Clinical Neurology and Neurosurgery最新文献

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Neuroendoscopic surgery for brainstem hemorrhage: Technical notes and preliminary clinical results 神经内镜手术治疗脑干出血:技术说明和初步临床结果。
IF 1.8 4区 医学
Clinical Neurology and Neurosurgery Pub Date : 2024-10-02 DOI: 10.1016/j.clineuro.2024.108576
{"title":"Neuroendoscopic surgery for brainstem hemorrhage: Technical notes and preliminary clinical results","authors":"","doi":"10.1016/j.clineuro.2024.108576","DOIUrl":"10.1016/j.clineuro.2024.108576","url":null,"abstract":"<div><h3>Background</h3><div>Brainstem hemorrhage accounts for a relatively small proportion of spontaneous intracerebral hemorrhages (∼10 %) but tends to occur earlier in life and has poorer prognosis. Numerous studies support the therapeutic potential of minimally invasive hematoma evacuation for intracerebral hemorrhage; however, there have been few assessments of the benefits for brainstem hemorrhage.</div></div><div><h3>Methods</h3><div>We evaluated the safety and efficacy of a minimally invasive approach under neuroendoscopic guidance with pneumatic arm fixation for removing the hematoma in severe brainstem hemorrhage patients. 14 patients diagnosed with primary brainstem hemorrhage and treated by neuroendoscopy-assisted evacuation at Suzhou Ninth Hospital affiliated to Soochow University were included in the study. Relevant clinical and prognostic date were collected and analyzed.</div></div><div><h3>Results</h3><div>Hematoma volume ranged from 8 to 13 mL according to preoperative CT, while GCS at admission ranged from 4 to 6. The average operative time was 157 min and average intraoperative blood loss was 86 mL. All patients achieved satisfactory hematoma evacuation (over 90 %) according to immediate postoperative CT. Postoperative intensive care unit stay averaged 9.5 days and respiratory support averaged 7.5 days. 11 patients required tracheotomy due to pulmonary infection and absence of pharyngeal reflexes. 9 patients achieved satisfactory functional recovery (GOS score of 4 and 3), while 5 remained in a vegetative state (GOS score of 2).</div></div><div><h3>Conclusion</h3><div>Neuroendoscopy provides excellent direct visualization of brainstem hematomas for safe and reliable evacuation. Patients with a new PPH score of 2 or 3 are more likely to benefit from surgical treatment. Large-scale studies are required to identify patients most likely to benefit from this technique.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375228","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
Outcome of intravenous thrombolysis in acute ischemic stroke patients with small vessel disease 对患有小血管疾病的急性缺血性脑卒中患者进行静脉溶栓治疗的结果。
IF 1.8 4区 医学
Clinical Neurology and Neurosurgery Pub Date : 2024-10-01 DOI: 10.1016/j.clineuro.2024.108570
{"title":"Outcome of intravenous thrombolysis in acute ischemic stroke patients with small vessel disease","authors":"","doi":"10.1016/j.clineuro.2024.108570","DOIUrl":"10.1016/j.clineuro.2024.108570","url":null,"abstract":"<div><h3>Introduction</h3><div>Lacunar stroke (LS) subtype accounts for a quarter of ischemic strokes. Intravenous thrombolysis (IVT) is known to improve overall stroke outcomes. Very few studies have focused on the outcome of IVT in lacunar strokes. <em>Aim:</em> To detect the outcome of IVT in LS patients compared to non-thrombolysed LS patients<em>.</em></div></div><div><h3>Methods</h3><div>Fifty patients presenting with LS received the standard protocol of IVT (Group I). They were compared to fifty matched LS patients who presented beyond the time window and were selected as the control group (Group II). Clinical outcome was measured using NIHSS within 24 h, NIHSS at discharge, and MRS after 3 months. Risk factors that could have affected clinical outcomes were compared in the thrombolysis group.</div></div><div><h3>Results</h3><div>The short-term clinical outcome of Group I showed statistically significant improvement of NIHSS after 24 hrs compared to Group II (mean NIHSS = 5.52±3.89 and 7.44±1.82 respectively), as well as on discharge (mean NIHSS = 3.88±3.50 and 5.78±2.97) respectively. For long-term outcomes, 94 % of GroupⅠ reached MRS 0, 1, and 2 (n = 47/50) versus 74 % (n = 36/50) in Group II. Longer door-to-needle time, severe WMCs (Fazekas score), and pneumonia were shown to be significant predictor factors for the worst outcome.</div></div><div><h3>Conclusion</h3><div>IVT has improved short- and long-term outcomes in LS patients. Longer door-to-needle time, severe WMCs, and pneumonia were shown to be significant predictor factors for the worst outcome<strong>.</strong></div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380188","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
Brain lesion and echocardiogenic predictors of newly detected atrial fibrillation in acute ischemic stroke 急性缺血性脑卒中患者新发现心房颤动的脑损伤和超声心动图预测因素。
IF 1.8 4区 医学
Clinical Neurology and Neurosurgery Pub Date : 2024-10-01 DOI: 10.1016/j.clineuro.2024.108581
{"title":"Brain lesion and echocardiogenic predictors of newly detected atrial fibrillation in acute ischemic stroke","authors":"","doi":"10.1016/j.clineuro.2024.108581","DOIUrl":"10.1016/j.clineuro.2024.108581","url":null,"abstract":"<div><h3>Objectives</h3><div>Atrial fibrillation (AF) is one of the notorious risk factors in acute ischemic stroke (AIS), and the use of anticoagulants has been shown to be effective in preventing ischemic stroke in AF patients. Therefore, identifying AF in AIS patients has become increasingly important. However, the impact of brain imaging and cardiac indices on the development of new AF after stroke remains unclear.</div></div><div><h3>Methods</h3><div>A consecutive series of AIS patients who were admitted to the Ulsan University Hospital between January 2013 and December 2019 were identified. Patients with relevant ischemic brain lesions on MRI were included, and those without echocardiography data were excluded. We included and classified the AF patients who had the disease prior to or during hospitalization or met the criteria for cryptogenic stroke (CS). Differences in baseline characteristics, stroke risk factors, stroke severity, insular lesion, and echocardiographic data were investigated among each group.</div></div><div><h3>Results</h3><div>A total of 850 patients were enrolled in the study, comprising 231 patients with AF detected after stroke (AFDAS), 287 patients with known AF (KAF), and 350 patients with CS. Compared with KAF, patients with AFDAS had a lower prevalence of underlying coronary heart disease and stroke history. They had greater right insular cortex lesions and lesser left atrial enlargement in unadjusted analysis. Following adjusted analysis, the involvement of the right insular cortex was found to be associated with the AFDAS patient group (odds ratio, 1.57). When compared to the CS group, AFDAS patients were older, experienced more severe initial strokes, and had similar rates of pre-stroke anticoagulation prescription. Additionally, they demonstrated a higher prevalence of both insular lesions, increased left atrium volume index, reduced ejection fraction, and elevated e/e′ ratio. After adjustment, age, initial stroke severity, insular involvement, left atrium volume index, ejection fraction, and e/e′ ratio were found to be significant.</div></div><div><h3>Conclusions</h3><div>These results suggest that the right insular cortex lesion on acute stroke may be a cause of AFDAS.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388580","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}
引用次数: 0
Clinicopathological and radiological characteristics of false-positive and false-negative results in T2-FLAIR mismatch sign of IDH-mutated gliomas IDH突变胶质瘤T2-FLAIR错配征假阳性和假阴性的临床病理学和放射学特征
IF 1.8 4区 医学
Clinical Neurology and Neurosurgery Pub Date : 2024-10-01 DOI: 10.1016/j.clineuro.2024.108579
{"title":"Clinicopathological and radiological characteristics of false-positive and false-negative results in T2-FLAIR mismatch sign of IDH-mutated gliomas","authors":"","doi":"10.1016/j.clineuro.2024.108579","DOIUrl":"10.1016/j.clineuro.2024.108579","url":null,"abstract":"<div><h3>Purpose</h3><div>To explore the clinicopathological and radiological characteristics associated with false-positive and false-negative results in the identification of isocitrate dehydrogenase (IDH) mutations in gliomas using the T2-fluid-attenuated inversion recovery (FLAIR) mismatch sign.</div></div><div><h3>Methods</h3><div>In 1515 patients with cerebral gliomas, tumor location, restricted diffusion using diffusion-weighted imaging, and the T2-FLAIR mismatch sign were retrospectively analyzed using preoperative magnetic resonance imaging. Moreover, both the false-positive and false-negative results of the T2-FLAIR mismatch sign were obtained. Univariate and multivariate logistic analyses were performed to evaluate the risk factors associated with false-positive and false-negative results.</div></div><div><h3>Results</h3><div>The overall false-positive rate was 3.5 % (53/1515), and its independent risk factors were the patient’s age (adjusted odds ratio [OR], 0.977; 95 % confidence interval [CI], 0.957, 0.997; <em>P</em> = 0.027) and non-restricted diffusion (adjusted OR, 1.968; 95 % CI, 1.060, 3.652; <em>P</em> = 0.032). The overall false-negative rate was 39.7 % (602/1515); its independent risk factors were the patient’s age (adjusted OR, 1.022; 95 % CI, 1.005, 1.038; <em>P</em> = 0.008), 1p/19q co-deletion (adjusted OR, 3.334; 95 % CI, 1.913, 5.810; <em>P</em> &lt; 0.001), and telomerase reverse transcriptase promoter mutation (adjusted OR, 2.004; 95 % CI, 1.181, 3.402; <em>P</em> = 0.010). For the mismatch sign in idiopathic IDH, the area under the receiver operating characteristic curve (AUC) was 0.602. The combined AUC for the T2-FLAIR mismatch sign and risk factors was 0.871.</div></div><div><h3>Conclusions</h3><div>Clinicopathological and radiological characteristics can lead to the misinterpretation of IDH status in gliomas based on the T2-FLAIR mismatch sign. However, this can be avoided if careful attention is paid.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142421548","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
Current status and influencing factors of fear disease progression in Chinese primary brain tumor patients: A mixed methods study 中国原发性脑肿瘤患者恐惧性疾病进展的现状及影响因素:混合方法研究
IF 1.8 4区 医学
Clinical Neurology and Neurosurgery Pub Date : 2024-09-27 DOI: 10.1016/j.clineuro.2024.108574
{"title":"Current status and influencing factors of fear disease progression in Chinese primary brain tumor patients: A mixed methods study","authors":"","doi":"10.1016/j.clineuro.2024.108574","DOIUrl":"10.1016/j.clineuro.2024.108574","url":null,"abstract":"<div><h3>Objective</h3><div>In this study, we investigated the fear of disease progression in Chinese PBT patients and examined the correlation between sociodemographic, clinical, and psychological variables of patients with the fear of progression (FoP). Additionally, the study also evaluated the subjective experience of FoP in patients with primary brain tumors (PBT).</div></div><div><h3>Methods</h3><div>A mixed-methods study was conducted between March 2022 and December 2023, consisting of two phases: a quantitative approach in phase I, and a qualitative approach in phase II. In phase I, 305 patients with PBT filled in several questionnaires. An analysis was performed to identify potential predictors associated with FoP. In phase II, semi-structured interviews were conducted with 16 participants whose FoP scores were ≥ 34 in phase I to obtain information on their personal experiences with FoP.</div></div><div><h3>Results</h3><div>The results of the quantitative study showed that 192 (63 %) patients experienced high levels of FoP. The mean score of fear of progression was (34.02±6.78). Young age, high disease uncertainty, low social support, high negative coping and low positive coping are important factors affecting FoP in PBT patients. Qualitative research focused on three themes: triggers, coping styles, and the help needed.</div></div><div><h3>Conclusion</h3><div>Enhanced screening and assessment of FoP is essential to identify dysfunctionin PBT. Meanwhile, the implications of these predictors for enhanced healthcare professional education and patient self-management may help healthcare providers implement relevant interventions promptly and help patients reduce their FoP. However, due to limitations such as sample, reporting bias, and specific mechanisms between predictors and FOPs that have not yet been explored in depth, further exploration is needed in the future.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364666","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
Placebo-controlled efficacy of 5-HT3 antagonists for postoperative nausea and vomiting prophylaxis in supratentorial craniotomies: A systematic review and comparative meta-analysis of randomized clinical trials 5-HT3拮抗剂对脑室上开颅手术术后恶心和呕吐预防的安慰剂对照疗效:随机临床试验的系统回顾和比较荟萃分析。
IF 1.8 4区 医学
Clinical Neurology and Neurosurgery Pub Date : 2024-09-26 DOI: 10.1016/j.clineuro.2024.108569
{"title":"Placebo-controlled efficacy of 5-HT3 antagonists for postoperative nausea and vomiting prophylaxis in supratentorial craniotomies: A systematic review and comparative meta-analysis of randomized clinical trials","authors":"","doi":"10.1016/j.clineuro.2024.108569","DOIUrl":"10.1016/j.clineuro.2024.108569","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative nausea and vomiting (PONV) are common and distressing complications following neurosurgical procedures, affecting up to 73 % of patients undergoing craniotomy. Therefore, we aimed to assess the placebo-controlled efficacy of 5-HT3 antagonists to prevent PONV following supratentorial craniotomies.</div></div><div><h3>Methods</h3><div>We searched Medline, Web of Science, and Embase databases following PRISMA guidelines for RCTs comparing the outcomes of prophylactic use of 5-HT3 antagonists with placebo to prevent PONV following supratentorial craniotomy. We pooled odds ratios (OR) with 95 % confidence intervals with a random-effects model. I<sup>2</sup> statistics was used to assess heterogeneity.</div></div><div><h3>Results</h3><div>Five RCTs, comprising 347 patients, of which 145 received a placebo, were included. The analysis identified a lower likelihood of early postoperative vomiting in 5-HT3 antagonists group (OR=0.47; 95 % CI: 0.24–0.91, p&lt;0.05; I<sup>2</sup>=7 %), a lower likelihood of vomit within the 24-h period in 5-HT3 antagonists group (OR=0.27; 95 % CI: 0.15–0.48, p&lt;0.01; I<sup>2</sup>=40 %), a lower likelihood of nausea within the 24-h period in 5-HT3 antagonists group (OR=0.47; 95 % CI: 0.28–0.72, p&lt;0.01; I<sup>2</sup>=34 %), and a lower likelihood of rescue interventions in 5-HT3 antagonists group (OR = 0.18; 95 % CI: 0.10–0.34; I<sup>2</sup> = 0 %. Subgroup analyses focusing on ondansetron also identified a lower likelihood of nausea and vomiting within the 24-h period in the 5-HT3 antagonist group.</div></div><div><h3>Conclusion</h3><div>This systematic review and meta-analysis identified that 5-HT3 antagonists are effective in preventing PONV in the postoperative period following supratentorial craniotomy when compared to placebo. Our findings provide synthesized and robust evidence derived from randomized studies to support the use of 5-HT3 antagonists in clinical practice.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379179","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
Impact of superficial middle cerebral vein compression on peritumoral brain edema of the sphenoid wing meningioma 大脑浅中静脉受压对蝶骨翼脑膜瘤瘤周脑水肿的影响
IF 1.8 4区 医学
Clinical Neurology and Neurosurgery Pub Date : 2024-09-26 DOI: 10.1016/j.clineuro.2024.108575
{"title":"Impact of superficial middle cerebral vein compression on peritumoral brain edema of the sphenoid wing meningioma","authors":"","doi":"10.1016/j.clineuro.2024.108575","DOIUrl":"10.1016/j.clineuro.2024.108575","url":null,"abstract":"<div><h3>Objective</h3><div>Sphenoid wing meningiomas (SWMs) often cause occlusion or stenosis of the superficial middle cerebral vein (SMCV) by tumor compression. This study aimed to analyze the correlation between SMCV compression and peritumoral brain edema (PTBE) in SWM patients and to clarify the importance of surgical preservation of the SMCV in SWM surgery.</div></div><div><h3>Methods</h3><div>This retrospective study included 31 patients who underwent surgery for SWM at our institution from April 2011 to March 2022. Patient demographics, tumor characteristics, PTBE size, and SMCV patency before and after surgery were evaluated using preoperative and postoperative MRI or digital subtraction angiography.</div></div><div><h3>Results</h3><div>Of the 31 patients, 24 (77.4 %) exhibited PTBE, with varying degrees of severity: mild (32.3 %), moderate (25.8 %), and severe (41.9 %). Preoperative MRI showed SMCV patency in 14 patients (45.2 %) and SMCV compression in 17 patients (54.8 %). There was a significant association between PTBE severity and SMCV compression (p = 0.002). Postoperatively, SMCV recanalization was observed in 4 out of 16 patients (25.0 %) with preoperative SMCV compression. These patients had significantly smaller tumors (p = 0.013) and larger preoperative PTBE volumes (p = 0.042) compared to those without recanalization.</div></div><div><h3>Conclusions</h3><div>Our study demonstrates a significant correlation between SMCV compression and severe PTBE in SWM patients. A subset of patients showed postoperative SMCV recanalization, particularly those with smaller tumors and more pronounced PTBE. These findings highlight the importance of SMCV preservation during SWM surgery to potentially improve postoperative outcomes.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142327455","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
Risk factors for acute symptomatic seizure in children with cerebral sinovenous thrombosis: Experience from a tertiary center 脑静脉血栓儿童急性症状性癫痫发作的风险因素:一家三级医疗中心的经验
IF 1.8 4区 医学
Clinical Neurology and Neurosurgery Pub Date : 2024-09-23 DOI: 10.1016/j.clineuro.2024.108571
{"title":"Risk factors for acute symptomatic seizure in children with cerebral sinovenous thrombosis: Experience from a tertiary center","authors":"","doi":"10.1016/j.clineuro.2024.108571","DOIUrl":"10.1016/j.clineuro.2024.108571","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the risk factors for acute symptomatic seizure (ASS) in children with Cerebral Sinovenous Thrombosis (CSVT) and to evaluate the effect of ASS on outcome.</div></div><div><h3>Methods</h3><div>Cross-sectional, single-center, hospital-based retrospective analysis of 42 children with neuroimaging-confirmed CSVT recorded between December 2009 and January 2023. ASS was defined as a seizure occurring within 7 days after CSVT. Predictors for ASS were analyzed by univariate and multivariate logistic regression. Functional outcomes were evaluated using the Pediatric Stroke Outcome Measure (PSOM).</div></div><div><h3>Results</h3><div>The average age of the 42 patients included in the study sample was 105.36 ± 63.1 months. Almost one-third (28.6 %) of patients with CSVT developed ASS. In univariate analysis, factors associated with seizure risk were young age, low Glasgow Coma Scale at admission, long hospital stay, headache, change of consciousness, focal neurological findings, cerebral hemorrhage, motor deficit and high D-dimer level (<em>p</em>=0.018, <em>p</em>&lt;0.001, <em>p=</em> 0.016, <em>p=</em> 0.001, <em>p=</em>0.014, <em>p</em>&lt;0.001, <em>p&lt;</em>0.001, <em>p</em>=0.019 and <em>p</em>=0.013, respectively). In multivariate analysis young age, focal neurological findings and D-dimer levels were potential predictors of ASS (p=0.004, p=0.003, p=0.036, respectively). Receiver operating characteristic (ROC) analysis for D-dimer diagnostic accuracy in patients with CSVT revealed D-dimer &gt; 498 ng/mL (AUC=0.743). In both cohorts, PSOM scores at last follow-up were worse in those with acute seizures compared to those without (<em>p</em>&lt;0.001).</div></div><div><h3>Conclusion</h3><div>Acute seizures occurred in approximately one-third of our cohort. Young age, focal neurological findings, and high D-dimer levels are potential predictors of ASS in children. Children with ASS had worse outcomes than those without.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142319294","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
Middle meningeal artery embolization versus conventional management for patients with chronic subdural hematoma: An umbrella review 慢性硬膜下血肿患者的脑膜中动脉栓塞治疗与传统治疗方法对比: 综述
IF 1.8 4区 医学
Clinical Neurology and Neurosurgery Pub Date : 2024-09-23 DOI: 10.1016/j.clineuro.2024.108572
{"title":"Middle meningeal artery embolization versus conventional management for patients with chronic subdural hematoma: An umbrella review","authors":"","doi":"10.1016/j.clineuro.2024.108572","DOIUrl":"10.1016/j.clineuro.2024.108572","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Conventional surgical modalities, including twist drill craniotomy, burr hole evacuation, and craniotomy, are the standard surgical interventions for chronic subdural hematomas (cSDH). More recently, treatment of cSDH with middle meningeal artery embolization (MMAE) is being explored. The comparative effectiveness of MMAE versus conventional surgical modalities remains controversial. The objective of this study is to analyze various postoperative outcomes in an umbrella review of existing meta-analysis comparing MMAE and conventional management in patients with cSDH.</div></div><div><h3>Methods</h3><div>A systematic literature search was executed with defined criteria across PubMed, Scopus, and Web of Science databases. Data was analyzed utilizing the <em>metaumbrella</em> R package, employing equivalent Hedges’ g values. The quality assessment of each meta-analysis was carried out using AMSTAR2, assigning scores within the range of 0–11. The credibility of the evidence was determined by applying the Ioannidis criteria.</div></div><div><h3>Results</h3><div>This umbrella review study included five meta-analyses. Upon pooling the meta-analyses, MMAE was associated with fewer reoperations and recurrence, supported by a weak level of evidence (class IV). Conversely, findings related to other postoperative outcomes did not reach statistical significance.</div></div><div><h3>Conclusion</h3><div>Our umbrella review offers a comprehensive summary investigating MMAE and conventional management for the treatment of cSDH. MMAE had fewer reoperations and recurrence, but they were classified as being of weak significance. These findings underscore insufficient evidence within the existing literature, emphasizing the imperative need for additional research in this area.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142314936","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
The effect of fibromyalgia syndrome on female patients diagnosed with chronic migraine 纤维肌痛综合征对女性慢性偏头痛患者的影响
IF 1.8 4区 医学
Clinical Neurology and Neurosurgery Pub Date : 2024-09-23 DOI: 10.1016/j.clineuro.2024.108573
{"title":"The effect of fibromyalgia syndrome on female patients diagnosed with chronic migraine","authors":"","doi":"10.1016/j.clineuro.2024.108573","DOIUrl":"10.1016/j.clineuro.2024.108573","url":null,"abstract":"<div><h3>Objective</h3><div>To compare pain, quality of life, sleep, anxiety and depression, central sensitization, and functionality between chronic migraine (CM) patients with comorbid fibromyalgia syndrome (FMS) and patients with CM alone.</div></div><div><h3>Method</h3><div>Thirty three female patients with CM and thirty three female patients with CM+FMS were enrolled in the study. Demographic and clinical characteristics of the patients were recorded. FM was diagnosed based on the 2016 American College of Rheumatology diagnostic criteria. All participants were evaluated with Allodynia Symptom Checklist, Short Form-36 (SF-36), Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale (HADS), Migraine Disability Assessment (MIDAS) and Headache Impact Test (HIT-6) questionnaires, and Central Sensitization Inventory (CSI). FM patients were also evaluated with Fibromyalgia Impact Questionnaire (FIQ).</div></div><div><h3>Results</h3><div>The average number of headache days was significantly higher in patients with CM+FMS (p = 0.006). Among migraine accompanying symptoms, the number of patients with phonophobia was significantly higher in patients with CM+FMS (p = 0.008). While CSI score was 39.0 ± 11.7 in CM patients, it was 52.2 ± 9.2 in CM+FMS patients. CSI scores were higher in CM+FMS patients (p &lt; 0.001). SF-36 sub-cores, including physical function, energy/fatigue, emotional well-being, and general health scores, were lower in CM+FMS patients (p &lt; 0.05). Sleep duration was significantly lower and use of medication to sleep was more common in same group (p &lt; 0.05). FIQ score in CM+FMS patients was associated with quality of life scores, sleep quality, anxiety, and central sensitization scores (p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>In patients with chronic migraine, FMS comorbidity negatively affects the quality of life and significantly increases central sensitization.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142314816","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}
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