{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T11:10:57Z","timestamp":1778238657273,"version":"3.51.4"},"reference-count":17,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Hirayama disease (HD) is a rare, benign neurological disorder predominantly affecting young males. It is characterized by an insidious onset of unilateral or asymmetrical distal upper-limb weakness and muscle wasting, primarily due to dynamic spinal cord compression during neck flexion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st2\">\n                    <jats:title>Case Description:<\/jats:title>\n                    <jats:p>We report on a 19-year-old right-hand-dominant schoolboy who presented with progressive right-hand weakness, numbness, and neck pain. Examination revealed right upper-limb muscle wasting, especially in the intrinsic hand muscles. Dynamic cervical magnetic resonance imaging demonstrated anterior displacement of the posterior dura and maximal cord compression at the C6\u2013C7 level during neck flexion. The patient underwent cervical laminectomy to decompress the spinal cord. Postoperatively, he was referred for physiotherapy but defaulted on further treatment. Management of HD includes conservative cervical collar immobilization to prevent neck flexion and progression of neurological deficits. Surgical intervention is reserved for progressive or severe cases with significant cord compression. Our decision for a laminectomy was based on the patient\u2019s radiological findings and clinical progression. Awareness and early diagnosis remain critical to preserving neurological function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st3\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This case underlines the importance of dynamic imaging in diagnosing HD and highlights surgical decompression as an effective treatment in progressive cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.25259\/sni_160_2026","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T10:33:46Z","timestamp":1778236426000},"page":"269","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hirayama disease - A case report and literature review"],"prefix":"10.25259","volume":"17","author":[{"given":"Nadun","family":"Danushka","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, National Hospital Galle, Galle, Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ravindri","family":"Jayasinghe","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Derriford Hospital,University Hospitals Plymouth NHS Trust, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sajani","family":"Biseka","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yamini","family":"Jeyaratnam","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepal","family":"Attanayaka","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Hospital Sri Lanka, Colombo, Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2026,5,8]]},"reference":[{"key":"10.25259\/SNI_160_2026\/ref-1","doi-asserted-by":"crossref","first-page":"810","DOI":"10.4103\/0028-3886.59488","article-title":"Familial monomelic amyotrophy (Hirayama disease): Two brothers with classical flexion induced dynamic changes of the cervical dural sac","volume":"57","author":"Atchayaram","year":"2009","journal-title":"Neurol India"},{"key":"10.25259\/SNI_160_2026\/ref-2","first-page":"e67627","article-title":"A case report and review of literature on hirayama disease","volume":"16","author":"Baddam","year":"2024","journal-title":"Cureus"},{"key":"10.25259\/SNI_160_2026\/ref-3","doi-asserted-by":"crossref","first-page":"3229","DOI":"10.1007\/s10143-021-01540-2","article-title":"Impact of various cervical surgical interventions in patients with Hirayama\u2019s disease-a narrative review and meta-analysis","volume":"44","author":"Bohara","year":"2021","journal-title":"Neurosurg Rev"},{"key":"10.25259\/SNI_160_2026\/ref-4","doi-asserted-by":"crossref","first-page":"46","DOI":"10.47276\/lr.94.1.46","article-title":"Hirayama disease: The importance of the differential diagnosis in suspected neural leprosy","volume":"94","author":"Brandsma","year":"2023","journal-title":"Lepr Rev"},{"key":"10.25259\/SNI_160_2026\/ref-5","doi-asserted-by":"crossref","first-page":"173","DOI":"10.5582\/irdr.2022.01105","article-title":"Do patients with Hirayama disease require surgical treatment? 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