Clinical Neurology and Neurosurgery最新文献

{"title":"Anti-IgLON-5 disease presenting with axial dystonia and acetazolamide-responsive apnea","authors":"Gwen Zeigler,&nbsp;Miriam Quinlan,&nbsp;Panayiotis N. Varelas,&nbsp;Matthew Collin,&nbsp;Eric Molho","doi":"10.1016/j.clineuro.2025.109117","DOIUrl":"10.1016/j.clineuro.2025.109117","url":null,"abstract":"<div><div>We present a 67-year-old male with anti-IgLON5 disease with cervical and upper trunk dystonic spasms. Intermittent hallucinations, occurring both with infections and without a precipitant, and hand tremors were also present. The MRI of the brain was nonspecific. The CSF results yielded positivity for IgLON5 antibodies, along with a CSF protein of 98. Treatment involved intravenous immunoglobulin, plasma exchange, and rituximab providing modest improvement in symptoms. The disease progressed to worsening apnea, without stridor or known aspiration, which resolved with acetazolamide. While acetazolamide has long been used for the treatment of sleep-breathing-related disorder, this is the first known case of its effective use in anti-IgLON5-related central hypoventilation. Additionally, this case demonstrates that axial dystonia with painful and disabling anterocollis can be a prominent feature of this disease.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"257 ","pages":"Article 109117"},"PeriodicalIF":1.6,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144880277","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":"Focal electroencephalography abnormality in the early stage of sporadic Creutzfeldt–Jakob disease corresponding to neuroradiological findings: A magnetoencephalography experience","authors":"Hiroaki Takeda ,&nbsp;Shogo Yazawa ,&nbsp;Takashi Murahara ,&nbsp;Katsuya Sakai ,&nbsp;Eiji Ochiai ,&nbsp;Yukiko Suzuki ,&nbsp;Katsuya Satoh ,&nbsp;Kazutaka Shiomi ,&nbsp;Kazuhito Tsuruta","doi":"10.1016/j.clineuro.2025.109115","DOIUrl":"10.1016/j.clineuro.2025.109115","url":null,"abstract":"<div><div>This study discusses the first electroencephalography (EEG) findings in two patients with sporadic Creutzfeldt–Jakob disease (sCJD) using magnetoencephalography (MEG). Case 1 involved a 71-year-old male who presented with progressive clumsiness of the right hand. An EEG performed 3 weeks after symptom onset revealed small periodic spikes over the left centroparietal region. MEG identified the spike source in the left parietal lobe, which subsequently exhibited glucose hypometabolism on positron emission tomography. Case 2 involved a 48-year-old male with progressive clumsiness and numbness in the left limbs. His EEG reported 3 weeks after onset, displayed rhythmic regional delta activity maximal in the right centroparietal region. MEG identified the delta source in the right parietal lobe, corresponding to hypoperfusion observed in single-photon emission computed tomography. In both cases, MEG successfully visualized electrophysiological dysfunction in the early stages of sCJD.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"257 ","pages":"Article 109115"},"PeriodicalIF":1.6,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890737","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 “Intraoperative antibiotic irrigation in cranial surgery: a constructive appraisal of Gunnarut et al.” [Clin. Neurol. Neurosurg. 257 (2025), 109083]","authors":"Parth Aphale ,&nbsp;Himanshu Shekhar ,&nbsp;Shashank Dokania","doi":"10.1016/j.clineuro.2025.109114","DOIUrl":"10.1016/j.clineuro.2025.109114","url":null,"abstract":"","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"257 ","pages":"Article 109114"},"PeriodicalIF":1.6,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144880278","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":"Prevention of valve reversal in lumboperitoneal shunt surgery: Effectiveness of above-the-superficial-fascia placement using an inline shunt passer","authors":"Tatsuya Tanaka,&nbsp;Eiichi Suehiro,&nbsp;Akira Saito,&nbsp;Shuhei Yamasaki,&nbsp;Ryohei Sashida,&nbsp;Tomihiro Wakamiya,&nbsp;Kimihiro Nakahara,&nbsp;Takashi Agari,&nbsp;Masahiro Indou,&nbsp;Takashi Sugawara,&nbsp;Hiroshi Itokawa,&nbsp;Kazuaki Shimoji,&nbsp;Keisuke Onoda,&nbsp;Akira Matsuno","doi":"10.1016/j.clineuro.2025.109113","DOIUrl":"10.1016/j.clineuro.2025.109113","url":null,"abstract":"<div><h3>Background</h3><div>Valve reversal following lumboperitoneal shunt (LPS) surgery can lead to valve mis adjustment or failure, potentially causing complications such as overdrainage and chronic subdural hematoma. While proper fixation and placement depth are considered important for prevention, effective strategies have not been well established.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 30 LPS procedures performed at our institution from January 2021 to December 2024. The technique involved valve placement above the superficial fascia using an inline shunt passer, combined with fascial sheath formation via fascial suturing. Postoperative CT or X-ray imaging was used to assess valve position and detect reversal.</div></div><div><h3>Results</h3><div>Among the 30 patients (17 men and 13 women; mean age, 73.3 years), no cases of valve reversal were observed (0 %). The mean distance from the skin to the valve center was 6.1 mm, and the mean distance from the spinous process to the valve was 7.9 cm.</div></div><div><h3>Conclusions</h3><div>Placement of the valve above the superficial fascia using an inline shunt passer, combined with fascial sheath formation, appears to be an effective strategy for preventing valve reversal after LPS surgery. This technique may offer a reliable and reproducible method to ensure valve stability regardless of anatomical positioning, with potential to improve postoperative safety.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"257 ","pages":"Article 109113"},"PeriodicalIF":1.6,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866541","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 intermittent theta burst stimulation on lower limb motor function in stroke patients: A systematic review and meta-analysis","authors":"Hui Zhao,&nbsp;Yue Zhou,&nbsp;Yu Long,&nbsp;Qiongge Yu,&nbsp;Yuyan Liu,&nbsp;Yuhang Wen,&nbsp;Dan Sun,&nbsp;Qiufeng Jia,&nbsp;Yufeng Yu","doi":"10.1016/j.clineuro.2025.109112","DOIUrl":"10.1016/j.clineuro.2025.109112","url":null,"abstract":"<div><h3>Objective:</h3><div>To systematically evaluate the effects of intermittent theta burst stimulation(iTBS) on lower limb motor function in stroke patients.</div></div><div><h3>Methods</h3><div>Following the PRISMA guidelines, we searched PubMed, Web of Science, Embase, Cochrane Library, CNKI, VIP, Wanfang, and SinoMed from their inception to 23 November 2024. Two researchers independently screened the literature, assessed quality, and extracted data. Statistical analysis was performed using RevMan5.4 and Stata16.0 software.</div></div><div><h3>Results:</h3><div>Thirteen studies involving 516 stroke patients were included. Meta-analysis showed that, compared with the control group, the iTBS group significantly improved lower limb motor function(FMA-LE) scores in stroke patients [MD= 2.31, 95 %CI= (0.78,3.84), <em>P</em> <em>&lt;</em> 0.01], as well as lower limb balance function(BBS) [MD= 3.75, 95 %CI= (2.19,5.32), <em>P</em> <em>&lt;</em> 0.01]. Subgroup analysis suggested that LE M1-iTBS intervention did not significantly improve FMA-LE scores and balance function. iTBS intervention improved patients' activities of daily living [SMD= 0.67, 95 %CI= (0.46,0.88), <em>P</em> <em>&lt;</em> 0.01], and shortened central motor conduction time(CMCT) [SMD= -0.78, 95 %CI= (-1.10, −0.46), <em>P</em> <em>&lt;</em> 0.01], but did not show significant improvement in MEP latency (<em>P</em> &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>Existing research evidence indicates that iTBS is an effective treatment method for improving lower limb function in stroke patients, helping to enhance lower limb motor function, lower limb balance, and activities of daily living.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"257 ","pages":"Article 109112"},"PeriodicalIF":1.6,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866540","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":"A novel guiding tool for lumbar puncture with the paramedian approach","authors":"Chihiro Akiba ,&nbsp;Yuji Ohta ,&nbsp;Ayane Mimori ,&nbsp;Hideki Bandai ,&nbsp;Yoshitaka Ito ,&nbsp;Kaito Kawamura ,&nbsp;Madoka Nakajima ,&nbsp;Masakazu Miyajima ,&nbsp;Akihide Kondo","doi":"10.1016/j.clineuro.2025.109099","DOIUrl":"10.1016/j.clineuro.2025.109099","url":null,"abstract":"<div><h3>Objective</h3><div>Lumbar puncture is an essential procedure of the lumboperitoneal shunts that is a major treatment strategy for older patients with hydrocephalus. It can be achieved using either a median or paramedian approach. The paramedian approach shows advantages over the median approach by facilitating needle placement while avoiding narrowed interspinous spaces and kinks during catheter insertion. However, determining the correct needle placement angle remains challenging. Therefore, we aimed to establish a method for calculating the appropriate needle placement angles in the paramedian approach, and experimentally designed and produced a novel guiding tool for the lumbar puncture.</div></div><div><h3>Methods</h3><div>Coordinate analysis using lumbar three-dimensional computed tomography data from 53 patients (28 men, 25 women; mean age, 78.2 years) was utilized to calculate the appropriate needle placement angles. A novel guiding tool was then designed to align the puncture needle to the two optimal angles, and produced using a three-dimensional printer.</div></div><div><h3>Results</h3><div>Pixel calculation of the coordinates revealed that the needle insertion angles were determined to be 30° and 33°, with no sex-related differences. Furthermore, because the target in practice has a certain volume, we analyzed the variable range of the two angles and found it to be more than 11° on average. Based on the calculated angles, we designed the novel guiding tool for lumbar puncture using the paramedian approach, defining the puncture angles as 30° and 33°.</div></div><div><h3>Conclusion</h3><div>Our method for calculating the appropriate needle placement angles using the paramedian approach is applicable for general use, allowing for the determination of proper needle placement angles prior to lumbar puncture.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"257 ","pages":"Article 109099"},"PeriodicalIF":1.6,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144880323","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":"Impact of intracranial vessel tortuosity on mechanical thrombectomy outcomes in acute ischemic stroke: A systematic review","authors":"Abdelrahman M. Hamouda ,&nbsp;Mohamed Derhab ,&nbsp;Nicholas Kendall ,&nbsp;Armin Zarrintan ,&nbsp;Julien Ognard ,&nbsp;Mohamed M. Elgohary ,&nbsp;Stanley Dennison ,&nbsp;Mark Cwajna ,&nbsp;Mohamed A. Ali ,&nbsp;Sherief Ghozy ,&nbsp;Ram Kadrivel ,&nbsp;Waleed Brinjikji ,&nbsp;David F. Kallmes","doi":"10.1016/j.clineuro.2025.109107","DOIUrl":"10.1016/j.clineuro.2025.109107","url":null,"abstract":"<div><h3>Background</h3><div>Acute ischemic stroke (AIS) is a leading cause of morbidity and mortality. Mechanical thrombectomy (MT) is the standard of care for large vessel occlusions (LVO), but anatomical factors like intracranial vessel tortuosity can influence procedural success. This systematic review evaluates the impact of intracranial vessel tortuosity on outcomes of MT in AIS patients, focusing on recanalization success, hemorrhagic complications, and functional recovery.</div></div><div><h3>Design/methods</h3><div>We conducted a systematic review following PRISMA guidelines across PubMed, EMBASE, Scopus, and Web of Science until August 2024. Studies were included if they demonstrate the effect of intracranial vessel tortuosity on MT outcomes.</div></div><div><h3>Results</h3><div>Of the 321 identified studies, 8 met the inclusion criteria, comprising 1942 patients. All studies focused exclusively on the anterior circulation. Studies evaluating the impact of intracranial vessel tortuosity on recanalization success have shown that higher tortuosity compared to no/low tortuosity is associated with an increased number of thrombectomy passes (mean: 2.1 vs. 1.6) and lower overall success rates, with an average final Thrombolysis in Cerebral Infarction (TICI) score &gt; 2b achieved in (63 % vs 76 %) of cases. First-pass effect (FPE) success was lower in tortuous vessels (average 34 % vs 59 %), with odds ratios for unsuccessful FPE ranging from 0.20 to 0.95. Tortuosity and functional recovery were inconsistently linked to hemorrhagic complications.</div></div><div><h3>Conclusions</h3><div>Intracranial vessel tortuosity reduces recanalization success and increases procedural challenges. Its impact on complications and long-term outcomes remains unclear, highlighting the need for further research.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"257 ","pages":"Article 109107"},"PeriodicalIF":1.6,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144842061","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":"Cerebral amyloid angiopathy and endovascular thrombectomy for acute ischemic stroke","authors":"Alis J. Dicpinigaitis,&nbsp;Heather Martin,&nbsp;Samuel S. Bruce,&nbsp;Alexander E. Merkler,&nbsp;Ava L. Liberman,&nbsp;Gloria C. Chiang,&nbsp;Costantino Iadecola,&nbsp;Jared Knopman,&nbsp;Hooman Kamel,&nbsp;Cenai Zhang,&nbsp;Santosh B. Murthy","doi":"10.1016/j.clineuro.2025.109105","DOIUrl":"10.1016/j.clineuro.2025.109105","url":null,"abstract":"","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"257 ","pages":"Article 109105"},"PeriodicalIF":1.6,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144827858","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":"Predicting endovascular recanalization success in symptomatic chronic carotid occlusion: A decision tree model based on 321 cases","authors":"Xiguang Fu ,&nbsp;Mengyuan Yuan ,&nbsp;Yong Zhang ,&nbsp;Haoyu Zhu ,&nbsp;Shengjun Sun ,&nbsp;Chuhan Jiang","doi":"10.1016/j.clineuro.2025.109108","DOIUrl":"10.1016/j.clineuro.2025.109108","url":null,"abstract":"<div><h3>Background</h3><div>Endovascular recanalization for chronic internal carotid artery occlusion (CICAO) remains technically challenging, with variable success rates and a lack of reliable predictive tools for patient selection. We aim to analyze risk factors associated with failed recanalization in CICAO patients and develop a decision tree model to quantify individualized recanalization potential.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 321 patients with symptomatic CICAO who underwent endovascular recanalization. Univariate and multivariate analyses were used to identify risk factors for recanalization failure. A decision tree model and logistic model were constructed. Models’ performance was evaluated using AUC analysis and decision curve analysis (DCA).</div></div><div><h3>Results</h3><div>The overall recanalization success rate was 61.7 %. Our study identified three independent risk factors for failed recanalization: occlusion length &gt; 10 cm, type III stump morphology, and contralateral internal carotid artery stenosis. The decision-tree model demonstrated good performance (AUC 0.839 in training, 0.834 in validation) and provided clinical interpretability compared to logistic regression. DCA confirmed clinical utility across probability thresholds.</div></div><div><h3>Conclusions</h3><div>We developed and validated a decision tree model that effectively predicts endovascular recanalization success in CICAO patients, which may serve as a valuable tool to support clinical decision-making for patients with CICAO.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"257 ","pages":"Article 109108"},"PeriodicalIF":1.6,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144842118","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":"Overall survival after carmustine wafers implantation for newly-diagnosed high grade glioma. A nationwide population-based controlled propensity score-matched analysis","authors":"Charles Champeaux Depond ,&nbsp;Vincent Jecko ,&nbsp;Joconde Weller ,&nbsp;Philippe Tuppin ,&nbsp;Philippe Metellus","doi":"10.1016/j.clineuro.2025.109081","DOIUrl":"10.1016/j.clineuro.2025.109081","url":null,"abstract":"<div><h3>Objective</h3><div>Widespread use of carmustine wafers (CW) for high-grade gliomas (HGG) has been limited by uncertainties about its efficacy. This study aimed to evaluate the overall survival (OS) of patients who underwent CW implantation after newly-diagnosed HGG resection.</div></div><div><h3>Methods</h3><div>In this retrospective study, we processed the French medico-administrative national database to retrieve ad hoc cases. Propensity score-matched (PSM) analysis was performed to reduce bias from confounding patient-related variables and, OS was compared between the two groups.</div></div><div><h3>Results</h3><div>A total of 2956 newly-diagnosed HGG patients who were post-operatively treated according the chemoradiotherapeutic Stupp regimen between the 1st January 2008 and the 31st December 2019 were extracted from the SNDS. 1518 (51.4 %) of these patients had CW implantation at HGG surgery. From the total recruited, 1604 (54.3 %) had missing data for at least 1 of the variables used to calculate the PS and, thus had to be excluded. Of the 1352 remaining subjects, we paired 500 treated patients with 852 controls. The median survival time for the treated group was 1.53 <em>versus</em> 1.42 years for the control group (<em>p</em> = 0.299). The estimated difference in restricted mean survival time between groups at 1, 2, 3 and 5 years were 0.02, _95 %CI[-0.02–0.05], <em>p</em> = 0.326; 0.06, _95 %CI[-0.04–0.16], <em>p</em> = 0.213; 0.11, _95 %CI[-0.04–0.27], <em>p</em> = 0.153 and 0.13, _95 %CI[-0.12–0.37], <em>p</em> = 0.322 respectively.</div></div><div><h3>Conclusion</h3><div>CW implantation with standard chemoradiotherapeutic treatment after newly-diagnosed HGG surgery did not increase the OS of patients.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"257 ","pages":"Article 109081"},"PeriodicalIF":1.6,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144887602","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}