{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T11:07:18Z","timestamp":1779361638418,"version":"3.51.4"},"reference-count":48,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"19","license":[{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"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":[[2026,5,11]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Spinal pencil-shaped softening after intramedullary hemorrhage of a thoracic intramedullary cavernous malformation (ICM) is an extremely rare phenomenon.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 76-year-old woman presented to the authors\u2019 hospital with back pain, sensory disturbance in the left leg, and gait disturbance. MRI revealed an intramedullary hemorrhage at T2\u20133, predominantly on the left side, spreading down to the T4 body level on T2-weighted imaging. This seemed to have the same appearance as pencil-shaped softening. Three days after admission, paralysis and bladder\/rectal dysfunction were observed, and by day 10, complete paralysis had occurred. Repeated MRI demonstrated that the pencil-shaped softening had spread from C7 to T6. On day 39, the abnormal lesion at T2\u20133 was completely resected and diagnosed as a cavernous malformation based on pathological findings. The patient\u2019s neurological symptoms did not improve after sufficient rehabilitation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Pencil-shaped softening of the spinal cord, which indicates high intramedullary pressure, due to hemorrhage of a spinal ICM is a rare phenomenon. Intervention may be attempted in the acute phase before neurological deterioration occurs if this phenomenon is observed in a timely manner.<\/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\/CASE25927\">https:\/\/thejns.org\/doi\/10.3171\/CASE25927<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case25927","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T16:15:31Z","timestamp":1778516131000},"source":"Crossref","is-referenced-by-count":0,"title":["Spinal pencil-shaped softening after intramedullary hemorrhage due to thoracic intramedullary cavernous malformation: illustrative case"],"prefix":"10.3171","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1004-3819","authenticated-orcid":true,"given":"Toshiyuki","family":"Okazaki","sequence":"first","affiliation":[{"name":"Center for Minimally Invasive Spinal Surgery, Shin-Yurigaoka General Hospital, Kawasaki City, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuma","family":"Doi","sequence":"additional","affiliation":[{"name":"Center for Minimally Invasive Spinal Surgery, Shin-Yurigaoka General Hospital, Kawasaki City, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazunori","family":"Shibamoto","sequence":"additional","affiliation":[{"name":"Center for Minimally Invasive Spinal Surgery, Shin-Yurigaoka General Hospital, Kawasaki City, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Tani","sequence":"additional","affiliation":[{"name":"Center for Minimally Invasive Spinal Surgery, Shin-Yurigaoka General Hospital, Kawasaki City, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junichi","family":"Mizuno","sequence":"additional","affiliation":[{"name":"Center for Minimally Invasive Spinal Surgery, Shin-Yurigaoka General Hospital, Kawasaki City, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"5","key":"bib1","series-title":"J Neurosurg","first-page":"718","article-title":"Intramedullary spinal cord metastasis associated with pencil-shaped softening of the spinal cord: case report","volume":"52","author":"Hirose","year":"1980","unstructured":"Hirose GShimazaki KTakado MKosoegawa HOhya NMukawa A.Intramedullary spinal cord metastasis associated with pencil-shaped softening of the spinal cord: case report. 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