{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T00:36:27Z","timestamp":1768437387345,"version":"3.49.0"},"reference-count":19,"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>H3K27-altered diffuse midline glioma (DMG) is a newly classified disease according to the 5<jats:sup>th<\/jats:sup> edition of the World Health Organization classification of the central nervous system tumors. However, little is known about its progression pattern and the timing of surgical intervention, especially regarding spinal cord lesions.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Case Description: <\/jats:title>\n<jats:p>A 26-year-old man presented with rapid muscle weakness progression in both upper and lower extremities and urinary dysfunction. Magnetic resonance imaging showed diffuse swelling of the cervicothoracic spinal cord. He underwent decompressive laminectomy with expansive duroplasty and tumor biopsy. The surgical specimen revealed DMG. Immediately after surgery, deterioration of limb paresis was observed, and the patient developed respiratory failure the day after surgery. Head-and-neck computed tomography on the 7<jats:sup>th<\/jats:sup> day after surgery showed spinal cord swelling and acute obstructive hydrocephalus.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Conclusion: <\/jats:title>\n<jats:p>We report a rare case of a spinal DMG with acute postoperative swelling. Neurological deterioration in patients with spinal cord DMG is often exacerbated, so it is essential to suspect DMG at an early stage based on neuroimaging, and if surgery is performed on the edematous spinal cord, further rapid swelling can occur, as in the present case.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_636_2023","type":"journal-article","created":{"date-parts":[[2023,10,13]],"date-time":"2023-10-13T08:23:03Z","timestamp":1697185383000},"page":"360","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Spinal cord diffuse midline glioma with postoperative acute swelling: A case report and review of literature"],"prefix":"10.25259","volume":"14","author":[{"given":"Hiroki","family":"Karita","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takao","family":"Tsurubuchi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taishi","family":"Amano","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takao","family":"Koiso","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noriaki","family":"Sakamoto","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eiichi","family":"Ishikawa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2023,10,13]]},"reference":[{"key":"10.25259\/SNI_636_2023\/ref-1","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1097\/01.nrl.0000159982.63592.9f","article-title":"Upward transtentorial herniation, hydrocephalus, and cerebellar edema in hypertensive encephalopathy","volume":"11","author":"Adamson","year":"2005","journal-title":"Neurologist"},{"key":"10.25259\/SNI_636_2023\/ref-2","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1093\/neuonc\/not144","article-title":"H3F3A K27M mutations in thalamic gliomas from young adult patients","volume":"16","author":"Aihara","year":"2014","journal-title":"Neuro Oncol"},{"key":"10.25259\/SNI_636_2023\/ref-3","doi-asserted-by":"crossref","first-page":"288","DOI":"10.4103\/sni.sni_350_17","article-title":"Cervicothoracic syringomyelia caused by cervical spinal stenosis: Case report and literature review","volume":"8","author":"Badri","year":"2017","journal-title":"Surg Neurol Int"},{"key":"10.25259\/SNI_636_2023\/ref-4","first-page":"S78","article-title":"Syringomyelia secondary to cervical spondylosis: Case report and review of literature","volume":"5","author":"Bhagavathula Venkata","year":"2014","journal-title":"J Neurosci Rural Pract"},{"key":"10.25259\/SNI_636_2023\/ref-5","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1016\/j.neuchi.2018.07.002","article-title":"Biopsying a spinal cord lesion: A diagnostic dilemma. 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