Clinical Neurology and Neurosurgery最新文献

{"title":"Management of cervical carotid pseudoaneurysms: Integrating clinical practice with computational fluid dynamics insights","authors":"Felipe Ramirez-Velandia ,&nbsp;Vincenzo T.R. Loly ,&nbsp;Emmanuel O. Mensah ,&nbsp;Jean Filo ,&nbsp;Rafael T. Tatit ,&nbsp;João de Sá Brasil Lima ,&nbsp;Christopher S. Ogilvy ,&nbsp;Carlos E. Baccin","doi":"10.1016/j.clineuro.2025.108836","DOIUrl":"10.1016/j.clineuro.2025.108836","url":null,"abstract":"<div><h3>Background</h3><div>Cervical carotid dissections are a significant cause of thromboembolic events in young adults. While endovascular treatment is often used for large or enlarging lesions, smaller lesions are frequently managed conservatively. However, there is limited research on the hemodynamic differences between conservatively managed and endovascularly treated cervical carotid pseudoaneurysms. This study aims to explore these hemodynamic variations.</div></div><div><h3>Methods</h3><div>A retrospective analysis was performed on patients with extracranial carotid pseudoaneurysms treated conservatively or endovascularly. Vessel and pseudoaneurysm volumes were reconstructed from pre-treatment digital angiographies using 3D Slicer software. Numerical simulations were performed using ANSYS® Fluent. Hemodynamic variables evaluated included: wall shear stress (WSS), low shear areas (LSA), and the parent artery WSS ratio (PAWSSR)</div></div><div><h3>Results</h3><div>Six male patients with seven cervical carotid pseudoaneurysms, aged 48–65 years, were included. Among the lesions, five were spontaneous, one occurred post-endovascular treatment of an anterior communicating artery aneurysm, and one was due to a post-gunshot wound in the neck. The average volume and area of the lesions evaluated were 311.1 mm³ and 238.7 mm², respectively. Three pseudoaneurysms were treated with stents (two flow diverters and one overed VIABAHN stent), and four lesions were managed conservatively with aspirin. Computational fluid dynamics (CFD) simulations revealed that the three pseudoaneurysms treated endovascularly displayed a higher volume (482.4 vs. 182.6 mm³), larger area (367.9 vs 158.0 mm²), greater parent vessel WSS (4.8 vs. 3.01 Pa), higher average LSA (44.9 % vs. 7.6 %), higher PAWSSR (3.95 vs. 1.46), and slightly higher average area-weighted aneurysmal WSS (2.4 vs. 2.1 Pa) compared to those managed conservatively.</div></div><div><h3>Conclusions</h3><div>Extracranial carotid pseudoaneurysms undergoing endovascular treatment experience more hemodynamic stressors, including higher WSS, larger LSAs, and higher PAWSSR than those treated conservatively. Individual assessment of these hemodynamic characteristics can aid clinicians in treatment decision-making.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"251 ","pages":"Article 108836"},"PeriodicalIF":1.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627817","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 non-inferiority analysis of surgical outcomes following outpatient laminoplasty for cervical spondylosis","authors":"Karim Rizwan Nathani ,&nbsp;Marc Ghanem ,&nbsp;Sufyan Ibrahim ,&nbsp;Aleeza Safdar ,&nbsp;Asimina Dominari ,&nbsp;Abdul Karim Ghaith ,&nbsp;Brett A. Freedman ,&nbsp;Mohamad Bydon","doi":"10.1016/j.clineuro.2025.108841","DOIUrl":"10.1016/j.clineuro.2025.108841","url":null,"abstract":"<div><h3>Objective</h3><div>A trend of outpatient spinal procedures has recently been observed due to evidence of less hospital-associated risks and better value-based care. We aimed to assess non-inferiority in surgical outcomes of outpatient and inpatient laminoplasty for cervical spondylosis.</div></div><div><h3>Methods</h3><div>The American College of Surgeons National Surgical Quality Improvement Program database was queried for patients undergoing cervical laminoplasty for spinal spondylosis. Patients with a hospital stay longer than 48 hours were excluded to increase baseline comparability between groups. Patients undergoing other spinal procedures during the same hospital stay were also excluded. The outcomes of interest were postoperative complications, readmissions, and reoperations within 30 days postoperatively. The non-inferiority of outpatient compared to inpatient surgery was defined as a risk difference of &lt; 10.0 % at a one-sided 97.5 % confidence interval.</div></div><div><h3>Results</h3><div>Total 808 cervical laminoplasty surgeries were identified. The study cohorts consisted of 107 and 701 patients in outpatient and inpatient groups, respectively. Baseline characteristics, except age (58.3 ± 10.6 vs. 61.4 ± 11.5 years, p = 0.01), were similar between groups. The incidences of postoperative complications were 2.8 % and 3.4 % for the outpatient and inpatient groups, respectively, while both groups had a 30-day readmission rate of 3.7 %. The 30-day reoperation rates were 2.8 % and 1.4 % for the outpatient and inpatient groups, respectively. Noninferiority of outpatient surgery was documented at a risk difference of 10 % for postoperative complications, readmissions, and reoperations.</div></div><div><h3>Conclusions</h3><div>Outpatient cervical laminoplasty demonstrated similar early postoperative outcomes to inpatient surgery, with non-inferiority documented in surgical outcomes. Therefore, outpatient laminoplasty can be safely offered in carefully selected patients with minimal perioperative risk factors. Future research should further refine patient selection criteria for outpatient procedures to optimize surgical decision-making.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"251 ","pages":"Article 108841"},"PeriodicalIF":1.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143592616","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 value of optimizing extent of resection in adult diffuse gliomas","authors":"Krishna Shroff ,&nbsp;Prakash Shetty ,&nbsp;Vikas Singh ,&nbsp;Sridhar Epari ,&nbsp;Ayushi Sahay ,&nbsp;Aliasgar Moiyadi","doi":"10.1016/j.clineuro.2025.108838","DOIUrl":"10.1016/j.clineuro.2025.108838","url":null,"abstract":"<div><h3>Background and Introduction</h3><div>Revision surgery for adult diffuse gliomas has benefits in terms of maximizing the extent of resection and providing accurate histopathological diagnosis. However, these benefits must be balanced against the potential higher morbidity of redo-surgery.</div></div><div><h3>Methodology</h3><div>We retrospectively analyzed patients who underwent revision surgery for adult-type diffuse gliomas. Benefits (histological reclassification, and achievement of gross total resection i.e. GTR), and harm (major morbidity) were incorporated into a scoring system, and outcome categories were proposed. For the subset of glioblastomas (IDH wild-type) who underwent GTR, we also calculated the estimated increase in survival, conferred by the relook surgery.</div></div><div><h3>Results</h3><div>There were 41 patients (M:F ratio of about 3.5), with a mean age of 35.4 years. GTR was achieved in 43.9 % and histopathological discordance seen in 46.3 %. Four (9.8 %) had major morbidity (including one death). Most (37/41) were categorized into the ‘definitely benefitted’ or ‘benefitted’ categories. Preoperative symptoms, raised ICP and comorbidities were more likely to predict subtotal resection, with resultant lower benefits from revision surgery. Glioblastomas were also less likely to have GTR, but in the subset that underwent GTR, there was an estimated survival benefit of 4–9 months.</div></div><div><h3>Conclusion</h3><div>Revision surgery provides valuable benefits in selected patients having undergone an incomplete primary resection, by increasing the extent of resection (and thereby survival) and providing a more accurate histopathological diagnosis due to adequate tumour sampling, provided morbidity can be minimized.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"251 ","pages":"Article 108838"},"PeriodicalIF":1.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143601411","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 mindfulness-based interventions for pain, anxiety, and depression in spinal cord injury patients: A systematic review and meta-analysis","authors":"Alison Reilly ,&nbsp;Ahmad Sharif ,&nbsp;Ojas Bhagra ,&nbsp;Asimina Dominari ,&nbsp;Konstantinos Katsos ,&nbsp;Karim R. Nathani ,&nbsp;Sarah E. Johnson ,&nbsp;Mohamad Bydon","doi":"10.1016/j.clineuro.2025.108839","DOIUrl":"10.1016/j.clineuro.2025.108839","url":null,"abstract":"<div><h3>Objective</h3><div>Rehabilitative measures following spinal cord injury (SCI) typically fail to mitigate the psychological symptoms that might heighten pain levels. Mindfulness-based interventions (MBI) have been proposed to address such concerns. We aim to review the literature on MBI used for pain, anxiety, and depression in SCI.</div></div><div><h3>Methods</h3><div>A systematic literature search for studies using MBI in patients with pain and psychological symptoms following SCI was conducted. Primary outcomes were pain, assessed by Numeric Pain Rating Scale (NPR) and Brief Pain Inventory (BPI), anxiety, and depression, assessed by the Hospital Anxiety and Depression Scale (HADS). Secondary outcomes included stress and quality of life, as measured by the Perceived Stress Scale (PSS) and World Health Organization Quality of Life (WHO-QOL). Only comparative studies were included.</div></div><div><h3>Results</h3><div>Seven studies (n = 419) were included pertaining to yoga, mental imagery, biofeedback, and mindfulness meditation. Five studies (n = 260) reported NPR pain. The mean post-treatment difference comparing the control and MBI groups was −1.26 (95 %CI: [-2.44; −0.07]), with MBI showing significant pain reduction (p = 0.04). The intergroup difference was not significant but trended favoring treatment. Three studies included HADS (n = 282) and BPI (n = 203), with neither reaching significance in post-treatment comparisons, but showing improvements favoring MBI for both. Further, changes for MBI groups revealed marginal mood benefits. Secondary outcomes were not statistically analyzed.</div></div><div><h3>Conclusions</h3><div>A significant difference was observed regarding NPR post-treatment scores. The results of this study trend positively towards the treatment groups, showing possible benefits in utilizing MBI for patients with SCI suffering from pain and psychological concerns.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"251 ","pages":"Article 108839"},"PeriodicalIF":1.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143601512","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":"Microstructural patterns in substantia nigra subregions are associated with depression and olfactory impairments in Parkinson’s disease","authors":"Mehrdad Mozafar ,&nbsp;Zobeydeh Dehghan Manshadi ,&nbsp;Zohreh Molaei ,&nbsp;Hedye Babaei ,&nbsp;Meysam Mansouri ,&nbsp;Sahba Shahbazi ,&nbsp;Shayan Shakeri ,&nbsp;Hanieh Mirhosseini ,&nbsp;David Gulisashvili ,&nbsp;Mahsa Mayeli ,&nbsp;Parkinson’s Progression Markers Initiative (PPMI)","doi":"10.1016/j.clineuro.2025.108817","DOIUrl":"10.1016/j.clineuro.2025.108817","url":null,"abstract":"<div><h3>Objective</h3><div>Parkinson's Disease (PD) manifests with both motor and non-motor symptoms, with non-motor symptoms often appearing first. The link between non-motor symptoms, particularly depression, and olfactory dysfunction, and substantia nigra (SN) subregions has been studied less. By utilizing Diffusion tensor imaging (DTI), we investigated the associations between microstructural patterns in the SN’s subregions and motor and non-motor symptoms in patients with PD, including those without evident dopaminergic deficits, compared to healthy controls (HC).</div></div><div><h3>Methods</h3><div>Complete baseline demographic data, motor assessments, full-scale non-motor tests, and DTI of SN subregions for 260 participants, including 156 with PD, 36 with scans without evidence of dopaminergic deficit (SWEDD), and 68 HC, were extracted from the PPMI database. Multiple linear regression models were used to evaluate the associations between symptom scores and DTI findings.</div></div><div><h3>Results</h3><div>A significant difference in depression between the groups was found (p &lt; 0.01), with patients with SWEDD having the highest rate of depression (approximately 36.1 %). Depressed SWEDD patients, compared to non-depressed ones, had higher FA values in the right rostral part of SN (p = 0.03, adjusted p = 0.15). Anxiety scores were significantly higher in both PD and SWEDD groups compared to HCs. PD patients exhibited a significantly higher prevalence of olfactory dysfunction compared to SWEDD and HCs (p &lt; 0.001, adjusted p = 0.03), with 54.5 % of PD patients experiencing hyposmia and 34 % of them suffering from anosmia. PD patients with normosmia and hyposmia had higher FA in the right caudal SN than those with anosmia.</div></div><div><h3>Conclusion</h3><div>Our findings suggest significant brain microstructural differences in SN associated with depression and olfactory dysfunction in patients with PD with or without evident dopaminergic deficits. This finding highlights the advantage of DTI in detecting microstructural changes in patients with SWEDD.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"251 ","pages":"Article 108817"},"PeriodicalIF":1.8,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143601412","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: “Evaluating prognostic factors for falls in Parkinson’s disease: A sex-based analysis”","authors":"Leroy D’Souza ,&nbsp;Maanini Singhvi","doi":"10.1016/j.clineuro.2025.108835","DOIUrl":"10.1016/j.clineuro.2025.108835","url":null,"abstract":"","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"251 ","pages":"Article 108835"},"PeriodicalIF":1.8,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143579023","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":"Trigeminal nerve stimulation in drug-resistant epilepsy: A systematic review","authors":"Muhammad I. Jalal ,&nbsp;Anjali K. Gupta ,&nbsp;Rohin Singh ,&nbsp;Nithin K. Gupta ,&nbsp;Harjiven Dodd ,&nbsp;Basel Musmar ,&nbsp;Aman Singh ,&nbsp;Derek D. George ,&nbsp;Melissa A. LoPresti ,&nbsp;Andrew M. Wensel","doi":"10.1016/j.clineuro.2025.108834","DOIUrl":"10.1016/j.clineuro.2025.108834","url":null,"abstract":"<div><h3>Introduction</h3><div>Trigeminal Nerve Stimulation (TNS) is a technique that may be useful to reduce seizure burden in drug-resistant epilepsy (DRE), but its efficacy is not well characterized. This study sought to understand the application of TNS in DRE by providing a comprehensive overview of the current use and efficacy of TNS for neuromodulation in DRE.</div></div><div><h3>Methods</h3><div>A systematic review examining the use of TNS for DRE was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Scopus, and Embase databases were queried; studies were included if they examined TNS for treatment of DRE in human patients and reported seizure outcomes. Demographic, clinical, TNS neurostimulation parameters, and outcome data were collected. Primary outcome measures included efficacy, measured by change in seizure frequency, and adverse events (AEs). Secondary outcomes included patient-reported metrics assessing quality of life (QoL).</div></div><div><h3>Results</h3><div>A total of 234 studies were identified; seven met inclusion criteria, comprising a total of 148 patients. Seizure history and epilepsy characteristics varied. Mean age ranged 28.8–44.3 years, with percent male ranging 7–24 %. All studies reporting seizure frequency showed a significant reduction in seizure frequency following TNS, though follow-up time varied. Adverse events included skin irritation and headache most commonly, reported at 12 % and 11 %, respectively. No serious or life-threatening adverse effects were reported. Multiple studies reported positive changes in Beck Depression Inventory (BDI) and Quality of Life in Epilepsy (QOLIE) scores indicating an increase in quality of life and mood throughout treatment periods.</div></div><div><h3>Conclusion</h3><div>TNS is a neuromodulatory therapy for DRE. Our review suggests it is well-tolerated and can reduce seizure frequency, while improving mental health and well-being, with minimal AEs. Larger comparative studies are needed to better explore the use of TNS for treatment of DRE.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"251 ","pages":"Article 108834"},"PeriodicalIF":1.8,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610419","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":"Diffusion-weighted imaging abnormalities patterns in bacterial meningitis","authors":"Akiyuki Hiraga ,&nbsp;Kazuho Kojima ,&nbsp;Satoshi Kuwabara","doi":"10.1016/j.clineuro.2025.108822","DOIUrl":"10.1016/j.clineuro.2025.108822","url":null,"abstract":"<div><h3>Purpose</h3><div>Information on abnormal diffusion-weighted imaging (DWI) patterns in bacterial meningitis (BM) is limited. This study aimed to investigate the frequency and patterns of DWI abnormalities in BM in patients with culture-positive BM.</div></div><div><h3>Methods</h3><div>The medical records of 14 consecutive patients with BM with magnetic resonance imaging evaluation, admitted to our hospital over the past 14 years, were reviewed. BM was defined by a cerebrospinal fluid (CSF) culture positive for bacteria, or the combination of CSF pleocytosis and a positive blood culture.</div></div><div><h3>Results</h3><div>Brain DWI abnormalities were identified in 13 (93 %) of the 14 patients and classified into six patterns: ischaemic stroke (n = 9), ventriculitis (n = 4), sulcal hyperintensity (n = 7), scattered hyperintensities surrounding the cerebral hemispheres (n = 6), middle meningeal arterial sign (n = 5), or abscess (n = 1). The causes of ischaemic stroke included infective endocarditis (n = 4), vasculitis (vasculopathy; n = 2), and unclassified (n = 3).</div></div><div><h3>Conclusion</h3><div>DWI abnormalities in BM were very frequent. Based on the high frequency and wide spectrum of DWI abnormalities in BM, we suggest performing DWI for all patients with BM.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"251 ","pages":"Article 108822"},"PeriodicalIF":1.8,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143592615","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":"Multicentric low-grade glioma: A systematic review of a rare neuro-oncological disease","authors":"Rabeet Tariq ,&nbsp;Nowal Hussain ,&nbsp;Mohammad Hamza Bajwa ,&nbsp;Hafiza Fatima Aziz ,&nbsp;Muhammad Shahzad Shamim ,&nbsp;Syed Ather Enam","doi":"10.1016/j.clineuro.2025.108821","DOIUrl":"10.1016/j.clineuro.2025.108821","url":null,"abstract":"<div><h3>Introduction</h3><div>Multicentric and multifocal gliomas are rare and mainly described in high-grade gliomas, however, they have rarely been reported with LGG in about 2–10 % of all cases. This study aims to identify the reported multicentric low-grade gliomas (mLGGs) in literature and review their pathologies, management, and outcomes.</div></div><div><h3>Methods</h3><div>A systematic search using a pre-defined search strategy was conducted across three databases (PubMed, Cochrane Library, and Scopus). Following the PRISMA guidelines, relevant articles were selected. The data including demographic details, clinical presentations, lesion locations, pathology, neurosurgical interventions, extent of resection, adjuvant therapies, and survival outcomes were reported.</div></div><div><h3>Results</h3><div>We identified 36 patients across 17 studies. Presenting symptoms varied, with seizures (27.7 %) and headaches (22.2 %) being the most common. Typical imaging features involve hypo- to isotense signals on T1-weighted images and hyperintensity on T2-weighted images, with MR spectroscopy aiding in differentiation. Histological consistency across tumor sites was observed in 29 cases, with some variability in a few. Survival was 66.6 % among patients, and initial reports in the 1960s indicated high mortality due to intracranial pressure shifts. Adjuvant therapies included chemotherapy (14 patients) and radiotherapy (9 patients), though many cases lacked complete therapy data. Although chemotherapy and radiotherapy lacked a significant impact on progression-free survival, early, extensive resection remains advocated, with a mean progression-free survival of 30.14 months.</div></div><div><h3>Conclusion</h3><div>Most of the current evidence surrounding mLGG consists of case reports with few retrospective case series. Early, extensive resection appears to be the most effective approach for managing mLGG, while adjuvant therapies have limited impact on progression-free survival, highlighting the need for more comprehensive molecular profiling to guide treatment. Further research into standardized protocols for adjuvant therapies and long-term outcomes is essential to optimize survival and improve management of unresectable or recurrent cases.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"251 ","pages":"Article 108821"},"PeriodicalIF":1.8,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143579021","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":"Neurological manifestations and complications of Kikuchi-Fujimoto disease: A comprehensive systematic review","authors":"H.Shafeeq Ahmed ,&nbsp;Leroy D’Souza ,&nbsp;Vibhav M S,&nbsp;Mohammed Sulaiman Sache","doi":"10.1016/j.clineuro.2025.108818","DOIUrl":"10.1016/j.clineuro.2025.108818","url":null,"abstract":"<div><h3>Background</h3><div>Kikuchi-Fujimoto disease (KFD) is a self-limiting inflammatory condition primarily affecting young and pediatric patients of Asian descent. This systematic review aims to consolidate current knowledge on the neurological manifestations associated with KFD.</div></div><div><h3>Methods</h3><div>The present review followed the PRISMA guidelines and was registered on PROSPERO (CRD42024579757). PubMed, Scopus and CINAHL Ultimate were searched to identify relevant studies. We included case reports and case series detailing neurological manifestations and complications of KFD of any age/gender.</div></div><div><h3>Results</h3><div>The initial search identified 456 articles out of which seventy-five case reports and series were included, encompassing a total of 81 cases. The median age of the patients was 23 years (IQR: 15–30). Patients most frequently presented with fever, headache and signs of meningeal irritation. Most patients diagnosed with KFD showed signs of neurological complications at the initial presentation. Meningitis (commonly aseptic meningitis) was the most frequently reported neurological complication followed by encephalitis, encephalopathy and neuro-ophthalmological complications. All patients had lymphadenopathy and showed the characteristic histopathological picture for KFD on biopsy. Steroids and immunosuppressive agents remained the treatment of choice. Complication and symptom specific treatment for neurological findings was provided wherever deemed necessary. Almost every study reported an improvement in neurological complications post treatment.</div></div><div><h3>Conclusion</h3><div>Neurological manifestations and complications associated with KFD are diverse and have a significant impact on patients. The complications associated with KFD need to be promptly recognized and evaluated by clinicians. Further investigation into the long-term effects and treatment strategies for KFD is warranted.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"251 ","pages":"Article 108818"},"PeriodicalIF":1.8,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143562896","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}