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Hemorrhagic astroblastoma: atypical presentation of a rare tumor. Illustrative case.
J Neurosurg Case Lessons
January 2025
Neurosurgery Department, Palmetto General Hospital, Hialeah, Florida.
Background: Astroblastoma is an extremely rare tumor of the central nervous system, and its origin and validity as a different entity are still being debated. Because of its rarity and similarities to other glial neoplasms, it is often misdiagnosed, impacting treatment and outcomes.
Observations: Astroblastoma is very rare and mainly affects children and young adults.
Intentional staged embolization via the "highway bypass" using a radial artery graft for a large posterior circulation aneurysm: illustrative case.
J Neurosurg Case Lessons
January 2025
Department of Neurosurgery, Kanto Rosai Hospital, Kanagawa, Japan.
Background: The presence of significant tortuosity in access routes to aneurysms can interfere with catheter guidance and manipulation and significantly impact treatment strategies.
Observations: In this report, the authors combined intentional staged aneurysm embolization with the construction of a new direct access route, which they call a "highway bypass," for a symptomatic posterior circulation cerebral aneurysm that was difficult to access with a catheter. Notably, the highway bypass is used for catheter passage, and technical tips should be considered.
Iatrogenic pseudoaneurysm formation of the anterior cerebral artery following placement of an external ventricular drain: illustrative case.
J Neurosurg Case Lessons
January 2025
Department of Neurological Surgery, Cooper University Health Care, Camden, New Jersey.
Background: External ventricular drains (EVDs) provide an invaluable diagnostic method for accessing cerebrospinal fluid and therapeutically treating elevated intracranial pressure. Although complications including hemorrhage and infection have been well documented, the formation of iatrogenic pseudoaneurysms following EVD placement has rarely been reported. The authors present a case of this exceedingly rare complication of iatrogenic pseudoaneurysm formation following EVD placement.
View Article and Find Full Text PDFRetrograde thrombosis of the superficial sylvian vein following liquid adhesive hemostat use during craniotomy: illustrative case.
J Neurosurg Case Lessons
January 2025
Department of Neurosurgery, University of California, Irvine, Orange, California.
Background: Intravascular injection of liquid adhesive hemostats is a rare but serious complication that can result in cerebral thromboembolism.
Observations: A 64-year-old female underwent orbitozygomatic craniotomy for posterior communicating artery aneurysm clipping with the routine use of a flowable hemostatic agent during extradural dissection. After placement of the aneurysm clip, flow was confirmed through the parent vessel and nearby branches.
Cryptic presentation: primary amoebic meningoencephalitis mimicking a high-grade malignancy resulting in surgical fatality within 48 hours. Illustrative case.
J Neurosurg Case Lessons
January 2025
Neurosurgery Clinic, Birgunj, Nepal.
Background: A 71-year-old male presented with weakness of the right upper limb and headache for the past 3 months. Brain magnetic resonance imaging (MRI) with contrast showed a left frontal space-occupying lesion, suggestive of a high-grade malignancy. Awake craniotomy with complete excision of the lesion was performed under immunofluorescence guidance.
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