Clinical Neurology and Neurosurgery最新文献

{"title":"Functional and cognitive outcomes three years after COVID-19","authors":"Melanie Li ,&nbsp;Thomas Wisniewski ,&nbsp;Floyd Silva ,&nbsp;Salma Hammam ,&nbsp;Zariya Alvarez ,&nbsp;Nadir Bilici ,&nbsp;Leomaris Caba Caceres ,&nbsp;Natasha De La Cruz ,&nbsp;Celia Engelson ,&nbsp;Julia Greenberg ,&nbsp;Bavica Gummadi ,&nbsp;Jessica Hunter ,&nbsp;Daniella Iglesias Hernandez ,&nbsp;Sohail Karimi ,&nbsp;Jon Links ,&nbsp;Miguel Rodriguez ,&nbsp;Alok Vedvyas ,&nbsp;Hanna Vinitsky ,&nbsp;Amin Yakubov ,&nbsp;Yulin Ge ,&nbsp;Jennifer A. Frontera","doi":"10.1016/j.clineuro.2025.109180","DOIUrl":"10.1016/j.clineuro.2025.109180","url":null,"abstract":"<div><h3>Background</h3><div>There is paucity of data on long-term functional and cognitive outcomes after COVID-19 compared to COVID-negative controls.</div></div><div><h3>Methods</h3><div>We conducted an observational cohort study of patients ≥ 1 year after COVID-19 compared to contemporaneous COVID-19 negative controls (SARS-CoV-2 nucleocapsid IgG negative with no history of COVID-19). Functional (modified Rankin Scale [mRS], Barthel Index), cognitive (telephone MoCA [t-MoCA]), and patient-reported neuropsychiatric symptoms were compared between groups using multivariable logistic regression analysis. In a subgroup of COVID-19 patients who were followed longitudinally, trajectories of recovery were assessed using the paired samples Sign test.</div></div><div><h3>Results</h3><div>Of 145 participants, N = 115 COVID-19 patients (median age 62, 51 % female, 33 % hospitalized for COVID-19, median 2.9 years from index infection), and N = 30 non-COVID-19 controls (median age 75, 70 % female) were enrolled. Neuropsychiatric symptoms were reported in 76 % of COVID-19 patients versus 7 % of controls (aOR 15.0, 95 %CI 3.09–72.47, P &lt; 0.001). Abnormal mRS&gt; 0 occurred in 42 % of COVID-19 patients compared to 11 % of controls (P = 0.002). However, this difference was not significant after adjusting for age, sex, COVID-19 hospitalization and history of mood disorder (aOR 2.10, 95 %CI 0.52–8.51). Rates of abnormal t-MoCA≤ 18 (40 % of COVID-19 versus 41 % of controls, P = 1.00) and Barthel scores&lt; 100 (19 % of COVID-19 versus 14 % in controls, P = 0.785) were similar. Among N = 26 COVID-19 patients with repeated measures, mRS significantly improved between 6-months to 3-years post-COVID (+1.3 points, p = 0.004), while no changes were observed in t-MoCA or Barthel.</div></div><div><h3>Conclusions</h3><div>Three years after COVID-19, neuropsychiatric symptoms were significantly more frequent compared to controls, however no differences in functional or cognitive status were detected.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"258 ","pages":"Article 109180"},"PeriodicalIF":1.6,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145217347","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":"Arachnoid prolapse reduction with flapless reconstruction technique in pituitary adenomas treated with endoscopic transsphenoidal surgery","authors":"Mariano Montes de Oca-Delgado ,&nbsp;Jaime Jesús Martínez-Anda ,&nbsp;Gerardo Guinto-Balanzar ,&nbsp;Juan Luis Gómez-Amador ,&nbsp;Abraham Gallegos-Pedraza ,&nbsp;Carolina de la Llata-Segura ,&nbsp;Ildefonso Muñoz-Romero ,&nbsp;Pablo David Guerrero-Suárez","doi":"10.1016/j.clineuro.2025.109178","DOIUrl":"10.1016/j.clineuro.2025.109178","url":null,"abstract":"<div><h3>Background</h3><div>Effective reconstruction of the pituitary fossa following, transsphenoidal surgery is critical in the prevention of postoperative cerebrospinal fluid, (CSF) leaks and empty sella syndrome. Therefore, reducing arachnoid prolapse into, the sphenoidal sinus is essential to avoid these and other complications.</div></div><div><h3>Objective</h3><div>This study aims to identify factors that are related to arachnoid prolapse into the sphenoidal sinus. As secondary objective we propose a novel flapless reconstruction technique and prove its effectiveness in avoiding postoperative CSF leak.</div></div><div><h3>Methods</h3><div>A case-control study was conducted including patients with and without arachnoid prolapse. We analyzed the clinical and surgical results of a novel arachnoid prolapse involving reduction technique with resorbable oxidized cellulose material and flapless multilayer reconstruction in patients surgically treated by transsphenoidal endoscopic surgery with diagnosis of pituitary adenoma.</div></div><div><h3>Results</h3><div>Between January 2014 and December 2024, 105 patients were included in this study. Intraoperatively, tumor consistency was soft in 71.4 % of cases; arachnoid prolapse occurred in 45.8 % of patients, and 3.8 % developed postoperative CSF leak. Factors related to arachnoid prolapse were tumor resection technique, wider diaphragma sellae (DS) area, gross total resection and soft tumor consistency.</div></div><div><h3>Conclusions</h3><div>The most important factor to found arachnoid prolapse during endoscopic transsphenoidal surgery is to have intact arachnoid membrane. If this condition is fulfilled, all the previously mentioned factors are related to the development of the prolapse. Flapless reconstruction technique for arachnoid prolapse reduction using resorbable oxidized cellulose, is a safe and effective alternative to nasoseptal flaps, offering comparable protection against postoperative complications with significantly fewer sinonasal complications.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"258 ","pages":"Article 109178"},"PeriodicalIF":1.6,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145217346","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":"Low back pain, disability and sagittal alignment of obese patients before and after bariatric surgery: A comparative study","authors":"Mohammad Daher ,&nbsp;Alice Boishardy ,&nbsp;Maud Monsaingeon-Henry ,&nbsp;Ibrahim Obeid ,&nbsp;Olivier Gille ,&nbsp;Amer Sebaaly ,&nbsp;Blandine Gatta-Cherifi ,&nbsp;Louis Boissiere","doi":"10.1016/j.clineuro.2025.109175","DOIUrl":"10.1016/j.clineuro.2025.109175","url":null,"abstract":"<div><h3>Study design</h3><div>Retrospective analysis of prospectively collected data.</div></div><div><h3>Objective</h3><div>This study compared low back pain, patient-reported outcome measures (PROMs), and sagittal alignment in a cohort of obese patients before and after BS.</div></div><div><h3>Background</h3><div>Many studies suggest that bariatric surgery (BS) has a positive impact on improving low back pain and decreasing disability. However, there are no studies describing global sagittal balance before and after BS.</div></div><div><h3>Methods</h3><div>A cohort of 41 obese patients with1 year follow up after BS in a single center. The extracted data consisted of baseline demographics and characteristics, Numerical Rating Scale (NRS) for back and leg pain, PROMs (Short Form 12 (SF12) score, Oswestry Disability Index (ODI) scores and Quebec score), and radiographic parameters.</div></div><div><h3>Results</h3><div>Patients undergoing BS had a significant reduction in weight, and BMI at 1 year post-operatively. In addition, there was a significant reduction in the number of patients having back pain (66 % vs 17 %, p &lt; .001). In fact, the back and leg NRS scores improved significantly 1 year post-operatively (3.8 ± 2.6 vs 1.2 ± 1.9, p &lt; .001; 3.8 ± 2.0 vs 3.0 ± 1.4, p &lt; .001, respectively) as did both ODI and PCS-SF12. As for radiographic parameters, there was a decrease in sacral slope (39.0 ± 10.0 vs 36.9 ± 9.0, p &lt; 0.05) alongside the number of vertebras in lumbar lordosis (7.4 ± 1.5 vs 7.0 ± 1.2, p &lt; 0.01), and an increase in quebe the mean disc-height of both L4-L5 (0.28 ± 0.06 vs 0.32 ± 0.06, p &lt; 0.01) and L5-S1 (0.26 ± 0.07 vs 0.30 ± 0.08, p &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>This study demonstrates that BS significantly reduces low back pain and improves function in obese patients, making it a compelling alternative to spinal surgery in morbidly obese patients suffering from back pain. It also supports the mechanical theory linking excess weight to disc-degeneration.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"258 ","pages":"Article 109175"},"PeriodicalIF":1.6,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205715","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":"Immature granulocytes as novel blood-based biomarkers for brain tumours: A prospective case-control study","authors":"Vedat Acik ,&nbsp;Mehmet Özer ,&nbsp;Selcuk Matyar ,&nbsp;Ali Harmanoğullarından ,&nbsp;Ahmet Hamit Çınkı ,&nbsp;Zeki Boğa ,&nbsp;Ümit Kara ,&nbsp;Ali Arslan ,&nbsp;Mustafa Emre Saraç ,&nbsp;Semih Kıvanç Olguner ,&nbsp;Yurdal Gezercan","doi":"10.1016/j.clineuro.2025.109176","DOIUrl":"10.1016/j.clineuro.2025.109176","url":null,"abstract":"<div><h3>Introduction</h3><div>Chronic inflammation within the tumour microenvironment has been recognised as a key factor in the initiation and progression of tumours. Brain tumours significantly affect patient survival and quality of life. Identifying an accessible biomarker for diagnosing and monitoring brain tumours could support earlier detection and intervention.</div></div><div><h3>Materials and methods</h3><div>This single-centre prospective observational study included 334 patients with histopathologically confirmed intracranial tumours and 299 age- and sex-matched controls with normal brain magnetic resonance imaging findings. Blood samples were evaluated for levels of procalcitonin, C-reactive protein (CRP), plateletcrit (PCT), platelet distribution width (PDW), neutrophil-to-lymphocyte ratio (NLR), red cell distribution width (RDW), mean platelet volume (MPV) and both the absolute count and percentage of immature granulocytes (IGs). The diagnostic accuracy, sensitivity and specificity of these parameters in identifying intracranial tumours were statistically analysed.</div></div><div><h3>Results</h3><div>Procalcitonin, CRP, NLR, RDW and both the absolute count and percentage of IGs were significantly elevated in patients with brain tumours compared to the control group. In the ROC analysis, IG percentage demonstrated the highest AUC and specificity, whereas NLR showed the highest sensitivity. Procalcitonin, NLR, RDW and both IG count and percentage were significantly higher in Grade III-IV tumours than in grades I–II.</div></div><div><h3>Conclusion</h3><div>Readily available and cost-efficient inflammatory markers may support the detection and follow-up of brain tumours. In particular, immature granulocyte percentage and neutrophil to lymphocyte ratio demonstrated complementary diagnostic performance, favouring specificity and sensitivity, respectively. Integration of such blood-based indices with molecular classifiers could enhance risk stratification and guide personalised neuro-oncological management.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"258 ","pages":"Article 109176"},"PeriodicalIF":1.6,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205626","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":"Alterations in brain functional connectivity associated with pain relief following intradiscal injection of condoliase: A prospective observational study","authors":"Ryo Takahashi ,&nbsp;Kosuke Misaki ,&nbsp;Katsunori Mizuno ,&nbsp;Ryo Sakai ,&nbsp;Tomoki Ogawa ,&nbsp;Mikihiro Suzuki ,&nbsp;Yasutaka Kobayashi","doi":"10.1016/j.clineuro.2025.109174","DOIUrl":"10.1016/j.clineuro.2025.109174","url":null,"abstract":"<div><h3>Background</h3><div>Lumbar disk herniation, a common cause of low back and lower limb pain (hereafter referred to as low back pain [LBP]), is associated with the degeneration of the nucleus pulposus, leading to nerve root compression. Chemonucleolysis using condoliase is a minimally invasive treatment for lumbar disk herniation. Although most pain treatments focus on peripheral and spinal reorganization, little is known about changes in brain activity before and after treatment. This study investigated the neural basis of treatment efficacy by comparing brain activity before and after intradiscal condoliase injection from the perspective of functional brain networks.</div></div><div><h3>Methods</h3><div>Twenty-one patients with LBP who received intradiscal condoliase injections were included. Clinical evaluations and resting-state brain activity measurements were conducted 3 months after treatment. Brain activity before and after treatment was compared in patients whose pain intensity was reduced by over 50 %.</div></div><div><h3>Results</h3><div>Of the 21 patients, 18 showed reduced pain. In these 18 patients, functional connectivity between the anterior insula–seeded salience network (SN) and regions including the brainstem and cerebellar vermis significantly decreased post-treatment. Conversely, functional connectivity between the rostral prefrontal cortex–seeded SN and regions, including the precentral and postcentral gyri, significantly increased. Connectivity between the supramarginal gyrus–seeded SN and the temporal occipital fusiform cortex and the inferior temporal gyrus (temporooccipital region) also significantly increased.</div></div><div><h3>Conclusions</h3><div>Intradiscal condoliase altered the functional connectivity between the SN and other brain regions. These findings suggest that functional reorganization of SN-related networks may be involved in the therapeutic effects of pain relief.</div></div><div><h3>Significance statement</h3><div>Our findings demonstrate that pain relief following condoliase injection is accompanied by functional reorganization within salience network–related brain connectivity, thereby providing new insights into the central mechanisms underlying therapeutic effects in low back pain.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"258 ","pages":"Article 109174"},"PeriodicalIF":1.6,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154866","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":"Impact of anxiety and depression on migraine-related disability: Results from the Headache Assessment via Digital Platform in the United States (HeAD-US) study.","authors":"Adalmina K Sarkar, Elham Ghanbarian, Kristina M Fanning, Alexandre Urani, François Cadiou, Richard B Lipton, Ali Ezzati","doi":"10.1016/j.clineuro.2025.109172","DOIUrl":"https://doi.org/10.1016/j.clineuro.2025.109172","url":null,"abstract":"<p><strong>Background: </strong>Anxiety and depression are common psychiatric comorbidities among people with migraine and may increase disease burden. However, their impact on both disability during and between attacks is not well-characterized in real-world studies. We aimed to assess the relationship between anxiety and depressive symptoms and migraine-related disability and interictal burden in a large real-world sample.</p><p><strong>Methods: </strong>We used cross-sectional data from 6267 participants with migraine recruited using the Migraine Buddy app to create the Headache Assessment via Digital Platform in the United States (HeAD-US) registry. Disability and interictal burden were assessed using the Migraine Disability Assessment Scale (MIDAS) and the Migraine Interictal Burden Scale (MIBS), respectively. Anxiety and depressive symptoms were evaluated using the 4-item Personal Health Questionnaire (PHQ-4). Participants were categorized into four subgroups: anxiety symptoms only, depressive symptoms only, both, or neither. Negative binomial regression was used to explore associations with disability or burden.</p><p><strong>Results: </strong>Participants were 41.5 ± 13 years old; 90.8 % were women. Coexisting anxiety and depression were more common in chronic than episodic migraine (30.3 % vs. 20.0 %, p < 0.001). In adjusted models, anxiety symptoms alone were associated with 8.7 % increases in MIDAS and 11.7 % increases in MIBS scores; depressive symptoms alone with 28.4 % and 15.5 % increases, respectively; and coexisting anxiety and depressive symptoms with 32.5 % higher MIDAS and 22.6 % higher MIBS scores (all p < 0.05).</p><p><strong>Conclusions: </strong>In this large real-world study, anxiety and depression were more prevalent in chronic migraine and independently associated with greater migraine-related disability and interictal burden. Findings extend previous results to a digital health cohort.</p>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"258 ","pages":"109172"},"PeriodicalIF":1.6,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243817","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":"Comparative effectiveness of gram-positive versus mixed antibiotic prophylaxis on surgical site infection rates following three-column osteotomy for adult spinal deformity","authors":"Sadegh Bagherzadeh ,&nbsp;Navid Moghadam ,&nbsp;Mohammad Rostami-Ravari ,&nbsp;Pershang Nazemi ,&nbsp;Zohreh Koohpayezadeh-Esfahani ,&nbsp;Marzieh Rostami ,&nbsp;Ricardo B.V. Fontes ,&nbsp;Mohsen Rostami ,&nbsp;P. Mitchell Johansen ,&nbsp;Sawyer Bauer ,&nbsp;Mark Greenberg ,&nbsp;Puya Alikhani","doi":"10.1016/j.clineuro.2025.109173","DOIUrl":"10.1016/j.clineuro.2025.109173","url":null,"abstract":"<div><h3>Background</h3><div>Surgical Site Infection (<strong>SSI</strong>) remains a major complication following spine surgery, particularly in complex procedures such as three-column osteotomies (3COs), where infection rates may reach up to 35 %. Standard perioperative antibiotic protocols primarily target gram-positive organisms, yet gram-negative bacteria have been increasingly implicated in SSIs, raising concerns about the adequacy of current prophylactic regimens. This study aims to evaluate whether the addition of gram-negative antibiotic coverage to standard gram-positive prophylaxis (Mixed Coverage, MC) reduces the incidence of SSI in adult patients with spinal deformity undergoing high-grade osteotomies.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 236 adult patients who underwent lumbar 3CO and spinopelvic fixation at a tertiary academic center. Patients were divided into two sequential cohorts based on a change in institutional antibiotic prophylaxis protocol: gram-positive coverage alone (GPC, n = 128) and combined gram-positive and gram-negative coverage (MC, n = 108). The primary endpoint was SSI occurrence, categorized as superficial or deep. Statistical comparisons included both univariate and multivariate analyses.</div></div><div><h3>Results</h3><div>Univariate analysis demonstrated a significantly lower SSI rate in the MC group (3 %) compared to the GPC group (10 %) (p = 0.03). However, after multivariate adjustment, the difference was not statistically significant (OR = 0.31, 95 % CI: 0.09 – 1.04, p = 0.059). Rates of deep infections (GPC: 2.4 %, MC: 0 %, OR = not estimable) and bacteremia (GPC: 3.9 %, MC: &lt;1 %, OR = 4.1, p = 0.14) were also higher in the GPC group, though these differences did not reach statistical significance.</div></div><div><h3>Conclusions</h3><div>While univariate analysis suggests a potential benefit from adding gram-negative coverage, multivariate analysis did not confirm this effect. Larger prospective studies are needed to assess the efficacy and safety of expanded prophylactic regimens in high-risk spinal deformity surgery.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"258 ","pages":"Article 109173"},"PeriodicalIF":1.6,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154862","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":"Novel association of sensorineural hearing loss with childhood-onset neurodegeneration with brain atrophy (CONDBA): Expanding the phenotypic spectrum of UBTF-related disorders","authors":"M. Yathwin Kanagavel,&nbsp;Lokesh Saini,&nbsp;Ranjith Kumar Manokaran","doi":"10.1016/j.clineuro.2025.109171","DOIUrl":"10.1016/j.clineuro.2025.109171","url":null,"abstract":"","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"258 ","pages":"Article 109171"},"PeriodicalIF":1.6,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154864","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":"Fibrinogen to albumin ratio (FAR) is associated with remote diffusion-weighted imaging lesions (RDWILs) and 1-month short-term outcomes in patients with acute intracerebral hemorrhage","authors":"Yuting Zhu ,&nbsp;Teng Zhang ,&nbsp;Yingge Wang ,&nbsp;Xiaotian Xu","doi":"10.1016/j.clineuro.2025.109167","DOIUrl":"10.1016/j.clineuro.2025.109167","url":null,"abstract":"<div><h3>Aims</h3><div>To investigate the associations between fibrinogen to albumin ratio (FAR) and remote diffusion-weighted imaging lesions (RDWILs) as well as 1-month short-term outcomes in patients with acute intracerebral hemorrhage (ICH).</div></div><div><h3>Methods</h3><div>A total of 229 consecutive patients with acute ICH were retrospectively included from our hospital between January 2022 and February 2024. RDWILs were defined as focal hyperintensities on diffusion-weighted imaging (DWI) while corresponding hypointensities on apparent diffusion coefficient (ADC), located ≥ 10 mm from the primary hemorrhage focus. FAR1 (within 24 h of admission) and FAR2 (3–7 days post-admission) were both collected. Primary analyses assessed relationships of FAR with RDWILs. Secondary analyses assessed the relationships of FAR with poor 1-month functional outcomes (defined as a modified Rankin Scale [mRS] score of 4–6).</div></div><div><h3>Results</h3><div>This study included 229 patients (mean age 63 years; 65.9 % male). The mean values of FAR1 and FAR2 were 7.1 and 8.1, respectively. RDWILs were detected in 19.7 % of patients, with 17.5 % having poor 1-month functional outcomes. After adjusting for key covariates, multivariate logistic regression revealed: FAR1 (OR=1.137, 95 %CI:1.057–1.223, p &lt; 0.05) and FAR2 (OR=1.198, 95 %CI:1.088–1.320, p &lt; 0.05) independently associated with RDWILs; FAR2 independently associated with poor 1-month outcomes (OR=1.276, 95 %CI:1.109–1.469, p &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>We found FAR independently correlates with RDWILs and poor 1-month outcomes in acute ICH patients, with its underlying mechanism to be further explored.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"258 ","pages":"Article 109167"},"PeriodicalIF":1.6,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154867","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":"Response to letter to the editor: “Normalized longitudinal data on thoracic disc herniation surgical repair approaches\" (CNN-D-25–2800)”","authors":"Pranav Kumar,&nbsp;Manish K. Kasliwal","doi":"10.1016/j.clineuro.2025.109166","DOIUrl":"10.1016/j.clineuro.2025.109166","url":null,"abstract":"","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"258 ","pages":"Article 109166"},"PeriodicalIF":1.6,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148012","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}