sebastian Juan Mária Giovannini, Mariela Cecilia Salerno, Erica Antunes Effgen, Érico Samuel Gomes Galvão da Trindade, José Maria de Campos Filho, Feres Chaddad-Neto","doi":"10.25259/SNI_285_2025","DOIUrl":"10.25259/SNI_285_2025","url":null,"abstract":"<p><strong>Background: </strong>Cerebral cavernous malformations are vascular abnormalities of the central nervous system with an incidence of 0.4-0.5% and an annual hemorrhage rate ranging from 0.7% to 1%. The most important and consistent risk factor for rebleeding is a prior hemorrhage, and deep lesions (within the thalamus, basal ganglia, and brainstem) characteristically carry a worse prognosis regarding annual hemorrhage rates (10.6% per patient per year vs 0.4% per patient per year for superficial cerebral lesions) and subsequent neurologic deterioration. The ventral striatum is a difficult region to approach. The conservative treatment and also radiosurgery are not compatible with this kind of lesion, in the virtue of the eloquence and high risk of rebleeding, and the worsening of the perilesional edema, respectively, resulting in a motor deficit.</p><p><strong>Case description: </strong>This video presents a case of a 37-year-old male patient with a 6-month history of headaches, with a magnetic resonance imaging (MRI) showing a lesion in the left ventral striatum compatible with cavernoma with signs of recent bleeding. The patient underwent an ipsilateral transcallosal transrostral approach. The procedure was uneventful, and the patient was discharged without neurological deficits. A postoperative MRI confirmed complete resection.</p><p><strong>Conclusion: </strong>The anatomical aspects to consider are analyzed as the dissection progresses toward the lesion, and the other surgical alternatives are studied in this video. The ipsilateral transcallosal transrostral pathway permits an intuitive awareness of the midline at all times, facilitating safer manipulation of the brain tissue when accessing deep-seated lesions. Consequently, the risk of intraoperative and postoperative complications decreases.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"199"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228171","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":"Cranial-orbital approaches for vascular pathology: A review of surgical approach selection and technical considerations.","authors":"Kara A Parikh, Vincent N Nguyen, Mustafa Motiwala, Taylor J Orr, Kaan Yagmurlu, C Stewart Nichols, Adam S Arthur, Jeffrey M Sorenson, L Madison Michael Ii, Nickalus R Khan","doi":"10.25259/SNI_106_2025","DOIUrl":"10.25259/SNI_106_2025","url":null,"abstract":"<p><strong>Background: </strong>Modified cranial approaches for vascular pathology are sometimes necessary to enhance exposure and can be tailored by the pathology treated and surgical conditions. The authors outline these approaches, comparing the advantages and disadvantages of each.</p><p><strong>Methods: </strong>Surgical footage of the senior author performing cranial-orbital skull base approaches for intracranial aneurysms as part of routine care was reviewed to identify and describe the advantages and disadvantages of these approaches to vascular pathology. The variations of cranial-orbital approaches included supraorbital, lateral supraorbital (LSO), orbito-pterional, cranio-orbital, and transcavernous approaches. Four illustrative cases are included. The literature was also reviewed for a concise compilation and summary of technical considerations and comparisons of cranial-orbital approaches for the microsurgical treatment of vascular pathology.</p><p><strong>Results: </strong>The supraorbital approach provides a trajectory along the orbital roof, allowing access to anterior circulation aneurysms without drilling the anterior clinoid process. While this approach is suited for inferiorly and anteriorly projecting anterior communicating artery (AcomA) aneurysms, orbito-pterional approaches are better suited for superiorly projecting AcomA aneurysms. The LSO approach allows access to anterior circulation and low-lying basilar apex lesions. The orbito-pterional approach is an \"outside-in\" approach to access the intracranial space from the orbit; the cranio-orbital approach is considered an \"inside-out\" approach to access the orbit from the intracranial space.</p><p><strong>Conclusion: </strong>Modifications of the traditional pterional craniotomy are useful for various anterior and posterior circulation vascular pathologies. Extensions of these surgical corridors with transcavernous approaches can also be useful. Understanding the advantages and disadvantages of each is important in optimal approach selection.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"191"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228185","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 resection of a giant colloid cyst in the cavum septum pellucidum: Illustrative case.","authors":"Nurali Ashirov, Murat Arlanbekov, Daniyar Teltayev, Berik Zhetpisbaev, Serik Akshulakov","doi":"10.25259/SNI_1082_2024","DOIUrl":"10.25259/SNI_1082_2024","url":null,"abstract":"<p><strong>Background: </strong>Colloid cysts (CCs) are a rare type of benign tumor, and the ones >30 mm in diameter are determined as giant CCs. The giant CCs of the cavum septum pellucidum (CSP) are located in the hard-to-reach areas of the brain, and they can be removed microsurgically and endoscopically. At present, the transition from the microsurgical resection to the endoscopic is observed, and researchers demonstrate several benefits of the endoscopic resection over the microsurgical. We noticed the absence of research illustrating the endoscopic resection of the giant CC of the CSP. Therefore, we decided to demonstrate a rare case performed in our hospital.</p><p><strong>Case description: </strong>Our patient was a 57-year-old male who had suffered from dizziness, headache, nausea, urinary incontinence, short-term forgetfulness, gait ataxia, cognitive decline, and vision blurring. The eventual diagnosis of the giant CC in the CSP was established, and it was complicated by occlusive hydrocephalus and headache syndrome. The endoscopic resection of the giant CC in the septum pellucidum was performed using the endoscopic transseptal approach.</p><p><strong>Conclusion: </strong>No complications were observed in the postoperative period. The tumor was removed completely, no recurrence was noted, and only a capsule of the tumor was observed in the control magnetic resonance imaging image taken 3 months after the operation. Considering these results, we conclude that endoscopic removal may have positive and safe outcomes as the surgical treatment method for the giant CCs located in the septum pellucidum.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"186"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228097","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":"Anomalous origin of the thenar motor branch encountered during carpal tunnel release.","authors":"Megan Rajagopal, Emily Dunbar, Satya Siri Paruchuri, Robert Scott Graham","doi":"10.25259/SNI_3_2025","DOIUrl":"10.25259/SNI_3_2025","url":null,"abstract":"<p><strong>Background: </strong>This illustrative case demonstrates the thenar motor branch (TMB) arising from the median nerve proper through the palmaris fascia, visualized during a carpal tunnel release procedure.</p><p><strong>Case description: </strong>A 64-year-old with a history of hypertension and diabetes presents to the clinic with 1 year of neck pain, upper extremity numbness and tingling, wasting of hand muscles, and weakness of the left hand. Electromyography confirmed cubital tunnel syndrome bilaterally and right carpal tunnel syndrome. The patient underwent right cubital and carpal tunnel decompressions.</p><p><strong>Conclusion: </strong>Awareness of TMB anomalies and careful identification during surgery can prevent iatrogenic injury and further complications.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"180"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228169","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":"Extra-neural metastases of recurrent myxopapillary ependymoma: A patient case and literature review.","authors":"Dinali Jayawardena, Joseph Yates, Enrico Clarke, Georges Sinclair","doi":"10.25259/SNI_190_2025","DOIUrl":"10.25259/SNI_190_2025","url":null,"abstract":"<p><strong>Background: </strong>Biologically and morphologically distinct from other ependymomas, myxopapillary ependymomas (MPEs) are rare, slow-growing glial tumors originating predominantly from the conus medullaris, cauda equina, or filum terminale. Gross total resection is the standard of care for primary MPE. Nevertheless, despite maximal resection, the risk of recurrence, usually within the neural axis, remains high. However, extra-neural metastases can also occur. Due to the rarity of the entity, there is a lack of consensus on the management of recurrences and extra-neural metastatic disease. We present a case report and literature review of this rare ependymal tumor.</p><p><strong>Case description: </strong>We describe a case of a male patient with MPE who developed multiple recurrences, treated with numerous surgical resections, radiotherapy, and salvage chemotherapy before eventually developing extra-neural metastatic disease to lungs, abdomen, and lymph nodes 37 years after initial diagnosis. A biopsy of an axillary lymph node confirmed histomorphology comparable to the primary histology.</p><p><strong>Conclusion: </strong>To our knowledge, there are <30 cases of extra-craniospinal metastatic MPE reported since 1955. Consequently, there is no major consensus on the treatment of extra-neural metastatic MPE. Case reports and series remain of utter importance to share experience and help customize management. From this angle, surgery, and radiotherapy are still used in the face of central nervous system recurrence and \"limited\" extra-neural spread, depending on the patterns of invasion. Chemotherapy has shown a modest effect so far; however, positive outcomes from targeted agents and immunotherapy (alone or combined) have been reported, which warrants further exploration.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"182"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228116","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":"Postoperative management of diabetes insipidus in a pediatric patient with Rathke's cleft cyst undergoing transsphenoidal endonasal surgery.","authors":"Eko Nofiyanto, Radian Ahmad Halimi, Iwan Fuadi","doi":"10.25259/SNI_156_2025","DOIUrl":"10.25259/SNI_156_2025","url":null,"abstract":"<p><strong>Background: </strong>Postoperative Rathke cleft cyst surgery can cause injury to the pituitary gland or impaired secretion of antidiuretic hormone (ADH), leading to central diabetes insipidus (DI). This case report describes the successful postoperative management of DI in pediatric patients with Rathke's cleft cyst who underwent transsphenoidal endonasal tumor surgery.</p><p><strong>Case description: </strong>An 8-year-old girl with diabetes insipidus (DI) following transsphenoidal endonasal surgery for a Rathke's cleft cyst was admitted to the intensive care unit (ICU) for postoperative management. Initially, the patient received oxytocin infusion at 20 mU/min. Between the 13th and 15th hour postoperatively, urine output increased to 100-200 mL/h (5-10 mL/kgBW/h). In response, oral desmopressin therapy was initiated at a dose of 0.05 mg once daily. Twelve-hour evaluations showed stable urine output at approximately 500 mL/h (2.5 mL/kgBW/h). Based on this, the decision was made to discontinue oxytocin and prepare for transfer to the high care unit (HCU). In the HCU, urine output was monitored every 24 hours, and oral desmopressin was continued at the same dosage. On the third day of treatment, urine output increased significantly to 6400 mL/24 h (14.03 mL/kgBW/h). Consequently, the desmopressin dose was increased to 0.05 mg twice daily. This adjusted therapy was maintained. By the fifth day, urine output began to decrease, reaching 6 mL/kgBW/h.</p><p><strong>Conclusion: </strong>Postoperative management of DI using desmopressin therapy yields favorable outcomes during both intensive care and high-care treatment in pediatric patients undergoing transsphenoidal endonasal surgery for Rathke's cleft cyst.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"178"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228137","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 trinity of the internal carotid artery: Unifying terminologies of the main classifications to improve its surgical understanding.","authors":"Carlos Salvador Ovalle Torres, Gervith Reyes Soto, Álvaro Campero, Carlos Castillo Rangel, Alejandro Gonzalez, Iype Cherian, Maximiliano Núñez, Luis Arnulfo Perez, Vladimir Nikolenko, Alfredo Espinosa Mora, José Adonai García Campos, Raúl Neri Alonso, Andreina Rosario Rosario, Danil Nurmukhametov, Manuel De Jesus Encarnacion Ramirez, Agustín Dorantes Argandar","doi":"10.25259/SNI_27_2025","DOIUrl":"10.25259/SNI_27_2025","url":null,"abstract":"<p><strong>Background: </strong>The internal carotid artery (ICA) has multiple classification systems; it is essential for brain blood supply, which has bone/neurovascular relationships of wide neurosurgical interest; its anatomy must be known in detail, its angiographic-imaging aspect (endovascular), its ventral aspect (endoscopic endonasal approaches); and its lateral aspect (anterolateral skull base surgery). Our objectives were to identify coincidences/differences between the main classifications of the ICA to improve its surgical-anatomical understanding, unify the terminology of ICA segments, avoid confusion, and carry out a simple description.</p><p><strong>Methods: </strong>There are differences between classifications; however, these may overlap each other and determine the correspondence between segments, regardless of their purpose. Literature on ICA classifications was reviewed; a cadaver endonasal endoscopic and anterolateral skull base dissection was performed, obtaining representative images of the ICA, as well as angiography. The main terminology of ICA segments was collected, and artistic-anatomical illustrations were created to facilitate the study of ICA.</p><p><strong>Results: </strong>We compared the endoscopic roadmap to the ICA by Labib/Kassam, the extradural ICA at its lateral aspect by Cherian, and the classic classification by Bouthillier (as well as a small reference to the classification by Gibo/Rhoton). We found the shared characteristics and differences between classifications, with a total of 17 interrelated segments, with a variety of nomenclature and anatomical extension. Initially, we except the extradural ICA by Cherian because it uses almost the same nomenclature that Labib, varying in one segment, which coincides with the nomenclature of Bouthillier and does not change the total summary. The initial and terminal segments were nominative/anatomically equivalent, and there is anatomical nominal variation in the intermediate segments and its relation/correspondence has been easily demonstrated.</p><p><strong>Conclusion: </strong>Anatomical knowledge of all aspects of ICA using its main classifications, the relation between them, and its diversity of nomenclature is essential to improve its anatomical-surgical understanding and avoid anatomical nominal confusion. It can be achieved through our comparative tables/illustrations.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"177"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228164","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 atypical intradiploic epidermoid cyst, radiological findings, and surgical management.","authors":"Ahmed Adel Farag, Mohammad Ghazi Abdoh, Yoseri Jameel Alhamss, Abdelmoneim Almoatazbellah Kamar, Zaina Brinji, Alaa Alkhotani, Yahya Mubasher Mir, Hussein Kheshaifati","doi":"10.25259/SNI_170_2025","DOIUrl":"10.25259/SNI_170_2025","url":null,"abstract":"<p><strong>Background: </strong>Epidermoid cysts are benign, slow-growing, and extra-axial lesions that typically develop between the brain structures. Intradiploic and intra-axial involvement is exceptionally rare. We present a case of an intradiploic epidermoid cyst with distinct clinical and radiological features. This case highlights an unusual location and radiological presentation of an epidermoid cyst located within the skull base and may be misdiagnosed as other pathologies.</p><p><strong>Case description: </strong>A 44-year-old male presented with a dull, aching frontal headache and slowly growing right frontal swelling, worsening over several months. On examination, the patient had a hard, non-tender, non-mobile right frontal swelling above the right orbit, with an unremarkable neurological examination. Computed tomography brain revealed an extra-axial hypodense lesion in the right frontal region, causing bony thinning and focal defects in the roof of the right orbit and the zygomatic process of the frontal bone. A mild mass effect on the superior rectus muscle and adjacent brain parenchyma was noted, with the left midline shift and effaced sulci. Magnetic resonance imaging (MRI) brain showed heterogeneous signals in both T1 and T2 as well as a central area of restricted diffusion in diffusion-weighted imaging, the blood products indicated by susceptibility-weighted imaging blooming artifacts, which were suggestive of hemorrhage. The radiological differential diagnosis included an epidermoid cyst, arachnoid cyst, dermoid cyst, abscesses, metastasis, and an aneurysmal bone cyst. The patient underwent a right frontal craniotomy and excision of the cyst. Intraoperative gross inspection and histopathological analysis confirmed the diagnosis of an intradiploic epidermoid cyst.</p><p><strong>Conclusion: </strong>Epidermoid cysts occurring outside their usual locations are exceptionally rare, exhibiting atypical imaging characteristics, including unusual signal intensities on T1- and T2-weighted MRI sequences, along with the absence of the typical pattern of complete restricted diffusion. These findings may be indicative of a mixture of blood products and proteinaceous substances within the cyst. Subsequently, it may be misdiagnosed as other intracranial pathologies.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"183"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228167","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}