Clinical Neurology and Neurosurgery最新文献

{"title":"Corrigendum to 'Long-term outcomes after shunt surgery in older patients with idiopathic normal pressure hydrocephalus' [Clin. Neurol. Neurosurg., Vol. 249 (2025) 108783].","authors":"Hiroyuki Momota, Tsuyoshi Saito","doi":"10.1016/j.clineuro.2025.108998","DOIUrl":"https://doi.org/10.1016/j.clineuro.2025.108998","url":null,"abstract":"","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":" ","pages":"108998"},"PeriodicalIF":1.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265502","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 the Editor: The Impact of cSDH membranes on MMA embolization outcomes","authors":"Rukai Jiao, Wanyuan Guo, Xiaolin Du","doi":"10.1016/j.clineuro.2025.109010","DOIUrl":"10.1016/j.clineuro.2025.109010","url":null,"abstract":"","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"256 ","pages":"Article 109010"},"PeriodicalIF":1.8,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144230323","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":"Twist-drill craniostomy with pressure-controlled fibrinolytic irrigation therapy reduces recurrence of chronic subdural hematomas: Could spontaneous intracranial hypotension be more common during chronic subdural hematomas than we diagnose?","authors":"Nicolas Engrand , Gergele Laurent","doi":"10.1016/j.clineuro.2025.108997","DOIUrl":"10.1016/j.clineuro.2025.108997","url":null,"abstract":"","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"256 ","pages":"Article 108997"},"PeriodicalIF":1.8,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242362","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":"Radiological insights into pachymeningitis imaging diagnosis: A state-of-the-art review","authors":"A. Aranaz Murillo ,&nbsp;P. Briceño Torralba ,&nbsp;I. Marquina Ibáñez ,&nbsp;C. Bernal Lafuente ,&nbsp;P. Seral Moral ,&nbsp;A. Vela Marín","doi":"10.1016/j.clineuro.2025.109001","DOIUrl":"10.1016/j.clineuro.2025.109001","url":null,"abstract":"<div><div>Hypertrophic pachymeningitis, characterized by inflammation and thickening of the dura mater in the skull or spinal cord, poses diagnostic and management challenges. This review provides a comprehensive exploration of the condition, emphasizing the importance of a multidisciplinary approach involving clinical and radiological assessments. Clinical manifestations vary based on lesion location, with cranial involvement typically causing headaches and cranial nerve issues, while spinal cases present with back pain, radicular symptoms, and spinal cord compression. MRI emerges as the gold standard for diagnosis, offering insights into the severity of dural thickening and potential complications. Differentiating between idiopathic and secondary pachymeningitis is fundamental, with the latter arising from various sources such as infections, immune-mediated processes, neoplasms, and more. Management predominantly centers on inflammation control, often employing corticosteroids, and surgical intervention might be considered in severe cases. This holistic approach, blending clinical expertise and advanced diagnostic tools, holds promise for enhancing therapeutic outcomes and refining patient care strategies in hypertrophic pachymeningitis.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"256 ","pages":"Article 109001"},"PeriodicalIF":1.8,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144230321","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 the editor, regarding “Transition from alteplase to tenecteplase for treatment of acute ischemic stroke in a rural stroke network of the Midwest: Planning, execution, safety, and outcomes” recently published by Loggini","authors":"Senta Frol,&nbsp;René Chapot","doi":"10.1016/j.clineuro.2025.108999","DOIUrl":"10.1016/j.clineuro.2025.108999","url":null,"abstract":"","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"256 ","pages":"Article 108999"},"PeriodicalIF":1.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144230322","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":"Clinical utility of neutrophil to lymphocyte ratio (NLR) for epileptic seizures: A systematic review and meta-analysis","authors":"Tiemin Li ,&nbsp;Da Wei ,&nbsp;Huawei Zhang ,&nbsp;Adilijiang Aihemaitiniyazi ,&nbsp;Changqing Liu","doi":"10.1016/j.clineuro.2025.108996","DOIUrl":"10.1016/j.clineuro.2025.108996","url":null,"abstract":"<div><h3>Background</h3><div>The neutrophil-to-lymphocyte ratio (NLR) is a commonly used biomarker for inflammation and is typically elevated in patients experiencing epileptic seizures making it a valuable diagnostic indicator in clinical practice. However, there is no consensus on the clinical utility of NLR in patients with epileptic seizures. Given this controversy, we conducted a meta-analysis to clarify the clinical utility of NLR for epileptic seizures. The meta-analysis has been registered in the PROSPERO database (registration number CRD42024550918).</div></div><div><h3>Methods</h3><div>We conducted a comprehensive literature search in the PubMed, Embase, Cochrane Library, and Web of Science databases, systematically reviewing the literature from January 1, 2000, to May 1, 2024, and determined the eligible studies. NLR values and corresponding sample sizes were extracted from each included study, and a random effects model was used for the meta-analysis. Sensitivity analysis was performed to investigate heterogeneity. Subgroup analysis was conducted to explore the sources of heterogeneity. Egger's test was also used in this meta-analysis to investigate publication bias.</div></div><div><h3>Results</h3><div>After a comprehensive literature search and screening, we included 16 studies in our meta-analysis. The pooled results indicate that NLR levels in the epileptic seizure group are significantly higher compared to the non-seizure group (random effects model, SMD 0.49, 95 % CI: 0.31, 0.67, P &lt; 0.0001). Heterogeneity tests revealed significant heterogeneity (I² = 82 %). Sensitivity analysis results indicate that our findings are robust to the influence of individual studies. Subgroup analysis results suggest that the testing time of NLR and mean/median age are sources of heterogeneity. Egger's test shows no significant publication bias in this meta-analysis.</div></div><div><h3>Conclusions</h3><div>This is the first meta-analysis to demonstrate the potential clinical utility of NLR as a biomarker in patients with epileptic seizures.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"256 ","pages":"Article 108996"},"PeriodicalIF":1.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222912","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":"Comparing different techniques in the management of chronic subdural hematoma - What is the role of middle meningeal artery embolization?: A systematic review and network meta-analysis","authors":"Luis F. Fabrini Paleare ,&nbsp;Sávio Batista ,&nbsp;Raphael Camerotte ,&nbsp;Ocílio Ribeiro Gonçalves ,&nbsp;Lucas Pari Mitre ,&nbsp;Pedro Guimarães Lameira Bittencourt Borges ,&nbsp;Marina Vilardo ,&nbsp;Henrique Maia ,&nbsp;Christian Ken Fukunaga ,&nbsp;Jhon E. Bocanegra-Becerra ,&nbsp;Bernardo Vieira Nogueira ,&nbsp;André Luis Dias de Figueiredo ,&nbsp;Ricardo Nascimento Brito ,&nbsp;Márcio Yuri Ferreira ,&nbsp;Gustavo Sousa Noleto ,&nbsp;Wellingson Silva Paiva","doi":"10.1016/j.clineuro.2025.108995","DOIUrl":"10.1016/j.clineuro.2025.108995","url":null,"abstract":"<div><h3>Background</h3><div>Chronic subdural hematomas (cSDHs) are potentially life-threatening neurological conditions with an increasing incidence worldwide. However, comparative data on the different cSDH managements remain limited. Herein, we aimed to conduct a network meta-analysis comparing standalone embolization (EMB), surgery, EMB plus surgery (EMBSurgery), and observation, to provide further clarity.</div></div><div><h3>Method</h3><div>We systematically searched <em>PubMed</em>, <em>Embase</em>, <em>Web of Science</em>, and <em>Cochrane Library</em> for studies comparing at least two cSDH approaches between EMB, surgery, EMBSurgery, and observation. Primary endpoints included the need for reintervention, length of hospital stay, procedure-related complications, and mortality. Random-effects model was used to calculate mean difference (MD) and odds ratio (OR) under a 95 % confidence interval (CI). Cost-effective analysis and subanalyses for the randomized studies were conducted.</div></div><div><h3>Results</h3><div>A total of 19 studies involving 23,996 patients were included. A significant reduction in reintervention was observed with EMBSurgery (OR 0.21, CI 0.04–0.79), while EMB showed a non-significant reduction (OR 0.41, CI 0.12–1.32), compared to surgery. EMBSurgery neither significantly increased hospital stay (MD 4.80, CI −0.435–11.4) nor yielded higher complications (OR 1.11, CI 0.49–2.36) compared to surgery. Indeed, lower mortality was observed in both groups (EMB: OR 0.61, CI 0.03–5.08; EMBSurgery: OR 0.41, CI 0.03–3.05) and procedural costs were not significantly higher for EMB and EMBSurgery compared to surgery (EMB: MD 32,000, CI –13,500–70,300; EMBSurgery: MD 16,200, CI –40,100–72,600). Subanalyses revealed significantly lower reintervention rates in the EMBSurgery group versus the surgery group (OR 0.34, CI 0.16–0.74; I² 0 %).</div></div><div><h3>Conclusion</h3><div>EMB combined with surgery seems to reduce reinterventions in cSDH compared to surgery alone with non significant complications that need further analysis through randomized trials with longer follow-ups.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"256 ","pages":"Article 108995"},"PeriodicalIF":1.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144230320","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":"Surgical management and visual outcomes of optic-pathway cavernous malformations: A comprehensive literature review of 80 reported cases (1979 – 2025)","authors":"Shrey Kumar Shah ,&nbsp;Asmita Indurkar ,&nbsp;Biren Khimji Patel","doi":"10.1016/j.clineuro.2025.108988","DOIUrl":"10.1016/j.clineuro.2025.108988","url":null,"abstract":"<div><h3>Objective</h3><div>Cavernous malformations (CMs) of the optic chiasm, optic tract, and hypothalamus are exceedingly rare. Most patients present with acute or progressive visual loss, and surgery aims to maximize visual recovery while minimizing neural manipulation. We describe an updated review of all reported operated optic-pathway cavernomas to clarify surgical strategies and visual outcomes.</div></div><div><h3>Methodology</h3><div>PubMed, MEDLINE, and Google Scholar were searched with the terms optic pathway cavernoma, optic chiasm cavernoma, hypothalamic cavernoma, and surgical outcomes. Eighty published cases (1979 – May 2025) were analyzed for presentation, surgical corridor, extent of resection, and postoperative vision.</div></div><div><h3>Results</h3><div>Among 80 patients (42 females, 36 males; mean age 34.9 ± 11.7 years), visual disturbance was the initial symptom in 75/78 with available data (96.2 %); headache occurred in 29 (37 %). Surgical corridors included fronto-temporal/pterional (55 %), mid-line subfrontal or inter-hemispheric (16 %), orbito-zygomatic (6 %), EEA/TNTS (6 %), and other or unspecified craniotomies (16 %). Gross-total resection (GTR) was achieved in 59 patients (73.8 %). Post-operative vision (reported in 75 patients) improved in 54 (72.0 %), stabilised in 17 (22.7 %), and deteriorated in 4 (5.3 %). GTR conferred the highest likelihood of improvement (78.9 % vs 50 % after subtotal resection). The EEA/TNTS corridor, now reported in six cases, allowed complete excision without brain retraction or Sylvian fissure dissection and achieved visual improvement or stability in all patients.</div></div><div><h3>Conclusion</h3><div>Early surgical excision offers visual improvement or preservation in more than 94 % of optic-pathway CM cases, with GTR the strongest predictor of favourable outcome. The endoscopic endonasal route, when guided by neuronavigation and multilayer skull-base reconstruction, provides direct mid-line access with minimal manipulation of critical perforators and should be considered a first-line corridor for mid-line chiasmatic or retro-chiasmatic lesions.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"256 ","pages":"Article 108988"},"PeriodicalIF":1.8,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144212582","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":"Incidence of paraneoplastic antibodies in United Kingdom – An estimate from a regional centre","authors":"C.A. Chadwick ,&nbsp;E.J. Jackson ,&nbsp;S.L. Hanton ,&nbsp;C. Rocchi ,&nbsp;M. Forcadela ,&nbsp;S. Hamid ,&nbsp;A. Jacob","doi":"10.1016/j.clineuro.2025.108993","DOIUrl":"10.1016/j.clineuro.2025.108993","url":null,"abstract":"<div><h3>Background</h3><div>A paraneoplastic neurological syndrome (PNS) describes the neurological complications of a malignancy that are not due to local or metastatic effects. PNS are often associated with the presence of serum paraneoplastic neuronal antibodies (PNAb). However, the frequency of identification of PNAb in hospitals and laboratories is rarely reported. This information will help plan and deliver diagnostic and clinical services.</div></div><div><h3>Objectives</h3><div>To review the frequency, type and association with cancer of PNAb in a tertiary neurological centre over 9 years.</div></div><div><h3>Design</h3><div>Retrospective observational study in an adult and paediatric population.</div></div><div><h3>Setting</h3><div>Walton Centre NHS Foundation Trust (WCFT), Liverpool, United Kingdom.</div></div><div><h3>Patients</h3><div>Patients seen at the WCFT who tested positive for PNAb with a ‘high risk’ for cancer (HR PNAb) from April 2012 - April 2021.</div></div><div><h3>Main outcome measures</h3><div>Antibodies detected, neurological diagnosis, presence of cancer.</div></div><div><h3>Results</h3><div>1.6 % (107/6863) of the samples tested were positive for HR PNAb. We estimate the incidence of patients with HR PNAb seropositivity in the population to be 3.8/million/year. 20/33 patients for whom clinical details were available were found to have an associated malignancy. Crucially it was the initial detection of ‘high risk’ antibodies that led to the search and subsequent detection of cancer in 10 of the patients in this study.</div></div><div><h3>Conclusion</h3><div>This is the first UK study to provide an estimated minimum incidence rate of HR PNAb from a defined geography and population. The inclusion of intermediate and low risk antibodies will make this number even higher. PNAb testing remains a vital investigation in neurology and for the early detection of cancer.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"256 ","pages":"Article 108993"},"PeriodicalIF":1.8,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242361","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":"Neurosurgical management of cranial and spinal pathologies during civil war: Lessons from an isolated neurosurgical department during the insurrection in New Caledonia","authors":"Lorenzo Mongardi ,&nbsp;Costanza Vitali ,&nbsp;Marie-Charlotte Hesler ,&nbsp;Thierry De Greslan ,&nbsp;Etienne Lefevre ,&nbsp;Guillaume Coll ,&nbsp;Leo Nanty ,&nbsp;Yves Ryckwaert ,&nbsp;Jean-Rodolphe Vignes ,&nbsp;Stephane Fuentes ,&nbsp;Paul Roblot","doi":"10.1016/j.clineuro.2025.108994","DOIUrl":"10.1016/j.clineuro.2025.108994","url":null,"abstract":"<div><h3>Introduction</h3><div>Since November 2023, a neurosurgery department has been created in Nouméa, New Caledonia. Meanwhile, the 13th of May, 2024 a civil war and a subsequent transient humanitarian crisis dramatically influenced the surgical activity. Several technical and ethical limits have been faced during the “war induced” isolation.</div></div><div><h3>Civil war neurosurgical experience</h3><div>During the 2 months long civil war, 52 urgent surgeries have been performed: 27 were cranial and 25 were spinal procedures. Surgical indications were mostly traumatic, infectious, tumoral, CSF related disorders and vascular pathology. One neurosurgeon was systematically locked inside the hospital without the possibility of going out during the 2–6-days shifts.</div></div><div><h3>Patients characteristics</h3><div>Fifty-two patients have been operated: 40 males, and 12 females. The median age was 47 years. Seventeen patients were admitted for spinal fractures (32,7 %) and 7 patients (13,5 %) for skull fractures or post traumatic hematoma. Four patients (7.6 %) were reoperated on for postoperative infection or CSF leaks including one cranial and three spinal patients.</div></div><div><h3>Conclusion</h3><div>In this particular situation of civil war, having an available neurosurgeon appears to be of upmost importance to face urgent cranial or spinal surgeries considering the impossibility to transfer any patient. Considering the current conflicts and risks of war around the world we recommend a depot of spinal and cranial neurosurgical tools in every first line neurosurgical department that can cover at least 30 % of the annual activity especially in isolated territories.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"255 ","pages":"Article 108994"},"PeriodicalIF":1.8,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144196108","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}