Clinical Neurology and Neurosurgery最新文献

{"title":"Corrigendum to “Modified Five-item Frailty Index (mFI-5) versus Grip Strength as predictors of length of stay, discharge to home, and early surgical complications in patients undergoing long segment fusion” [Clin. Neurol. Neurosurg. 252 (2025) 108864]","authors":"Yamenah Ambreen , Cole Veliky , Joshua H. Weinberg , Joshua Wang , Stephanus Viljoen , David S. Xu , Vikram Chakravarthy , Siri Sahib Khalsa , Bryan Ladd , Andrew J. Grossbach","doi":"10.1016/j.clineuro.2025.108885","DOIUrl":"10.1016/j.clineuro.2025.108885","url":null,"abstract":"","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"252 ","pages":"Article 108885"},"PeriodicalIF":1.8,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143854903","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":"Revision surgery for proximal junctional failure: A single-center analysis","authors":"Samuel Adida ,&nbsp;Joseph S. Hudson ,&nbsp;Andrew D. Legarreta ,&nbsp;Suchet Taori ,&nbsp;Regan M. Shanahan ,&nbsp;Mohamed-Ali H. Jawad-Makki ,&nbsp;Jhair A. Colan ,&nbsp;Rida Mitha ,&nbsp;Nitin Agarwal ,&nbsp;David O. Okonkwo ,&nbsp;D. Kojo Hamilton ,&nbsp;Thomas J. Buell","doi":"10.1016/j.clineuro.2025.108880","DOIUrl":"10.1016/j.clineuro.2025.108880","url":null,"abstract":"<div><h3>Background</h3><div>Proximal junctional kyphosis (PJK) is a radiographic complication following adult spinal deformity (ASD) surgery due to degeneration of mobile segments adjacent to fused spine. Proximal junctional failure (PJF) represents PJK with structural failure, neurologic deficit, or mechanical instability warranting revision with extension of fusion above the uppermost instrumented vertebra (UIV). This study investigates the clinical presentation, mechanisms of failure, revision strategies, and outcomes for ASD patients who develop PJF after instrumented fusion to the pelvis.</div></div><div><h3>Methods</h3><div>Fifty-four ASD patients who developed PJF after a posterior instrumented fusion to the pelvis at a single institution from 2009 to 2021 were analyzed. PJF was defined by radiographic PJK with (1) UIV or UIV+1 fracture, UIV screw pullout, or soft-tissue posterior ligamentous disruption, and (2) neurological deficit at presentation.</div></div><div><h3>Results</h3><div>The cohort was stratified into upper thoracic (UT, 10 patients, T2-T6), lower thoracic (LT, 35 patients, T8-T11), and lumbar (L, 9 patients, L1-L3) spine UIV groups based on index surgery. Patients developed PJF at a median of 14 months (mean 18 ± 16, range: 1–78) after their index surgery. Neurological deficits at presentation included radiculopathy (61 %), myelopathy (48 %), motor deficits (33 %), and bowel or bladder incontinence (9 %). Mechanisms of PJF were vertebral fracture and screw pullout (UT: 50 %, LT: 80 %, L: 89 %, <em>P</em> &lt; 0.001) or soft-tissue disruption (UT: 50 %, LT: 20 %, L: 11 %, <em>P</em> = 0.089) at the UIV. Revision surgery commonly involved posterior column osteotomies (63 %) rather than three-column osteotomies (9 %). Of patients in the UT group, 40 % were extended above the cervicothoracic junction. In the LT and L groups, 91 % and 89 % of patients were extended to the UT and LT spine, respectively. Median follow-up for the cohort after revision for PJF was 24 months (range: 2–89). A total of 26 patients (48 %) required a second revision surgery (median 14 months, range: 1–50), 16 of whom (28 %) were revised for recurrent PJF. Patient-specific and radiographic risk factors for recurrent PJF could not be elucidated.</div></div><div><h3>Conclusion</h3><div>In this series of ASD patients, after revision for PJF, recurrent PJF was the most common complication requiring another revision. Junctional failures tended to be vertebral body fracture and screw pullout in the LT and L spine and soft tissue disruption in the UT spine. Most revisions involved posterior column osteotomies with proximal extension across the thoracolumbar junction or apex of thoracic kyphosis (e.g., L to LT, LT to UT); notably, nearly half of UT failures were not extended to the cervical spine. Future research is warranted to elucidate risk factors for recurrent PJF and potential preventative strategies.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"253 ","pages":"Article 108880"},"PeriodicalIF":1.8,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143851590","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":"Corrigendum to “Augmented reality in cranial surgery: Surgical planning and maximal safety in resection of brain tumors via head-mounted fiber tractography” [Clin. Neurol. Neurosurg. 251 (2025), 108820]","authors":"Muhammet Enes Gurses ,&nbsp;Adham M. Khalafallah ,&nbsp;Elif Gökalp ,&nbsp;Jordan Spatz ,&nbsp;Siyar Bahadir ,&nbsp;Vratko Himic ,&nbsp;Ricardo J. Komotar ,&nbsp;Michael E. Ivan","doi":"10.1016/j.clineuro.2025.108886","DOIUrl":"10.1016/j.clineuro.2025.108886","url":null,"abstract":"","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"252 ","pages":"Article 108886"},"PeriodicalIF":1.8,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143854904","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 characteristics and treatment responses of epilepsy in the elderly in northwestern China","authors":"Bofei Tan ,&nbsp;Qiang Liu ,&nbsp;Mengyun Li ,&nbsp;Jianming Wu ,&nbsp;Feng Rao ,&nbsp;Qing Zhang","doi":"10.1016/j.clineuro.2025.108887","DOIUrl":"10.1016/j.clineuro.2025.108887","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the clinical characteristics and treatment responses of epilepsy in the elderly.</div></div><div><h3>Methods</h3><div>Consecutive epilepsy patients (age≥65) who were admitted to the tertiary medical center in northwestern China from 2019 to 2022 and were</div><div>divided into the early-onset epilepsy (EOE) group and the late-onset epilepsy (LOE) group. Clinical data were analyzed retrospectively, and all patients were followed for one year.</div></div><div><h3>Results</h3><div>A total of 239 elderly PWE (100 in the EOE group) were enrolled, with ischemic stroke being the primary cause (27.2 %). The proportion of epilepsy due to ischemic stroke was higher in the LOE group compared to the EOE group (33.8 % vs. 27.0 %, p = 0.007). Generalized tonic-clonic seizures (GTCS) were the most common seizure type in elderly PWE (34.7 %) and EOE group (46.0 %). Complex partial seizures (CPS) were the most common seizure type in the LOE group (30.2 %). Hypertension (49.8 %) was the most prevalent comorbidity, and it was more common in the LOE group than in the EOE group (56.8 % vs. 40.0 %, p &lt; 0.05). Of the 207 patients who completed follow-up, 184 were on anti-seizure medications (ASMs) including125 being prescribed a single type of ASM and 59 two or more types. Among patients receiving one type of ASM, more EOE group received traditional ASM (55.6 % vs. 31.0 %), while more LOE group received novel ASM (69.0 % vs. 44.4 %, p = 0.006). More patients receiving two or more type of ASMs were included in the EOE group than in the LOE group (35.9 % vs. 22.6 %, p = 0.036). Seizure freedom was achieved in 61.8 % of the elderly PWE,and the seizure freedom rate was higher in the LOE group than in the EOE group(67.0 % vs51.7 %, p = 0.035).</div></div><div><h3>Conclusion</h3><div>In elderly PWE, there are differences between EOE and LOE across several aspects, including etiology, semiology, and ASMs selection, etc. Furthermore, patients with LOE having a higher likelihood of achieving seizure freedom. Conversely, more patients with EOE need two or more type of ASMs to control their seizures.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"253 ","pages":"Article 108887"},"PeriodicalIF":1.8,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143825615","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":"Efficacy and safety of surpass evolve flow diverters: A systematic review and meta-analysis","authors":"Seyed Behnam Jazayeri ,&nbsp;Abdullah Reda ,&nbsp;Jonathan Cortese ,&nbsp;Aryan Gajjar ,&nbsp;Sherief Ghozy ,&nbsp;Ramanathan Kadirvel ,&nbsp;David F. Kallmes","doi":"10.1016/j.clineuro.2025.108884","DOIUrl":"10.1016/j.clineuro.2025.108884","url":null,"abstract":"<div><h3>Objective</h3><div>To provide cumulative evidence on the safety and efficacy of the Surpass Evolve Flow Diverters (SE-FDs) in treating intracranial aneurysms.</div></div><div><h3>Methods</h3><div>PubMed, Scopus, Embase, and Web of Science were searched until May, 2024. The primary efficacy endpoint was complete occlusion rate, and the safety endpoints included rate of different complications and mortality. Data is pooled and reported with 95 % confidence intervals (CIs) using random-effect models. A meta-regression analysis was performed to assess the potential effects of confounding factors on study endpoints.</div></div><div><h3>Results</h3><div>Eleven studies with 690 patients and 757 aneurysms were included. There was moderate risk of bias in all studies. With a median follow-up of 243 days, the complete occlusion rate was 67.1 % (95 %CI: 57.3–75.5 %, I²=72 %), with no difference between ruptured and unruptured aneurysms (p = 0.97). Stent stenosis was the most frequent complication which occurred in 18.2 % (95 %CI: 10.3–30.1 %, I²=71 %) of aneurysms at a median follow-up of 306 days. The rate of thromboembolic complications was 6.6 % (95 %CI: 3.8–11 %, I²=50 %), including ischemic stroke in 1.9 % (95 %CI: 1.1–3.4 %, I²=0 %) of patients. Device-related mortality rate was 0.5 % (95 %CI: 0.2–1.5 %, I²=0 %). Meta-regression showed that diameter of aneurysm was significantly associated with complete occlusion rate (coefficient: - 0.11, p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>SE-FD is effective for treating intracranial aneurysms, with moderate efficacy compared to other devices and an acceptable rate of complications. Larger aneurysm size predicts lower occlusion rates. The lack of controlled trials warrants further research to explore the efficacy and safety of SE-FDs in clinical practice.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"252 ","pages":"Article 108884"},"PeriodicalIF":1.8,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143799639","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: Re-evaluating liver fibrosis as a contributor to early motor dysfunction in Parkinson’s disease","authors":"Zaryab Bacha,&nbsp;Fathimathul Henna,&nbsp;Muhammad Osama ,&nbsp;Muhammad Danyal Tariq","doi":"10.1016/j.clineuro.2025.108883","DOIUrl":"10.1016/j.clineuro.2025.108883","url":null,"abstract":"","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"253 ","pages":"Article 108883"},"PeriodicalIF":1.8,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143835075","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":"Weekend admission for cervical spinal cord injury associated with shorter length of stay at private non-profit centers","authors":"Robert J. Quon ,&nbsp;Josh Feler ,&nbsp;Ziqi Wang ,&nbsp;Varun Rao ,&nbsp;Jared S. Fridley","doi":"10.1016/j.clineuro.2025.108881","DOIUrl":"10.1016/j.clineuro.2025.108881","url":null,"abstract":"<div><h3>Objective</h3><div>We assessed if weekend versus weekday admission for cervical spinal cord injury (CSCI) influenced medical comorbidities, length of stay, and mortality while also exploring the role of hospital-specific factors.</div></div><div><h3>Methods</h3><div>The National Inpatient Sample (2015–2020) was queried for patients with CSCI. Propensity score matching (PSM) controlled for age, gender, hospital region, and illness severity, matching weekend admissions in a 1:1 ratio with weekday admissions. Parametric statistical tests then compared clinical and hospital-specific factors.</div></div><div><h3>Results</h3><div>5036 patients were analyzed (mean age 56, 24 % female). Weekend admissions showed no increase in mortality (p = 0.305) despite a higher likelihood of shock (p = 0.0154), cervical fractures (p = 0.0408), and ventilatory support requirements (p &lt; 0.001). Patients with spinal fractures had higher mortality than those with non-spinal fractures (p &lt; 0.001). After stratification by weekend status, hospital ownership/control and hospital location/teaching status were significantly correlated with length of stay (p &lt; 0.001, p = 0.0276, respectively). Private non-profit hospitals showed a shorter length of stay for weekend admissions (p = 0.00573), though fewer were discharged directly home (p = 0.0314). There was a weak association between payer type and disposition (Cramér's V = 0.146, p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>This national retrospective study revealed no difference in overall mortality rates between weekend and weekday admissions for patients presenting with CSCI. In patients with associated fractures, spinal fractures showed higher mortality rates than non-spinal fractures. Decreased length of stay was associated with weekend admissions to private non-profit centers, with no difference in mortality rates in this cohort.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"252 ","pages":"Article 108881"},"PeriodicalIF":1.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143785705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spinal deformity surgery in patients with movement disorders: Trade-off between increased complications and improved long-term quality of life","authors":"Omar Zakieh ,&nbsp;Hani Chanbour ,&nbsp;Maryam Y. Jawid ,&nbsp;Harsh Jain ,&nbsp;Ranbir Ahluwalia ,&nbsp;Tyler Zeoli ,&nbsp;Julian G. Lugo-Pico ,&nbsp;Amir M. Abtahi ,&nbsp;Byron F. Stephens ,&nbsp;Scott L. Zuckerman","doi":"10.1016/j.clineuro.2025.108882","DOIUrl":"10.1016/j.clineuro.2025.108882","url":null,"abstract":"<div><h3>Introduction</h3><div>Movement disorders are associated with poor outcomes after adult spinal deformity (ASD) surgery. In a cohort of patients undergoing ASD surgery, we sought to: 1) describe the operations performed in patients with movement disorders, 2) compare outcomes between patients with movement disorders vs. without movement disorders in the areas of mechanical complications, reoperations, and patient-reported outcome measures (PROMs).</div></div><div><h3>Methods</h3><div>A single-institution, retrospective cohort study was performed for patients with a movement disorder undergoing ASD surgery from 2009 to 2021. Inclusion criteria were: ≥ 5-level fusion, spinal deformity, and 2-year follow-up. Postoperative outcomes included mechanical complications, reoperations, and PROMs. A 3–1 propensity matching was performed, based on age, sex, BMI, and prior surgery.</div></div><div><h3>Results</h3><div>Among 238 patients undergoing ASD surgery, 10 (4.2 %) had a movement disorder. Five (50.0 %) had Parkinson’s Disease and 5 (50.0 %) had Essential Tremor. No significant difference was found in the type of surgery performed between patients with and without movement disorders, including total instrumented levels, three-column osteotomy, and pelvic instrumentation. Patients with movement disorders developed a higher rate of proximal junctional kyphosis and failure (PJK/F) (80.0 % vs. 40.0 %, p = 0.028) without a significant difference in other mechanical complications or reoperations. Patients with movement disorders had better 2-year ODI (20.1 ± 12.5 vs. 36.7 ± 14.3, p = 0.015) and NRS-back pain than patients without movement disorders (2.3 ± 2.5 vs. 5.0 ± 2.4, p = 0.022).</div></div><div><h3>Conclusion</h3><div>Patients with and without movement disorders undergo similar ASD operations. Despite a two-fold higher PJK/F rate, movement disorder patients reported better disability and pain at 2-years postoperative.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"252 ","pages":"Article 108882"},"PeriodicalIF":1.8,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143784034","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":"Efficacy and safety of stereotactic radiosurgery for idiopathic glossopharyngeal neuralgia: A systematic review and meta-analysis","authors":"Jie Zhang ,&nbsp;Zonghao Li ,&nbsp;Ning Wang ,&nbsp;Peihua Zhang ,&nbsp;Yongzhen Li ,&nbsp;Yonghan Chen","doi":"10.1016/j.clineuro.2025.108878","DOIUrl":"10.1016/j.clineuro.2025.108878","url":null,"abstract":"<div><h3>Background</h3><div>We performed this study to comprehensively assess the efficacy and safety of stereotactic radiosurgery (SRS) in patients with glossopharyngeal neuralgia (GPN).</div></div><div><h3>Methods</h3><div>Searches of PubMed, Embase, Cochrane Library, and Web of Science were performed from inception to date. The protocol for this study was registered with the PROSPERO international prospective register of systematic reviews.</div></div><div><h3>Results</h3><div>A total of seven studies involving 79 patients were included. At the last follow-up, the pooled proportion of patients achieving Barrow Neurological Institute (BNI) grade I was 37.5 % (95 % CI: 26.2 %–49.3 %). The proportion of patients attaining BNI grades I–IIIa was 58.5 % (95 % CI: 46.6 %–70.1 %). In terms of treatment failure, the pooled rate was 11.9 % (95 % CI: 4.6 %–21.3 %). Regarding recurrence, the pooled rate was 23.1 % (95 % CI: 13.4 %–34.0 %). The pooled complication rate was 0.2 % (95 % CI: 0.0 %–4.4 %). Among those who experienced treatment failure after microvascular decompression (MVD), 41.67 % (5/12) reached BNI grades I–IIIb, while 66.67 % (4/6) of those who failed rhizotomy achieved BNI grades I–IIIa. A total of 18 patients underwent repeat SRS; Of these, 44.4 % (8/18) achieved BNI grade I, and 66.7 % (12/18) attained BNI grades I–IIIa.</div></div><div><h3>Conclusion</h3><div>This study demonstrated that SRS is an acceptable treatment for idiopathic GPN, offering effective pain relief with an extremely low complication rate. It could serve as a valuable salvage therapy for those who have not achieved success with MVD or rhizotomy. Repeat SRS remains effective for patients experiencing recurrence.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"252 ","pages":"Article 108878"},"PeriodicalIF":1.8,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143759584","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":"Predictors of ischemic stroke recurrence in patients with symptomatic ICAS and contralateral high-grade stenosis","authors":"Zhicai Chen ,&nbsp;YanYan Li ,&nbsp;Weikang Chen ,&nbsp;Pengshuai Liu ,&nbsp;Jiajia Xiao ,&nbsp;Hongwei Shi ,&nbsp;Weiwen Qiu ,&nbsp;Genlong Zhong","doi":"10.1016/j.clineuro.2025.108876","DOIUrl":"10.1016/j.clineuro.2025.108876","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to identify predictive factors for the recurrence risk of ischemic stroke in patients with symptomatic ICAS and contralateral high-grade stenosis (sICAS-CHS).</div></div><div><h3>Methods</h3><div>We consecutively enrolled patients diagnosed with sICAS-CHS, which characterized by severe symptomatic intracranial artery stenosis (sICAS) alongside severe contralateral asymptomatic internal carotid artery or middle cerebral artery stenosis, confirmed by CT angiography (CTA). Over a one-year period, these patients were followed up to assess the recurrence risk of ischemic stroke. Binary logistic regression analysis was utilized to investigate the independent predictors of ipsilateral ischemic stroke recurrence within the territory of the symptomatic ICAS.</div></div><div><h3>Results</h3><div>The study included 80 patients with sICAS-CHS, comprising 56 males (70 %) with an average age of 69.44 ± 9.97 years. Over the one-year follow-up period, 16 patients (20 %) experienced recurrent ischemic strokes. Binary logistic regression analysis revealed that presence of watershed infarction (OR=6.002, p = 0.019), hyperhomocysteinemia (OR=4.469, p = 0.039), medication adherence (OR=0.207, p = 0.034), and endovascular therapy (OR=0.084, p = 0.029) were independent predictors of ischemic stroke recurrence in this cohort.</div></div><div><h3>Conclusions</h3><div>Patients with severe sICAS-CHS portended a considerable high recurrence risk of ischemic stroke. It is advisable to prioritize these individuals for endovascular therapy, particularly those who have suffered watershed infarctions.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"252 ","pages":"Article 108876"},"PeriodicalIF":1.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}