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Introduction: Schwannoma, also known as neurilemmoma, is a benign tumor commonly found around the spinal nerve roots. Large, solitary cases of cystic degeneration within the extramedullary intradural compartment (IDEM) can be challenging for preoperative diagnosis. Furthermore, these cases are not extensively documented in the medical literature., Case Presentation: We report a case of giant invasive IDEM schwannoma in a 28-year-old man who presented with intermittent pain radiating to the left thigh without numbness. Magnetic resonance imaging (MRI) showed a complex cystic lesion within the spinal canal from the inferior end plate of L4 to the mid-body of S1., Clinical Discussion: The patient underwent a series of surgical procedures, including laminectomy and decompression at the L4-L5 level for resection of the tumor. Histopathological examination confirmed the diagnosis of schwannoma. The patient had a favorable postoperative recovery and experienced a resolution of symptoms., Conclusion: The giant cystic lumbar schwannoma, although rare, necessitates careful diagnosis and management. The utilization of contrast-enhanced MRI aids in distinguishing it from other lesions. In cases of cystic spinal schwannoma, the lesion walls tend to be thicker and more irregular compared to other cysts, including arachnoid cysts. Histopathological examination should be utilized to identify these lesions intraoperatively. Surgical excision is the primary treatment, and complete excision should be attempted whenever feasible., Competing Interests: Conflict of interest The authors declare that there they have no conflict of interest., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Plexiform schwannomas (PSs) are rare. Here, we describe the clinical features, diagnosis, treatment, and outcome of a 17-year-old male presenting with a T1-T4 intradural extramedullary (IDEM)., Case Description: A 17-year-old male presented with back pain and pain radiating down both legs. The thoracic magnetic resonance revealed a left-sided T1-T4 IDEM mass. The patient underwent a T2-T4 laminectomy for gross total tumor excision, followed by posterior fusion. Immunohistochemical examination revealed S100 positivity, supporting the diagnosis of PS., Conclusion: IDEM PSs are rare, may be readily diagnosed with MR, and can be successfully resected., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Surgical Neurology International.)

Background: Ventriculoperitoneal shunt (VPS) is an effective intervention for managing hydrocephalus; however, various complications may arise, one of which is infection due to shunt exposure. In this study, we report the incidence, risk factors, clinical presentation, and management strategies of four cases of shunt exposure in patients with hydrocephalus., Case Description: The first case involves a 1-year-10-month-old female who underwent her initial VPS placement at 7 months old due to hydrocephalus. The second case is a 3-month-old female who had a VPS placed at 20 days old for obstructive hydrocephalus and ventriculomegaly secondary to toxoplasmosis. The third case is a 15-year-old female who received a VPS due to a cerebral abscess with a prior history of tuberculous meningoencephalopathy. The fourth case is a 38-year-old male who underwent VPS placement for hydrocephalus. Two years post-intervention, the fourth patient was diagnosed with VPS exposure and subsequently underwent shunt removal., Conclusion: The identification of risk factors and clinical symptoms in patients, supported by ancillary examinations such as cerebrospinal fluid analysis, can predict the incidence of VPS infections. Bacterial VPS infections can be managed with appropriate antibiotics tailored to the specific bacterial species. However, in certain cases, surgical removal of the VPS may be considered as a measure to eradicate infectious pathogens., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Surgical Neurology International.)

Background: Spinal gout, a rare and often underdiagnosed condition, significantly impacts patients' quality of life. Therefore, the aim of the research is to analyze cases of spinal gout, including clinical features, anatomical location of spinal gout, laboratory studies, imaging studies, treatment choices, and outcomes from various cases of spinal gout., Methods: The author conducted a systematic literature search in the PUBMED and Science Direct databases from 2013 to 2023. We included clinical case presentations of spinal cases in adults, published in English. The three researchers independently reviewed the title and abstract of each article, and any differences in opinions were resolved through consensus. The extracted data were subsequently analyzed descriptively., Results: A total of 88 cases of spinal gout were obtained and studied. Out of the total reviewed cases of spinal gout, 89.77% of the subjects were male, with an average age of 51.9 years (age range 16-87 years). Common symptoms include back/neck pain (78.41%) and lower extremity weakness (37.50%). The lumbar spine is the most frequently affected region (62.50%), diagnosed primarily through magnetic resonance imaging (MRI) scans. Surgery, performed in 61.36% of cases, commonly involves decompressive laminectomy. Posttreatment, symptoms resolve in 87.50% of cases., Conclusion: Cases of spinal gout present with a variety of symptoms, including back pain and weakness. Diagnosis typically involves an MRI examination and synovial fluid analysis for confirmation. Treatment varies and includes medication therapy and surgical interventions. A deeper understanding of these cases can assist healthcare practitioners in the management and diagnosis of spinal gout cases., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Craniovertebral Junction and Spine.)