Clinical Neurology and Neurosurgery最新文献_第10页

Comment on “The application of machine learning for treatment selection of unruptured brain arteriovenous malformations: A secondary analysis of the ARUBA trial data" 《机器学习在未破裂脑动静脉畸形治疗选择中的应用：ARUBA试验数据的二次分析》点评

IF 1.8 4区医学

Clinical Neurology and Neurosurgery Pub Date : 2025-07-24 DOI: 10.1016/j.clineuro.2025.109051

Muhammad Hasan , Muhammad Hammad Chola

引用次数: 0

Tranexamic acid with surgery vs. surgery alone for chronic subdural hematoma: Propensity score-matched analysis 氨甲环酸联合手术与单独手术治疗慢性硬膜下血肿：倾向评分匹配分析

IF 1.6 4区医学

Clinical Neurology and Neurosurgery Pub Date : 2025-07-24 DOI: 10.1016/j.clineuro.2025.109071

Hamza Adel Salim , Nadeem Khayat , Huanwen Chen , Aneri B. Balar , Marco Colasurdo , Nimer Adeeb , Basel Musmar , Muhammed Amir Essibayi , Ahmed Msherghi , Sanjay Bhatia , Adam A. Dmytriw , Tobias D. Faizy , Max Wintermark , Vivek Yedavalli , Ajay Malhotra , Dheeraj Gandhi , Dhairya A. Lakhani

{"title":"Tranexamic acid with surgery vs. surgery alone for chronic subdural hematoma: Propensity score-matched analysis","authors":"Hamza Adel Salim , Nadeem Khayat , Huanwen Chen , Aneri B. Balar , Marco Colasurdo , Nimer Adeeb , Basel Musmar , Muhammed Amir Essibayi , Ahmed Msherghi , Sanjay Bhatia , Adam A. Dmytriw , Tobias D. Faizy , Max Wintermark , Vivek Yedavalli , Ajay Malhotra , Dheeraj Gandhi , Dhairya A. Lakhani","doi":"10.1016/j.clineuro.2025.109071","DOIUrl":"10.1016/j.clineuro.2025.109071","url":null,"abstract":"<div><h3>Background</h3><div>Chronic subdural hematoma (CSDH) is frequently managed with surgical evacuation, but recurrence often necessitates repeat surgery. Tranexamic acid (TXA), an antifibrinolytic agent, has been proposed as an adjunct to reduce rebleeding and recurrence. Data on its benefits and risks remain limited.</div></div><div><h3>Methods</h3><div>Using a federated electronic health record network (TriNetX), we identified adults (≥18 years) with CSDH who underwent surgical evacuation. Patients who received TXA within 14 days of CSDH (TXA group) were compared with those managed without TXA (surgery-alone group). Outcomes were assessed at 6-months. Propensity score matching (1:1) was performed.</div></div><div><h3>Results</h3><div>Of 15,423 eligible patients, 541 received TXA and 14,882 underwent surgery alone. After matching, 442 patients remained in each group. TXA was associated with a similar rate of needing repeat surgery (8.4 % vs. 9.5 %; OR, 0.870; 95 % CI, 0.548–1.382; P = 0.556). Secondary analysis showed significantly higher mortality rates in the TXA group (29.2 % vs. 14.0 %; OR, 2.526; 95 % CI, 1.802–3.541; P < 0.001), and a non-significant trend toward more thromboembolic events, including pulmonary embolism and deep vein thrombosis (9.3 % vs. 6.8 %; OR, 1.404; 95 % CI, 0.860–2.293; P = 0.173).</div></div><div><h3>Conclusions</h3><div>TXA as an adjunct to surgical evacuation of cSDH was not associated with different rates of disease recurrence requiring repeat surgery. Analyses of secondary outcomes showed that TXA was associated with numerically higher rates of DVT/PE and significantly higher mortality.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"257 ","pages":"Article 109071"},"PeriodicalIF":1.6,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144749430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Recurrent stroke due to biatrial myxoma lacking typical transesophageal echocardiographic findings 双房黏液瘤所致卒中复发，经食管超声心动图无典型表现

IF 1.6 4区医学

Clinical Neurology and Neurosurgery Pub Date : 2025-07-23 DOI: 10.1016/j.clineuro.2025.109063

Hiroyasu Komuro, Tetsuhito Nohara, Yuta Kato, Ayako Miki, Keita Mizuma, Masato Keicho, Seiya Takahashi, Tasuku Nagumo, Ayako Kuriki, Ryuta Kinno

引用次数: 0

Focal areas of signal intensity in neurofibromatosis type 1: Correlation between MRI findings and cognitive function 1型神经纤维瘤病的病灶信号强度：MRI表现与认知功能的相关性

IF 1.6 4区医学

Clinical Neurology and Neurosurgery Pub Date : 2025-07-22 DOI: 10.1016/j.clineuro.2025.109070

Chiara Distefano , Manuela Lo Bianco , Stefano Palmucci , Martino Ruggieri , Agata Polizzi , Andrea D. Praticò

{"title":"Focal areas of signal intensity in neurofibromatosis type 1: Correlation between MRI findings and cognitive function","authors":"Chiara Distefano , Manuela Lo Bianco , Stefano Palmucci , Martino Ruggieri , Agata Polizzi , Andrea D. Praticò","doi":"10.1016/j.clineuro.2025.109070","DOIUrl":"10.1016/j.clineuro.2025.109070","url":null,"abstract":"<div><h3>Background</h3><div>Focal areas of signal intensity (FASI) are T2-weighted hyperintensities detected on brain MRI in 43 %–93 % of children with neurofibromatosis type 1 (NF1). Their association with cognitive impairment, a common feature of NF1, remains controversial.</div></div><div><h3>Objective</h3><div>To investigate potential correlations between the presence, number, and location of FASI and cognitive performance in children with NF1.</div></div><div><h3>Materials and methods</h3><div>Brain MRIs and neuropsychological reports of 17 patients with NF1 (mean age 9.29 ± 3.7 SD) were retrospectively reviewed. Cognitive profiles were assessed using standardized Wechsler scales (WPPSI-III, WISC-III, WAIS-R).</div></div><div><h3>Results</h3><div>The mean Full Scale Intelligence Quotient (FSIQ) was 84 ± 14.54, within the borderline range; 11.76 % of patients had a diagnosis of Intellectual Disability (ID). A clinically significant discrepancy between Verbal and Performance Intelligence Quotient (PIQ) was observed in 64.7 % of patients, favoring PIQ. The mean number of FASI per patient was 3.94 ± 1.76. Pearson’s correlation revealed a non-significant inverse association between total FASI count and FSIQ (r = –0.12, p = 0.621). The cerebellum was the most frequently affected region (70.6 %). Patients with FASI in the cerebellum or brainstem had significantly higher PIQ than those with FASI elsewhere (p < 0.05). The two patients with ID both had thalamic FASI.</div></div><div><h3>Conclusions</h3><div>This exploratory study suggests that FASI location and number may be associated with cognitive variability in NF1, but larger studies are needed to confirm these trends.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"257 ","pages":"Article 109070"},"PeriodicalIF":1.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Letter to the Editor: Emergent role of complement inhibitors in myasthenic crisis: Understanding why, when and how 致编辑的信：补体抑制剂在肌无力危机中的紧急作用：理解为什么，何时以及如何

IF 1.8 4区医学

Clinical Neurology and Neurosurgery Pub Date : 2025-07-22 DOI: 10.1016/j.clineuro.2025.109066

Muhammad Tabish, Mantsha Ahmed, Laiba Shoukat

引用次数: 0

Supraorbital craniotomy for microvascular decompression of optic nerve due to neurovascular conflict with anterior cerebral artery: 2-Dimensional operative video 因神经血管与大脑前动脉冲突而行视神经微血管减压的眶上开颅术：二维手术影像

IF 1.6 4区医学

Clinical Neurology and Neurosurgery Pub Date : 2025-07-22 DOI: 10.1016/j.clineuro.2025.109062

Sakibul Huq , Michael M. McDowell , Ali A. Alattar , S. Tonya Stefko , Paul A. Gardner

{"title":"Supraorbital craniotomy for microvascular decompression of optic nerve due to neurovascular conflict with anterior cerebral artery: 2-Dimensional operative video","authors":"Sakibul Huq , Michael M. McDowell , Ali A. Alattar , S. Tonya Stefko , Paul A. Gardner","doi":"10.1016/j.clineuro.2025.109062","DOIUrl":"10.1016/j.clineuro.2025.109062","url":null,"abstract":"<div><div>Optic neuropathy due to vascular compression is a rare and poorly understood phenomenon. While contact between the optic nerve and nearby arteries is not uncommon, in most cases, it is an incidental finding in asymptomatic patients. Vascular compression has previously been suggested to be associated with optic neuropathy and visual dysfunction, with a plausible role for surgical decompression in appropriately selected patients.<sup>2–5</sup> We present the case of a 63-year-old male who presented with eight years of progressive left optic neuropathy with worsening binocular diplopia, visual field deficits, depth perception, and color vision. Left-sided fundus exam demonstrated diffuse pallor. Imaging demonstrated atrophy of the left optic nerve with compression by the A1 segment of the anterior cerebral artery. Extensive neuro-ophthalmology workup did not reveal other conceivable causes for his presentation. The patient underwent a left supraorbital craniotomy for microvascular decompression through an eyebrow incision, during which the left A1 was found to be compressing the left optic nerve. The artery was released and the nerve decompressed using felt pledgets. Postoperatively, the patient experienced subjective and objective improvement in visual acuity. Our case suggests that patients with progressive optic neuropathy, radiographic evidence of vascular compression, and no alternative cause for visual dysfunction should be carefully evaluated for consideration of microvascular decompression.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"257 ","pages":"Article 109062"},"PeriodicalIF":1.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144739680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Response to letter to the editor: “Emergent role of complement inhibitors in myasthenic crisis” (CNN-D-25-2224) 回复致编辑的信：“补体抑制剂在肌无力危机中的紧急作用”（CNN-D-25-2224）

IF 1.8 4区医学

Clinical Neurology and Neurosurgery Pub Date : 2025-07-22 DOI: 10.1016/j.clineuro.2025.109069

Elena Rossini , Stefania Morino, Matteo Garibaldi, Luca Leonardi, Laura Tufano, Antonio Lauletta, Francesca Forcina, Giovanni Antonini, Laura Fionda

引用次数: 0

Response to comment on: “Emergent role of complement inhibitors in myasthenic crisis – Complement for crisis, FcRn for continuity (CNN-D-25–2177)” 对以下评论的回应：“补体抑制剂在肌无力危象中的紧急作用——补体应对危象，FcRn维持连续性（CNN-D-25-2177）”

IF 1.8 4区医学

Clinical Neurology and Neurosurgery Pub Date : 2025-07-21 DOI: 10.1016/j.clineuro.2025.109068

Elena Rossini , Stefania Morino, Matteo Garibaldi, Luca Leonardi, Laura Tufano, Antonio Lauletta, Francesca Forcina, Giovanni Antonini, Laura Fionda

引用次数: 0

Development and validation of a remote NIH stroke scale (rNIHSS) for caregiver-assisted telestroke assessments 远程NIH卒中量表（rNIHSS）的开发和验证，用于护理人员辅助的远程卒中评估

IF 1.6 4区医学

Clinical Neurology and Neurosurgery Pub Date : 2025-07-21 DOI: 10.1016/j.clineuro.2025.109065

Ning Wei, Xuegan Lian, Dan Ye, Hao Zhang, Jian Ding, Keshi Mao, Dawen Li, Song Yang, Yi Ren

{"title":"Development and validation of a remote NIH stroke scale (rNIHSS) for caregiver-assisted telestroke assessments","authors":"Ning Wei, Xuegan Lian, Dan Ye, Hao Zhang, Jian Ding, Keshi Mao, Dawen Li, Song Yang, Yi Ren","doi":"10.1016/j.clineuro.2025.109065","DOIUrl":"10.1016/j.clineuro.2025.109065","url":null,"abstract":"<div><h3>Objectives</h3><div>NIH stroke scale (NIHSS) assessment is crucial in Telestroke. However, certain NIHSS items demonstrated poor reliability when assessed remotely. We aimed to develop a modified remote version of the NIHSS (rNIHSS) for caregiver-assisted telestroke assessments.</div></div><div><h3>Materials and methods</h3><div>We evaluated 102 stroke patients. A neurologist conducted the NIHSS assessment remotely via smartphone, assisted by caregivers, and followed by bedside evaluation by another neurologist. The agreement for total NIHSS scores and each individual item was tested. The rNIHSS was developed by excluding unreliable items, followed by evaluation of its reliability and validity.</div></div><div><h3>Results</h3><div>Caregiver-assisted remote NIHSS assessments demonstrated limited reliability (84.3 % agreement). The rNIHSS was developed by excluding items with poor wK values: visual field, facial palsy, extinction/inattention, and ataxia. Remote rNIHSS assessments in mild stroke cases were equivalent to bedside assessments, with 98.2 % of the subjects having total scores that differed by ≤ 2 points; however, the reliability was limited in moderate and severe strokes (93.1 % and 77.8 % agreement, respectively). The correlation coefficients for the rNIHSS scores and bedside NIHSS scores, and the 90-day and 1-year modified Rankin scale scores were 0.97, 0.88, and 0.86, respectively (<em>p</em> < 0.01).</div></div><div><h3>Conclusions</h3><div>Caregiver-assisted rNIHSS remote assessment improved reliability in mild stroke patients but was limited in severe cases. Prospective validation of the rNIHSS is needed.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"257 ","pages":"Article 109065"},"PeriodicalIF":1.6,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comment on: “Emergent role of complement inhibitors in myasthenic crisis – Complement for crisis, FcRn for continuity” 评论：“补体抑制剂在肌无力危象中的紧急作用——补体危象，FcRn持续”

IF 1.8 4区医学

Clinical Neurology and Neurosurgery Pub Date : 2025-07-21 DOI: 10.1016/j.clineuro.2025.109067

Haris Afridi , Kainat Afzal

引用次数: 0