Pub Date : 2025-12-01Epub Date: 2025-10-12DOI: 10.1016/j.inat.2025.102134
Guan-Sian Wu, Shih-Huang Tai, Yu-Ning Chen, E-Jian Lee
Spinal surgery following by spinal epidural hematoma is a rare condition, the Factors related to symptomatic spinal epidural hematomas include coagulopathy, trauma, surgery, and vascular lesions. Most hematomas occur spontaneously without known etiology, but some spontaneous lesions are related to vascular anomalies [1].The study showed the higher incidence of hematoma associated with spinal deformity, the location of thoracic spine, posterior approach, and minimally invasive surgery [2].
We present a case of an obese patient with spinal deformity who underwent multiple spinal surgeries and subsequently developed symptomatic spinal epidural hematomas following kyphoplasty. Early diagnosis via computed tomography scan enabled prompt surgical intervention, minimizing neurological injury.
{"title":"A rare case of spontaneous spinal epidural hematoma after kyphoplasty","authors":"Guan-Sian Wu, Shih-Huang Tai, Yu-Ning Chen, E-Jian Lee","doi":"10.1016/j.inat.2025.102134","DOIUrl":"10.1016/j.inat.2025.102134","url":null,"abstract":"<div><div>Spinal surgery following by spinal epidural hematoma is a rare condition, the Factors related to symptomatic spinal epidural hematomas include coagulopathy, trauma, surgery, and vascular lesions. Most hematomas occur spontaneously without known etiology, but some spontaneous lesions are related to vascular anomalies [<span><span>1</span></span>].The study showed the higher incidence of hematoma associated with spinal deformity, the location of thoracic spine, posterior approach, and minimally invasive surgery [<span><span>2</span></span>].</div><div>We present a case of an obese patient with spinal deformity who underwent multiple spinal surgeries and subsequently developed symptomatic spinal epidural hematomas following kyphoplasty. Early diagnosis via computed tomography scan enabled prompt surgical intervention, minimizing neurological injury.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"42 ","pages":"Article 102134"},"PeriodicalIF":0.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-09-03DOI: 10.1016/j.inat.2025.102121
Ralph J Mobbs , Daniel B Breuninger
Background
Metal pedicle screws, particularly titanium, can cause significant imaging artifacts and may lead to stress shielding. Carbon fibre–reinforced polyetheretherketone (CFR-PEEK) pedicle screws offer radiolucency and a more bone-like modulus of elasticity, potentially improving postoperative imaging and reducing implant-related complications in non-oncologic spinal surgery.
Objective
To evaluate the clinical and radiographic outcomes of CFR-PEEK pedicle screws in a series of non-oncologic spinal surgeries, covering degenerative disease in the setting of osteoporosis, trauma, and revision for non-union.
Methods
We retrospectively reviewed 11 consecutive patients who underwent CFR-PEEK pedicle screw fixation at a single institution for non-oncologic spinal pathology between June 6, 2022, and July 8, 2024. Data included patient demographics, surgical approach, radiographic fusion and complications.
Results
Mean age was 60 years, with 4 cases for revision of non-union, 4 cases for degenerative disease, and 3 for spinal cord compression and/or trauma. Postoperative imaging confirmed improved clarity of bony anatomy and neural structures due to the screws’ radiolucency, and all patients achieved fusion at final follow-up. There have been no implant-related complications in any patient at the time of this writing.
Conclusion
CFR-PEEK pedicle screws provided satisfactory stabilisation in this series of 11 non-oncologic cases, enabling clearer postoperative imaging and offering a theoretical advantage in reducing stress shielding. No patient has required revision to date, although future complications cannot be excluded. If adjacent segment pathology were to necessitate additional fusion, the biomechanical implications of extending constructs with existing carbon-based screws remain uncertain and warrant further study. Larger prospective trials are needed to validate these findings and define optimal patient selection.
{"title":"Radiolucent carbon fibre pedicle screws in non-oncologic spinal surgery: A clinical series of 11 patients","authors":"Ralph J Mobbs , Daniel B Breuninger","doi":"10.1016/j.inat.2025.102121","DOIUrl":"10.1016/j.inat.2025.102121","url":null,"abstract":"<div><h3>Background</h3><div>Metal pedicle screws, particularly titanium, can cause significant imaging artifacts and may lead to stress shielding. Carbon fibre–reinforced polyetheretherketone (CFR-PEEK) pedicle screws offer radiolucency and a more bone-like modulus of elasticity, potentially improving postoperative imaging and reducing implant-related complications in non-oncologic spinal surgery.</div></div><div><h3>Objective</h3><div>To evaluate the clinical and radiographic outcomes of CFR-PEEK pedicle screws in a series of non-oncologic spinal surgeries, covering degenerative disease in the setting of osteoporosis, trauma, and revision for non-union.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 11 consecutive patients who underwent CFR-PEEK pedicle screw fixation at a single institution for non-oncologic spinal pathology between June 6, 2022, and July 8, 2024. Data included patient demographics, surgical approach, radiographic fusion and complications.</div></div><div><h3>Results</h3><div>Mean age was 60 years, with 4 cases for revision of non-union, 4 cases for degenerative disease, and 3 for spinal cord compression and/or trauma. Postoperative imaging confirmed improved clarity of bony anatomy and neural structures due to the screws’ radiolucency, and all patients achieved fusion at final follow-up. There have been no implant-related complications in any patient at the time of this writing.</div></div><div><h3>Conclusion</h3><div>CFR-PEEK pedicle screws provided satisfactory stabilisation in this series of 11 non-oncologic cases, enabling clearer postoperative imaging and offering a theoretical advantage in reducing stress shielding. No patient has required revision to date, although future complications cannot be excluded. If adjacent segment pathology were to necessitate additional fusion, the biomechanical implications of extending constructs with existing carbon-based screws remain uncertain and warrant further study. Larger prospective trials are needed to validate these findings and define optimal patient selection.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"42 ","pages":"Article 102121"},"PeriodicalIF":0.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145011147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-09-10DOI: 10.1016/j.inat.2025.102123
Juan Esteban Muñoz Montoya , Praveen R. Iyer , Karthik Ramachandran , Ajoy Prasad Shetty , Shanmuganathan Rajasekaran
Study Design: A retrospective cross-sectional study.
Purpose
To analyze the global sagittal spinopelvic alignment in the asymptomatic Indian population through the conventional and new global-regional parameters.
Methods
We included asymptomatic adults between 18 and 50 years old without a history of spinal surgery or significant musculoskeletal disorders. The sagittal profile was classified according to the theoretical Roussouly classification. The conventional and new spinopelvic parameters were measured using Surgimap. Correlation analysis was performed using Pearson’s correlation coefficient.
Results
104 participants (62 females and 42 males) were recruited. The type 3AP was the most common theoretical Roussouly classification at 28.8 %. Analyzing the new spinopelvic parameters, the mean values are Pelvic Incidence (PI): 45.433° ± 9.72°, L1 Pelvic Angle (PA): 5.240°± 6.7°, T1 Slope: 26.260°± 8.24°, C7 Slope: 23.073°± 8.35°, C2 Slope: 2.308°± 11.42°, T4 − L1 Pelvic Angle (PA): 2.10° ± 3.797°, Global Tilt (GT): 15.029° ± 10.80. PI correlated with the new parameters such as T4 Pelvic Angle (PA) and L1 PA. Furthermore, PT had a good correlation with GT, Spino Pelvic Angle (SPA), Spino Sacral Angle (SSA), and T1 − L1 Pelvic Angle (PA). Finally, the SVA C7 − S1 strongly correlates with the Odontoids – Hip Axis (ODHA).
Conclusion.
This study comprehensively analyzes the correlations between conventional and new regional and global sagittal spinal parameters in the asymptomatic Indian population. The normative data for the sagittal profile in Indian volunteers enunciated in this study can be used to guide surgical decisions.
{"title":"Comprehensive analysis of global spinopelvic alignment based on traditional and new parameters in normal Indian population","authors":"Juan Esteban Muñoz Montoya , Praveen R. Iyer , Karthik Ramachandran , Ajoy Prasad Shetty , Shanmuganathan Rajasekaran","doi":"10.1016/j.inat.2025.102123","DOIUrl":"10.1016/j.inat.2025.102123","url":null,"abstract":"<div><div><strong>Study Design:</strong> A retrospective cross-sectional study.</div></div><div><h3>Purpose</h3><div>To analyze the global sagittal spinopelvic alignment in the asymptomatic Indian population through the conventional and new global-regional parameters.</div></div><div><h3>Methods</h3><div>We included asymptomatic adults between 18 and 50 years old without a history of spinal surgery or significant musculoskeletal disorders. The sagittal profile was classified according to the theoretical Roussouly classification. The conventional and new spinopelvic parameters were measured using Surgimap. Correlation analysis was performed using Pearson’s correlation coefficient.</div></div><div><h3>Results</h3><div>104 participants (62 females and 42 males) were recruited. The type 3AP was the most common theoretical Roussouly classification at 28.8 %. Analyzing the new spinopelvic parameters, the mean values are Pelvic Incidence (PI): 45.433° ± 9.72°, L1 Pelvic Angle (PA): 5.240°± 6.7°, T1 Slope: 26.260°± 8.24°, C7 Slope: 23.073°± 8.35°, C2 Slope: 2.308°± 11.42°, T4 − L1 Pelvic Angle (PA): 2.10° ± 3.797°, Global Tilt (GT): 15.029° ± 10.80. PI correlated with the new parameters such as T4 Pelvic Angle (PA) and L1 PA. Furthermore, PT had a good correlation with GT, Spino Pelvic Angle (SPA), Spino Sacral Angle (SSA), and T1 − L1 Pelvic Angle (PA). Finally, the SVA C7 − S1 strongly correlates with the Odontoids – Hip Axis (ODHA).</div><div>Conclusion.</div><div>This study comprehensively analyzes the correlations between conventional and new regional and global sagittal spinal parameters in the asymptomatic Indian population. The normative data for the sagittal profile in Indian volunteers enunciated in this study can be used to guide surgical decisions.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"42 ","pages":"Article 102123"},"PeriodicalIF":0.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-10-12DOI: 10.1016/j.inat.2025.102133
Fan He, Shirong Gu
A 68-year-old female patient was admitted to our outpatient clinic with back and low back pain. There were no remarkable physical or neurological findings of the patient. Imaging workup revealed two cystic lesions of the right T8 and left T11 nerve root at the level of the foramen. Conservative treatment for this patient was ineffective in a half-year follow-up period. We performed laminectomies at the level of interests and cysts were dissected from the underlying dura after removal of the cerebrospinal fluid. We found there is an internal fistula at the communication between the cyst and the dura mater and nerve root passing through it. The cysts were excised and the nerve roots were preserved. Surgical resection resulted in significant improvement in patient symptoms, and pathology revealed a perineural cyst. We conclude that back pain may be generated when distention of the cyst activates neural, dural, or bone nociceptors. And surgical treatment can be curative.
{"title":"Surgical excision of symptomatic multiple nerve root perineural cysts in thoracic intervertebral foramen: A case report","authors":"Fan He, Shirong Gu","doi":"10.1016/j.inat.2025.102133","DOIUrl":"10.1016/j.inat.2025.102133","url":null,"abstract":"<div><div>A 68-year-old female patient was admitted to our outpatient clinic with back and low back pain. There were no remarkable physical or neurological findings of the patient. Imaging workup revealed two cystic lesions of the right T8 and left T11 nerve root at the level of the foramen. Conservative treatment for this patient was ineffective in a half-year follow-up period. We performed laminectomies at the level of interests and cysts were dissected from the underlying dura after removal of the cerebrospinal fluid. We found there is an internal fistula at the communication between the cyst and the dura mater and nerve root passing through it. The cysts were excised and the nerve roots were preserved. Surgical resection resulted in significant improvement in patient symptoms, and pathology revealed a perineural cyst. We conclude that back pain may be generated when distention of the cyst activates neural, dural, or bone nociceptors. And surgical treatment can be curative.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"42 ","pages":"Article 102133"},"PeriodicalIF":0.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-11-16DOI: 10.1016/j.inat.2025.102151
K. Kundhavai , B. Archana , Lawrence D Cruze , P. Bhaskar Naidu
Ependymomas involving the corpus callosum are relatively rare tumours of the central nervous system which poses diagnostic and therapeutic challenge to the treating clinician. Ependymomas with presence of giant cells are uncommon histological findings. Here we present an interesting case of an 8-year-old male child with a space occupying lesion arising from the body of the corpus callous on the left side, which was diagnosed as Supratentorial ependymoma Grade 3 by histopathology and immunohistochemistry on initial biopsy after considering the differential diagnosis of other lesions of the central nervous system with similar histomorphology. The patient received radiation therapy, however lesion recurred within a period of 10 months. Subsequently histopathology revealed the presence of predominantly numerous highly pleomorphic bizarre cells and multinucleate giant cells arranged in sheets having brisk mitosis (15/10HPF) with adjacent areas of necrosis and haemorrhage, implying the aggressive nature of the lesion.
{"title":"Supratentorial ependymoma with giant cells of the corpus callosum: A case report","authors":"K. Kundhavai , B. Archana , Lawrence D Cruze , P. Bhaskar Naidu","doi":"10.1016/j.inat.2025.102151","DOIUrl":"10.1016/j.inat.2025.102151","url":null,"abstract":"<div><div>Ependymomas involving the corpus callosum are relatively rare tumours of the central nervous system which poses diagnostic and therapeutic challenge to the treating clinician. Ependymomas with presence of giant cells are uncommon histological findings. Here we present an interesting case of an 8-year-old male child with a space occupying lesion arising from the body of the corpus callous on the left side, which was diagnosed as Supratentorial ependymoma Grade 3 by histopathology and immunohistochemistry on initial biopsy after considering the differential diagnosis of other lesions of the central nervous system with similar histomorphology. The patient received radiation therapy, however lesion recurred within a period of 10 months. Subsequently histopathology revealed the presence of predominantly numerous highly pleomorphic bizarre cells and multinucleate giant cells arranged in sheets having brisk mitosis (15/10HPF) with adjacent areas of necrosis and haemorrhage, implying the aggressive nature of the lesion.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"42 ","pages":"Article 102151"},"PeriodicalIF":0.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hydrocephalus is excessive accumulation of cerebrospinal fluid within the cerebral ventricles. It has a complex pathogenesis with various causes. Periventricular edema refers to the abnormal accumulation of fluid in the brain tissue surrounding the cerebral ventricles, an indicative of elevated intracranial pressure or disruption in cerebrospinal fluid flow. Periventricular edema can serve as one of the severity indicators of hydrocephalus, and can assist physicians in predicting the outcomes of treatments and determining appropriate therapeutic interventions. In this study, our goal is to identify periventricular edema in hydrocephalus disease. In this regard, the smoothing-sharpening image filter (SSIF) algorithm is applied to enhance hydrocephalic CT images due to the low quality of CT images and the ambiguity between the boundaries of periventricular edema, ventricles, and other brain regions. Some well-known deep learning models including UNet, PSPNet, LinkNet and FPN are suggested to segment periventricular edema. From the obtained results, the FPN model, compared to the other models, achieves the best evaluation criteria with AUC, dice score, F1-score, precision, and recall values of 95 %, 93 %, 91 %, 91 %, and 92 %, respectively.
{"title":"Artificial intelligence-based determination of periventricular edema in hydrocephalic brain CT scan","authors":"Mahtab Gholami , Shirin Kordnoori , Maliheh Sabeti , Yashar Goorakani , Hamed Mohseni Takallou , Ehsan Moradi","doi":"10.1016/j.inat.2025.102128","DOIUrl":"10.1016/j.inat.2025.102128","url":null,"abstract":"<div><div>Hydrocephalus is excessive accumulation of cerebrospinal fluid within the cerebral ventricles. It has a complex pathogenesis with various causes. Periventricular edema refers to the abnormal accumulation of fluid in the brain tissue surrounding the cerebral ventricles, an indicative of elevated intracranial pressure or disruption in cerebrospinal fluid flow. Periventricular edema can serve as one of the severity indicators of hydrocephalus, and can assist physicians in predicting the outcomes of treatments and determining appropriate therapeutic interventions. In this study, our goal is to identify periventricular edema in hydrocephalus disease. In this regard, the smoothing-sharpening image filter (SSIF) algorithm is applied to enhance hydrocephalic CT images due to the low quality of CT images and the ambiguity between the boundaries of periventricular edema, ventricles, and other brain regions. Some well-known deep learning models including UNet, PSPNet, LinkNet and FPN are suggested to segment periventricular edema. From the obtained results, the FPN model, compared to the other models, achieves the best evaluation criteria with AUC, dice score, F1-score, precision, and recall values of 95 %, 93 %, 91 %, 91 %, and 92 %, respectively.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"42 ","pages":"Article 102128"},"PeriodicalIF":0.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145267785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The ventriculoperitoneal shunting (VPS) is a frequently performed neurosurgical procedure with common complications. Delayed intracerebral hemorrhage (DICH) is one of the rarest, with mechanisms and etiology still under debate. The currently described cases of DICH occur within 2 weeks of shunt placement.
We report on a unique case of extremely delayed intracerebral hemorrhage (eDICH) 15 years after ventricular catheter placement. The patient, an otherwise healthy female aged 30, was admitted with an acute onset of headache and vomiting for 4 days. She had a VPS procedure shortly after birth due to hydrocephalus secondary to perinatal intraventricular hemorrhage. Subsequent ventricular catheter replacement was required 15 years later due to acute catheter obstruction. On admission, the head CT showed a small volume of intracerebral hemorrhage adjacent to the catheter with even smaller intraventricular breakthrough. Current medical history was unremarkable, and the patient had none of the already recognized risk factors. Conservative management was undertaken with satisfactory results. Serial imaging showed a significant variation in ventricle volume by 6 weeks after the incident.
Currently, the few case reports and series of DICH offer a glimpse into the possible sensitizing factors for its occurrence. Management is on a case-by-case basis since clinical manifestations vary widely. This unique case of eDICH was managed conservatively with a good patient outcome. We believe that variation in ventricle volume and contraction/expansion of brain parenchyma around the ventricular catheter could explain the etiology behind this case and be a yet undescribed mechanism of DICH.
{"title":"How late is too late? Delayed intracerebral hemorrhage 15 years after ventriculoperitoneal shunting − a unique case report and review of the literature","authors":"Dimo Yankov , Assen Bussarsky , Dilyan Ferdinandov","doi":"10.1016/j.inat.2025.102129","DOIUrl":"10.1016/j.inat.2025.102129","url":null,"abstract":"<div><div>The ventriculoperitoneal shunting (VPS) is a frequently performed neurosurgical procedure with common complications. Delayed intracerebral hemorrhage (DICH) is one of the rarest, with mechanisms and etiology still under debate. The currently described cases of DICH occur within 2 weeks of shunt placement.</div><div>We report on a unique case of extremely delayed intracerebral hemorrhage (eDICH) 15 years after ventricular catheter placement. The patient, an otherwise healthy female aged 30, was admitted with an acute onset of headache and vomiting for 4 days. She had a VPS procedure shortly after birth due to hydrocephalus secondary to perinatal intraventricular hemorrhage. Subsequent ventricular catheter replacement was required 15 years later due to acute catheter obstruction. On admission, the head CT showed a small volume of intracerebral hemorrhage adjacent to the catheter with even smaller intraventricular breakthrough. Current medical history was unremarkable, and the patient had none of the already recognized risk factors. Conservative management was undertaken with satisfactory results. Serial imaging showed a significant variation in ventricle volume by 6 weeks after the incident.</div><div>Currently, the few case reports and series of DICH offer a glimpse into the possible sensitizing factors for its occurrence. Management is on a case-by-case basis since clinical manifestations vary widely. This unique case of eDICH was managed conservatively with a good patient outcome. We believe that variation in ventricle volume and contraction/expansion of brain parenchyma around the ventricular catheter could explain the etiology behind this case and be a yet undescribed mechanism of DICH.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"42 ","pages":"Article 102129"},"PeriodicalIF":0.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145267788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cabergoline, a dopamine agonist, is the first-line drug for treating prolactinoma. However, some rare cases exhibit resistance to cabergoline. Here, we report a rare case of prolactinoma in a male patient that recurred in a short period while the patient was undergoing cabergoline treatment following tumor resection. A 50-year-old man was diagnosed with a pituitary tumor (Knosp grade 3) and presented with symptoms of decreased libido, erectile dysfunction, and bilateral hemianopia. He underwent endoscopic transnasal pituitary tumor resection. The pathological diagnosis was prolactinoma. The intrasellar tumor was excised, except around the bilateral cavernous sinus, improving the patient’s visual dysfunction. However, despite postoperative treatment with cabergoline, the residual tumor rapidly enlarged, and the bilateral hemianopia recurred. The second tumor resection was performed 15 months after the initial surgery. The patient’s visual field loss once more improved, and postoperative oral cabergoline treatment was resumed. However, radiation therapy was required because the residual tumor in the cavernous sinus grew back. Since then, the patient’s condition has remained stable, and the tumor did not enlarge. In this case, the patient consistently showed strong resistance to cabergoline and required surgery and radiation therapy due to early recurrence of tumor growth after the initial surgery. Combined therapy involving surgical resection and radiotherapy may be beneficial for male patients with cabergoline-resistant prolactinoma.
{"title":"A case of rapidly increasing cabergoline-resistant male prolactinoma","authors":"Toshiya Ichinose, Yasuo Sasagawa, Mitsutoshi Nakada","doi":"10.1016/j.inat.2025.102147","DOIUrl":"10.1016/j.inat.2025.102147","url":null,"abstract":"<div><div>Cabergoline, a dopamine agonist, is the first-line drug for treating prolactinoma. However, some rare cases exhibit resistance to cabergoline. Here, we report a rare case of prolactinoma in a male patient that recurred in a short period while the patient was undergoing cabergoline treatment following tumor resection. A 50-year-old man was diagnosed with a pituitary tumor (Knosp grade 3) and presented with symptoms of decreased libido, erectile dysfunction, and bilateral hemianopia. He underwent endoscopic transnasal pituitary tumor resection. The pathological diagnosis was prolactinoma. The intrasellar tumor was excised, except around the bilateral cavernous sinus, improving the patient’s visual dysfunction. However, despite postoperative treatment with cabergoline, the residual tumor rapidly enlarged, and the bilateral hemianopia recurred. The second tumor resection was performed 15 months after the initial surgery. The patient’s visual field loss once more improved, and postoperative oral cabergoline treatment was resumed. However, radiation therapy was required because the residual tumor in the cavernous sinus grew back. Since then, the patient’s condition has remained stable, and the tumor did not enlarge. In this case, the patient consistently showed strong resistance to cabergoline and required surgery and radiation therapy due to early recurrence of tumor growth after the initial surgery. Combined therapy involving surgical resection and radiotherapy may be beneficial for male patients with cabergoline-resistant prolactinoma.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"42 ","pages":"Article 102147"},"PeriodicalIF":0.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145578600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-11-15DOI: 10.1016/j.inat.2025.102145
Miguel A. Hernandez-Rovira , Tyler Bales , Keerthana N. Prabhu , Brianna Augustin , Asia Carey , Sonika Dahiya , Francis S. Wu , David N. Loy , Ali Y. Mian , Omar Butt , Albert H. Kim , Dimitrios Mathios
Although high-grade gliomas most commonly present in older individuals, they infrequently present in women of childbearing age. We report the case of a 27-year-old woman previously diagnosed with a grade 4 astrocytoma who became pregnant during treatment. The patient had a stable pregnancy until the perinatal period, when she experienced worsening headache, nausea, and vomiting, and was confirmed to have disease recurrence. Labor was induced at the 37th week of gestation with delivery of a healthy neonate. With the low incidence of high-grade gliomas in the pregnant population and resulting paucity of literature, there is no consensus on the treatment strategy for this population. To better characterize this disease process and investigate the optimal management of these challenging cases, we reviewed the literature and identified 81 cases of high-grade gliomas in pregnant individuals, but we were unable to identify any factors associated with increased survival. We discuss topics of importance to physicians managing these complex cases and make suggestions for the management of common issues for this patient population.
{"title":"Management of high-grade glioma in pregnancy: Case report and review of the literature","authors":"Miguel A. Hernandez-Rovira , Tyler Bales , Keerthana N. Prabhu , Brianna Augustin , Asia Carey , Sonika Dahiya , Francis S. Wu , David N. Loy , Ali Y. Mian , Omar Butt , Albert H. Kim , Dimitrios Mathios","doi":"10.1016/j.inat.2025.102145","DOIUrl":"10.1016/j.inat.2025.102145","url":null,"abstract":"<div><div>Although high-grade gliomas most commonly present in older individuals, they infrequently present in women of childbearing age. We report the case of a 27-year-old woman previously diagnosed with a grade 4 astrocytoma who became pregnant during treatment. The patient had a stable pregnancy until the perinatal period, when she experienced worsening headache, nausea, and vomiting, and was confirmed to have disease recurrence. Labor was induced at the 37th week of gestation with delivery of a healthy neonate. With the low incidence of high-grade gliomas in the pregnant population and resulting paucity of literature, there is no consensus on the treatment strategy for this population. To better characterize this disease process and investigate the optimal management of these challenging cases, we reviewed the literature and identified 81 cases of high-grade gliomas in pregnant individuals, but we were unable to identify any factors associated with increased survival. We discuss topics of importance to physicians managing these complex cases and make suggestions for the management of common issues for this patient population.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"42 ","pages":"Article 102145"},"PeriodicalIF":0.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145578601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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