Journal of Neurosurgery Academy

Rare desmoplastic myxoid tumor of pineal region, SMARCB1 mutant in adult - A brief report

Rajesh Menon Moothedath — 2025-03-29

A 40-year-old lady presented with clinical features of Parinaud syndrome. Contrast MRI showed a mass in the pineal region with tectal compression and moderate obstructive hydrocephalus. She underwent gross total excision of the lesion through an occipital transtentorial approach. Histopathology and IHC were confirmative of desmoplastic myxoid tumor (DMT), a SWI/SNF-related matrix-associated actin-dependent regulator of chromatin subfamily B member 1 (SMARCB1) mutant of the pineal region predominantly seen in adolescents and older individuals with a slight preponderance to females (M:F, 4:6). SMARCB1 mutant DMT is a recently described yet sporadic and distinct pineal parenchymal tumor according to the new WHO 2021 classification. Even though the tumor has a better prognosis as per limited literature reviews, its optimum therapeutic protocol is evolving. The neoplasm is characterized by alterations of the SMARCB1/INI1 locus with variable amounts of desmoplasia and myxoid matrix. We hope this case study will provide additional insight into this newly described neoplastic entity and its management.

Tuberculum sellae meningiomas

Maximiliano Calatroni — 2025-03-29

This case report describes a 65-year-old female with tuberculum sellae meningioma presenting with progressive visual impairment. A pterional craniotomy with extradural anterior clinoidectomy enabled tumor resection and optic nerve decompression. Microsurgical techniques achieved gross-total resection without vascular complications. This report highlights the surgical nuances and importance of early optic nerve decompression for skull base neurosurgeons managing complex meningiomas.

Unilateral biportal endoscopic spine surgery: A game changer in spine care

Atmaranjan Dash — 2025-03-31

Unilateral Biportal Endoscopic spine surgery is a minimally invasive technique using two portals for visualization and instrumentation. It offers enhanced precision, reduced tissue disruption, and faster recovery. This paper reviews its applications, advantages, and evolving role in spine care, including recent advancements in robotics and augmented reality.

Tuberculum meningioma – Deﬁning those ideal for endoscopic extended endonasal approach

Alistair Lawrence — 2025-03-29

This study evaluates the endoscopic extended endonasal approach (EEA) for tuberculum sellae meningiomas, emphasizing key anatomical factors for optimal patient selection. The EEA offers direct tumor access with minimal neural manipulation, facilitating complete resection in suitable cases. Limitations include tumors extending beyond the medial optico-carotid recess or encasing vascular structures. Careful preoperative assessment can maximize resection success and minimize complications. A video demonstration of an ideal case is included.

Networking neurosurgery

Kodeeswaran M. — 2025-03-31

Neuro-exoscopic clipping of ruptured basilar apex aneurysm: a step-by-step video

Priyadharshan KP — 2025-03-31

This article presents a step-by-step video demonstrating neuro-exoscopic clipping of a ruptured basilar apex aneurysm in a 68-year-old female. The neuro-exoscope provided enhanced visualization and improved surgeon ergonomics, facilitating precise clip placement. Despite intraoperative rupture, immediate control was achieved. The case underscores the advantages of the exoscope in managing complex posterior circulation aneurysms, offering a viable alternative to endovascular treatment. Key surgical nuances and postoperative considerations are discussed to aid neurosurgeons in refining their approach.

Surgical video of septum cavum colloid cyst

BC Anil Kumar — 2025-03-31

Cavum septum pellucidum (CSP) cysts are rare midline intracranial cysts, typically asymptomatic but capable of causing neurological symptoms when enlarged. With an incidence of approximately 0.04%, symptomatic cases are even rarer and may present with headaches, ataxia, seizures, visual disturbances, or cerebrospinal fluid (CSF) obstruction leading to hydrocephalus. These cysts are characterized by lateral bowing of the septal walls and a width of at least 10 mm. We present an operative video of a 41-year-old gentleman who presented with imbalance while walking, lower limb weakness, and memory impairment. His radiological evaluation was suggestive of a CSP cyst extending into the third ventricle with gross ventriculomegaly. Surgical excision of the cyst was performed via a transcallosal approach, leading to significant improvement in symptom complexity. This manuscript highlights the importance of considering CSP cysts in unexplained neurological conditions and the potential benefits of timely surgical intervention.