Clinical Neurology and Neurosurgery最新文献

{"title":"Revealing the diagnostic value of cerebrospinal fluid presepsin (sCD14) as a new biomarker for postneurosurgical and nosocomial central nervous system infections: A systematic review and meta-analysis of diagnostic test accuracy studies","authors":"Hazem E. Mohammed ,&nbsp;Mohamed Nasser ,&nbsp;Moaz Elsayed Abouelmagd ,&nbsp;Mohamed E. Haseeb ,&nbsp;Mohamed Khalafalla Darwish ,&nbsp;Mohamed Salem Abdelqader ,&nbsp;Ahmed Tawfik ,&nbsp;Rania Elsayed Mahmoud Abdel-Mawla ,&nbsp;Mahmoud Diaa Hindawi","doi":"10.1016/j.clineuro.2025.108767","DOIUrl":"10.1016/j.clineuro.2025.108767","url":null,"abstract":"<div><h3>Background</h3><div>Central nervous system (CNS) infections represent life-threatening conditions. Emerging evidence suggests cerebrospinal fluid (CSF) presepsin (sCD14) as a promising biomarker for these infections. However, its diagnostic accuracy remains controversial. This study aimed to systematically evaluate the reliability of CSF presepsin in diagnosing CNS infections through a comprehensive meta-analysis.</div></div><div><h3>Methods</h3><div>A systematic search of PubMed, Scopus, and Web of Science databases was conducted up to November 2024. Five prospective studies involving 384 participants were included. CSF presepsin levels were compared between infected and non-infected patients. Pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive predictive value (PPV), and negative predictive value (NPV) were calculated using a random-effects model. Publication bias and clinical utility were assessed through Deek’s funnel plot and Fagan’s nomogram, respectively.</div></div><div><h3>Results</h3><div>Infected patients exhibited significantly higher CSF presepsin levels (mean difference: 760.16 pg/mL; 95 % confidence interval (CI): 426.26–1094.05, p &lt; 0.01). Pooled sensitivity and specificity were 87 % (95 % CI: 82–91 %) and 67 % (95 % CI: 60–74 %), respectively, with a DOR of 13.04 (95 % CI: 7.51–22.64). The pooled PPV and NPV were 79 % (95 % CI: 73–84 %) and 79 % (95 % CI: 71–85 %), respectively. The area under the curve of the summary receiver operating characteristic curve was 86 %, emphasizing high diagnostic accuracy. No statistically significant publication bias was detected (P = 0.12).</div></div><div><h3>Conclusion</h3><div>CSF presepsin demonstrated potential as a diagnostic biomarker for CNS infections, demonstrating high sensitivity and moderate specificity. Further large-scale studies are needed to refine its clinical applicability and establish standardized thresholds.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"249 ","pages":"Article 108767"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122063","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}

{"title":"Letter to editor \"Intraoperative indocyanine green (ICG) videoangiography in spinal hemangioblastoma surgery - helpful tool or unnecessary?\" by Jan-Helge Klinger et al. [1]","authors":"Savera Ejaz Ahmed ,&nbsp;Javeria Imran ,&nbsp;Marhama Alamgeer","doi":"10.1016/j.clineuro.2024.108717","DOIUrl":"10.1016/j.clineuro.2024.108717","url":null,"abstract":"","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"249 ","pages":"Article 108717"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001180","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}

{"title":"Evaluation of resilience in pediatric well-controlled epilepsy patients","authors":"Mutluay Arslan ,&nbsp;Ayşe Nur Coşkun ,&nbsp;Canan Üstün ,&nbsp;Özgen Hür ,&nbsp;Bülent Ünay","doi":"10.1016/j.clineuro.2025.108779","DOIUrl":"10.1016/j.clineuro.2025.108779","url":null,"abstract":"<div><h3>Objective</h3><div>The main objective of this study was to assess the resilience scores of children with well-controlled epilepsy and their healthy counterparts using the Connor-Davidson Resilience Scale (CD-RISC). The secondary objective was to investigate the potential association between the age at onset, seizure type, and anti-seizure medication, and resilience in pediatric patients with well-controlled epilepsy.</div></div><div><h3>Methods</h3><div>This cross-sectional case-control study was performed on children aged 10–18 in a Training and Research Hospital Pediatric Neurology and Pediatric Outpatient Clinic. The study encompassed a total of 103 participants, comprising 57 children diagnosed with epilepsy and 46 healthy counterparts. Resilience and its individual components, namely hardiness, flexibility, coping, purpose, optimism, regulation of emotion and cognition, and self-efficacy, were assessed utilizing the Connor-Davidson Resilience Scale (CD-RISC).</div></div><div><h3>Results</h3><div>There was no statistically significant difference observed in the total CD-RISC scores between children with epilepsy (61.0 ± 17.7) and the healthy cohort (60.8 ± 14.4) (p: 0.97). Furthermore, a comprehensive analysis revealed no significant correlations between the CD-RISC total score and its individual component scores, taking into consideration various factors such as age, gender, age at onset, last seizure date, seizure type, EEG findings, and brain MRI findings.</div></div><div><h3>Conclusion</h3><div>Regardless of age, gender, age at onset, seizure type and anti-seizure medication, in well-controlled epilepsy, resilience is similar to that of healthy children. New studies are needed to evaluate resilience in children with epilepsy who have uncontrolled seizures and receive polytherapy.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"249 ","pages":"Article 108779"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143372466","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}

{"title":"Correlation of the clinical rating scale for tremor with a global assessment","authors":"Susanna D. Howard ,&nbsp;Shikha Singh ,&nbsp;Dominick Macaluso ,&nbsp;Jesse Y. Hsu ,&nbsp;Iahn Cajigas ,&nbsp;Liming Qiu ,&nbsp;Casey H. Halpern ,&nbsp;Whitley W. Aamodt ,&nbsp;John T. Farrar","doi":"10.1016/j.clineuro.2024.108710","DOIUrl":"10.1016/j.clineuro.2024.108710","url":null,"abstract":"<div><h3>Objective</h3><div>The Fahn-Tolosa-Marín Clinical Rating Scale for Tremor (CRST) includes three parts (tremor severity, motor task performance, functional disability) and a separate global assessment of impairment completed by both the patient and examiner. Although the CRST is used to determine tremor severity and the efficacy of treatments for tremor, the instrument may not sufficiently capture the patient’s perspective. The objective of this study was to determine the association of the CRST subpart and total scores with the global assessment.</div></div><div><h3>Methods</h3><div>This cross-sectional study included patients with essential tremor who completed a CRST within a tertiary health system electronic health record from 2013 to 2023. The global assessment was rated on a 0–100 % (most severe impairment) scale.</div></div><div><h3>Results</h3><div>116 patients were included. The total CRST score was significantly associated with the examiner-reported global assessment (Spearman’s correlation coefficient (ρ) 0.63, 95 % confidence interval (CI) 0.51 – 0.73, p &lt; 0.001) but not the patient-reported global assessments (ρ 0.15, 95 % CI −0.04 – 0.33, p = 0.13). There were no significant associations between Part A, B, or C sub-scores and the patient-reported global assessments.</div></div><div><h3>Conclusion</h3><div>CRST scores have a stronger association with the examiner-reported global assessment than the patient-reported global assessment. The impact of tremor may be determined by functional detriments not readily measured with the CRST. By using the global assessments as a standard for comparison, our findings call into question the relevance of the CRST total scores and sub-scores as an accurate patient-centered outcome metric.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"249 ","pages":"Article 108710"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892734","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}

{"title":"The PANDA score: External validation and modification of a simple upfront prediction tool for poor outcomes despite successful stroke thrombectomy","authors":"Sonesh D. Amin ,&nbsp;Huanwen Chen ,&nbsp;Scott E. Rewinkel ,&nbsp;David A. Lockwood ,&nbsp;Daniel Kim ,&nbsp;Ryan A. Priest ,&nbsp;Gary M. Nesbit ,&nbsp;Jesse J. Liu ,&nbsp;Masahiro Horikawa ,&nbsp;Wayne M. Clark ,&nbsp;Rachel K. Laursen ,&nbsp;Gaurav Jindal ,&nbsp;Seemant Chaturvedi ,&nbsp;Marco Colasurdo","doi":"10.1016/j.clineuro.2025.108722","DOIUrl":"10.1016/j.clineuro.2025.108722","url":null,"abstract":"<div><h3>Background</h3><div>While endovascular thrombectomy (EVT) has become standard of care for patients’ acute ischemic stroke (AIS) due to large vessel occlusion (LVO), many patients still suffer profound neurological disability, also termed futile recanalization (FR). The BAND score, which incorporates baseline disability, age, stroke severity, and treatment time window, is derived as a simple tool for upfront prediction of FR prior to EVT. This study aims to externally validate the BAND score and to incorporate upfront imaging biomarkers into the prediction tool.</div></div><div><h3>Methods</h3><div>Consecutive stroke thrombectomy patients with anterior circulation LVO who achieved successful recanalization (mTICI 2b or greater) were retrospectively identified at a single institution from 2019 to 2023. Clinical information, procedural details, and 90-day outcomes were recorded. The performance of the BAND score in predicting FR (90-day modified Rankin scale [mRS] &gt;3) and loss of complete independence (LCID, 90-day mRS&gt;2) was assessed. Then, Alberta stroke programme early CT score (ASPECTS) was added to create the PANDA score (pre-stroke disability, age, NIH stroke scale, delay from last known normal, and ASPECTS). The performance of PANDA to predict FR was assessed and compared with the original BAND score and also the widely validated THRIVE score.</div></div><div><h3>Results</h3><div>296 patients were included; 36.5 % experienced FR. BAND had areas under the receiver-operating curve (AUCs) of 0.72 and 0.74 for predicting FR and LCID, respectively (both p &lt; 0.001). The new PANDA score had AUCs of 0.76 and 0.78 for predicting FR and LCID, respectively (both p &lt; 0.001), and it outperformed both BAND and THRIVE (all p &lt; 0.05). Of the 30 patients (11.2 %) with high PANDA scores (≥7), 24 patients (80.0 %) suffered FR and 26 (86.7 %) suffered LCID.</div></div><div><h3>Conclusion</h3><div>This external validation study confirmed the adequate performance of BAND in predicting FR. The improved PANDA score performed better than the original BAND score and the widely validated THRIVE score.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"249 ","pages":"Article 108722"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142963997","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}

{"title":"Long-term effect of non-invasive brain stimulation on hemispatial neglect, functional outcomes, and mortality after stroke: ELETRON trial extend","authors":"Luana Aparecida Miranda ,&nbsp;Fernanda Cristina Winckler ,&nbsp;Taís Regina da Silva ,&nbsp;Hélio Rubens de Carvalho Nunes ,&nbsp;Gabriel Pinheiro Modolo ,&nbsp;Natalia Cristina Ferreira ,&nbsp;Diandra B. Favoretto ,&nbsp;Luan Aguiar ,&nbsp;Silméia Garcia Zanati Bazan ,&nbsp;Taiza G.S. Edwards ,&nbsp;Octávio Pontes-Neto ,&nbsp;Gustavo José Luvizutto ,&nbsp;Rodrigo Bazan","doi":"10.1016/j.clineuro.2024.108705","DOIUrl":"10.1016/j.clineuro.2024.108705","url":null,"abstract":"<div><h3>Introduction</h3><div>Our primary clinical trial indicated that anodal stimulation of the right posterior parietal region associated with specific and perceptual task training was superior to placebo in reducing stroke-induced hemispatial neglect (HN) immediately after the treatment protocol. However, our primary study did not investigate whether this benefit was maintained in the long term after stroke. Therefore, this study aimed to evaluate the long-term effects of the protocol applied in the ELETRON trial on outcomes associated with HN, functionality, and mortality.</div></div><div><h3>Methods</h3><div>This was a pilot, multicenter, prospective, randomized, double-blind trial in patients with HN after stroke who underwent either active tDCS (anodal tDCS or C-tDCS) or sham tDCS in addition to specific and perceptual task training. The outcomes were evaluated on the last day of the session and after 1 year of stimulation (follow-up). Daily evolution rates were calculated as the difference between the values observed between the moments divided by the follow-up time for each individual. The primary outcome was the rate of HN evolution according to the BIT-C scale. The secondary outcome was CBS evolution rate. The exploratory outcomes were the evolution rate of functional disability and autonomy assessed by FIM and BI, quality of life assessed by EQ 5D, stroke severity using the NIHSS, and functional dependence assessed by mRS. Death was examined separately. A linear regression model with a time-adjusted identity link function was used to explain the evolution rates of each outcome of A-tDCS and C-tDCS as a function of sham tDCS. Survival models were adjusted to compare mortality groups.</div></div><div><h3>Results</h3><div>The evolution rate of BIT-C was not different between A-tDCS (B = 3.18; CI: −4.84–11.19; p = 0.438) and C-tDCS (B = −0.95; CI: −8.97–7.07; p = 0.816) with sham. The secondary and exploratory outcomes showed the same pattern. In addition, there were no statistically significant differences in mortality over time between A-tDCS and S-tDCS (B = 0.322; 95 % CI 0.284–6.707; p = 0.689) and between C-tDCS and S-tDCS (B = −0.798; 95 % CI 0.063–3.195; p = 0.425).</div></div><div><h3>Conclusion</h3><div>The benefits of A-tDCS and C-tDCS were maintained for all long-term post-stroke outcomes.</div></div><div><h3>Trial registration</h3><div>RBR-78jvzx - Brazilian Registry of Clinical Trials (Rebec), registered on March 13, 2016.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"249 ","pages":"Article 108705"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969891","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}

{"title":"A nationwide provider survey of neuro-oncology tumor boards in a lower-middle-income country: Comparing centers with and without tumor boards","authors":"Roua Nasir ,&nbsp;Saad Akhtar Khan ,&nbsp;Mohad Kamran Abbasi ,&nbsp;Ahsan Amir Khan ,&nbsp;Mishal Zaman ,&nbsp;Alishba Mustafa ,&nbsp;Hana Habib ,&nbsp;Syeda Ayesha Hussain ,&nbsp;Naveed Zaman ,&nbsp;Saqib Kamran Bakhshi ,&nbsp;Saad Bin Anis ,&nbsp;Syed Ather Enam","doi":"10.1016/j.clineuro.2025.108728","DOIUrl":"10.1016/j.clineuro.2025.108728","url":null,"abstract":"<div><h3>Objectives</h3><div>To provide information about implementation, resources, practice patterns and prevalent perceptions regarding neuro-oncology tumor boards (NOTBs) in a lower middle income country.</div></div><div><h3>Methods</h3><div>A nationwide survey was designed to include licensed neurosurgeons involving data on practice, structure, and perceptions of NOTBs with non-probability sampling, a pre-validated proforma, data analysis using SPSS v27, and geospatial mapping using Quantum GIS.</div></div><div><h3>Results</h3><div>139 neurosurgeons were surveyed from 63 neurosurgical centers of a lower middle income country. 15/63 neurosurgical centers had dedicated NOTBs. Neurosurgeons from centers with NOTBs had better access to palliative care with radiation oncologists (70 %) and services (73 %) as compared to those without NOTBs (44 %, p = 0.012 and 44 %, p = 0.004). 76.3 % of neurosurgeons routinely prescribed postoperative CT scans with higher rate in centers without NOTBs (94 % vs. 80 %, p = 0.024). 57.6 % of neurosurgeons prescribed postoperative MRI scans within six weeks for intra-axial pathology, with higher rates in NOTB centers (63 % vs. 56 %, not significant). The perceived positive effects of NOTBs included improved patient outcomes (87.6 %), expedited centralized patient care (88.3 %), decreased referral times (74.4 %), increased uptake of adjuvant management (66.4 %), decreased mortality/morbidity (73.1 %), and significant treatment (78.5 %) and diagnostic plan changes (77.4 %) while perceived negative effects included the time-consuming nature (20.7 %), and suffering of patients due to wait associated with NOTBs (36 %). The perceived barriers included “lack of administrative support” (17.1 %), “limited resources” (15.2 %), and “lack of standardized protocols or guidelines” (13.8 %).</div></div><div><h3>Conclusion</h3><div>In this nationwide situational report from a lower middle income country, only a quarter of neurosurgical units had dedicated NOTBs. The centers with NOTBs were mostly education/training centers, and had better access/availability to palliative decision-making and care. The neurosurgeons from centers with NOTBs had lower rates of prescribing immediate postoperative CT scans while higher rates of prescribing MRI scans within 6 weeks for intra-axial pathology. Therefore, NOTBs can help advocate for judicious use of neuroimaging and increased uptake of adjuvant palliative treatment. While perceived effects were similar, the nature of perceived barriers was different for LMIC and HIC. Our study can aid policymakers, hospitals, and healthcare professionals, and can provide a roadmap for future in-depth studies with geospatial mapping of resources/services to fully elucidate the inequalities.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"249 ","pages":"Article 108728"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982138","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}

{"title":"Concomitant multiple sclerosis and cervical myelopathy: A propensity-matched QOD analysis of patient-reported outcomes and return to work after cervical spine surgery","authors":"Joseph Tingen,&nbsp;Jainith Patel,&nbsp;Hiba Hamid,&nbsp;Helen Karimi,&nbsp;Ron I. Riesenburger,&nbsp;James Kryzanski","doi":"10.1016/j.clineuro.2025.108742","DOIUrl":"10.1016/j.clineuro.2025.108742","url":null,"abstract":"<div><h3>Objective</h3><div>The diagnosis of degenerative cervical myelopathy (CM) in multiple sclerosis (MS) patients is challenging due to overlapping symptomatology and radiological findings. Minimal literature reports patient reported outcomes measures (PROMs) for MS patients undergoing surgery for CM. Given the diagnostic difficulty, we aimed to determine if patients with MS have worse outcomes after elective cervical spine surgery.</div></div><div><h3>Methods</h3><div>126 patients who underwent surgery for CM were retrospectively obtained from the Quality Outcomes Database (QOD). 63 MS patients were age and gender matched to 63 without MS. Postoperative PROMs including Visual Analogue Scale for neck/arm pain (VAS), Neck Disability Index (NDI), and satisfaction were compared at 3 and 12 months. Postoperative complications and return to work were studied as secondary outcomes.</div></div><div><h3>Results</h3><div>The average age of both cohorts was 57.9 years, and 63.5 % were female. Baseline functional status and symptomatology were similar, although fewer MS patients could independently ambulate (p = .014). The operative time and length of stay were similar. MS patients had a greater average ASA grade (p = 0.018), however there were no significant differences in VAS, NDI, or satisfaction. MS patients had a higher 3-month readmission rate (p = .044), however returned to work at a similar rate greater than 70 %.</div></div><div><h3>Conclusion</h3><div>PROMs do not significantly differ for CM patients with concomitant MS. Patients with MS had a higher 3-month complication rate, although readmissions were largely unrelated to the procedure. Thus, despite the diagnostic challenge of CM in MS patients, the surgical outcomes are comparable to those without MS.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"249 ","pages":"Article 108742"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000726","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}

{"title":"Posterior reversible encephalopathy syndrome as a multiple sclerosis relapse mimic during interferon therapy","authors":"Mariana Dias da Costa ,&nbsp;Miguel Leal Rato ,&nbsp;João Ferreira ,&nbsp;João de Sá ,&nbsp;Mónica Santos","doi":"10.1016/j.clineuro.2024.108666","DOIUrl":"10.1016/j.clineuro.2024.108666","url":null,"abstract":"<div><div>Posterior reversible encephalopathy syndrome is a rare syndrome involving the subcortical cerebral white matter. We describe the case of a 63-year-old male patient with relapsing remitting multiple sclerosis under interferon beta therapy and acute onset of atypical unilateral posterior reversible encephalopathy syndrome mimicking a relapse. This case highlights the importance of clinical suspicion for multiple sclerosis mimics, namely in older patients, which may need disease modifying treatment suspension and directed treatment in order to achieve better clinical prognosis.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"249 ","pages":"Article 108666"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142790977","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}

{"title":"Parasellar region meningiomas with optic canal (OC) invasion: Correlation between the degree of decompression of the OC and the improvement of visual acuity","authors":"Bianca Maria Baldassarre ,&nbsp;Alessandro Pesaresi ,&nbsp;Giuseppe Di Perna ,&nbsp;Enrico Lo Bue ,&nbsp;Raffaele De Marco ,&nbsp;Irene Portonero ,&nbsp;Alice Antico ,&nbsp;Federica Penner ,&nbsp;Fabio Cofano ,&nbsp;Diego Garbossa ,&nbsp;Michele Maria Rosario Lanotte ,&nbsp;Francesco Zenga","doi":"10.1016/j.clineuro.2024.108672","DOIUrl":"10.1016/j.clineuro.2024.108672","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the correlation between the degrees of circumferential decompression of the optic canal (OC) and the improvement of visual acuity in patients with parasellar meningiomas (PMs) with optic canal invasion.</div></div><div><h3>Methods</h3><div>This is a monocentric retrospective study conducted at author’s institution. The visual acuity was evaluated preoperative and at 3-months after surgery with Snellen acuity test. The degree of decompression of the OC was calculated through postoperative multiplanar CT-scan reconstructions in coronal plane at intraorbital opening (IOO), intracranial opening (ICO) and middle point between them (MP). OC was then divided in two segments (anterior and posterior).</div></div><div><h3>Results</h3><div>29 consecutive patients were identified. Improvement of visual acuity was observed in 18 patients (62 %). Mean decompression achieved at ICO, MP and IOO was 226.2°± 43.6° (range: 68.7°-297.1°), 217.5°± 37.2° (range: 75.3°-268.7°) and 204.6°± 41.2° (range: 67.3°-252.6°) respectively. A decompression &gt; 90° of the anterior segment of the OC, a decompression &gt; 180° of the posterior segment and a full-length decompression &gt; 90° were associated visual acuity improvement at univariate analysis (p = 0.010, p = 0.002 and p &lt; 0.001, respectively). A decompression &gt; 180° of the posterior segment and a full-length decompression &gt; 90° of the OC maintained statistical significance at multivariate analysis (p = 0.030 and p = 0.035, respectively).</div></div><div><h3>Conclusion</h3><div>Anterior segment decompression &gt; 90° and posterior segment decompression &gt; 180° were associated with improvement of visual acuity at 3 months after surgery. A full-length decompression of the optic canal &gt; 90° showed better visual outcome, while a full-length decompression &gt; 180° did not seem to be related to significative improvements in visual acuity.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"249 ","pages":"Article 108672"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}