Neurosurgery Cases and Reviews is an international, peer reviewed, open access journal that deals with the medical specialty concerned with the prevention, diagnosis, surgical treatment, and rehabilitation of disorders affecting portions of the nervous system including the brain, spinal cord, peripheral nerves, and extra-cranial cerebrovascular system.
All the published articles are permanently archived without any restriction barriers to access under terms of creative commons attribution license. The submitted manuscripts undergo thorough double blind peer review process and are accepted only by recommendation of editorial experts. The journal invites various type of articles covering but not limited to ablative surgery, astroglias, brain hemorrhages, cervical spinal stenosis, cranial/peripheral nerve pain, deep brain stimulation surgery, drug-resistant epilepsy, glioblastomas, hydrocephalus infections, intracerebral hemorrhage, intractable psychiatric disorders, invasive stereotactic neurosurgery, lumbar spinal stenosis, movement disorders, moyamoya disease, skull fractures, spinal cord trauma, spinal disc herniation, traumatic injuries of peripheral nerves, tumors of the spine, spinal cord and peripheral nerves, vascular malformations, etc.
Articles Search by Keyword | Journal title | Author name | DOI
Open Access DOI:10.23937/2643-4474/1710114
Lydia A Leavitt
Article Type: Case Report | First Published: June 03, 2022
A 69-year-old female with a 30-year history of hyperprolactinemia symptomatically controlled with dopamine agonist therapy presented with complaints of worsening headaches. Findings on physical examination and endocrine studies were unremarkable....
Open Access DOI:10.23937/2643-4474/1710113
Maidan Aiman, MD, Moldabekov Aidos, MD, Zhetpisbaev Berik, MD, Ryskeldiyev Nurzhan, Ashirov Nurali, MD, Teltayev Daniyar, MD and Akshulakov Serik
Article Type: Case Report | First Published: June 03, 2022
Pineal region tumors are classically presented with vertical gaze palsy, hypothalamic symptoms, or, more often, hydrocephalus, by obstructing the aqueduct. This case report describes a patient with obstructive hydrocephalus and a hearing loss as an initial complaint of pineal region tumor....
Open Access DOI:10.23937/2643-4474/1710112
Victoria Becerra, MD, PhD, Jose Hinojosa, MD, PhD, Santiago Candela, MD, PhD, Diego Culebras, MD and Mariana Alamar, MD
Article Type: Case Report | First Published: June 03, 2022
We report three patients diagnosed with anterior plagiocephaly caused by frontosphenoidal synostosis and compare it with the clinical features and surgical implications of a patient affected by unilateral coronal craniosynostosis....
Open Access DOI:10.23937/2643-4474/1710110
Mohamed Alhantoobi, Almunder Algird, Jian-Qiang Lu, John Provias and Kesava Reddy
Article Type: Case Report | First Published: May 20, 2022
A 55-year-old male with a history of left thigh invasive melanoma resected a year ago with negative margins, presented to emergency department with a few days of severe headaches followed by urinary incontinence and decreased level of consciousness....
Open Access DOI:10.23937/2643-4474/1710111
Christian Schill, BS, Sabrina Meftali, MD, Hugh Moulding, MD, PhD and Bankim Bhatt, MD
Article Type: Case Report | First Published: May 21, 2022
Cerebral salt wasting, a rare complication of cranial neurosurgery, has not been reported after a functional pituitary tumor resection. The simultaneous presentation of diabetes insipidus (DI) and cerebral salt wasting after pituitary surgery presents a unique diagnostic challenge. We present a case of a 27 y.o. man with a 6-month history of acromegaly as evident by an IGF-1 of 1040 ng/ mL (reference range: 101-307 ng/mL). MRI of the pituitary revealed a 3.2 cm × 3.2 cm × 3.1 cm macroadenoma e...
Open Access DOI:10.23937/2643-4474/1710109
Atul Vats, Shahid Khan and Farooq Aziz
Article Type: Case Report | First Published: May 20, 2022
Cervical spondylotic myelopathy can mimic an intramedullary tumor. We report a case of a young male who presented with gradually progressive myelopathy. MRI cervical spine with contrast revealed a contrast enhancing lesion. Anterior cervical discectomy with fusion was done. In case of a progressive cervical myelopathy with atypical radiographic appearance initial decompression and follow-up with an MRI might be the procedure of choice, if a clear diagnosis for a causative treatment cannot be mad...
Open Access DOI:10.23937/2643-4474/1710108
Guido GABRIELE, Flavia CASCINO, Linda LATINI and Biagio Roberto CARANGELO
Article Type: Case Report | First Published: April 30, 2022
Meningosarcoma represent a rare disease with an uncertain prognosis. Moreover, localization of tumours in the infratemporal fossa is rare. Lack of associated symptomatology of infratemporal fossa’s lesions could result in a diagnosis and treatment delay. Also, surgical management of infratemporal fossa neoplasm remain challenging. The authors present the case of a meningosarcoma extended to the infratemporal fossa, which presented in an advanced stage and required other treatment further than ...
Open Access DOI:10.23937/2643-4474/1710107
Pilipenko Yuri, MD, PhD, Konovalov Anton, MD, PhD, Poluektov Yuri and Eliava Shalva, MD, PhD
Article Type: Case Report | First Published: April 25, 2022
Patient F, male, 43-years-old, presented with a subarachnoid hemorrhage. CT angiography revealed an 8 mm saccular aneurysm in the trifurcation of the left middle cerebral artery (MCA) (Figure 1). When the patient’s condition stabilized, he was transferred to our center for surgical treatment 30 days after the hemorrhage. The patient’s condition was satisfactory at admission. No cerebral neurological symptoms were detected. The patient underwent microsurgical clipping of the aneurysm neck in ...
Open Access DOI:10.23937/2643-4474/1710106
Loukas Georgiou, BS, Mark Burton, MD, Brian Walker, DO and Anastasios Georgiou, MD
Article Type: Case Report | First Published: April 20, 2022
Gliosarcoma is a very uncommon primary brain malignancy and is considered a subtype of glioblastoma. It represents approximately 2% of cases classified as glioblastoma. Treatment of gliosarcoma follows the paradigm for glioblastoma with recommendations for a maximal allowable resection followed by post-operative radiation therapy to the operative bed with concurrent temozolomide. Although still being a rare occurrence, gliosarcomas have a relatively higher propensity for transdural growth either...
Open Access DOI:10.23937/2643-4474/1710105
Shivum Desai, BS, Jingya Miao, MS, Alice S Wang, BS and Omid Hariri, DO, MSc
Article Type: Case Study and Literature Review | First Published: April 20, 2022
Denosumab is a human monoclonal antibody to receptor activator of NF-κB ligand (RANKL), which has been FDAapproved for the management of giant cell tumor of bone. Here, we present a case of 21-year-old female with solid aneurysmal bone cyst (ABC) treated with denosumab for 6 months to date. The patient experienced positive outcomes as the result of denosumab therapy. Although the use of denosumab has been reported in a number of studies, its off-label use for treatment of ABC and other giant ce...
Open Access DOI:10.23937/2643-4474/1710099
Catherine Zhang, Lauren Harris, Hamza Itum, Sanjiv Chawda, Julian Coker, Jonathan Pollock, Ahmed Sadek and Shoakazemi
Article Type: Case Report | First Published: March 05, 2022
Internal jugular vein (IJV) stenosis is being increasingly associated with certain neurological conditions, including benign intracranial hypertension, cerebrospinal fluid (CSF) disorders, multiple sclerosis and Alzheimer’s disease. The role of surgery in IJV stenosis have typically been to manage the associated CSF disorders, or with IJV stents. We describe a case of a patient incidentally found to have bilateral possible IJV stenosis with dilated paraspinal collateral venous channels during ...
Open Access DOI:10.23937/2643-4474/1710104
George Bonanos, Shahid Kahn, Peter Kralt and Nitin Mukerji
Article Type: Case Report | First Published: April 15, 2022
We present a rare cause of increased Intracranial Pressure (ICP) and papilloedema in a male adult. The presenting symptoms of blurred vision and headaches were investigated with brain imaging which revealed an intradiploic epidermoid cyst, extending intracranially compressing the torcular Herophilli. Presence of papilloedema should trigger cranial imaging to look for causes of raised intracranial pressure. Obstruction of the venous sinuses flow is a recognized cause of raised intracranial pressu...
Open Access DOI:10.23937/2643-4474/1710103
Baticam NS, Alloy E, Rolland A, Fuchs F and Roujeau T
Article Type: Case Report | First Published: April 08, 2022
Suprasellar Arachnoid Cysts (SAC) are rare heterogenous entities that can be diagnosed and treated prenatally or postnatally, depending on their type and symptoms. We report a case of a prenatally diagnosed suprasellar arachnoid cyst treated postnatally. The cyst was diagnosed on a routine ultrasound at 22 weeks of gestation. It was a very large cyst in the prepontine region, compressing the brain stem and the 4th ventricle, causing a ventriculomegaly. The cyst was rapidly evolutive in the ultra...
Open Access DOI:10.23937/2643-4474/1710102
Christopher Alan Brooks, Jessica Wang, Ashraf Dower, Alar Enno, Andrew Bonura and Joanna Lee
Article Type: Case Report | First Published: March 25, 2022
Squamous cell carcinoma of cutaneous origin is an insidiously developing cancer, and seldom metastasises. Patient and lesion characteristics that predispose to more aggressive biological behaviours include immune incompetence, recurrence following excision and those demonstrating invasion of local lymphovascular and neural structures. An elderly man with a history of Crohn’s disease requiring long-term immunosuppression, and cutaneous squamous cell carcinoma of the chest wall with locoregional...
Open Access DOI:10.23937/2643-4474/1710101
Ketan S Khurjekar, Himanshu Gurunath Kulkarni, Shailesh Hadgaonkar, Ajay Kothari, Parag K Sancheti and Ashok Shyam
Article Type: Case Report | First Published: March 25, 2022
The term ‘tandem spinal stenosis’ (TSS) is usually used to describe a double stenotic lesion in the cervical and lumbar spine, which are the most mobile segments of spine. There have also been a few reports describing the clinical course of tandem thoracic and lumbar spinal stenosis. Triple-region spinal stenosis (TRSS), or concurrent stenosis in the cervical, thoracic, and lumbar spine is the least documented variety of tandem spinal stenosis in literature. Combination of three co-existing ...
Open Access DOI:10.23937/2643-4474/1710100
Pulmonary Infarction and Acute Respiratory Distress Syndrome Resulted from Small Amount of Peripheral Pulmonary Cement Embolism following Cement-Augmented Pedicle Screw Fixation: A Rare Case and Literature Review
Chia-Jung Hsieh and Fon-Yih Tsuang
Article Type: Case Report | First Published: March 14, 2022
The information about symptomatic pulmonary cement embolism (PCE) following vertebroplasty and cement-augmented pedicle screw fixation is limited. To our knowledge, this is the first reported case of severe acute respiratory distress syndrome (ARDS) caused by a relatively small amount of peripheral PCE, which resulted in mortality. A 78-year-old man underwent L1 corpectomy and reconstruction and posterior fixation for painful T11, T12, and L1 burst fracture and concurrent osteonecrotic changes o...
Open Access DOI:10.23937/2643-4474/1710098
Maia Osborne-Grinter, MBChB, Julie Woodfield, PhD, Ana M Casado Lopez, LMS, Anna Solth, FCSEd (SN) and Mark A Hughes, PhD
Article Type: Case Report | First Published: February 12, 2022
Posterior fossa mature teratomas are rare congenital lesions that contain differentiated tissue from all three germ cell layers. The imaging characteristics can be highly variable, reflecting the variety of potential tissue types. A 22-year-old presented with headache, papilloedema, and diplopia. CT head showed a hyperdense lesion in the posterior fossa, initially suspicious of haemorrhage, with acute hydrocephalus. Digital subtraction angiogram was normal. MRI was suggestive of a melanin contai...
Open Access DOI:10.23937/2643-4474/1710097
Glaucia Suzanna Jong A Liem, Fernando Mendes Paschoal Junior, Feres Eduardo Aparecido Chaddad Neto, Eberval Gadelha Figueiredo, Manoel Jacobsen Teixeira, Edson Bor-Seng-Shu and Eric Homero Albuquerque Paschoal
Article Type: Case Report | First Published: February 10, 2022
We describe a case of cerebral proliferative angiopathy in a patient with frequent episodes of disabling headaches. The clinical details, radiographic and angiogram findings and medical management are reviewed. This is the first described cerebral proliferative angiopathy case in which we noticed shrinkage of a vascular lesion with the use of a betablocker. A 29-year-old young man attended the neurosurgery outpatient clinic with a chief complaint of headache, mild cognitive impairment, and inter...
Open Access DOI:10.23937/2643-4474/1710096
XiaoBo Kou, MS, LunXin Liu, MD and LiangXue Zhou, MD
Article Type: Case Report | First Published: February 05, 2022
Intracranial xanthoma is a rare benign intracranial tumor. It often occurs in patients with hyperlipidemia. Intracranial xanthomas grow slowly, and clinical symptoms only appear when the mass compresses the surrounding tissues, so early diagnosis of the disease is difficult. A 25-year-old female complained of right-sided facial paralysis and hearing loss for 4 years, and an intracranial mass was found for 1 week. The patient had a history of FH and excision of the left elbow mass; positive sign:...
Open Access DOI:10.23937/2643-4474/1710095
Ali A, Parry A, Halliday D, Pretorius PM and Halliday J
Article Type: Case Report | First Published: January 22, 2022
To report a rare case of malignant transformation of a peripheral nerve sheath tumour (MPNST) with associated metastasis in a patient with Neurofibromatosis 2 (NF2). NF2 is a hereditary disorder which presents with both central and peripheral nervous system tumours; caused by defects in the long arm of chromosome 22. The prevalence of NF2 is 1 in 50,000. NF2 is not a recognised risk factor for malignant transformation of schwannomas and this in this group is rarely seen, despite their high burde...
Open Access DOI:10.23937/2643-4474/1710091
Yigit Can SENOL, MD, Ayberk KARAMAN, MD, Bige SAYIN, MD, İlkay AKMANGIT and Ergun DAGLIOGLU, MD
Article Type: Case Report | First Published: November 29, 2021
We report an exceptional case of vertebral artery aneurysm presented with dyspnea and cough symptoms which is misdiagnosed with bronchiectasis. Literature showed that cough can be an exceptional symptom of vertebral aneurysms. Vertebral aneurysms presented with cough are rare and might be confused with other lung diseases such as pneumonia, chronic obstructive lung disease (COPD) or bronchiectasis. Giant intracranial aneurysms are rare entities defined by a diameter of at least 25 mm, accounting...
Open Access DOI:10.23937/2643-4474/1710089
Ayse Uzuner, Anil Ergen, Burak Cabuk, Ihsan Anik and Savas Ceylan
Article Type: Case Report | First Published: November 18, 2021
Craniopharyngiomas are benign but locally invasive tumors which are frequently located in the suprasellar region. Primary infundibular and infundibulo-tuberal craniopharyngiomas are rare because of their location and generally result in late diagnosis. Due to the unusual location, the chosen mode of treatment is very important for patient’s recovery. With infundibular and infundibulo-tuberal lesions, two patients were referred to our clinic, one of them was not considered as craniopharyngioma ...
Open Access DOI:10.23937/2643-4474/1710094
Ya Lyn Samantha Ang, MBBS, FRCSEd, FAMS, Jiani Sherry Liu, MBBS, Chi Long Ho, MD, MMed, MRCS, FRCR, FAMS, Cristine Szu Lyn Ding, MBBch Bao, FRCPath and Jai Prashanth Rao, MBBS, MMed, FRCSEd
Article Type: Case Report | First Published: January 14, 2022
Epidermoid cysts are benign indolent lesions that account for around 1% of all primary brain tumours. Embryologically, they are thought to arise from entrapped ectodermal elements during neural tube closure. They often display classic magnetic resonance imaging (MRI) characteristics compared to atypical ‘white epidermoids’ which display reversed MRI signal intensities. In this article, we describe a 55-year-old lady who presented with progressively worsening headaches and was subsequently fo...
Open Access DOI:10.23937/2643-4474/1710090
Hatim Belfquih, MD, Hassan Baallal, MD and Adil Arrob, MD
Article Type: Clinical Images | First Published: November 29, 2021
Dermoid Cysts are considered congenital lesions, but not all of them are diagnosed at birth. Dermoid cyst involving subgaleal temporal area with no intracranial extension is a rare scalp swelling. We report a case of 37-year-old female patient presented with a history of a scalp swelling since birth. The swelling increased in size progressively. Magnetic resonance imaging of the brain revealed extracranial cystic lesion over the temporal bone with no intracranial extension. Cyst was excised comp...
Open Access DOI:10.23937/2643-4474/1710088
Camarano JG, Hrushka JM, Allison RZ, Robledo A, Raghuram K and Kan P
Article Type: Case Report | First Published: October 30, 2021
A 63-year-old man with a known left frontal AVM presented with a recent increase in seizure activity. Approximately two weeks prior to admission the patient was found seizing and febrile with a temperature of 38.2 °C. At that time the patient had reported a one-week history of dry cough, shortness of breath and dyspnea on exertion. Nasopharyngeal swab testing with polymerase chain reaction (PCR) was positive for SARS-CoV-2. The patient’s left frontal lobe AVM was first identified in 2007 with...
Open Access DOI:10.23937/2643-4474/1710087
Roman Khalepa and Yuliy Kubetskiy
Article Type: Case Presentation | First Published: October 23, 2021
Spinal arachnoid cysts are the benign intradural extramedullary lesions that usually occur at the thoracic region. Such cysts can cause compression of spinal cord with symptoms of myelopathy. The diagnosis is clinical and radiological with the use of MRI. Nowadays there are some surgical options to eliminate compression of spinal cord: laminectomy and total removal of the arachnoid cyst, puncture aspiration, cyst fenestration, cystoperitoneal shunting. Each of these options can be used in arachn...
Open Access DOI:10.23937/2643-4474/1710086
Ling Jyh Chyang, Mohamad Hidir Abdullah, Mohd Syahiran bin Mohd Sidek and Mohamad Azhari Omar
Article Type: Case Report | First Published: October 13, 2021
Meningiomas are the most common primary intracranial tumors. They arise from meningothelial cells of the arachnoid layer. Trauma as a cause for meningioma has been mentioned in literatures but still remains controversial. We present a case of 69-year-old lady who developed a large meningioma at previous site of burrhole-craniostomy within 6 months period. Meningiomas are the most common primary intracranial tumors. They arise from meningothelial cells of the arachnoid layer. Common risk factors ...
Open Access DOI:10.23937/2643-4474/1710085
Zahraa M Kareem, Mohamed M Arnaout, Ruqayah A Al-Baidar, Zahraa F Al-Sharshahi and Samer S Hoz
Article Type: Case Report and Literature Review | First Published: October 11, 2021
A cerebral cavernous malformation [CCM] is a cluster of abnormally thin and dilated blood vessels. In rare instances, diagnosis can be clouded by the possibility of an intracranial aneurysm. In this paper, we report a case of CCM that was initially misdiagnosed as intracranial aneurysm. We conduct a review of the literature on similar cases. A healthy, 43-year-old man had a three-month history of recurrent headaches and seizure episodes. Imaging studies, including CT, GRE T2W MRI, and CTA were i...
Open Access DOI:10.23937/2643-4474/1710084
Mohamad Hidir Abdullah, Ling Jyh Chyang, Neoh Yee Yik and Mohamad Azhari Omar
Article Type: Case Report | First Published: October 09, 2021
Spine extraosseous chordoma is a rare primary malignant tumor which may be easily misdiagnosed. In this report, we describe a case of an elderly man who presented with severe low back pain and gradual limb weakness with physical examination consistent with L3/L4 radiculopathy. MRI showed intervertebral disc extrusion which is proven histologically as a chordoma. Despite its rarity and radiological finding mimicking the more commonly encountered prolapsed intervertebral disc, a differential diagn...
Open Access DOI:10.23937/2643-4474/1710082
Samer S Hoz, MD, FRCS, Zahraa F Al-Sharshahi, MD, Gheyath Algawwam, MD and Anshit Goyal, MD
Article Type: Case Report | First Published: October 09, 2021
The emergence of psychiatric symptoms purely as a sequela of brain lesions is a rare occurrence. The exact neural circuits governing such manifestations are poorly understood; their early recognition is, nonetheless, of pivotal importance to patient management. Herein, we report a case of a 23-year-old male patient who presented with a new-onset pseudobulbar affect following trans-cerebellar resection of a hemorrhagic pontine cavernous malformation. Following a one-month course of 5 mg Olanzapin...
Open Access DOI:10.23937/2643-4474/1710083
Michael Brooks, MD, Rebecca Nguyen, MD, Ganeshwaran Shivapathasundram, MBBS, FRACS and Mark Sheridan, MBBS, FRACS
Article Type: Case Series | First Published: October 09, 2021
Suboccipital decompressive craniectomy is a procedure that has been performed to treat malignant cerebellar oedema secondary to posterior fossa strokes. Due to the rarity of the procedure, more evidence is required to better identify factors associated with good or poor outcomes to aid in appropriate patient selection for surgical intervention. Currently known good prognostic factors include reduced time until surgery from deterioration and unilateral infarction. A retrospective review was perfo...
Open Access DOI:10.23937/2643-4474/1710081
Omar Akel, MBS, Blake Taylor, MD, Omar Ashraf, Fareed Jumah, MD, Bharath Raju, MD, Priyank Khandelwal, MD, Margaret Pain, MD, Stephen Johnson, MD, Anil Nanda, MD, Sudipta Roychowdhury, MD and Gaurav Gupta, MD
Article Type: Case Report and Review Article | First Published: September 26, 2021
Intracerebral hemorrhage (ICH) is the leading cause of death in patients with hemophilia. The incidence of ICH is up to 50 times greater than that of the general population, and most frequently occurs in children less than two years of age and among those with the severe forms of the disease. The ideal perioperative management of this patient population, however, remains unclear. A 9-month-old boy with a known history of hemophilia A (HA) presented to the emergency department with lethargy, anor...
Open Access DOI:10.23937/2643-4474/1710080
Kali Uppalapati, Narindra Ramnarine, FRCS and Panduranga Seetahal-Maraj
Article Type: Case Report | First Published: September 20, 2021
Cerebral infarction caused by Pituitary Apoplexy is a rare phenomenon with less than 30 reported cases in literature. We report this rare phenomenon in a 42-year-old female, who was diagnosed and underwent urgent trans-sphenoidal decompression of the sella. A 42-year-old female presented with sudden onset of headaches, left hemiplegia and bitemporal hemianopia. Radiological investigations revealed right anterior circulation infarction from mechanical obstruction of the right internal carotid art...
Open Access DOI:10.23937/2643-4474/1710078
Panduranga Seetahal-Maraj, MRCS, Nadeem Hosein, FRCP, Patrick Knight, FRCS and Narindra Ramnarine, FRCS
Article Type: Case Report | First Published: September 15, 2021
Ganglioneuromas of the cervical spine are rare lesions. There are only 6 documented cases in the existing literature that are associated with neurofibromatosis type 1, in which all patients presented with tetraparesis. We present a case of a young female with NF1, who developed bilateral upper limb paresthesia after a minor fall. Her neurological examination was consistent with cervical myelopathy, with long tract signs evident but no loss of power. MRI of the cervical spine showed bilateral dum...
Open Access DOI:10.23937/2643-4474/1710076
Abdulnasser Alyafei, Ghanem Al Sulaiti, Nissar Shaikh, Sirajelddin Belkhair, Ahmed Quateen, Surya Batas, Aisha AL Kubaisi, Ghaya AL Rumahi, Alaalden, Husham Abdul Rahman, Ahmed Own, Ali Raza and Hassan AL Thani
Article Type: Orginal Research | First Published: September 03, 2021
Thoracolumbar injury is one of the most common spine injuries. The injury manifesting as neurologic deficit usually requires surgery because of the underlying spinal instability and/or neural compression. The objectives of surgical treatment are to restore the biomechanical stability of the spine and/or to achieve neural decompression. The aim of the study was to evaluate short-term outcomes in patients with symptomatic vertebral injury, underwent posterior instrumentation surgery in the acute s...
Open Access DOI:10.23937/2643-4474/1710077
Panduranga Seetahal-Maraj, MRCS, Narindra Ramnarine, FRCS and Yourki Pierri Tairouz Zeitoune, MD
Article Type: Case Report | First Published: September 04, 2021
The management of fusiform anterior circulation aneurysms has been controversial, due to the rare nature of such lesions. They provide a unique management challenge compared to saccular aneurysms, and a variety of microsurgical techniques have been attempted in the past, with varying success rates. Fusiform middle cerebral artery aneurysms can be fraught with morbidity and even mortality, if perforator ischaemia results from intervention. In this neuroendovascular era, flow diverters have shown ...
Open Access DOI:10.23937/2643-4474/1710075
Hejazi N, MD and Al-Kassab M, MD
Article Type: Review Article | First Published: July 28, 2021
The goal of this study was to evaluate the therapeutic role of decompressive craniectomy for severe brain injury in children. Between 1993 and 2020 we treated 37 children with severe brain injury (Glasgow Coma Scores lower than 8) and primary intracranial pressure of 30 mmHg or higher. In all cases follow up data could be obtained. Mean age was 6.5 years (range 2 years - 16 years). Initial computerized tomography scans of all patients demonstrated diffuse brain injury with generalized brain swel...
Open Access DOI:10.23937/2643-4474/1710074
Krishan Kumar Sharma and Asgar Ali
Article Type: Case Report | First Published: July 28, 2021
Surgical intervention in posterior fossa extradural haematoma (PFEDH) carries very good results. But there are no defined indications for surgical evacuation when patient is asymptomatic and normal neurologically, even in the guidelines for surgical management of traumatic brain injury by ‘the brain trauma foundation & the congress of neurological surgeons’. Haematoma volume > 10 ml, haematoma thickness > 15 mm, perimesencephalic cisterns obliteration, fourth ventricle displacement and hydro...
Open Access DOI:10.23937/2643-4474/1710073
Cristiano Antunes, Paulo Pereira, Daniela Alves, Rui Vaz and Josue Pereira
Article Type: Case Reports and Case Series | First Published: July 23, 2021
More than 450 skeletal dysplasias have been described including Achondroplasia. Due to defective ossification of the occipital bone and upper cervical spine, neural structures may be compressed, causing increased morbidity/mortality during childhood, mainly from sleep apnoea and other respiration abnormalities, myelopathy, syringomyelia, hydrocephalus, and even sudden infant death. This highlights the importance of early and effective treatment of craniovertebral stenosis in infants with skeleta...
Open Access DOI:10.23937/2643-4474/1710067
Qiang Fang, Yun Yang, Jiajun Wei, Ligen Fan, Zhuoxi Xie, Zhouming Zhu and Hao li
Article Type: Clinical Research | First Published: May 27, 2021
In-stent restenosis (ISR) is a key parameter influencing long-term stent use in patients that have undergone cerebrovascular stent implantation, and it additionally impacts surgical treatment outcomes. Inflammation is a key driver of ISR incidence, To date, however, no studies have evaluated the relationship between ISR and prognostic nutritional index (PNI), which is based upon lymphocyte counts and serum albumin levels and is closely linked with inflammatory activity. In this study, we therefo...
Open Access DOI:10.23937/2643-4474/1710072
Cuauhtemoc Gil-Ortiz, Alberto Ramírez-Romero, Javier Lagos-Servellon and Dulce Bonifacio- Delgadillo
Article Type: Clinical Case | First Published: June 28, 2021
Percutaneous vertebroplasty (PV) is a minimally invasive procedure that requires the injection of cement into a fractured vertebral body. Spine Jack® is a vertebroplasty system with an intracorporal implant designed to restore the height of the vertebral body in osteoporotic vertebral fractures. There are no reported cases of PV with Spine Jack® system as treatment for multilevel compression fractures in patients with vertebral osteoporosis due to Cushing disease. A 55-year-old male with lumba...
Open Access DOI:10.23937/2643-4474/1710071
Taofiq Sanusi, William Owiti, Juraj Schwab and Ashraf Abouharb
Article Type: Case Report | First Published: June 24, 2021
Posterior circulation aneurysms are less common compared to the anterior circulation aneurysm. Dissection distal Posterior Inferior Cerebellar Artery, PICA, aneurysm is very uncommon. In this case report, we describe an adult who had distal PICA aneurysm in the 4th ventricle which radiologically and symptomatically mimics a fourth ventricular mass lesion. Our aim is to add to the literature about rare but possible differential diagnosis of 4th ventricular tumour. A 43-year-old lady presented wit...
Open Access DOI:10.23937/2643-4474/1710070
Joel Passer, MD, Anand Kaul, MD and Rami O Almefty, MD
Article Type: Case Report | First Published: June 24, 2021
Arachnoid cysts are common findings on neuroimaging and account for approximately 1% of all intracranial lesions. The cerebellopontine angle is the second most common location. When arachnoid cysts become symptomatic due to cyst growth, or rarely, cyst rupture, they create mass effect on adjacent neurovascular structures and may require neurosurgical management. This involves a posterior fossa decompression and cyst fenestration with or without cyst fluid diversion. We present a case of a 40-yea...
Open Access DOI:10.23937/2643-4474/1710069
Krishan Kumar Sharma and Asgar Ali
Article Type: Case Report | First Published: June 18, 2021
According to guidelines of the brain trauma foundation and the congress of neurological surgeons for managing traumatic brain injury, surgical evacuation recommended for extradural haematoma with volume more than 30 cm3 regardless Glasgow coma scale (GCS) of patient. A case of asymptomatic extradural haematoma (volume 40.5 cm3) treated on regular clinico-radiological assessment (CRA) showed near complete resolution of extradural haematoma. This supports CRA as an ethically justified treatment ap...
Open Access DOI:10.23937/2643-4474/1710068
Choo Heng Tan, FRCS, Felicia HZ Chua, MBBS, MRCS and Peter Y K Hwang, FRACS
Article Type: Case Report and Literature Review | First Published: May 29, 2021
Hemangioblastoma is known to be a vascular tumor although its hemorrhagic rate is low. The association with aneurysm can be due to flow related in highly vascular pathology like hemangioblastoma or secondary to presence of hypoxic induced factor and vascular endothelial growth factor in case of Von-Hippel Lindau syndrome. However, the hemorrhagic rate and management strategy is not well established in patients with co-existence of hemangioblastoma and aneurysm. This is a 60-years-old man who dev...
Open Access DOI:10.23937/2643-4474/1710066
Florence Constance Maria Reith, MD, PhD, Markus Schmidt, MBBS(Hons), FANZCA and Gabriel Yin Foo Lee, MBBS(Hons), MS, FRACS
Article Type: Case Report | First Published: April 23, 2021
Intracranial arachnoid cysts (AC) rarely enlarge and become symptomatic, especially in adults and when located retrocerebellar. This report describes an adult in which an expanding retrocerebellar arachnoid cyst prompted surgical resection and it provides an overview of the literature and recommendations for optimal management. A 65-year-old women was diagnosed with an incidental retrocerebellar AC. She presented 10 years later with headaches, aural fullness and poor balance. Consecutive MRI sho...
Open Access DOI:10.23937/2643-4474/1710065
Andrey Vladimirovich Gavrjushin, MD, PhD and Danil Mihajlovich Chelushkin, MD
Article Type: Case Report | First Published: April 23, 2021
NECs are rare congenital lesions that are thought to be a result of persistence of the neurenteric canal to arise from a persistent neurenteric canal connecting primitive gut and neural tube. Despite the congenital nature NECs can be diagnosed at any age and at a similar frequency in women and men. To our knowledge, 140 intracranial NC, confirmed by histology, including the patient presented in this review, have been reported since 1952. Parenchymal NCs are extremely rare and there are no any pu...
Open Access DOI:10.23937/2643-4474/1710064
Morgan A Clond, MD, PhD, Evin A Koleini, MD, Timothy E Richardson, DO, PhD, Stephanie A Zyck, MD, Vandana Sharma, MD, Mashaal Dhir, MD, Fenghua Li, MD, Satish Krishnamurthy, MD, Xiuli Zhang, MD and P Sebastian Thomas, MD
Article Type: Case Report | First Published: April 21, 2021
We present an unusual case of a 60-year-old female who developed subtle, new-onset left upper and lower extremity weakness on day five after perioperative thoracic epidural placement. The onset of a focal neurological deficit in any patient undergoing epidural anesthesia usually raises suspicion for the presence of an epidural hematoma, abscess, or traumatic cord lesion. However, in this patient, brain imaging revealed a large, occult intracranial mass. Classically, the risk of mass related intr...
Open Access DOI:10.23937/2643-4474/1710063
Xigong Li, Weiyi Diao, Shuo Wang, Dongdong Yu, Junsong Wu and Yuzhu Zhang
Article Type: Case Report and Literature Review | First Published: March 31, 2021
Oblique lumbar interbody fusion (OLIF) can achieve better reconstruction of the lumbar spine via the anatomic corridor between the psoas muscle and the great vessels. Despite OLIF is considered as an effective and relatively safer procedure, congenital anomalies of the main vessels surrounding the oblique corridor may pose higher risk of vascular damage, which should bear in mind in deciding to use the OLIF procedure. We presented a case of an anomalous left-sided inferior vena cava (IVC) who un...
Open Access DOI:10.23937/2643-4474/1710062
Masanori Kurimoto, MD and Hiromichi Yamamoto, MD
Article Type: Case Report and Literature Review | First Published: March 05, 2021
'Talk and die' patients are a small number of patients who present with a mild head injury (Glasgow coma scale [GCS] 13-15) and then subsequently deteriorate and die from intracranial causes. We report the case of a 60-year-old man who had the first mild head injury, followed by chronic subdural hematoma and finally suffered from the high-energy second head injury and was ambulated to our hospital with a GCS of 15. He presented with severe headache and uncontrollable high blood pressure but he c...
Open Access DOI:10.23937/2643-4474/1710060
Rida Touab, MD, Mohammed Rabii Andaloussi, MD, Khalil Mounir, PhD, Mustapha Bensghir, PhD and Hicham Belkhi, PhD
Article Type: Case Report | First Published: February 28, 2021
Hemorrhagic stroke can be an exceptional complication of meningitis and constitute a differential diagnosis in our observation. A 73-year-old man, with a history of arterial hypertension, chronic smoking for 25 years, and has been abstinent for 30 years. The patient had had a fever of 38 °C for one week before admission with vomiting, headache complicated by altered consciousness, with suspension of contact. The patient had a Glascow Coma Scale at 10, and normal hemodynamic and respiratory para...
Open Access DOI:10.23937/2643-4474/1710061
Ioan Alexandru FLORIAN, Magdalena BALACI, Teodora Larisa TIMIȘ, Cristina Caterina ALDEA, Laura MUREȘAN, Oana Maria RADU and Ioan Stefan FLORIAN
Article Type: Case Report | First Published: February 27, 2021
The neurological complications of COVID-19 are still under scrutiny, stroke and intracranial hemorrhages being the most commonly described events. Hemorrhagic stroke in previously healthy patients and with a normal coagulative status has only rarely been described. We present three males aged 30, 57 and 38 respectively, who suffered from intracranial hemorrhages, having been diagnosed with COVID-19, with no medical history and under no previous medication. They were all operated via external ven...
Open Access DOI:10.23937/2643-4474/1710059
Anne-Laure Hermann, MD, Christine Bulteau, MD, PhD, Marc Polivka, MD and Augustin Lecler, MD, PhD
Article Type: Case Report | First Published: February 19, 2021
The World Health Organization (WHO) Classification of Central Nervous System describes several types of glioneuronal tumors, which are known to induce refractory partial seizures in children and adults. The most frequent ones are Dysembryoplastic Neuroepithelial Tumors (DNETs), gangliogliomas and oligodendrogliomas, but other types of complex glioneuronal lesions can be observed and are described as Low-Grade Epilepsy Associated Neuroepithelial Tumors (LEAT). The angiocentric glioma, previously ...
Open Access DOI:10.23937/2643-4474/1710058
Senol Yigit Can, MD, Daglioglu Ergun, MD, Aydogdu Basaran Ozge, MD and Belen Deni, MD
Article Type: Case Report | First Published: February 19, 2021
We presented a unique case of infantile type hemangioma corresponding with aortic stenosis. Therefore, we accepted this case as a PHACES syndrome. This case will be the 4th case of the literature. The most remarkable feature of PHACE syndrome is infantile hemangioma but abnormalities in the arteries which are not obvious on the clinical examination have considerable potential morbidity. We have certain diagnosis with pathology and no conflicts of interest disclosure. The most prevalent benign ne...
Open Access DOI:10.23937/2643-4474/1710057
Joana Vanessa Soares Silva, Benedita Sousa Amaral Bianchi de Aguiar, Eduardo Miguel Pereira da Costa, António Adriano Gonçalves Vilarinho, Josué Augusto de Carvalho Pereira and Magalys Sotto Gómez Pereira
Article Type: Case Report | First Published: February 15, 2021
Intracranial hemorrhage (ICH) is a rare entity in pediatric age, that is responsible to high rates of morbidity and mortality. Vascular malformations, such as Arteriovenous malformation (AVM), are the main causes in this age group. Despite its congenital nature, AVM is less commonly discovered in children than in adults unless it complicates. The authors present the clinical case of a 17-year-old boy, previously healthy, who suffered sudden focal neurologic deficits due to a hemorrhage located i...
Open Access DOI:10.23937/2643-4474/1710056
George P Lee, MD, Bhaveshkumar Ahir, PhD, Nauman Chaudhry, MD and Herbert H Engelhard, MD, PhD
Article Type: Review Article | First Published: January 23, 2021
Cervical spondylotic myelopathy (CSM) is a common cause of spinal cord dysfunction. The degenerative disease can cause serious neurological symptoms that can significantly affect the quality of life. The heterogenous presentation of CSM and a lack of a single comprehensive outcome instrument can make the management of suspected CSM very difficult. Despite the advances in surgical techniques to treat CSM, the indications to do surgery remain contr...
Open Access DOI:10.23937/2643-4474/1710055
Senai Goitom Sereke, MBChB, MMed (Radiology) and Felix Bongomin, MBChB, MSc
Article Type: Case Report | First Published: January 16, 2021
Osteoblastoma is a rare osteoid tissue forming tumor commonly affecting the posterior element of the spine. Intramedullary osteoblastoma of the calvarium is extremely rare. Osteoblastoma rarely occurs in the first decade of life. In this report we describe osteoblastoma of a very uncommon location in an 8-years-old male. An 8-year-old male presented with a 2-year history of progressive painless swelling of the left forehead. There was no prior hi...
Open Access DOI:10.23937/2643-4474/1710054
Ryuzaburo Kanazawa, Takanori Uchida, Tetsuhiro Higashida, Yuichi Takahashi, Naoyuki Arai, Hidenori Ohbuchi and Tomoyuki Yoshihara
Article Type: Technical Note | First Published: December 31, 2020
In some endovascular procedures, the insertion of stent delivery catheters (SDCs) is difficult. We demonstrated the efficacy of the Echelon 10 MicroCatheter (90-degree angle; Medtronic, Dublin, Ireland) during such procedures. We used the Echelon 10 MicroCatheter during difficult procedures to navigate SDCs to the distal artery from the aneurysm. The purpose of this was to reduce mechanical stress on the aneurysmal wall. The SDC was inserted by means of an exchange technique with an intermediate...
Open Access DOI:10.23937/2643-4474/1710053
J Nuyts, J Demeestere, M Jorissen and L Van Gerven
Article Type: Case Report and Literature Review | First Published: December 31, 2020
Spontaneous cerebrospinal fluid (CSF) leaks are defined as leaks without identifiable etiology, often presenting as spontaneous rhinorrhea. This is thought to be a variant of idiopathic intracranial hypertension (IIH). Spontaneous CSF leak closure often requires surgery, which has proven to be less successful than their non-spontaneous counterparts. There is growing evidence that active intracranial pressure (ICP) management in the postoperative care can improve success rates. We aim to give an ...
Open Access DOI:10.23937/2643-4474/1710052
Alejandro Vargas-Moreno, María Fajardo-Montes, Diego Miguel Rivera-Mariño and Juan Carlos Acevedo-González
Article Type: Case Report and Literature Review | First Published: December 26, 2020
Full-term female-neonate, delivered by cesarean section without complications, with prenatal ultrasound documentation of bilateral congenital talipes equinovarus and suggestive imaginological signs of a non-specific thoracolumbar spine malformation. At the time of birth, the physical examination reflected the presence of a dorsal complex cutaneal appendix covered by skin, associated with lower limbs hypertonia and bilateral talipes equinovarus. There were no respiratory alterations. MRI images o...
Open Access DOI:10.23937/2643-4474/1710051
Krishan Kumar Sharma and Asgar Ali
Article Type: Case Report | First Published: December 26, 2020
As per Guidelines for surgical management of Traumatic Brain Injury by Brain Trauma Foundation & The Congress of Neurological surgeons, surgery is indicated in Acute subdural haematoma if CT scan shows midline shift > 5 mm, or haematoma thickness > 10 mm regardless of patient’s Glasgow coma scale score. However, nothing specified separately for sub-acute subdural haematoma. Mostly same criteria are being followed for selecting patients for surgery in sub-acute and chronic subdural haematoma. S...
Open Access DOI:10.23937/2643-4474/1710050
Dhruv Jain, MS, Michael Broduhn, MD, Sophie Rosahl and Steffen K Rosahl, MD, PhD
Article Type: Case Study and Review of Literature | First Published: December 17, 2020
A 32-year-old female presented with neck pain radiating to the ulnar forearm along with occasion-al tingling sensations. Three years earlier, she had suffered from left-sided cerebellar infarction caused by dissection of the left vertebral artery. The dissection was provoked by manual therapy administered by a certified physiotherapist. Antiplatelet treatment with Aspirin 100 mg/day was established. One year later, she experienced tingling in the left side of her face. At the time, intracerebral...
Open Access DOI:10.23937/2643-4474/1710049
Dimitri Laurent, MD, Brian Corlis, MD and Gregory JA Murad, MD
Article Type: Case Report | First Published: December 09, 2020
Transorbital penetrating injuries are particularly rare in the adult population. We present a case of TOPI sustained in an assault using a ballpoint pen-with concomitant transmaxillary injury due to a pencil stab wound-and a review of the literature. Transorbital penetrating injuries (TOPI) are particularly rare in the adult population, accounting for 0.096% of all head injuries. In the setting of TOPI, there should be a high index of suspicion for damage to the intracranial vascular and neural ...
Open Access DOI:10.23937/2643-4474/1710048
Carlos Roberto Massella, MD, Yasmeen Elsawaf, BS, Sabino Luzzi, MD, Paulo Mácio Porto de Melo, MD and Samer K Elbabaa, MD, FAANS, FAAP, FACS
Article Type: Case Report and Comprehensive Literature Review | First Published: December 06, 2020
Resection of a cavernous sinus tumor may be performed utilizing three primary approaches: The middle cranial fossa epidural approach, the combined transsylvian- subtemporal approach, and the medial transsphenoidal approach. Herein, we describe an exceedingly rare cavernous sinus chondroma in an 18-year-old male who presented with a history of binocular diplopia and trochlear nerve palsy. Brain CT scan detected a left sided cavernous sinus calcified mass and the MRI confirmed an enhancing lesion ...
Open Access DOI:10.23937/2643-4474/1710047
Crystal N Adams, MD, Mohamad Z Koubeissi, MD, Aalap Herur-Raman and Donald C Shields, MD, PhD
Article Type: Case Report | First Published: November 28, 2020
Deep brain stimulation of the anterior thalamic nucleus for treatment of pharmacoresistant epilepsy is a surgical option for patients who are not candidates for resective surgery. One of the challenges of this technique relates to the small size of the anterior thalamic nucleus (approximately 10 mm × 5 mm × 5 mm). Stimulation several millimeters outside the intended target provides suboptimal seizure control. One option for achieving accurate stimulation includes the use of virtual reality sof...
Open Access DOI:10.23937/2643-4474/1710046
Himanshu Raval, Mona Bhatt and Nihar Gaur
Article Type: Case Report | First Published: November 25, 2020
Head injury is common component of any road traffic accident injury. Injury involving only frontal sinus is uncommon and unique as its management algorithm is changing over time with development of radiological modalities as well as endoscopic intervention. Frontal sinus injuries may range from isolated anterior table fractures causing a simple aesthetic deformity to complex fractures involving the frontal recess, orbits, skull base, and intracranial contents. Only anterior table injury of front...
Open Access DOI:10.23937/2643-4474/1710045
Marek Prokopienko, Teresa Wierzba-Bobrowicz, Wiesława Grajkowska, Tomasz Stępień and Michał Sobstyl
Article Type: Case report and Review of the Literature | First Published: November 16, 2020
Chordoid meningioma is an uncommon histopathological type of meningioma, frequently associated with Castleman’s syndrome. Histologically, chordoid meningiomas are similar to chordomas. Because of their high proliferative index, they present aggressive biological behavior and high risk of postoperative recurrence. We report a case of choroid meningioma in adult patient without Castleman’s syndrome manifestation. As its chordoid features is related with a rapid recurrence after incomplete remo...
Open Access DOI:10.23937/2643-4474/1710044
Takahiro Ogishima, MD, PhD, Takashi Sugawara, MD, PhD, Shoko Hara, MD, Tadashi Nariai, MD, PhD, and Taketoshi Maehara, MD, PhD
Article Type: Case report and Case Series | First Published: October 29, 2020
We present a case with localized subarachnoid hemorrhage in cisterna magna. The patient exhibited re-bleeding after admission. Repeated angiography couldn’t find the bleeding cite. Surgical exploration revealed that the responsible artery was a tiny pial artery on the posterior surface of medulla oblongata. Even though the artery was too small to be delineated in angiogram, subarachnoid hemorrhage and re-bleeding did occur. In this report we discuss the cause of the small artery rupture and po...
Open Access DOI:10.23937/2643-4474/1710043
İsmail KAYA, MD
Article Type: Case Report and Literature Review | First Published: October 01, 2020
Chondromyxoid fibroma is a benign tumor of long bone metaphysis. In this article, we reported L4 laminar attachment of chondromyxoid fibroma case and made extensive literature revive. A 56-year-old Caucasian female unable to walk without pain at her right leg diagnosed with chondromyxoid fibroma at right l4 lamina. Complete excision of the lesion via routine lumbar disc surgery with 6 months follow up without pain. Her Hypoesthesia cured also muscle weakness totally recovered. Chondromyxoid fibr...
Open Access DOI:10.23937/2643-4474/1710042
Zhanna Semenova, MD, PhD and Andrei Marshintsev
Article Type: Case Report | First Published: September 21, 2020
In the absence of autogenous bone due to various reasons, the choice of an implant becomes an important problem of reconstructive surgery. With introduction of computer modelling and development of prototyping technologies the issues of cosmetic reconstructive operations are becoming less relevant. In late cranioplasty implant production and installation is complicated by the presence of significant bone growth along the perimeter of cranial defect. The ability to adjust implant to a bone window...
Open Access DOI:10.23937/2643-4474/1710041
Chrystal Calderon, MBBS, MRCS, Alberto Perez Villafuerte, Arianne Lalla, MBBS and Sandeep Maharajh, MBBS
Article Type: Case Report | First Published: September 16, 2020
A malignant paraganglioma is a rare form of cancer that depicts varying symptomatology on presentation. This case serves to highlight an aggressive form of the disease, with considerable metastasis to the cervical, thoracic, and lumbar spine. This case was reliant on histopathological analysis to confirm the diagnosis. A 34-year-old male of Afro-Caribbean descent presented with a 1-month history of shortness of breath, body pains and lower limb weakness. On investigation for a pulmonary embolus,...
Open Access DOI:10.23937/2643-4474/1710040
Cristopher Mayer O, Tomás Donoso H, Roberto García B, Claudio Huentequeo M and Francisco Pampin L
Article Type: Case Report | First Published: August 12, 2020
Cranioplasty has numerous indications, and its main objective is to support the underlying noble structures, along with restoring shape and aesthetics. The treatment of choice is controversial, and is mainly related to the type of material to be used. There were no complications in the perioperative period, nor were there rejection reactions, infection or exposure of the implant in the postoperative period, with satisfactory aesthetic (improvement of the cranial contour) and functional results d...
Open Access DOI:10.23937/2643-4474/1710039
Velázquez Domínguez Héctor Eduardo, Guerrero Jazo Francisco Javier, Velázquez Santana Héctor, Pozos Ochoa Luis Iván, López Rodríguez Christopher Josué, Salcedo Hernández Missael de Jesús and Fraga González Rodrigo
Article Type: Case Report | First Published: July 27, 2020
Pleomorphic xanthoastrocytoma (PXA) is a rare tumor with favorable prognosis, classified as grade II in the World Health Organization (WHO) and accounts for less than 1% of all astrocytic neoplasm. It is commonly found in childhood and young adults. This tumor has been described as part of the spectrum of Long-Term Epilepsy Associated Tumors (LEAT). The most common location is supratentorial, involving predominantly the temporal lobe. Here we present the case of a 6-year-old female with long-ter...
Open Access DOI:10.23937/2643-4474/1710038
Ismail Latifaci, MD, Selcuk Gozcu, MD and Ahmet Celal Iplikcioglu
Article Type: Case Report | First Published: June 19, 2020
Syringomyelia associated with atlantoaxial dislocation is usually described in patients with complex craniovertebral junction anomaly. However, atlantoaxial dislocation without craniovertebral junction bony anomaly very rarely causes syringomyelia. In this report, we describe a case of syringomyelia associated with atlantoaxial dislocation secondary to metastatic tumour of the axis vertebra. Syringomyelia is characterized by the presence of a fluid filled cystic cavity within the spinal cord. Ce...
Open Access DOI:10.23937/2643-4474/1710036
Selçuk Gözcü and Ahmet Celal İplikçioğlu
Article Type: Case Report | First Published: June 18, 2020
Ossified cephalhematoma is rare and usually occur in newborns due to birth injury. Some ossified cephalhematomas can resorb spontaneously while others require surgery because of cosmetic reasons. Simple excision of new bone is usually sufficient. It should be also differentiated from another clinical entity called intradiploic hematoma which requiers surgery. In reported cases, of infant intradiploic hematoma cases clinical and radiologicial findings are similar to those of ossified cephalhemato...
Open Access DOI:10.23937/2643-4474/1710037
Nimetullah Alper Durmus, Iddi Kassım Mkopi and Ali Kurtsoy
Article Type: Case Report | First Published: June 19, 2020
Pituitary apoplexy followed by cerebral ischaemia is very rare and life-threatening clinical syndrome. Ischemia is a rare complication after pituitary apoplexy. Cerebral ischemia due to pituitary apoplexy has been linked to two mechanisms; this can occur through one of two mechanisms- direct compression of the artery or vasospasm caused by vasoactive factors/agents released from haemorrhagic or necrotic material of the pituitary adenoma....
Open Access DOI:10.23937/2643-4474/1710034
Nasiru Jinjiri Ismail, Ali Lasseini, Aliyu Muhammad Koko and Bello B Shehu
Article Type: Research Article | First Published: May 16, 2020
Fibrous dysplasia is an aberration in normal bone development that results from a defect in osteoblastic differentiation and maturation originating in a mesenchymal precursor; it’s characterized by foci of abnormal fibro-osseous proliferation that can affect any area of the calvaria. Craniofacial fibrous dysplasia is a rare condition that can presents with craniofacial swelling and disfigurement. Usually, cranial computerised tomography scan is needed for radiological evaluation and excision a...
Open Access DOI:10.23937/2643-4474/1710035
Baliga V, Ganapathy S and Pandey P
Article Type: Case Report | First Published: May 16, 2020
There are quite a few entities which can present as dura- based masses. Most common being meningioma, others are gliosarcomas, solitary fibrous tumor, leiomyosarcoma, haemangiopericytomas and melanocytomas. Recently, a number of neoplastic and non-neoplastic entities have been reported that radiographically and clinically mimic meningiomas. This is a rare case of glioblastoma with rhabdoid features presented as dura-based tumor. Even though the imaging helps to narrow down the diagnostic possibi...
Open Access DOI:10.23937/2643-4474/1710033
Shunsuke Yanagisawa, Yuya Sakakura, Shota Ozaki, Ryuichi Noda, Yuta Tamai, Makiko Fujitani, Masato Inoue and Tetsuo Hara
Article Type: Case Series and Literature Review | First Published: May 01, 2020
Primary CNS lymphoma is rare primary brain tumor. Meanwhile there are given number of acquired immune deficiency syndrome related primary CNS lymphoma. This brain tumor was reported that it showed ring enhancement in contrast MRI or CT. Here we analysed six acquired immune deficiency syndrome related primary CNS lymphoma cases. All cases showed ring enhancement in contrast MRI. The central low uptake and peripheral high uptake were observed in 18F-fluorodeoxyglucose PET, and these imaging featur...
Open Access DOI:10.23937/2643-4474/1710032
Joel Caballero-García, Carlos Aparicio-García, Misael López-Sánchez and Jhohana Linares Benavides
Article Type: Case Report | First Published: April 18, 2020
A 58-year-old woman with a previous history of partial resection for a parietal glioblastoma in another center and trapped temporal horn is presented. A ventriculoperitoneal shunt was done with completely resolution of the temporal lobe entrapment. Trapped temporal horn is a rare condition, and many different surgical approaches have been described. Ventriculoperitoneal shunting remains the standard treatment and has some particularly advantages in patients with malignant tumors. The ideal treat...
Open Access DOI:10.23937/2643-4474/1710031
Katherine M Morgan, MD, PhD, Simon Hanft, MD and Zhenggang Xiong, MD, PhD
Article Type: Case Report | First Published: April 08, 2020
Angiolipomas are slow-growing, soft tissue tumors consisting of mature adipocytes and thin-walled blood vessels. While most Angiolipomas are subcutaneous lesions in the trunk and upper extremities, intraosseous angiolipomas are rare at cranial site. We present the case of a 61-year-old female with an enlarging lesion in the left frontoparietal skull following minor head trauma. Radiography confirmed an expansile, enhancing, spiculated bony lesion in the left frontoparietal calvarium with extensi...
Open Access DOI:10.23937/2643-4474/1710030
Ismail Kaya, MD
Article Type: Case Report | First Published: March 24, 2020
Paraspinal schwannomas are relatively common but hardly classified subject of spinal neurosurgery. We present a rare and unclassified case of paravertebral schwannoma that causes non-discogenic low back pain. A 45-year-old Caucasian female came to our clinic with low back pain. Her pain steadily worsened for two years. Her physical exam showed right straight leg raise positivity at 45-degree angle but provocation test negative. Magnetic resonance imaging showed a mass in the paravertebral muscle...
Open Access DOI:10.23937/2643-4474/1710029
AA Sufianov, SM Karasev, RR Khafizov and RA Sufianov
Article Type: Case Report | First Published: November 04, 2019
Carotid - cavernous fistulas (CCF) are spontaneous or acquired communications between the internal carotid artery (ICA) and the cavernous sinus, which can be classified as direct or indirect. Direct fistulas between the internal carotid artery and the cavernous sinus can occur due to trauma, ruptures of intracavernous carotid artery aneurysms, collagen deficiency syndromes, stratification of arteries, fibromuscular dysplasia, and direct surgical trauma. Symptoms caused by CCF are associated with...
Open Access DOI:10.23937/2643-4474/1710028
Maria Habib Hanna, MD, Bansal A, MD and Belani P, MD
Article Type: Review Article | First Published: October 24, 2019
Ependymomas are glial tumors that typically arise from the lining of the ventricles or the central canal of the spinal cord. The most common site of occurrence is within the posterior fossa. Subtypes of ependymomas include anaplastic ependymoma, myxopapillary ependymoma, and subependymoma. Its characteristic imaging features include findings of a heterogeneous mass with necrosis, calcifications, cystic changes, and hemorrhage. Treatment options includes partial resection with or without irradiat...
Open Access DOI:10.23937/2643-4474/1710027
AA Sufianov, SM Karasev, RR Khafizov and RA Sufianov
Article Type: Case Report | First Published: October 21, 2019
Arteriovenous abnormalities of cerebral vessels are quite common. One of the main manifestations of this pathology are arteriovenous malformations. Also, a combination of malformations with aneurysmal expansion of the vascular wall of various localization is not rare. The frequent localization of such aneurysms are afferents going to the malformation site; therefore, such aneurysms are also called proximal flow-related aneurysms. As a rule, a combined approach is used mainly for endovascular tre...
Open Access DOI:10.23937/2643-4474/1710026
Elia Guadagno, MD, Lorenzo Ugga, MD, Annarita Gencarelli, MD, Valentina Orlando, MD, Sergio Corvino, MD, Maria Rosaria Cervasio, MD, Sara Pignatiello, MD, Andrea Elefante, MD, Francesco Maiuri, MD and Maria Laura Del Basso De Caro, MD
Article Type: Case Report | First Published: October 18, 2019
Liponeurocytoma is a very rare tumor of the nervous system, with only 63 reported cases, mainly in the cerebellum and ventricular system. The key-points for the diagnosis are the histological findings of neurocytic cells with lipidic accumulation, with positivity for S-100 and synaptophysin and negativity for IDH-1, and the MR finding of hyperintensity areas on T1Wi corresponding to fatty tissue within the tumor. This article reports a case of cerebellar liponeurocytoma presenting with acute ict...
Open Access DOI:10.23937/2643-4474/1710025
Munibe Busra Erdem, MD, Emrah Celtikci, MD, Utku Aydil, MD, Mesut Emre Yaman, MD and Hakan Emmez, MD
Article Type: Case Report | First Published: October 07, 2019
Pharyngeal perforation is a serious complication of anterior cervical fusion surgery. If it is not diagnosed in the early period and the treatment is delayed, catastrophic consequences may occur which may cause death such as septicemia, mediastinitis, pneumonia and meningitis. We shared the presentation of our two cases. In the first case, pharyngeal perforation and spontaneous extrusion of the C2-C3 fixation device occurred after eight years from surgery. The fixation device removed and the pha...
Open Access DOI:10.23937/2643-4474/1710024
Ibiwari Pepple and Debasish Hajra
Article Type: Case Report | First Published: October 05, 2019
Small cell lung cancer (SCLC) accounts for 10-20% of all lung cancers and is characterised by early and rapid spread. Ten percent of patients already have cerebral metastases at time of presentation. We report a case of a 37-yr-old female whose pre-operative CT and MRI brain revealed multicentric left frontal and temporal lesions which mimicked intracerebral abscess intraoperatively and confirmed on gram stain as moderate growth of white cells. The patient was commenced on prolonged antimicrobia...
Open Access DOI:10.23937/2643-4474/1710023
Nissar Shaikh, Gulzar Hussain, Adnan Khan, Muhammad Mohsin Khan, Mamdouh Al Mustafa, Moad Ehfeda, Muhammad Zubair and Umais Momin
Article Type: Case Report | First Published: September 13, 2019
A 38-year-old Asian male had craniotomy with excision of a left frontal mass which extended into the lateral ventricles. External ventricular and subdural drains were inserted at the end of the procedure. He received mannitol and furosemide intraoperatively. Immediately after surgery he developed tension pneumocephalus, diabetes insipidus and fever. Two days after surgery, magnetic resonance imaging (MRI) showed transverse, sagittal sinus thrombosis extending into the right internal jugular vein...
Open Access DOI:10.23937/2643-4474/1710022
Hu Liang Low and Ahsan Taqvi
Article Type: Case Report | First Published: September 05, 2019
Post-traumatic conus medullaris syndromes (CMS) such as after L1-burst fractures are uncommon, being encountered in only 1.7% of patients with spinal cord injuries. These injuries are almost invariably associated with bladder, erectile or bowel dysfunction, disturbance of perineal sensation and varying sensorimotor deficits in the legs. To date, there are only 6 reported cases of CMS after a L1-burst fracture without sensory or motor deficits in the lower limbs. In this case report, we describe ...
Open Access DOI:10.23937/2643-4474/1710021
Andrea Bianco, Riccardo Fornaro, Christian Cossandi, Sara Forgnone, Emanuela Crobeddu and Piergiorgio Car and Gabriele Panzarasa
Article Type: Commentary | First Published: July 05, 2019
Pregnancy can change the behavior of brain gliomas with increased growth rate, increased frequency of seizures, and anaplastic transformation. Very rarely the presentation may be hyperacute due to intratumoral hemorrhage. We report and discuss them a management of the hemorrhagic infarction of a newly diagnosed postcentral anaplastic astrocytoma in a pregnant woman. A first MRI discovered the glioma; two days later, after acute neurological deterioration, a second MRI showed a dramatic increase ...
Open Access DOI:10.23937/2643-4474/1710020
Uri P Hadelsberg, MD and Nevo Margalit, MD
Article Type: Commentary | First Published: June 29, 2019
This patient was admitted to our department and eventually underwent surgery with gross total resection after pre-operative endovascular embolization of the tumor. The patient underwent a successful recovery and was discharged without major neurological deficits to rehab. On follow up the patient is doing well and is back home with her children. On the day of surgery the patient was intubated and underwent cerebral embolization with occlusion of several tumor-feeding arteries. The patient was th...
Open Access DOI:10.23937/2643-4474/1710019
Matías Negrotto, MD, Ramon Figueroa, MD and Katherine Sotomayor, MD
Article Type: Case Report | First Published: June 26, 2019
Although gunshot injury to the head is usually mortal, survivors frequently show retained metal shrapnel or full bullet intracranially. An important though uncommon complication of retained bullet is that of spontaneous migration. A migrating intracranial bullet is a dilemma to neurosurgeons, as its management is challenging, since the removal of a deep-seated bullet may cause additional neurological deficit. Migration of a retained bullet may cause damage to vital structures and cranial nerves,...
Open Access DOI:10.23937/2643-4474/1710018
Umang Khandpur, BS, Wilson Z Ray, MD and Matthew R MacEwan, PhD
Article Type: Case Series | First Published: June 17, 2019
A retrospective case series was performed to evaluate the efficacy of a novel, fully synthetic dura substitute. Clinical outcomes (e.g. infectious, reoperation rates, cerebrospinal fluid leak) and surgeon experiences with the dura substitute intraoperatively were collected. All methods were approved by the Institutional Review Board at Washington University School of Medicine....
Open Access DOI:10.23937/2643-4474/1710017
Article Type: Review Article | First Published: June 17, 2019
A summary of available data on neurosurgical mission trips has been collected from PubMed and Google Scholar on the following mesh keywords: Neurosurgery trips, mission neurosurgery, and neurosurgery in third world countries. We gathered our information that was closely related to neurosurgical education such as proficiency, equipment, ethics and outcomes....
Open Access DOI:10.23937/2643-4474/1710016
Siavash S Haghighi
Article Type: Case Report | First Published: June 08, 2019
A case report of psychogenic hemiplegia following a two level anterior cervical discectomies and fusion was contradicted by a thorough electrophysiological findings. To report an unusual case of post-operative hemiplegia in spite of normal electrophysiological and noncompromising radiographic findings. Conversion disorder with sensory or motor system symptoms is a subtype which includes symptoms such as impaired motor balance, paraplegia, muscle weakness, and urinary retention....
Open Access DOI:10.23937/2643-4474/1710015
Siavash S Haghighi, MD, Bertha Ramirez, MD and Richard Zhang, MD
Article Type: Case Report | First Published: May 08, 2019
Acute or delayed paraplegia or quadriplegia following anterior cervical discectomies and fusion are not common. We report this single case report of delayed quadriplegia following an anterior cervical discectomies and fusion without any change of sensory or motor evoked potentials during the operation. The intraoperative somatosensory (SSEPs) were performed by stimulation of tibial nerves or the median (MN). Motor evoked potentials (TcMEPs) were recorded from intrinsic hand or foot muscles after...
Open Access DOI:10.23937/2643-4474/1710014
Thierry Patrice, MD, PhD, Romain Bourcier, MD, Hubert Desal, MD, PhD, Bertrand Rozec, MD, PhD and Yvonnick Blanloeil, MD
Article Type: Case Study | First Published: April 26, 2019
Oxidative stress (OS) could be involved during intracranial aneurysms (ICA) progression but knowledge about comorbidities likely to induce OS is poor. We studied the medical and surgical history of patients with an ICA discovered after a subarachnoidal haemorrhage (SAH) or unruptured (UIA). 175 patients, 58 with a UIA, had been successively recruited from a single centre. Their medical history, comorbidities and treatments had been gathered from hospital files, general practitioners, relatives a...
Open Access DOI:10.23937/NCR-2017/1710013
Wyatt McGilvery, BS, Marc Eastin, MD, Anish Sen, MD and Maciej Witkos, MS, MD
Article Type: Case Report | First Published: April 05, 2019
The authors report a case in which a 38-year-old male who presented himself to the emergency department with a chief complaint of cervical neck pain and paresthesia radiating from the right pectoral region down his distal right arm following self manipulation of the patient's own cervical vertebrae. Initial emergency department imaging via cervical X-ray and magnetic resonance imaging (MRI) without contrast revealed no cervical fractures; however, there was evidence of an acute cervical disc her...
Open Access DOI:10.23937/NCR-2017/1710012
Giuseppe Mariniello, MD, Carmela Peca, MD, Maria Laura Del Basso De Caro, MD, Sergio Corvino, MD, Valentina Orlando, MD, Elia Guadagno, MD and Francesco Maiuri, MD
Article Type: Case Report | First Published: February 14, 2019
This article reports a left cerebellopontine angle glioblastoma presenting with two week history of rapidly progressive hearing loss and trigeminal pain, treated by subtotal resection and radiotherapy with concomitant and adjuvant temozolomide. At one year, local tumor control and diffuse neoplastic seeding in the cervical spinal cord were evidenced. Glioblastomas involving the cerebellopontine angle are exceptional with only 10 reported cases. The possibility of a glioblastoma should be conside...
Open Access DOI:10.23937/ncr-2017/1710011
Pouya Entezami, MD, Emad Nourollahzadeh, MD, Adedamola Adepoju, MD, David Michael Jones, MD and John Dalfino, MD
Article Type: Case Report | First Published: February 11, 2019
As our patient population grows older with improved health care technology and resources, chronic subdural hematoma (CSDH) is an increasingly common disease faced by the modern neurosurgeon. Despite good results with burr-hole irrigation and evacuation - the gold standard treatment for CSDH - recurrence rate remains high. Recent advancements in endovascular management of this diagnosis via embolization of the middle meningeal artery (MMA), either alone or in conjunction with surgical evacuation,...
Open Access DOI:10.23937/ncr-2017/1710010
Pouya Entezami, M Reid Gooch, Emad Nourollahzadeh and John Dalfino
Article Type: Case Report | First Published: January 21, 2019
The basilar artery is the main arterial contributor to the posterior circulation. Interruptions of this flow can cause devastating strokes and neurological demise. While most patients with a basilar artery occlusion suffer from a high rate or morbidity and/or mortality, a small subset survive but have progressive symptomatic decline. Delayed revascularization of these patients with chronic basilar artery occlusions based on symptomatic progression may provide a favorable risk-benefit ratio, but ...
Open Access DOI:10.23937/ncr-2017/1710009
Alexandra Benouaich-Amiel, Shlomit Yust-Katz, Suzana Fichman and Tali Siegal
Article Type: Case Report | First Published: December 20, 2018
Lymphomatoid granulomatosis (LYG) is a rare, Epstein barr virus (EBV) associated, angiocentric B cell proliferation, which usually involves the lung but may also involve, more rarely, the central nervous system. Its malignant potential is uncertain, and seems to be linked to the number of EBV positive B cells. We report the case of a 32-years-old patient, with an antecedent of LYG grade 2, involving lung, who presented with a brain mass lesion one year later, which appears to be a grade 1 LYG wi...
Open Access DOI:10.23937/ncr-2017/1710008
Alice Venier, Luca Roccatagliata, Alessandro Cianfoni and Emanuele Pravata
Article Type: Case Report | First Published: December 15, 2018
Glioblastoma scalp dissemination is uncommon. Infiltration may occur through the craniotomy, suggesting diffusion from the surgical site as the most likely mechanism. At Magnetic Resonance Imaging (MRI), features of the metastatic tissue resemble those of the primary tumor. We show multimodal MRI appearance of a glioblastoma disseminating to the scalp. The patient presented with a stiff, non-tender palpable mass within the extracranial soft tissues, five months after surgery. Distinctive finding...
Open Access DOI:10.23937/ncr-2017/1710007
A Giorgianni, P Veiceschi, G Agresta, S Balbi and D Locatelli
Article Type: Case Report | First Published: November 19, 2018
We report a case of right internal carotid artery pseudo-aneurysm, arising in the aspects of a giant macroadenoma in a 57-years-old man, presented with right severe temporal orbital headache and vomiting. Computed tomography scan (CT) revealed a destructive skull base mass extended from sellar region to clivus. Pre and post-gadolinium brain magnetic resonance (MRI) confirmed the lesion, characterized by an encasement of optic nerves and carotid siphons bilaterally, with a pseudo-aneurysm of cave...
Open Access DOI:10.23937/ncr-2017/1710006
Adriana Rodrigues Liborio dos Santos, Gabriel Mufarrej, Priscila Oliveira da Conceicao, Paulo Luiz da Costa Cruz, Daniel Dutra Cavalcanti, Leila Chimelli and Paulo Niemeyer Filho
Article Type: Original Article | First Published: November 19, 2018
Selective Amygdalohippocampectomy (SAH) is a widespread technique for Mesial Temporal Lobe Epilepsy (MTLE) treatment. Dr. Niemeyer was the first to describe SAH using transventricular approach technique in 1958. In 2018, we celebrate 60 years of the original description of Niemeyer's approach. This study reviews the approach in light of currently technology and shows the results achieved with patients submitted to SAH following Niemeyer's approach at Instituto Estadual do Cérebro Paulo Niemeyer...
Open Access DOI:10.23937/ncr-2017/1710005
Manuel Dujovny, Channan Kositzke, Pablo Sosa and Fabian Cremaschi
Article Type: Research Article | First Published: November 10, 2018
Suction capability in neurosurgery is a critical tool utilized to clear the field and improve visualization of anatomical structures. It is also used for fragmentation and debulking of pathological tumor masses. Prior to the Frazier cannula, there was no orifice bent pressure relief valve associated with suction; this tool provides independent dual suction force. The Frazier cannula has the capability to reach absolute suction or zero suction instantaneously. In this article, we introduce a new ...
Open Access DOI:10.23937/ncr-2017/1710004
Article Type: Case Report | First Published: November 05, 2018
Acute peritentorial subdural hematoma (APSDH) is an extremely rare intracranial bleeding, which generally occurs due to a trauma. And, It usually regresses spontaneously without the need for a surgical intervention. However, it is difficult to determine the surgical method when it is life-threatening. A 15-year-old boy was brought to the hospital after a crash with a car whilst on a motorcycle. No significant intracranial bleeding was detected following an isolated severe head trauma; however, G...
Open Access DOI:10.23937/ncr-2017/1710003
Francesco Restelli, Gianluca Agresta, Tommaso Alfiero, Alessandro Dario and Davide Locatelli
Article Type: Case Report | First Published: October 31, 2018
As physicians and neurosurgeons, our daily practice in Emergency Departments sometimes calls us to manage patients and to take decisions in sub-optimal conditions, maybe with partial anamnesis, incomplete neurological examinations or with lacks in routine radiological and laboratory exams. Such eventuality, although it may sometimes lead to misdiagnose and to confound some pathological conditions, fortunately is not always linked to bad repercussions for patients. This is especially true when de...
Open Access DOI:10.23937/ncr-2017/1710002
Giyas Ayberk, Selen Isık Adiloglu, Aylin Kılıc Yazgan, Mahmut Ferhat and Mehmet Faik Ozveren
Article Type: Case Report | First Published: June 15, 2018
A giant cell granuloma (GCG) rarely occurs in the skull bones. Although it has destructive character, the GCG is used as the synonym of giant cell reparative granuloma (GCRG) in the literature. Differentiation from other osteolytic lesions quite difficult. The first case of GCG in the temporal bone was reported by Hirschl and Katz in 1974. Even though the GCG is not a true neoplasm, the locally aggressive behavior of this tumor necessitates surgical excision whenever possible....
Open Access DOI:10.23937/ncr-2017/1710001
Renu Pokharna, Miles W Reese, Souvik Sen and Tushar Trivedi
Article Type: Case Report | First Published: January 11, 2018
Primary Central Nervous System Lymphoma (PCNSL) is a rare non-Hodgkin type neoplasm, which crosses the midline. We report an unusual case of a 71-year-old Caucasian female who was shown to have PCNSL by a tissue biopsy after the brain Magnetic Resonance Imaging (MRI) showed Central Nervous System (CNS) lesions crossing the corpus callosum....
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