Clinical Neurology and Neurosurgery最新文献

{"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":"Effects of speech rehabilitation training combined with repetitive transcranial magnetic stimulation on patients with post-stroke aphasia","authors":"Hui Dang ,&nbsp;Jun Chen ,&nbsp;Jianming Li ,&nbsp;Yueqiu Wu ,&nbsp;Zhifen Zeng","doi":"10.1016/j.clineuro.2025.108833","DOIUrl":"10.1016/j.clineuro.2025.108833","url":null,"abstract":"<div><h3>Objective</h3><div>The study focused on effects of speech rehabilitation training combined with repetitive transcranial magnetic stimulation (rTMS) in patients with post-stroke aphasia (PSA).</div></div><div><h3>Methods</h3><div>Ninety-six patients with PSA were divided into two groups. One group received speech rehabilitation training (ST group, n = 48) and one group received speech rehabilitation training combined with rTMS treatment (ST + rTMS group, n = 48), both of which were treated continuously for 4 weeks. The post-treatment effects of the two groups and the Boston Diagnostic Aphasia Examination (BDAE), Chinese Rehabilitation Research Center Standard Aphasia Examination (CRRCAE), Communicative Ability in Daily Life (CADL), Stroop Color and Word Test (SCWT), Montreal Cognitive Assessment (MoCA), and Barthel Index (BI) scores before and after treatment were compared in both groups.</div></div><div><h3>Results</h3><div>After treatment, the total effective rate of the ST + rTMS group was higher than that of the ST group (<em>p</em> &lt; 0.05). Both groups exhibited improved BDAE grade; CRRCAE, CADL, SCWT, MoCA, and BI scores increased in both groups, and were higher in the ST + rTMS group than in the ST group (all <em>p</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Speech rehabilitation training combined with rTMS can effectively improve speech function in PSA, with remarkable rehabilitation effects.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"252 ","pages":"Article 108833"},"PeriodicalIF":1.8,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680474","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}

{"title":"Delayed diagnosis of ataxia with oculomotor apraxia type 2 in a Peruvian patient, a case report","authors":"Leonardo Cruz-Criollo ,&nbsp;Wilhelm Dávila-Salazar ,&nbsp;Elison Sarapura-Castro ,&nbsp;Andrea Rivera-Valdivia ,&nbsp;Jeny Bazalar-Montoya ,&nbsp;Krista Bluske ,&nbsp;Julie Taylor ,&nbsp;Erin Thorpe ,&nbsp;Akanchha Kesari ,&nbsp;Ryan J. Taft ,&nbsp;Mario Cornejo-Olivas","doi":"10.1016/j.clineuro.2025.108823","DOIUrl":"10.1016/j.clineuro.2025.108823","url":null,"abstract":"<div><h3>Introduction</h3><div>Ataxia with oculomotor apraxia type 2 (AOA2) is a rare autosomal recessive cerebellar ataxia characterized by progressive cerebellar ataxia, sensorimotor peripheral neuropathy, and occasional oculomotor apraxia.</div></div><div><h3>Case report</h3><div>A 50-year-old male with a history of orthopedic shoe use since childhood presented with slowly progressive ataxia and neuropathy. Laboratory tests showed elevated serum alpha-fetoprotein levels and increased total cholesterol. Clinical whole genome sequencing identified a c.4853C &gt; G (p.Ser1618Ter) homozygous pathogenic variant in <em>SETX</em>.</div></div><div><h3>Conclusion</h3><div>The case highlights the challenges identifying rare disorders like AOA2 due to limited access to genetic testing and socioeconomic and healthcare barriers.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"251 ","pages":"Article 108823"},"PeriodicalIF":1.8,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143592617","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":"Augmented reality in cranial surgery: Surgical planning and maximal safety in resection of brain tumors via head-mounted fiber tractography","authors":"Muhammet Enes Gurses ,&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.2025.108820","DOIUrl":"10.1016/j.clineuro.2025.108820","url":null,"abstract":"<div><div>Recent advancements in computer vision, enhanced augmented reality (AR) software and hardware are paving the way for AR to emerge as a promising and innovative tool for advancing and broadening neurosurgical pre-operative planning and intraoperative procedures. In this study, we describe the use of AR coupled with Magnetic Resonance (MR) and Diffusion Tensor Imaging (DTI) to map visual tracts around an occipital lesion, ensuring a safe resection without post-op complications. In a patient who underwent an elective craniotomy for the resection of an occipital brain tumor, preoperative MRI and Quicktome platform-based DTI MRI were uploaded onto the Medivis AR system. Pre-op and post-op fiber tractography was conducted using DSI Studio, and fiber volumes were compared. This technological setup was employed for pre-operative and intraoperative planning and further enhanced clinical decision-making for the actual tumor resection. The AR system and the preparation process are demonstrated via an illustrative video. The visual pathways were preserved during surgery consistent with the intraoperative visualization of these tracks on DTI using an AR headset. Clinically, postoperative visual field testing revealed no signs of visual loss. The volumes of the visual tracts were measured in preoperative and postoperative DTIs, showing that their volume was maintained. Our study highlights the feasibility in identifying preoperative tumor borders for incision planning and feasibility in preserving white matter tracts during tumor resection. AR FT–assisted surgery is safe and effective in planning the surgical approach for patients with brain tumors, thereby optimizing patient functional outcomes.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"251 ","pages":"Article 108820"},"PeriodicalIF":1.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143551310","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 of spinal accessory nerve to suprascapular nerve transfer to restore shoulder function in brachial plexus injury: A systematic review and meta-analysis","authors":"Jacob Vincent ,&nbsp;Alan Mathew ,&nbsp;Renuka Chintapalli","doi":"10.1016/j.clineuro.2025.108811","DOIUrl":"10.1016/j.clineuro.2025.108811","url":null,"abstract":"<div><h3>Introduction</h3><div>Transfer of the spinal accessory nerve (SAN) to the suprascapular nerve (SSN) is a common surgical intervention employed for restoring shoulder function in both obstetric and traumatic brachial plexus injury (TBPI). Despite widespread use, there is a paucity of evidence surrounding the efficacy of this procedure.</div></div><div><h3>Methods</h3><div>A systematic search of the literature in the National Institutes of Health MEDLINE and Embase databases was performed in accordance with the PRISMA guidelines. Patients had to have a minimum postoperative follow-up of 6 months. Cohorts containing patients with obstetric brachial plexus injuries were excluded. We extracted data on shoulder abduction strength, measured using the British Medical Research Council (MRC) scale and range of motion (ROM) of shoulder abduction.</div></div><div><h3>Results</h3><div>Of the 298 studies screened, 12 with 311 total participants met our inclusion criteria. The average age of participants was 27.03 ± 3.05 years and the male:female ratio was 25.4:1. All patients underwent surgery following TBPI and average time-to surgery was 5.91 ± 1.52 months. 66.37 % of patients achieved a post-operative MRC grade of shoulder abduction of ≥M3 with a mean MRC score of 2.67 ± 1.02. Average post-operative shoulder abduction ROM was 56.97 degrees. Average follow-up time for all reported outcomes was 24.64 ± 7.47 weeks. Nine studies comprising 243 patients were included in the meta-analysis, which revealed a cumulative weighted effect size of 56.83 degrees (95 % CI = 52.31, 61.34).</div></div><div><h3>Conclusion</h3><div>These findings suggest that SAN-SSN transfer is an effective intervention for the restoration of shoulder function following TBPI.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"250 ","pages":"Article 108811"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143521141","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":"Corrigendum to “Correlation of pre-operative and post-operative retinal nerve fibre layer thickness with visual outcome following decompression of pituitary macroadenoma” [Clin. Neurol. Neurosurg. 244 (2024) 108446]","authors":"Soumya S. Nair ,&nbsp;Arla Sai Varsha ,&nbsp;Ajay Hegde ,&nbsp;Bharath Raju ,&nbsp;Raghavendra Nayak ,&nbsp;Girish Menon ,&nbsp;Sudha Menon","doi":"10.1016/j.clineuro.2025.108765","DOIUrl":"10.1016/j.clineuro.2025.108765","url":null,"abstract":"","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"250 ","pages":"Article 108765"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457031","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":"Letter to the editor: Sleep disturbances and associated factors in patients with Parkinson’s disease","authors":"Rimsha Murtaza Sohu ,&nbsp;Laila Murtaza Sohu","doi":"10.1016/j.clineuro.2025.108816","DOIUrl":"10.1016/j.clineuro.2025.108816","url":null,"abstract":"","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"250 ","pages":"Article 108816"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143526599","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":"Predictive factors of poor surgical outcome in thoracic ossified ligamentum flavum: A multivariate analysis","authors":"Madhusudhan Nagesh ,&nbsp;Ajit Mishra ,&nbsp;Andiperumal R. Prabhuraj ,&nbsp;Bhushan Diwakar Thombre ,&nbsp;Mathangi Krishnakumar ,&nbsp;Manish Beniwal ,&nbsp;Nishanth Sadashiva ,&nbsp;Abhinith Shashidhar ,&nbsp;Nupur Pruthi","doi":"10.1016/j.clineuro.2025.108815","DOIUrl":"10.1016/j.clineuro.2025.108815","url":null,"abstract":"<div><h3>Objective</h3><div>Ossified ligamentum flavum (OLF) of the spine is a rare cause of compressive myelopathy. OLF is prevalent in Asian countries. Surgery is the only treatment option for symptomatic patients. The recovery after surgery depends upon multiple clinical and radiological factors and varies significantly. We report our series of surgically managed thoracic OLF and the factors predicting poor outcomes.</div></div><div><h3>Methods</h3><div>A retrospective study was conducted including 52 patients who underwent surgery for thoracic OLF. The pre-operative clinical status, radiology findings, intraoperative observations and complications were analyzed with post-op clinical outcomes. The mean follow-up period was 24 months (range 12–72).</div></div><div><h3>Results</h3><div>There were 35 males and 17 females with a mean age of 49.5 years (range: 30–75). The mean duration of symptoms was 13 months (range: 1 month to 5 years). The mean modified Japanese Orthopedic Association (mJOA) score was 5.8 preoperatively, 5.5 postoperatively and improved to 7.5 at the last follow-up. A good recovery rate (&gt;50 %) was found in 18 patients, poor recovery (&lt;50 %) in 24 patients, seven remained unchanged and three patients had worsened. In univariate analysis, the statistically significant factors for the recovery rate were the number of OLF levels, CT axial classification (tuberous type), associated OALL and cervical OPLL, T2W cord signal changes, ossification of dura mater, dural tear, and CSF leak. Dural tear and the number of OLF levels were the most predictive factors for the poor outcome on multivariate analysis.</div></div><div><h3>Conclusion</h3><div>Predictors of poor surgical outcomes are the extent of OLF involved and dural tear. The patient improves with rehabilitation despite the immediate postoperative deterioration.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"250 ","pages":"Article 108815"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143526597","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}