- Recurrent spontaneous cervical hemorrhage in a patient with neurofibromatosis type 1 requiring repeated endovascular embolization: illustrative case. [Journal Article]J Neurosurg Case Lessons. 2026 Jul 27; 12(4).JN
- CONCLUSIONS: In patients with NF1, cervical hemorrhage may recur early from a vascular territory distinct from the initially treated lesion. Even after a technically successful embolization, close early surveillance is required. https://thejns.org/doi/10.3171/CASE26354.
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- Delayed coil migration after endovascular treatment of a ruptured intracranial aneurysm managed by open microsurgical surgery: illustrative case. [Journal Article]J Neurosurg Case Lessons. 2026 Jul 27; 12(4).JN
- CONCLUSIONS: Open microsurgical coil retrieval combined with aneurysm clipping can be an effective treatment option in selected cases of coil migration, particularly when endovascular retrieval is not feasible or carries significant risk. Early recognition of this complication and timely multidisciplinary decision-making are essential to prevent ischemic injury and achieve acceptable outcomes. https://thejns.org/doi/10.3171/CASE26239.
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- Unmasking the role of a thoracic arachnoid web and watershed ischemia in rapidly progressing paraplegia: illustrative case. [Journal Article]J Neurosurg Case Lessons. 2026 Jul 27; 12(4).JN
- CONCLUSIONS: This case challenges the conventional understanding of SAWs as slowly progressive lesions and highlights the diagnostic complexity introduced by atypical presentations. The location of the web in a vascular watershed zone of the midthoracic spine likely contributed to the development of cord ischemia, which was suspected to be the primary driver of the patient's fulminant course. This case underscores the importance of considering SAWs in the differential diagnosis of acute myelopathy. https://thejns.org/doi/10.3171/CASE2682.
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- Primary intradural intramedullary melanocytoma of the spinal cord: illustrative cases. [Journal Article]J Neurosurg Case Lessons. 2026 Jul 27; 12(4).JN
- CONCLUSIONS: These cases demonstrate that molecular characterization, such as BAP1 inactivation or GNAQ mutation, offers valuable prognostic insights and may inform the need for adjuvant therapies including chemotherapy, radiotherapy, or close surveillance. https://thejns.org/doi/10.3171/CASE25946.
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- Lessons in balancing function with oncological control in a destructive lumbosacral tumor of uncertain pathology: illustrative case. [Journal Article]J Neurosurg Case Lessons. 2026 Jul 27; 12(4).JN
- CONCLUSIONS: Destructive lumbosacral tumors should be approached with an oncological mindset even when histology is uncertain. In urgent cases, timely decompression and functional preservation may outweigh radical resection, underscoring the value of adaptable, multidisciplinary management. https://thejns.org/doi/10.3171/CASE2646.
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- Emergency superficial temporal artery-middle cerebral artery bypass under dual antiplatelet therapy: an extreme salvage procedure for a misleading moyamoya case. Illustrative case. [Journal Article]J Neurosurg Case Lessons. 2026 Jul 27; 12(4).JN
- CONCLUSIONS: MMA may rapidly progress from unilateral to bilateral involvement. When medical therapy fails, urgent revascularization-even under DAPT-can be safe and effective. Vigilant postoperative surveillance and readiness for contralateral bypass are crucial in atypical, rapidly evolving cases. https://thejns.org/doi/10.3171/CASE25903.
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- Vessel wall MRI detection of an angiographically occult A3 blister aneurysm presenting with subarachnoid hemorrhage: illustrative case. [Journal Article]J Neurosurg Case Lessons. 2026 Jul 27; 12(4).JN
- CONCLUSIONS: This case emphasizes the adjunctive value of VW-MRI in the diagnostic workup of suspected BAs. By targeting the arterial wall beyond the luminal contour, VW-MRI enhances lesion visibility and delineates associated parent artery abnormalities. https://thejns.org/doi/10.3171/CASE26248.
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- Resection of a thalamomesencephalic cavernous malformation via a retrosigmoid supracerebellar transtentorial approach: illustrative case. [Journal Article]J Neurosurg Case Lessons. 2026 Jul 27; 12(4).JN
- CONCLUSIONS: A tailored retrosigmoid supracerebellar transtentorial corridor may enable safe resection of selected thalamomesencephalic cavernous malformations while preserving eloquent tracts and deep neurovascular structures. https://thejns.org/doi/10.3171/CASE26210.
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- Direct superior ophthalmic vein puncture for cavernous sinus dural arteriovenous fistula with dual orbital venous outflow: illustrative case. [Journal Article]J Neurosurg Case Lessons. 2026 Jul 27; 12(4).JN
- CONCLUSIONS: Direct SOV puncture is a safe and effective TVE route when standard access is challenging, particularly in cases with dual orbital outflows and preserved posterior drainage. Selecting a single SOV for access minimizes hemodynamic disruption. Preoperative venous mapping is essential to confirm safe drainage pathways and guide approach selection. https://thejns.org/doi/10.3171/CASE2673.
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- Sequential deep brain stimulation of anterior and centromedian nuclei in juvenile myoclonic epilepsy: illustrative case. [Journal Article]J Neurosurg Case Lessons. 2026 Jul 27; 12(4).JN
- CONCLUSIONS: This case highlights the complementary roles of ANT and CMT stimulation in modulating distinct thalamocortical pathways. Although CMT DBS has been described in patients with generalized epilepsy, this case demonstrates a meaningful reduction specifically in disabling myoclonic jerks that previously resulted in falls and dropped objects. https://thejns.org/doi/10.3171/CASE251033.
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- Biphasic growth and subsequent spontaneous regression of posterior fossa meningioma with progressive calcification: illustrative case. [Journal Article]J Neurosurg Case Lessons. 2026 Jul 27; 12(4).JN
- CONCLUSIONS: This case illustrates that meningiomas may undergo dynamic biological transitions over extended periods, including growth phases and spontaneous regression. Progressive intratumoral calcification observed throughout tumor evolution may represent a tumor aging and biological involution indicator rather than reflecting slow tumor growth. https://thejns.org/doi/10.3171/CASE26353.
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- Tuberculous brain abscess mimicking a neoplastic lesion in a patient with well-controlled human immunodeficiency virus infection: illustrative case. [Journal Article]J Neurosurg Case Lessons. 2026 Jul 27; 12(4).JN
- CONCLUSIONS: Tuberculous brain abscess can occur even in patients without overt immunodeficiency, including those with well-controlled HIV infection. Because imaging findings may overlap with neoplastic lesions and systemic infectious features may be absent, maintaining a broad differential diagnosis and pursuing timely tissue confirmation are essential to guide appropriate management and avoid delays in treating either infection or malignancy. https://thejns.org/doi/10.3171/CASE26178.
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- Multisuture craniosynostosis and acquired Chiari malformation secondary to vitamin D deficiency rickets: illustrative case. [Journal Article]J Neurosurg Case Lessons. 2026 Jul 27; 12(4).JN
- CONCLUSIONS: Secondary or postnatal craniosynostosis often does not present with characteristic head shape changes but may be associated with elevated ICP and acquired CM-I, which may require surgical intervention. Late presentation or diagnosis of craniosynostosis in young children without typical features should prompt investigation for underlying disorders of bone metabolism. https://thejns.org/doi/10.3171/CASE26200.
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- Right-sided chyle leak encountered during supraclavicular brachial plexus exposure: illustrative case. [Journal Article]J Neurosurg Case Lessons. 2026 Jul 27; 12(4).JN
- CONCLUSIONS: Although uncommon, right-sided chyle leaks may occur during supraclavicular dissection. Awareness of potential anatomical variations, meticulous intraoperative inspection, and prompt recognition allow immediate management and prevention of postoperative morbidity. This case highlights the need for heightened vigilance for lymphatic injury even during nononcological neck procedures. https://thejns.org/doi/10.3171/CASE26349.
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- Purely cystic meningioma: extremely rare clinical and radiographic mimic of intra-axial glioblastoma multiforme with systematic review of the literature. Illustrative case. [Journal Article]J Neurosurg Case Lessons. 2026 Jul 27; 12(4).JN
- CONCLUSIONS: Cystic meningiomas are rarely GBM "imitators." Surgeons should consider cystic meningioma when classic radiological hallmarks are absent. Despite an aggressive imaging profile, these tumors are biologically and clinically benign. Gross-total resection remains the gold-standard treatment, offering excellent long-term prognosis and the potential for a permanent cure. This case highlights the need for histological tissue diagnosis before final treatment plans are considered. https://thejns.org/doi/10.3171/CASE26438.
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