Clinical Neurology and Neurosurgery最新文献_第2页

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

IF 1.6 4区医学

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

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

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

引用次数: 0

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

IF 1.8 4区医学

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

Muhammad Tabish, Mantsha Ahmed, Laiba Shoukat

引用次数: 0

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

IF 1.6 4区医学

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

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

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

引用次数: 0

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

IF 1.8 4区医学

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

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

引用次数: 0

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

IF 1.8 4区医学

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

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

引用次数: 0

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

IF 1.6 4区医学

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

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

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

引用次数: 0

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

IF 1.8 4区医学

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

Haris Afridi , Kainat Afzal

引用次数: 0

Urinary complaints and voiding function in patients operated for lumbar spinal stenosis 腰椎管狭窄手术患者的泌尿系统不适及排尿功能

IF 1.8 4区医学

Clinical Neurology and Neurosurgery Pub Date : 2025-07-18 DOI: 10.1016/j.clineuro.2025.109060

Bjørn Hjall , Sigurd Liavaag , Hans Thorvild Thomassen , Tor Brommeland

{"title":"Urinary complaints and voiding function in patients operated for lumbar spinal stenosis","authors":"Bjørn Hjall , Sigurd Liavaag , Hans Thorvild Thomassen , Tor Brommeland","doi":"10.1016/j.clineuro.2025.109060","DOIUrl":"10.1016/j.clineuro.2025.109060","url":null,"abstract":"<div><h3>Background</h3><div>Degenerative lumbar spinal stenosis (LSS) is a condition with compression of the dural sac at one or more lumbar levels. Studies investigating whether LSS may affect the urinary function are scarce and have traditionally included few patients. The aim of this study was to examine voiding complaints and urinary function before and after surgery for LSS.</div></div><div><h3>Methods</h3><div>A total of 81 patients undergoing surgery for symptomatic LSS were prospectively enrolled between October 1, 2022, and July 31, 2024, of which 60 patients were included in the final analyses. Patients were evaluated by questionnaire (International Prostate Symptom Score, IPSS), urinary flow (Q<sub>max</sub>, ml/s) and residual urinary bladder volume (RUV) (ultrasonographic measurement, ml) at pre- and post-operative controls.</div></div><div><h3>Results</h3><div>36 patients were males, median age was 69.5 years. Median dural-sac cross sectional area (DSCA) was 41.7 mm<sup>2</sup> and 53/59 (89.8 %) patients had Schizas grade C or D indicating significant lumbar stenosis. Median pre-operative scores for urinary symptoms were IPSS 11.0, uroflowmetry 14.3 ml/s and RUV 59.5 ml. Post-operatively, median values of IPSS were 9.0, uroflowmetry 13.8 ml/s and RUV 69.0 ml. There were no statistically significant differences between pre- and post-operative results for neither men nor women. A pre-operative RUV > 100 ml was noted in 21/60 (35.0 %) patients.</div></div><div><h3>Conclusion</h3><div>Urinary complaints were common in this cohort of surgically treated lumbar spinal stenosis. Decompressive surgery did not significantly alter the results of IPSS, uroflowmetry or RUV. Approximately one third of the patients had a RUV > 100 ml pre-operatively.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"257 ","pages":"Article 109060"},"PeriodicalIF":1.8,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144680213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Response: “Letter to the editor: Is rheumatoid arthritis associated with worse outcomes following adult spinal deformity surgery?” 回复：“致编辑的信：类风湿关节炎是否与成人脊柱畸形手术后较差的预后相关？”

IF 1.8 4区医学

Clinical Neurology and Neurosurgery Pub Date : 2025-07-16 DOI: 10.1016/j.clineuro.2025.109059

Harsh Jain, Advith Sarikonda, Scott L. Zuckerman

引用次数: 0

The effect of mechanical digit sensory stimulation on upper limb motor function recovery in convalescent stroke patients with hemiplegia 机械手指感觉刺激对脑卒中偏瘫恢复期患者上肢运动功能恢复的影响

IF 1.6 4区医学

Clinical Neurology and Neurosurgery Pub Date : 2025-07-15 DOI: 10.1016/j.clineuro.2025.109027

Kexin Yao , Qiqi Li , Yuqin Ma , Yaxing Tian , Shuting Zhang , Yongfeng Hong

{"title":"The effect of mechanical digit sensory stimulation on upper limb motor function recovery in convalescent stroke patients with hemiplegia","authors":"Kexin Yao , Qiqi Li , Yuqin Ma , Yaxing Tian , Shuting Zhang , Yongfeng Hong","doi":"10.1016/j.clineuro.2025.109027","DOIUrl":"10.1016/j.clineuro.2025.109027","url":null,"abstract":"<div><h3>Objective</h3><div>Mechanical digit sensory stimulation (MDSS), applied once solely to paralyzed fingers in stroke patients, has been clinically shown to immediately and significantly reduce muscle spasticity in the affected hand, enabling active finger extension. This study investigated the effects of one course of MDSS on upper limb motor function in stroke patients with hemiplegia.</div></div><div><h3>Methods</h3><div>Forty patients were randomly assigned to either a Control group, receiving only conventional rehabilitation, or an MDSS group, receiving both conventional rehabilitation and MDSS for 2–4 weeks. Before and after the intervention, measurements were taken, including muscle tone, surface electromyographic signals (sEMG), motor function, and activities of daily living.</div></div><div><h3>Results</h3><div>The results revealed that while both groups showed improvements, the MDSS group exhibited significantly lower muscle tone scores, larger sEMG for specific muscle groups, and higher motor function scores compared to the Control group. Although the MDSS group demonstrated greater improvements in activities of daily living, these differences were not statistically significant.</div></div><div><h3>Conclusion</h3><div>In conclusion, MDSS effectively alleviates muscle spasticity and aids in enhancing muscle strength and motor function in stroke patients with hemiplegia.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"257 ","pages":"Article 109027"},"PeriodicalIF":1.6,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144739267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0