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NMC Case Report Journal

Yusuke Takamine, Shun Yamamuro, Koichiro Sumi, Takashi Ohta, Katsunori Shijo, Yoko Nakanishi, Taku Homma, Atsuo Yoshino
Intracranial hemorrhage associated with lower grade glioma is unusual. Furthermore, pleomorphic xanthoastrocytoma (PXA) with intracranial hemorrhage, especially in a children, is extremely rare. We report here a rare case of child PXA with intracranial hemorrhage. An 11-year-old girl was admitted with headache and convulsions. A computed tomography scan demonstrated intracranial hemorrhage in the right temporal lobe. An angiogram revealed no vascular disease including arteriovenous malformation, angioma or aneurysm...
January 2019: NMC Case Report Journal
Kyongsong Kim, Toyohiko Isu, Daijiro Morimoto, Rinko Kokubo, Naotaka Iwamoto, Akio Morita
In rare cases, pedicle fracture is associated with spine surgery, spondylolysis, or stress fracture. We report a patient without trauma whose bilateral lumbar pedicle fracture was detected incidentally. A 67-year-old woman reported leg numbness and pain. Lumbar MRI showed spinal canal stenosis at the L4/L5 level. Drug treatment was only partially effective. A lumbar computed tomography (CT) scan performed 3 months later revealed bilateral pedicle fracture at L4. A second lumbar MRI showed fresh bilateral L4 pedicle fracture that was not observed on the first scan...
January 2019: NMC Case Report Journal
Satoru Yabuno, Masatoshi Yunoki, Takahiro Kanda, Atsushi Matsumoto, Koji Hirashita, Kimihiro Yoshino
Lumbar spondylolysis is commonly recognized at a single-level of the lumbar spine and frequently affects the L5 pars interarticularis unilaterally or bilaterally. Some reports have described multiple-level spondylolysis, most cases of which occur at consecutive lumbar segments. We herein present a rare case of lumbar spondylolysis involving nonconsecutive multiple-level segments; only eight such cases have been reported previously. A 38-year-old man presented with a 10-month history of chronic severe low back pain...
January 2019: NMC Case Report Journal
Hidenori Oishi, Kosuke Teranishi, Kenji Yatomi, Takashi Fujii, Munetaka Yamamoto, Hajime Arai
The management of giant vertebrobasilar junction (VBJ) aneurysms is extremely challenging. Flow diverter (FD) therapy has become an important alternative to treat difficult intracranial aneurysms for both open surgery and conventional endovascular therapy. Herein, we report a rare case of a giant fusiform VBJ aneurysm in a child that is successfully treated with FD therapy.
January 2019: NMC Case Report Journal
Fumiaki Fujihara, Masaki Takahara, Toshiro Katsuta, Koichiro Takemoto, Toshio Higashi, Tooru Inoue
The variation in which the posterior inferior cerebellar artery arises from the hypoglossal branch of the ascending pharyngeal artery is thought to be related to the remnant of the primitive hypoglossal artery, and is referred to as a primitive hypoglossal artery variant. Cases in which the posterior inferior cerebellar artery arises from the jugular branch of the ascending pharyngeal artery are extremely rare. The authors present a case of a 50-year-old male with vertebral artery dissection who had this extremely rare variation bilaterally...
January 2019: NMC Case Report Journal
Shinya Sonobe, Masahiro Yoshida, Kuniyasu Niizuma, Teiji Tominaga
Pulmonary vein thrombosis is a rare disease but can cause severe complications. However, pathophysiology of this entity is not fully understood. We report a case of mechanical thrombectomy for acute ischemic stroke arising from thrombus of the left superior pulmonary vein stump after left pneumonectomy. A 67-year-old male without atrial fibrillation presented with middle cerebral artery occlusion 11 days after left pneumonectomy. Contrast-enhanced computed tomography showed thrombus in the left superior pulmonary vein stump...
January 2019: NMC Case Report Journal
Takeshi Takayasu, Fumiyuki Yamasaki, Takeo Shishido, Motoki Takano, Hirofumi Maruyama, Kazuhiko Sugiyama, Kaoru Kurisu
We present the case of a 68-year-old man with brain metastasis from lung cancer and a history of immune checkpoint inhibitor administration, with overlapping abscess within the metastatic lesion. He initially received antibiotic treatment under a diagnosis of brain abscess because of a hyper-intense area on diffusion-weighted imaging inside the gadolinium-enhanced wall. The size of the enhanced lesion did not change much, but the extent of perifocal edema decreased after antibiotic treatment. After 2-4 months, the lesion gradually enlarged, and imaging characteristics changed from single cyst to multiple cysts...
January 2019: NMC Case Report Journal
Kyung Hyun Kim, Eun Jin Ha, Won-Sang Cho, Hyun-Seung Kang, Jeong Eun Kim
Background: Treatment options for a ruptured anterior communicating artery (ACoA) pseudoaneurysm are limited. In most cases trapping of the ACoA is the best treatment option. Occasionally, bypass surgery is warranted to ensure blood flow to the contralateral anterior cerebral artery (ACA) in cases with one dominant A1. We report a case of an ACoA pseudoaneurysm presenting with delayed subarachnoid hemorrhage following surgical clipping of an unruptured ACoA aneurysm, with a review of the literature...
January 2019: NMC Case Report Journal
Hakan Ozalp, Vural Hamzaoglu, Derya Karatas, Ahmet Dagtekin, Mehmet Yildız, Emel Avcı
Background: Neuroenteric cysts (NCs) are benign, rare congenital lesions which are most commonly found in the lower cervical and upper thoracic segments. Even though these are benign lesions, it may present with fatal neurologic deterioration particularly in pediatric patients. Case Report: We here report a 16-year-old boy who has unique manifestation with acute tetraplegia and respiratory arrest in emergency room. According to English literature, this is the first case of cervicomedullary intradural neuroenteric cyst which causes acute tetraplegia and respiratory arrest in a child...
January 2019: NMC Case Report Journal
Seung Young Jeong, Jin Uk Kim, Soo Yong Park, Jun Ho Lee, Kyu Jae Lee
The objective of this study is to present a rare case of an invaginated inferior vena cava (IVC) aneurysm in the lumbar intradiscal space. A 73-year-old woman with lower back pain and bilateral lower extremity swelling presented to the clinic. She had undergone spinal surgery performed thrice at the same site (L4-L5) in another hospital and a separate posterolateral fusion surgery procedure 3 years previously. On plain radiography, pseudarthrosis was observed at L4-L5 segment. Contrast computed tomography (CT) imaging revealed a dilatation of the IVC in the intradiscal space of L4-L5...
October 2018: NMC Case Report Journal
Atsushi Saito, Tomohisa Ishida, Tomoo Inoue, Takashi Inoue, Shinsuke Suzuki, Masayuki Ezura, Hiroshi Uenohara
Dermoid tumors originating from the cavernous sinus are typically intradural, and thus, presentation with ophthalmoplegia is uncommon. Infantile dermoid tumors originating from the interdural space of the lateral wall of the cavernous sinus are also very rare. We herein present a 4-year-old infantile case of a dermoid cyst that was embedded in the lateral wall of the cavernous sinus. The patient presented with oculomotor nerve palsy. Magnetic resonance image demonstrated a well-circumscribed oval lesion inside the lateral wall of the left cavernous sinus...
October 2018: NMC Case Report Journal
Shingo Matsuda, Yosuke Kajihara, Masaru Abiko, Takafumi Mitsuhara, Masaaki Takeda, Vega Karlowee, Satoshi Yamaguchi, Vishwa Jeet Amatya, Kaoru Kurisu
Concurrent multiple tumors developing in the spinal cord are rare, except for in genetic disorders, such as neurofibromatosis and von Hippel-Lindau disease. Furthermore, concurrent tumors arising in the same spinal level with discrete histopathology are much rarer. We report two such cases. Case 1: A 53-year-old man presented with intracranial hemorrhage that manifested as disturbed consciousness and right hemiparesis. Magnetic resonance (MR) angiography demonstrated severe stenosis of the terminal portion of the bilateral internal carotid arteries, implying Moyamoya disease...
October 2018: NMC Case Report Journal
Yuta Murakami, Shinya Jinguji, Yugo Kishida, Masahiro Ichikawa, Taku Sato, Masazumi Fujii, Jun Sakuma, Fumi Murakami, Kiyoshi Saito
We report a case of a young male who received multiple surgical treatments for repeated recurrence of skull base mesenchymal chondrosarcoma (MC). When the patient was 18 years old, we subtotally removed the skull base MC and he was treated with stereotactic radiosurgery for remnant tumors in the left cavernous sinus. After 30 months, we removed residual tumors that had regrown partially, via combined endonasal endoscopic and orbitozygomatic approaches. Over the next 65 months, the patient refused radical resection, and received six salvage surgeries, two stereotactic radiotherapies, and five stereotactic radiosurgeries for repeated recurrence...
October 2018: NMC Case Report Journal
Masaki Ujihara, Yoshinori Maki, Masaki Chin, Kensuke Takada, Yoshitaka Kurosaki, Sen Yamagata
The surgical removal of giant solid hemangioblastoma involves a high risk of perioperative bleeding and requires attentive hemostasis. Here, we present a case of a giant solid hemangioblastoma accompanied with hemophilia which was previously undiagnosed. A 35-year-old man without any past medical history was admitted with diplopia and ocular motility disorder. computed tomography (CT) and magnetic resonance imaging (MRI) revealed obstructive hydrocephalus and a solid giant tumor of more than 4.0 cm in diameter in the right cerebellopontine angle (CPA)...
October 2018: NMC Case Report Journal
Taku Nonaka, Tatsuya Ishikawa, Koji Yamaguchi, Takayuki Yasuda, Yoshihiro Omura, Mieko Oka, Takakazu Kawamata
The occurrence of cerebral vasospasm secondary to bacterial meningitis is relatively rare. Furthermore, there is no specific treatment cerebral vasospasm. Endovascular treatment may be essential for cases with the advanced clinical course. Balloon angioplasty or intra-arterial injection of verapamil, nicardipine, or nitroglycerin has been previously reported. We experienced successful treatment using intra-arterial infusion of fasudil hydrochloride. To our knowledge, this is the first case to report the intra-arterial injection of fasudil hydrochloride for treating cerebral vasospasm secondary to bacterial meningitis...
October 2018: NMC Case Report Journal
Ryuzaburo Kochi, Masaki Mino, Shinya Sonobe, Masahiro Yoshida, Teiji Tominaga
We report a case of an encapsulated subdural hematoma in the posterior cranial fossa, showing spontaneous development and rapid increase in size after cardiac surgery. An 86-year-old woman underwent aortic valve replacement for aortic valve stenosis, followed by anticoagulant therapy with heparin. Three days after the cardiac surgery, she complained of headache. Computed tomography revealed development of a subdural hematoma in the posterior cranial fossa. The hematoma rapidly increased in size within 7 days...
October 2018: NMC Case Report Journal
Jun Takei, Satoru Tochigi, Masami Arai, Toshihide Tanaka, Ikki Kajiwara, Keisuke Hatano, Daisuke Ichinose, Hiroki Sakamoto, Yuzuru Hasegawa, Toshihiro Ishibashi, Satoshi Tani, Yuichi Murayama
We report the case of a patient with a spinal extradural arteriovenous fistula (AVF) associated with Cowden syndrome (CS) that was successfully treated by endovascular surgery. CS is an autosomal dominant disorder associated with diverse symptoms caused by a deleterious mutation in the phosphatase and tensin homolog ( PTEN ) gene. A 67-year-old woman was diagnosed with CS based on her medical history of multiple cancers for which she underwent abdominal surgery, macrocephaly, Lhermitte-Duclos disease, and facial papules...
October 2018: NMC Case Report Journal
Homare Nakamura, Tadashi Kudo, Hiroo Kobayashi, Yoshio Taguchi
The authors reported a rare case of young women with neurofibromatosis type I (NF-I) who were successfully treated from the traumatic dislocation of a thoracic vertebra caused by a simple fall, and the relevant literature was reviewed. Due to various spinal dystrophic changes, the conventional posterior spinal fusion surgery was modified for the treatment. Spinal deformity is a common feature of NF-1, and a dystrophic lesion, like dural ectasia, provokes weakness in spinal structural. Unexpectedly, only seven similar cases were found...
October 2018: NMC Case Report Journal
Yuhei Michiwaki, Takuya Inoue, Yasutoshi Kai
Tentorial meningiomas, not involving the cerebellopontine angle cistern or cranial nerves, rarely cause symptoms of cranial nerve disturbance. We report a case of a patient with a paramedian tentorial meningioma who presented with hearing loss as a result of indirect compression of the vestibulocochlear nerve by the herniated cerebellar flocculus into the internal acoustic meatus. A 50-year-old woman had presented with hearing loss in her right ear. Magnetic resonance imaging (MRI) revealed a large tentorial meningioma in the right posterior cranial fossa...
October 2018: NMC Case Report Journal
Atsushi Saito, Takashi Sasaki, Tomoo Inoue, Ayumi Narisawa, Takashi Inoue, Shinsuke Suzuki, Masayuki Ezura, Hiroshi Uenohara
Olfactory neuroblastoma is an uncommon malignant tumor of neural crest origin arising from the olfactory epithelium of the superior nasal cavity. There are some reports of local recurrence or continuous extension along the olfactory epithelium to the central nervous system, but non-contiguous distant meningeal metastasis without local recurrence at the primary site is rare. We report a case of non-contiguous meningeal recurrence of olfactory neuroblastoma presenting as a giant frontal mass. A 66-year-old woman was admitted with a left nasal intranasal localized tumor without cranial extension and gross total removal was achieved...
July 2018: NMC Case Report Journal
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