{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T16:06:35Z","timestamp":1776096395528,"version":"3.50.1"},"reference-count":38,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"13","license":[{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,3,30]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Spontaneous intracranial hemorrhage (ICH) in children is rare and is most commonly attributed to vascular malformations or coagulopathies. When standard vascular and hematological evaluation is unrevealing, genetic small-vessel disease should be considered. Biallelic COLGALT1 variants represent an exceptionally uncommon cause of cerebral microangiopathy, with limited cases reported and minimal discussion of neurosurgical management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 14-year-old female with a known biallelic COLGALT1 variant presented with an acute basal ganglia hemorrhage with intraventricular extension and obstructive hydrocephalus. Given salvageable neurological function, she underwent emergency decompressive hemicraniectomy and external ventricular drain (EVD) placement. Because the hemorrhage etiology was unknown at the time of surgery, the hematoma was not aggressively evacuated. Extensive postoperative vascular, infectious, and hematological evaluation revealed no alternative cause. She demonstrated steady neurological recovery, was weaned from the EVD, underwent uncomplicated cranioplasty, and ultimately returned to her prehemorrhage neurological baseline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>When pediatric ICH remains unexplained after standard evaluation, genetic small-vessel disease should be included in the differential diagnosis. Recognition of collagenopathies such as COLGALT1 may influence operative strategy toward cautious decompression, inform family counseling regarding recurrence risk and inflammatory triggers, and support tailored long-term management.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE251029\">https:\/\/thejns.org\/doi\/10.3171\/CASE251029<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case251029","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T10:04:46Z","timestamp":1775642686000},"source":"Crossref","is-referenced-by-count":0,"title":["Spontaneous atraumatic pediatric basal ganglia hemorrhage in the setting of COLGALT1-related collagenopathy: illustrative case"],"prefix":"10.3171","volume":"11","author":[{"given":"Jacob M.","family":"Chaisson","sequence":"first","affiliation":[{"name":"School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Drake L.","family":"Darden","sequence":"additional","affiliation":[{"name":"School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adeleso E.","family":"Adesina","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roboan","family":"Guillen Arguello","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary O.","family":"Haastrup","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9196-0068","authenticated-orcid":true,"given":"Lucido","family":"Ponce Mejia","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oritsejolomi","family":"Roberts","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"17","key":"bib1","series-title":"N Engl J Med","first-page":"1589","article-title":"Spontaneous intracerebral hemorrhage","volume":"387","author":"Sheth","year":"2022","unstructured":"Sheth KN.Spontaneous intracerebral hemorrhage. 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Front Neurol. 2022;13:915813. doi:10.3389\/fneur.2022.915813"},{"issue":"3","key":"bib4","series-title":"J Neurosurg Pediatr","first-page":"357","article-title":"Etiology of intracerebral hemorrhage in children: cohort study, systematic review, and meta-analysis","volume":"27","author":"Boulouis","year":"2021","unstructured":"Boulouis GStricker SBenichi SEtiology of intracerebral hemorrhage in children: cohort study, systematic review, and meta-analysis. J Neurosurg Pediatr. 2021;27(3):357-363. doi:10.3171\/2020.7.PEDS20447"},{"issue":"1-2","key":"bib5","series-title":"J Neurol Sci","first-page":"367","article-title":"Etiology, clinical characteristics and prognosis of spontaneous intracerebral hemorrhage in children: a prospective cohort study in China","volume":"358","author":"Liu","year":"2015","unstructured":"Liu JWang DLei CEtiology, clinical characteristics and prognosis of spontaneous intracerebral hemorrhage in children: a prospective cohort study in China. J Neurol Sci. 2015;358(1-2):367-370. doi:10.1016\/j.jns.2015.09.366"},{"issue":"11","key":"bib6","series-title":"Nat Rev Nephrol","first-page":"778","article-title":"Collagen IV in Gould syndrome and Alport syndrome","volume":"21","author":"Massoudi","year":"2025","unstructured":"Massoudi DMiner JHGould DB.Collagen IV in Gould syndrome and Alport syndrome. Nat Rev Nephrol. 2025;21(11):778-793. doi:10.1038\/s41581-025-00982-x"},{"issue":"11","key":"bib7","series-title":"Genet Med","first-page":"843","article-title":"The expanding phenotype of COL4A1 and COL4A2 mutations: clinical data on 13 newly identified families and a review of the literature","volume":"17","author":"Meuwissen","year":"2015","unstructured":"Meuwissen MECHalley DJJSmit LSThe expanding phenotype of COL4A1 and COL4A2 mutations: clinical data on 13 newly identified families and a review of the literature. 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Ann N Y Acad Sci. 2000;903:273-284. doi:10.1111\/j.1749-6632.2000.tb06377.x"},{"issue":"5","key":"bib18","series-title":"J Stroke Cerebrovasc Dis","first-page":"104701","article-title":"Multiple border-zone infarcts triggered by influenza A virus infection in a patient with cerebral autosomal dominant arteriopathy presenting with subcortical infarcts and leukoencephalopathy","volume":"29","author":"Mizutani","year":"2020","unstructured":"Mizutani KSakurai KMizuta IMizuno TYuasa H.Multiple border-zone infarcts triggered by influenza A virus infection in a patient with cerebral autosomal dominant arteriopathy presenting with subcortical infarcts and leukoencephalopathy. 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J Neurol Sci. 2015;358(1-2):367-370. doi:10.1016\/j.jns.2015.09.366"},{"issue":"11","key":"bib6","series-title":"Nat Rev Nephrol","first-page":"778","article-title":"Collagen IV in Gould syndrome and Alport syndrome","volume":"21","author":"Massoudi","year":"2025","unstructured":"Massoudi DMiner JHGould DB.Collagen IV in Gould syndrome and Alport syndrome. Nat Rev Nephrol. 2025;21(11):778-793. doi:10.1038\/s41581-025-00982-x"},{"issue":"11","key":"bib7","series-title":"Genet Med","first-page":"843","article-title":"The expanding phenotype of COL4A1 and COL4A2 mutations: clinical data on 13 newly identified families and a review of the literature","volume":"17","author":"Meuwissen","year":"2015","unstructured":"Meuwissen MECHalley DJJSmit LSThe expanding phenotype of COL4A1 and COL4A2 mutations: clinical data on 13 newly identified families and a review of the literature. 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Ann Neurol. 2018;84(6):843-853. doi:10.1002\/ana.25367"},{"issue":"2","key":"bib10","series-title":"Neurol Genet","first-page":"e564","article-title":"Biallelic variants in the COLGALT1 gene cause severe congenital porencephaly: a case report","volume":"7","author":"Teunissen","year":"2021","unstructured":"Teunissen MWAKamsteeg EJSallevelt SCEHBiallelic variants in the COLGALT1 gene cause severe congenital porencephaly: a case report. Neurol Genet. 2021;7(2):e564. doi:10.1212\/NXG.0000000000000564"},{"issue":"2","key":"bib11","series-title":"Ann Indian Acad Neurol","first-page":"287","article-title":"Young-onset cerebral small vessel disease associated with COLGALT1 mutation","volume":"28","author":"Maramattom","year":"2025","unstructured":"Maramattom BV.Young-onset cerebral small vessel disease associated with COLGALT1 mutation. 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J Child Neurol. 2023;38(6-7):373-388. doi:10.1177\/08830738231186233"},{"issue":"7","key":"bib13","series-title":"Stroke","first-page":"e282","article-title":"2022 guideline for the management of patients with spontaneous intracerebral hemorrhage: a guideline from the American Heart Association\/American Stroke Association","volume":"53","author":"Greenberg","year":"2022","unstructured":"Greenberg SMZiai WCCordonnier C2022 guideline for the management of patients with spontaneous intracerebral hemorrhage: a guideline from the American Heart Association\/American Stroke Association. Stroke. 2022;53(7):e282-e361. doi:10.1161\/STR.0000000000000407"},{"key":"bib14","series-title":"Semin Thromb Hemost","article-title":"Impact of viral infections on the hemostatic system","author":"Marietta","year":"2025","unstructured":"Marietta MColuccio VCordella SLuppi M.Impact of viral infections on the hemostatic system. Semin Thromb Hemost. Published online May 27, 2025. doi:10.1055\/a-2601-9302"},{"issue":"12","key":"bib15","series-title":"J Neurol","first-page":"4407","article-title":"Posterior reversible encephalopathy syndrome and brain haemorrhage as COVID-19 complication: a review of the available literature","volume":"268","author":"Motolese","year":"2021","unstructured":"Motolese FFerrante MRossi MPosterior reversible encephalopathy syndrome and brain haemorrhage as COVID-19 complication: a review of the available literature. J Neurol. 2021;268(12):4407-4414. doi:10.1007\/s00415-021-10709-0"},{"key":"bib16","series-title":"Adv Exp Med Biol","first-page":"33","article-title":"Endothelial dysfunction as a primary consequence of SARS-CoV-2 infection","volume":"1321","author":"Mezoh","year":"2021","unstructured":"Mezoh GCrowther NJ.Endothelial dysfunction as a primary consequence of SARS-CoV-2 infection. 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