Clinical Neurology and Neurosurgery最新文献

{"title":"The use of onabotulinum toxin type A and other neurotoxins for the treatment of chronic migraine: An American Headache Society survey study","authors":"Utkarsh Agarwal ,&nbsp;Kendra Hamilton ,&nbsp;Ashhar Ali ,&nbsp;Paul G. Mathew","doi":"10.1016/j.clineuro.2025.108960","DOIUrl":"10.1016/j.clineuro.2025.108960","url":null,"abstract":"<div><h3>Purpose</h3><div>OnabotA is the only US Food and Drug Administration-approved neurotoxin for chronic migraine prevention; however, non-onabotA toxins may be equally effective. Few studies have explored clinician practices and patient outcomes with non-onabotA neurotoxins. Our study aimed to generate a statistical snapshot of clinician perspectives and treatment practices regarding onabotulinum toxin A (onabotA) and other neurotoxins for chronic migraine and comorbid conditions.</div></div><div><h3>Methods</h3><div>A 15-question survey was distributed online to clinician members of the American Headache Society (AHS) assessing clinical practices using onabotA and non-onabotA toxins for chronic migraine and comorbid conditions, and descriptive analysis was performed.</div></div><div><h3>Results</h3><div>168 respondents (162 from the United States and 6 from Canada) completed the survey (response rate 10.1 % [168/1665]). Of 48 respondents (28 % of total) using non-onabotA toxins for chronic migraine, 27 (16 %) used incobotulinum toxin A; 23 (14 %) used abobotulinum toxin A; and 12 (7 %) used rimabotulinum toxin B. Non-onabotA toxins were predominantly used due to administration/payor imposed issues (19/48; 40 %) and cost (18/48 [38 %]). Most clinicians using non-onabotA toxins reported similar efficacy to onabotA (32/48; 67 %), while fewer reported better efficacy (9/48 [19 %]) or worse efficacy (7/48 [15 %]) than onabotA. Many respondents (114/168 [68 %]) had used neurotoxins for chronic migraine in addition to other comorbid conditions, including temporomandibular joint disorders (95/114 [83 %]) and cervical dystonia (64/114 [56 %]).</div></div><div><h3>Conclusion</h3><div>While non-onabotA toxins are used less frequently for chronic migraine, they may have similar efficacy as onabotA and are used off-label in clinical practice due to administrative/payor issues or cost<strong>.</strong></div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"254 ","pages":"Article 108960"},"PeriodicalIF":1.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948431","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":"Drivers of neurosurgeon selection among operative intracranial tumor patients","authors":"Melanie Alfonzo Horowitz ,&nbsp;Joanna Roy ,&nbsp;Megan Parker ,&nbsp;Arushi Devgun ,&nbsp;Emre Derin ,&nbsp;A. Karim Ahmed ,&nbsp;Ryan P. Lee ,&nbsp;Christopher M. Jackson ,&nbsp;Debraj Mukherjee","doi":"10.1016/j.clineuro.2025.108932","DOIUrl":"10.1016/j.clineuro.2025.108932","url":null,"abstract":"<div><h3>Objective</h3><div>Despite increased access to online information, little is known about what factors patients consider when selecting a neurosurgeon for intracranial tumor resection. This study aims to identify patient priorities in neurosurgeon selection.</div></div><div><h3>Methods</h3><div>Patients who underwent intracranial tumor resection between January 1, 2023, and January 31, 2024, at a single institution were surveyed. They ranked 13 factors on a 5-point Likert scale. Survey data were analyzed alongside demographic and clinical information using ordinal logistic regression.</div></div><div><h3>Results</h3><div>Fifty patients (mean age 54.15 ± 13.82; 54 % female; 70 % white; 70 % privately insured) completed the survey. Surgeon caseload and procedure-specific experience (mean score 4.64 ± 0.72) were rated as most important, followed by hospital ranking (4.48 ± 0.68), years of experience (4.38 ± 0.75), and surgeon interpersonal skills (4.2 ± 1.14). Least important were social media presence, age, and word of mouth.</div><div>Subgroup analysis revealed that non-Caucasian patients valued word of mouth more (OR: 1.65), while patients undergoing repeat surgery valued it less (OR: 0.33). Older patients, non-Caucasians, ethnic minorities, and married individuals placed less importance on medical school prestige.</div></div><div><h3>Conclusion</h3><div>Neurosurgical patients prioritize surgeon experience, hospital reputation, and interpersonal qualities. These insights can inform provider transparency, resource allocation, and outreach to underserved groups.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"254 ","pages":"Article 108932"},"PeriodicalIF":1.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143928624","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":"Innovating stroke care: A performance study of the ALGO smart pump in smart static mode","authors":"Thomas Snyder ,&nbsp;William Ares ,&nbsp;Robert M. Starke ,&nbsp;Maksim Shapiro ,&nbsp;Eytan Raz ,&nbsp;Tareq Kass-Hout ,&nbsp;Pankajavalli Ramakrishnan ,&nbsp;Chris Fox ,&nbsp;Brian T. Jankowitz","doi":"10.1016/j.clineuro.2025.108929","DOIUrl":"10.1016/j.clineuro.2025.108929","url":null,"abstract":"<div><h3>Introduction</h3><div>While revascularization rates have improved for mechanical thrombectomy (MT) in acute ischemic stroke, advancements in aspiration pumps have been limited. The ALGO Smart Pump (Von Vascular, Sunrise, FL) is a small on-field, operator-driven pump offering two aspiration modes: Adaptive Pulsatile Aspiration (APA™) Mode and a continuous 'Static' mode. This study evaluates the performance of the ALGO Smart Pump's Static Mode compared to a commercially available aspiration pump.</div></div><div><h3>Methods</h3><div>Operators performed aspiration thrombectomy in a flow model with ALGO and the Penumbra ENGINE (Penumbra, Alameda, CA) using medium (ID.036–.057”) to large (ID.068–.071) bore aspiration catheters. Primary endpoint was complete clot ingestion (CCI), defined as the full ingestion of the clot within the catheter or pump's canister, without any clot at the catheter tip or evidence of embolization to new territories (ENT). Secondary endpoints included first pass recanalization, ENT and total aspiration time.</div></div><div><h3>Results</h3><div>When comparing all catheters, ALGO Smart Pump achieved CCI in 154 of 180 thrombectomies (85.6 %) compared to Penumbra ENGINE achieving CCI in 136 of 180 thrombectomies (75.6 %). The CCI rate between pump types across all catheters was statistically significant (p = 0.008), favoring ALGO pump. There was no difference between pump type on aspiration time.</div></div><div><h3>Conclusion</h3><div>The ALGO Smart Pump may represent an alternative in MT, with potential higher effectiveness compared to existing available aspiration pumps with additional user-friendly benefits including a sterile, smaller, on-field apparatus.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"254 ","pages":"Article 108929"},"PeriodicalIF":1.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143928626","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":"Association between statin treatment and outcomes among critically ill acute ischemic stroke patients","authors":"Tao Tang ,&nbsp;Aline M. Thomas ,&nbsp;Jianxin Zhou ,&nbsp;Shen Li","doi":"10.1016/j.clineuro.2025.108958","DOIUrl":"10.1016/j.clineuro.2025.108958","url":null,"abstract":"<div><h3>Objective</h3><div>The efficacy of statin treatment in cerebrovascular neurocritical care is uncertain. We aimed to assess the association between statin treatment and outcomes among patients with acute ischemic stroke that are critically ill.</div></div><div><h3>Methods</h3><div>This study is a retrospective analysis of patients in the Medical Information Mart for Intensive Care IV database with acute ischemic stroke that required intensive care unit admission. The exposure variable was statin treatment in intensive care. The primary outcome was in-hospital mortality, and secondary outcomes were favorable discharge (either discharge to home or to acute rehabilitation) and intracranial hemorrhage. Multivariable binary logistic regression analyses were used to evaluate the association of statin treatment with outcomes.</div></div><div><h3>Results</h3><div>A total of 1551 patients (median age, 73 years; 49.5 % female) were enrolled, amongst which 874 patients (56.4 %) received statin treatment. After adjusting for potential confounders, statin treatment was associated with in-hospital mortality (OR 0.34, 95 %CI 0.25–0.48, <em>p</em> <em>&lt;</em> 0.001) and favorable discharge (OR 1.72, 95 %CI 1.37–2.16, <em>p</em> <em>&lt;</em> 0.001). Moreover, these associations were more pronounced in patients receiving intensive statin treatment compared to those receiving less–intensive statin therapy (mortality: OR 0.24 [95 %CI 0.15–0.37] vs. OR 0.50 [95 %CI 0.33–0.76], <em>p</em> for trend &lt; 0.001; favorable discharge: OR 1.96 [95 %CI 1.51–2.54] vs. OR 1.40 [95 %CI 1.05–1.88], <em>p</em> for trend &lt; 0.001). Statin treatment showed no significant association with intracranial hemorrhage (OR 0.95, 95 %CI 0.73–1.24, <em>p</em> = 0.701).</div></div><div><h3>Conclusion</h3><div>Statin treatment was associated with reduced in-hospital mortality and improved discharge outcomes in critically ill acute ischemic stroke patients, while showing no significant effect on intracranial hemorrhage, indicating its potential benefit and safety in this specific population.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"254 ","pages":"Article 108958"},"PeriodicalIF":1.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143928625","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":"Medical complications associated with prolonged length of stay in patients with nontraumatic intracerebral hemorrhage: A nationwide cohort study","authors":"Andrea Loggini ,&nbsp;Victor J. Del Brutto ,&nbsp;Adnan I. Qureshi ,&nbsp;Jonatan Hornik ,&nbsp;Shawn S. Wallery ,&nbsp;Amber Schwertman ,&nbsp;Sarmad Nomani ,&nbsp;Alejandro Hornik ,&nbsp;Faddi G. Saleh Velez","doi":"10.1016/j.clineuro.2025.108934","DOIUrl":"10.1016/j.clineuro.2025.108934","url":null,"abstract":"<div><h3>Purpose</h3><div>This work aims to investigate the in-hospital medical complications associated with prolonged length of stay (PLOS) in a large cohort of patients with nontraumatic intracranial hemorrhage (ICH), using a nationwide inpatient sample.</div></div><div><h3>Methods</h3><div>In this retrospective cohort study, the National Inpatient Sample database was investigated for patients admitted with nontraumatic ICH from October 2015 to December 2022. Demographics, comorbidities, markers of ICH severity, in-hospital procedures, PLOS, and hospital mortality were noted. PLOS was defined as length of stay exceeding the 75th percentile of the entire cohort. Outcomes investigated were in-hospital medical complications, including acute ischemic stroke (AIS), seizures, aspiration pneumonia, acute respiratory failure, deep vein thrombosis (DVT), pulmonary embolism (PE), and acute kidney injury (AKI). Multivariable logistic models were used to determine the association between each preselected outcome and PLOS, adjusted for demographics, comorbidities, ICH severity, and surgical procedures. Significant P value was set at 0.05 for all analyses.</div></div><div><h3>Results</h3><div>Out of 211,879 ICH included in the study, 50,224 (23.7 %) had PLOS. PLOS was defined as a LOS that exceeded 12 days. ICH patients with PLOS were younger (63 [52–73] vs. 70 [58–80]), more likely to be male (56.1 % vs. 51.5 %), Black (25.9 % vs. 18.3 %) or Hispanic (12.4 % vs. 9.7 %), and being in the lower median household income quartile (31.9 % vs. 28.5 %), p &lt; 0.01 for all. In distinct multivariable logistic models, adjusted for demographics, comorbidities, ICH severity, and surgical procedures, AIS (OR: 1.469, 95 %CI: 1.428–1.511), seizures (OR: 1.214, 95 %CI: 1.164–1.265), aspiration pneumonia (OR: 2.911, 95 %CI: 2.809–3.016), acute respiratory failure (OR: 1.527, 95 %CI: 1.48–1.576), DVT (OR: 2.739, 95 %CI: 2.568–2.921), PE (OR: 1.638, 95 %CI: 1.521–1.765), and AKI (OR: 2.037, 95 %CI: 1.978–2.098) were independently associated with PLOS, p &lt; 0.01 for all. Age-stratified analysis revealed that the strongest association with PLOS was observed for DVT in patients &lt; 40 years (OR 3.797, 95 % CI: 2.991–4.822) and for aspiration pneumonia in those ≥ 80 years (OR 3.508, 95 % CI: 3.242–3.795). Patients with PLOS experienced a lower in-hospital mortality rate (13.4 % vs. 22.8 %, p &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>In this large cohort of ICH patients, racial/ethnic minorities and lower-income patients were more likely to experience PLOS. PLOS was associated with both neurological and medical complications, with aspiration pneumonia showing the strongest association in older patients and DVT in younger patients. Prolonged hospitalization did not impact short-term mortality.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"254 ","pages":"Article 108934"},"PeriodicalIF":1.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143921890","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":"Screening for Pompe disease in Serbian patients with limb-girdle muscle weakness","authors":"Aleksandar Sekulic ,&nbsp;Vanja Viric ,&nbsp;Teodora Todorovic ,&nbsp;Jovan Pesovic ,&nbsp;Marija Brankovic ,&nbsp;Nikola Andrejic ,&nbsp;Aleksa Palibrk ,&nbsp;Ivo Bozovic ,&nbsp;Vukan Ivanovic ,&nbsp;Ivana Basta ,&nbsp;Stojan Peric","doi":"10.1016/j.clineuro.2025.108950","DOIUrl":"10.1016/j.clineuro.2025.108950","url":null,"abstract":"<div><h3>Introduction/aims</h3><div>Patients with late-onset Pompe disease (LOPD) can be found among individuals with limb-girdle muscle weakness, as well as among individuals with isolated weakness of trunk and respiratory muscles. Some patients with asymptomatic hyperCKemia may have Pompe disease. Aim of this research was analysis of the frequency of LOPD among Serbian patients with unexplained limb-girdle muscle weakness, and/or respiratory muscle weakness, and/or hyperCKemia.</div></div><div><h3>Methods</h3><div>Analysis of acid alpha-glucosidase (GAA) activity was performed using tandem mass spectrometry in a sample of a dry blood spot. In patients who were found to have decreased enzyme activity, DNA was isolated from a dry blood spot and sequencing of the <em>GAA</em> gene was performed.</div></div><div><h3>Results</h3><div>During a 4.5-year period, 138 patients suspected of having LOPD were sent for the analysis. The average age at the time of testing was 44.3 ± 15.7 years, and symptoms duration was 7.3 ± 7.6 years. Mean GAA activity was 4.6 ± 1.9 umol/L/h. Decreased enzyme activity was observed in 10 (7 %) patients. Genetic analysis of the GAA gene was performed in these ten, and four (3 %) were diagnosed with LOPD.</div></div><div><h3>Conclusion</h3><div>In the Serbian cohort of 138 patients with limb-girdle muscle weakness and/or respiratory muscle weakness and/or hyperCKemia, 3 % had genetically confirmed LOPD. All diagnosed patients received enzyme replacement therapy which alters the course of the disease.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"254 ","pages":"Article 108950"},"PeriodicalIF":1.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143937271","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":"Traumatic odontoid fracture – Proposal of a treatment algorithm","authors":"Syed Ali Mujtaba Rizvi ,&nbsp;Hege Linnerud ,&nbsp;Pål Andre Rønning ,&nbsp;Tor Brommeland ,&nbsp;Mads Aarhus ,&nbsp;Jalal Mirzamohammadi ,&nbsp;Marianne Efskind Harr ,&nbsp;Vidar Tveit Vasfaret Stenset ,&nbsp;Magnus Evjensvold ,&nbsp;Eirik Helseth","doi":"10.1016/j.clineuro.2025.108951","DOIUrl":"10.1016/j.clineuro.2025.108951","url":null,"abstract":"<div><h3>Background</h3><div>Current management guidelines for odontoid fractures (OFx) lack emphasis on age, comorbidity, and frailty, leading to variability in clinical practice and highlighting the need for guideline reevaluation. We began implementing a new treatment algorithm for OFx management at Oslo University Hospital (OUH) in 2022 with the aim of making it part of standard care for OFx. The main objective of this study was to determine our department’s compliance with the new treatment algorithm for OFx.</div></div><div><h3>Methods</h3><div>In this population-based cohort study, we examine all traumatic OFx diagnosed in Southeast Norway from 2022–2023 and assess the rate of compliance with a new treatment algorithm implemented at OUH. Patient demographics, injury characteristics, treatment decisions, and outcomes, including union rates, rate of conversion from external immobilization to surgery, and long-term disability rates, were collected. Follow-up evaluations included imaging examinations and clinical and functional assessments.</div></div><div><h3>Results</h3><div>One hundred eighty-one patients with acute odontoid fractures (OFx) were registered from 2022 to 2023, and the median age of the patients was 78 years. Most fractures were caused by falls (92.3 %), and 70 % of the patients had some form of vulnerability (ASA ≥ 3 and/or CFS ≥ 4 and/or dependent living). Type II fractures were the most common (55.3 %), and 9.4 % of all OFx patients underwent surgical fixation. The treatment compliance rate was 97.2 %. At follow-up, 77.9 % of patients were alive, and 80.6 % of patients exhibited union, either bony or fibrous. Most patients (79.9 %) reported little neck pain (VAS score ≤3), and 87.8 % reported mild or no neck stiffness. The survival rate was 87 % at 30 days and 78 % at 6 months. There were no significant differences in the rates of disability, pain, bony union or fibrous union between the treatment groups. The new treatment algorithm resulted in favorable clinical outcomes.</div></div><div><h3>Conclusions</h3><div>In this observational cohort study involving 181 consecutive patients with traumatic OFx, 97 % were treated in accordance with the department’s recommended algorithm for OFx management. Of the patients who were 75 years or older with OFx type II, 7/79 (8.9 %) underwent surgical treatment. The patient outcomes and findings presented in this study align with those presented in previous international studies investigating optimal treatment strategies for OFx. We therefore recommend this algorithm as an appropriate treatment approach for OFx.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"254 ","pages":"Article 108951"},"PeriodicalIF":1.8,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143917365","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":"Analysis of factors associated with prognosis after successful thrombectomy after posterior circulation stroke","authors":"Qin Wang ,&nbsp;Wenxuan Zhao ,&nbsp;Junwei Qian ,&nbsp;Ziyu Sun ,&nbsp;Bao He ,&nbsp;Lei Shi ,&nbsp;Xiaojie Lu","doi":"10.1016/j.clineuro.2025.108948","DOIUrl":"10.1016/j.clineuro.2025.108948","url":null,"abstract":"<div><h3>Purpose</h3><div>With the continuous improvement of mechanical thrombectomy (MT) technology, the success rate of vascular recanalization has been significantly improved, and some patients still have poor prognosis based on vascular recanalization. This study aims to find clinical factors affecting prognosis after vascular recanalization and find valuable predictors.</div></div><div><h3>Methods</h3><div>We followed up patients who underwent posterior circulation thrombectomy for up to 180 days. Using univariate and multivariate logistic regression, we identified prognostic factors related to functional outcomes or survival. Cox analysis was further applied to determine the optimal cutoff values for these factors.</div></div><div><h3>Results</h3><div>Modified Thrombolysis in Cerebral Infarction (mTICI) and NIHSS (24 h), as independent prognostic factors, provide a reliable indication of patients' prognostic status within 90 days. Additionally, a lower Posterior Circulation Alberta Stroke Program Early CT Score (pc-ASPECTs) score and a higher NIHSS (24 h) score are closely associated with patients' 90-day survival status.</div></div><div><h3>Conclusion</h3><div>Retrospective analysis after thrombectomy showed that NIHSS (24 h) was a key independent prognostic factor for the rehabilitation prognosis and death of patients, which was helpful for clinical decision-making and postoperative care.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"254 ","pages":"Article 108948"},"PeriodicalIF":1.8,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906320","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":"Vestibular migraine: Onabotulinum toxin effectivity, prospective-randomized study","authors":"Reyhan Surmeli ,&nbsp;Mehmet Surmeli ,&nbsp;Ayse Destina Yalcin ,&nbsp;Ayse Asli Sahin Yilmaz ,&nbsp;Tulay Erden Habesoglu ,&nbsp;Gozde Gunay","doi":"10.1016/j.clineuro.2025.108949","DOIUrl":"10.1016/j.clineuro.2025.108949","url":null,"abstract":"","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"254 ","pages":"Article 108949"},"PeriodicalIF":1.8,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel artificial intelligence approach in neurointerventional practice: Preliminary findings on filter movement and ischemic lesions in carotid artery stenting","authors":"Hirotaka Sagawa ,&nbsp;Yuya Sakakura ,&nbsp;Ryoichi Hanazawa ,&nbsp;Satoru Takahashi ,&nbsp;Hikaru Wakabayashi ,&nbsp;Shoko Fujii ,&nbsp;Kyohei Fujita ,&nbsp;Sakyo Hirai ,&nbsp;Akihiko Hirakawa ,&nbsp;Kenichi Kono ,&nbsp;Kazutaka Sumita","doi":"10.1016/j.clineuro.2025.108930","DOIUrl":"10.1016/j.clineuro.2025.108930","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Embolic protection devices (EPDs) used during carotid artery stenting (CAS) are crucial in reducing ischemic complications. Although minimizing the filter-type EPD movement is considered important, limited research has demonstrated this practice. We used an artificial intelligence (AI)-based device recognition technology to investigate the correlation between filter movements and ischemic complications.</div></div><div><h3>Methods</h3><div>We retrospectively studied 28 consecutive patients who underwent CAS using FilterWire EZ (Boston Scientific, Marlborough, MA, USA) from April 2022 to September 2023. Clinical data, procedural videos, and postoperative magnetic resonance imaging were collected. An AI-based device detection function in the Neuro-Vascular Assist (iMed Technologies, Tokyo, Japan) was used to quantify the filter movement. Multivariate proportional odds model analysis was performed to explore the correlations between postoperative diffusion-weighted imaging (DWI) hyperintense lesions and potential ischemic risk factors, including filter movement.</div></div><div><h3>Results</h3><div>In total, 23 patients had sufficient information and were eligible for quantitative analysis. Fourteen patients (60.9 %) showed postoperative DWI hyperintense lesions. Multivariate analysis revealed significant associations between filter movement distance (odds ratio, 1.01; 95 % confidence interval, 1.00–1.02; p = 0.003) and high-intensity signals in time-of-flight magnetic resonance angiography with DWI hyperintense lesions. Age, symptomatic status, and operative time were not significantly correlated.</div></div><div><h3>Conclusion</h3><div>Increased filter movement during CAS was correlated with a higher incidence of postoperative DWI hyperintense lesions. AI-based quantitative evaluation of endovascular techniques may enable demonstration of previously unproven recommendations. To the best of our knowledge, this is the first study to use an AI system for quantitative evaluation to address real-world clinical issues.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"254 ","pages":"Article 108930"},"PeriodicalIF":1.8,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932166","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}