Clinical Neurology and Neurosurgery最新文献

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Repeated MRI-negative demyelinating attacks linked to MOG-IgG antibodies and silent lesions – Case series and literature review 反复mri阴性脱髓鞘发作与MOG-IgG抗体和无症状病变相关-病例系列和文献综述
IF 1.6 4区 医学
Clinical Neurology and Neurosurgery Pub Date : 2025-08-12 DOI: 10.1016/j.clineuro.2025.109111
Tal Friedman-Korn , Ariel Rechtman , Omri Zveik, Adi Vaknin-Dembinsky
{"title":"Repeated MRI-negative demyelinating attacks linked to MOG-IgG antibodies and silent lesions – Case series and literature review","authors":"Tal Friedman-Korn ,&nbsp;Ariel Rechtman ,&nbsp;Omri Zveik,&nbsp;Adi Vaknin-Dembinsky","doi":"10.1016/j.clineuro.2025.109111","DOIUrl":"10.1016/j.clineuro.2025.109111","url":null,"abstract":"<div><h3>Background</h3><div>Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD) is an inflammatory demyelinating disorder of the central nervous system. While spinal MRI in MOGAD typically reveals longitudinally extensive transverse myelitis lesions, often involving the conus, rare cases of clinical myelitis without radiological abnormalities have been reported. This study aimed to characterize such MRI-negative presentations in MOGAD and compare them with previously published cases.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 138 patients with MOGAD and identified 37 who had experienced at least one episode of clinical myelitis. Among these, five female patients presented with clinical relapses—four involving the spinal cord and one involving the brain—without corresponding lesions on brain or spinal MRI at the time of the attack. We analyzed their clinical, radiological, and serological profiles in detail. Additionally, we conducted a comprehensive literature review to contextualize our findings, focusing on the demographic and clinical characteristics of similar MRI-negative MOGAD cases, and explored potential explanations for this phenomenon.</div></div><div><h3>Results</h3><div>All five patients were MOG-IgG positive (one borderline), and most showed a favorable clinical response to corticosteroids or plasmapheresis. One patient later developed a radiologically apparent but clinically silent spinal lesion. Comparison with 14 cases reported in the literature revealed similar features, including high disease severity at onset, responsiveness to immunotherapy, and frequent diagnostic delays. Notably, our cohort exhibited exclusive female representation, in contrast to the mixed demographic profiles reported elsewhere.</div></div><div><h3>Conclusion</h3><div>Clinical attacks in MOGAD may occur despite normal spinal and brain MRI findings, emphasizing the limitations of current imaging modalities. A normal MRI does not exclude active or evolving disease. Early MOG-IgG testing, empirical treatment when clinically indicated, and scheduled follow-up imaging are essential to prevent misdiagnosis and mitigate morbidity. Increased awareness of MRI-negative MOGAD is crucial for timely recognition and effective management.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"257 ","pages":"Article 109111"},"PeriodicalIF":1.6,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866530","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
Edaravone plus compound cerebroside in elderly patients with carotid plaque cerebral infarction: Efficacy and prognosis 依达拉奉联合复方脑苷治疗老年颈动脉斑块性脑梗死的疗效及预后
IF 1.6 4区 医学
Clinical Neurology and Neurosurgery Pub Date : 2025-08-11 DOI: 10.1016/j.clineuro.2025.109104
Yidan Zhang , Wenbin Li , Qi Dong
{"title":"Edaravone plus compound cerebroside in elderly patients with carotid plaque cerebral infarction: Efficacy and prognosis","authors":"Yidan Zhang ,&nbsp;Wenbin Li ,&nbsp;Qi Dong","doi":"10.1016/j.clineuro.2025.109104","DOIUrl":"10.1016/j.clineuro.2025.109104","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the clinical efficacy, long-term prognosis and recovery of cognitive function of the elderly patients with carotid plaque massive cerebral infarction (CPMCI) who did not receive reperfusion therapy.</div></div><div><h3>Methods</h3><div>A multi-center, retrospective, single-arm design was adopted in this study, and 184 elderly patients with CPMCI who received the combined treatment of Edaravone, dextromethorphan and compound cerebroside from January 2021 to December 2023 were included. Main outcome measures include modified Rankin scale (mRS) score and National Institutes of Health Stroke Scale (NIHSS) score. Secondary outcome measures included Barthel index, Montreal Cognitive Assessment Scale (MoCA) score, recurrent stroke rate, survival rate and complications. The follow-up time was 1 year.</div></div><div><h3>Results</h3><div>After 6 months of treatment, 54.9 % patients achieved functional independence (mRS≤2), defined as a Modified Rankin Scale (mRS) score of ≤ 2. The NIHSS score significantly decreased from a mean of 16.52 ± 4.23 at baseline to 5.78 ± 3.19 at six months (P &lt; 0.001). Additionally, both the Barthel Index and MoCA scores showed significant improvements (P &lt; 0.001). The one-year recurrent stroke rate was 13.59 %, while the one-year survival rate was 77.7 %. Treatment-related complications were primarily mild to moderate, including aspiration pneumonia (10.87 %) and urinary tract infections (5.97 %), resulting in a total incidence of 16.85 %.</div></div><div><h3>Conclusion</h3><div>Edaravone, dextran and compound cerebroside combination therapy has a significant clinical effect on elderly CPMCI patients without reperfusion therapy, which can improve their functional independence, neurological function, activities of daily living and cognitive function, with acceptable safety.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"257 ","pages":"Article 109104"},"PeriodicalIF":1.6,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144827854","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
Clinical characteristics and prognostic analysis of glutamic acid decarboxylase 65-associated neurological syndromes: A retrospective study from Southwest China 谷氨酸脱羧酶65相关神经系统综合征的临床特点及预后分析:一项来自西南地区的回顾性研究
IF 1.6 4区 医学
Clinical Neurology and Neurosurgery Pub Date : 2025-08-11 DOI: 10.1016/j.clineuro.2025.109110
Tong Yi , Jierui Wang , Luwen Huang , Minjin Wang , Jinmei Li
{"title":"Clinical characteristics and prognostic analysis of glutamic acid decarboxylase 65-associated neurological syndromes: A retrospective study from Southwest China","authors":"Tong Yi ,&nbsp;Jierui Wang ,&nbsp;Luwen Huang ,&nbsp;Minjin Wang ,&nbsp;Jinmei Li","doi":"10.1016/j.clineuro.2025.109110","DOIUrl":"10.1016/j.clineuro.2025.109110","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the clinical characteristics, immunotherapeutic responses, and long-term outcomes of glutamic acid decarboxylase-65 (GAD65)-associated neurological syndromes, and to identify potential factors linked to poor outcomes.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of patients diagnosed with anti-GAD65-associated neurological syndromes at West China Hospital from August 2019 to March 2024. The clinical characteristics, laboratory and imaging findings, response to immunotherapy and prognosis of the patients were systematically analyzed.</div></div><div><h3>Results</h3><div>37 patients were included in this study. Predominant clinical phenotypes included epilepsy (Ep) (n = 12, 32.4 %), stiff-person spectrum disorder (SPSD) (n = 8, 21.6 %), limbic encephalitis (LE) (n = 7, 18.9 %), cerebellar ataxia (CA) (n = 3, 8.1 %). Among them, 26 (70.3 %) were female, with a median age of onset at 39 years (IQR 30; range 9–65). Concomitant systemic autoimmune diseases were observed in 10 patients (27.0 %), 15 (40.0 %) were positive for coexisting autoantibodies. Anxiety disorders were documented in 11 patients (29.7 %). 35 patients (94.6 %) received immunotherapy, with symptom remission observed in 30 patients. The follow-up data over a median duration of 16 months (IQR 31.0; range 12.0–67.0), anxiety disorders, elevated cerebrospinal fluid (CSF) protein, delayed treatment and disease relapse are associated with poor outcomes.</div></div><div><h3>Conclusions</h3><div>Neurological syndromes related to GAD65 antibodies exhibited marked clinical heterogeneity. Although most patients responded to immunotherapy, early intervention was critical for improving outcomes. Anxiety disorders, elevated CSF protein, treatment delay, and disease relapse were associated with adverse prognosis.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"257 ","pages":"Article 109110"},"PeriodicalIF":1.6,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144842062","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
Endovascular thrombectomy for acute ischemic stroke due to medium or distal vessel occlusion: A systematic review and meta-analysis 血管内取栓术治疗中端或远端血管闭塞引起的急性缺血性卒中:一项系统综述和荟萃分析
IF 1.6 4区 医学
Clinical Neurology and Neurosurgery Pub Date : 2025-08-11 DOI: 10.1016/j.clineuro.2025.109101
Julie de Lima Loiola , Gabriel de Almeida Monteiro , Marianna Leite , Beatriz Araújo , Giovanna Ueda , Antonio Mutarelli , Dhruvi Kalpesh Joshi , Caroline Serafim Dagostin , Thales Pardini Fagundes
{"title":"Endovascular thrombectomy for acute ischemic stroke due to medium or distal vessel occlusion: A systematic review and meta-analysis","authors":"Julie de Lima Loiola ,&nbsp;Gabriel de Almeida Monteiro ,&nbsp;Marianna Leite ,&nbsp;Beatriz Araújo ,&nbsp;Giovanna Ueda ,&nbsp;Antonio Mutarelli ,&nbsp;Dhruvi Kalpesh Joshi ,&nbsp;Caroline Serafim Dagostin ,&nbsp;Thales Pardini Fagundes","doi":"10.1016/j.clineuro.2025.109101","DOIUrl":"10.1016/j.clineuro.2025.109101","url":null,"abstract":"<div><h3>Introduction</h3><div>Acute ischemic stroke (AIS) due to medium-vessel occlusion (MeVO) accounts for up to 40 % of ischemic strokes. While traditionally assumed to have better outcomes than large-vessel occlusion (LVO) strokes, recent evidence suggests that MeVO often results in poor functional outcomes despite optimal medical management. The role of endovascular thrombectomy (EVT) in MeVO remains uncertain despite recent trials, due to limited high-quality evidence when considering observational studies. This systematic review and meta-analysis evaluated the efficacy and safety of EVT compared to standard medical therapy (SMT) in patients with AIS due to MeVO.</div></div><div><h3>Methods</h3><div>We systematically searched PubMed, Embase, and Cochrane Central for studies comparing EVT and SMT in patients after AIS secondary to MeVO that reported at least one clinical outcome of interest, such as functional outcome, mortality, and hemorrhagic complications. We used risk ratio (RR) with 95 % confidence intervals (CIs) as the effect size measure for binary outcomes, employing a random-effects model, and RoB-2 and ROBINS-I tools for risk of bias assessment.</div></div><div><h3>Results</h3><div>We included 23 studies (2 RCTs and 21 observational studies) encompassing 7100 patients. There was not significant difference between groups regarding excellent (RR 1.08; 95 % CI 0.96–1.22; p = 0.2204; I² = 65.2 %) and functional independence outcome (RR 1.04; 95 % CI 0.93–1.15; p = 0.4924; I² = 75.1 %), and mortality (RR 1.18; 95 % CI 0.97–1.43; p = 0.0937; I² = 16.6 %). Subgroup analyses showed a benefit of EVT over SMT in PCA occlusions regarding excellent functional outcome. However, EVT was associated with a significantly higher likelihood of hemorrhagic complication than SMT, such as sICH (RR 1.69; 95 % CI 1.18–2.43; p = 0.0042; I² = 39.7 %), and its subtype, SAH (RR 7.97, 95 % CI 4.78–13.30, p &lt; 0.0001; I² = 0.0 %).</div></div><div><h3>Conclusion</h3><div>The combined therapy of EVT and SMT on MeVO AIS showed similar functional status and mortality results as SMT alone. However, the use of EVT increased the risk of hemorrhagic complications (sICH and SAH). While most subgroup analyses showed no potential benefits for M2, ACA and PCA occlusions, overall randomized data remain limited. Future trials should stratify their patient population by occlusion site.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"257 ","pages":"Article 109101"},"PeriodicalIF":1.6,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144842117","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
K-point stimulation combined with temperature-differential herbal oral care in improving post-stroke dysphagia k点刺激联合温控中药口腔护理改善脑卒中后吞咽困难
IF 1.6 4区 医学
Clinical Neurology and Neurosurgery Pub Date : 2025-08-11 DOI: 10.1016/j.clineuro.2025.109103
Xianna Dong , Yuhua Yang , Yehong Wei , Caijiao Wang
{"title":"K-point stimulation combined with temperature-differential herbal oral care in improving post-stroke dysphagia","authors":"Xianna Dong ,&nbsp;Yuhua Yang ,&nbsp;Yehong Wei ,&nbsp;Caijiao Wang","doi":"10.1016/j.clineuro.2025.109103","DOIUrl":"10.1016/j.clineuro.2025.109103","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the efficacy of K-point stimulation combined with temperature-differential herbal oral care in improving swallowing function.</div></div><div><h3>Design</h3><div>A retrospective cohort study.</div></div><div><h3>Methods</h3><div>Patients treated between January 2022 and December 2023 were divided into a control group (routine care) and an observation group (routine care plus K-point stimulation combined with temperature-differentiated herbal oral care). After applying exclusion criteria and 1:1 propensity score matching, 85 patients were included in each group and followed for six months. The primary endpoint was the time to achieve a 3-point improvement on the Food Intake LEVEL Scale (FILS).</div></div><div><h3>Results</h3><div>The observation group demonstrated a significantly shorter median recovery time of 78 days (95 % CI: 62–96) compared to 96 days (95 % CI: 85–129) in the control group (HR = 2.351; 95 % CI: 1.688–3.276; P &lt; 0.001). Clinical improvement in swallowing was achieved in 91.76 % of the observation group versus 81.18 % of the control group (P = 0.036), and good functional recovery at six months was observed in 85.88 % versus 70.59 % (P = 0.012). At the six-month follow-up, serum albumin and total protein levels were significantly higher in the observation group compared to the control group (P &lt; 0.05). Multivariable Cox regression confirmed the intervention’s efficacy (HR = 2.641; 95 % CI: 1.860–3.750; P &lt; 0.001). Adverse events, including nausea, vomiting, pulmonary infections, and stroke recurrence, showed no significant differences between groups (P &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>K-point stimulation combined with temperature-differential herbal oral care is an effective and safe intervention for improving swallowing function and long-term outcomes in post-stroke dysphagia.</div></div><div><h3>Clinical evidence</h3><div>These findings highlight a promising therapeutic strategy for enhancing recovery in patients with post-stroke dysphagia.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"257 ","pages":"Article 109103"},"PeriodicalIF":1.6,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144827853","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
Efficacy and safety of endovascular therapy for posterior cerebral artery occlusion stroke – Cohort study 脑后动脉闭塞性卒中血管内治疗的有效性和安全性——队列研究
IF 1.6 4区 医学
Clinical Neurology and Neurosurgery Pub Date : 2025-08-11 DOI: 10.1016/j.clineuro.2025.109106
Marta Oliveira , Mariana Rocha , Henrique Costa , Joana Novo , Ludovina Paredes , Pedro Barros , Manuel Ribeiro , Sergio Castro , Marta Rodrigues , Pedro Pires , André Araújo , Vera Afreixo , Isabel Fragata , Ana Paiva Nunes , Tiago Gregorio
{"title":"Efficacy and safety of endovascular therapy for posterior cerebral artery occlusion stroke – Cohort study","authors":"Marta Oliveira ,&nbsp;Mariana Rocha ,&nbsp;Henrique Costa ,&nbsp;Joana Novo ,&nbsp;Ludovina Paredes ,&nbsp;Pedro Barros ,&nbsp;Manuel Ribeiro ,&nbsp;Sergio Castro ,&nbsp;Marta Rodrigues ,&nbsp;Pedro Pires ,&nbsp;André Araújo ,&nbsp;Vera Afreixo ,&nbsp;Isabel Fragata ,&nbsp;Ana Paiva Nunes ,&nbsp;Tiago Gregorio","doi":"10.1016/j.clineuro.2025.109106","DOIUrl":"10.1016/j.clineuro.2025.109106","url":null,"abstract":"<div><h3>Introduction</h3><div>Endovascular therapy (EVT) is a highly effective stroke treatment, but trials that led to its approval did not include patients with posterior cerebral artery (PCA) occlusion. Recent studies have suggested an increased risk of intracranial haemorrhage and mortality with treatment in this population. The aim of this study was to compare efficacy and safety of EVT for PCA occlusion with that of EVT for middle cerebral artery occlusion.</div></div><div><h3>Methods</h3><div>Multicentric retrospective cohort study involving a consecutive sample of 2501 patients treated with EVT between January 2015 and December 2022. Efficacy outcomes of interest were recanalization, early neurological improvement and 3-month good and excellent functional outcomes. Safety outcomes of interest were intracerebral hemorrhage, intracranial hemorrhage and 3-month mortality. Logistic regression was used to adjust for confounding.</div></div><div><h3>Results</h3><div>PCA treated patients were more often male, had higher systolic blood pressure, lower NIHSS and more frequently had stroke of atherosclerotic and other/undetermined cause. On univariate analysis, EVT for PCA occlusion was associated with lower rates of recanalization (OR=0.38) and early neurological improvement (OR=0.60), with no differences in functional outcomes or any of the safety outcomes. After adjustment for potential confounders, EVT for PCA occlusion was associated with lower rates of recanalization (OR=0.37), good (OR=0.58) and excellent functional outcome (OR=0.60), again with no differences in terms of safety outcomes.</div></div><div><h3>Conclusion</h3><div>Compared to MCA occlusion, EVT for PCA occlusion appears equally safe but less effective, owing to lower recanalization rates. Randomized trials are required to definitely determine the value of this intervention for this patient population.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"257 ","pages":"Article 109106"},"PeriodicalIF":1.6,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144827856","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
Correlation between estimated glucose disposal rate and the short-term thrombolytic prognosis of patients with acute cerebral infarction 急性脑梗死患者估计葡萄糖处置率与短期溶栓预后的相关性
IF 1.6 4区 医学
Clinical Neurology and Neurosurgery Pub Date : 2025-08-11 DOI: 10.1016/j.clineuro.2025.109102
Xuyou Zhou, Weiwei Ji, Xia Lu, Juan Qu, Jin Hu
{"title":"Correlation between estimated glucose disposal rate and the short-term thrombolytic prognosis of patients with acute cerebral infarction","authors":"Xuyou Zhou,&nbsp;Weiwei Ji,&nbsp;Xia Lu,&nbsp;Juan Qu,&nbsp;Jin Hu","doi":"10.1016/j.clineuro.2025.109102","DOIUrl":"10.1016/j.clineuro.2025.109102","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the correlation between the estimated glucose disposal rate (eGDR) and the short-term thrombolytic prognosis of patients with acute cerebral infarction.</div></div><div><h3>Methods</h3><div>A total of 214 patients with acute cerebral infarction who received thrombolytic treatment in our hospital from January 2022 to December 2023 were selected. The clinical data of the patients were collected, including general conditions, laboratory tests, etc. The eGDR was calculated using the homeostasis model assessment method and divided into four groups according to the quartiles of eGDR. The differences in clinical data among the groups were compared. According to the prognosis of the patients after thrombolysis, they were divided into the favorable functional outcome (modified Rankin scale 0–2 points) and the poor functional outcome group (modified Rankin scale 3–6 points). The eGDR and other clinical indicators of the two groups of patients were compared. Finally, univariate and multivariate analyses were used to evaluate the correlation between eGDR and related results.</div></div><div><h3>Results</h3><div>The median value of eGDR was 7.07 mg/kg/min (interquartile range, 6.15–9.23). Among them, the history of diabetes, BMI, HbA1c, triglycerides, and fasting blood glucose had statistical differences in the four subgroups (P &lt; 0.05). The eGDR of the patients in the good prognosis group was significantly higher than that in the poor prognosis group (P &lt; 0.05), while the systolic blood pressure, BMI, HbA1c, fasting blood glucose, NIHSS score at admission, and mRS score at admission were all lower than those in the poor prognosis group (P &lt; 0.05). Multivariate Logistic regression analysis showed that the hemorrhagic transformation rate in the low eGDR group was still significantly higher than that in the high eGDR group (adjusted OR 1.24, [95 %CI: 1.02–1.45; p &lt; 0.01]); the rates of favorable functional outcome (mRS score 0–2 points) and excellent functional outcome (mRS score 0–1 points) had statistical differences, and the high eGDR group was significantly higher than the low eGDR group. However, the rate of worse ending or death did not show a statistical difference.</div></div><div><h3>Conclusion</h3><div>eGDR is closely related to the thrombolytic prognosis of patients with acute cerebral infarction and can be used as an important indicator for evaluating the prognosis of patients.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"257 ","pages":"Article 109102"},"PeriodicalIF":1.6,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144893852","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
Benchmarking surgical approaches to thoracic disc herniation: A retrospective database study 胸椎椎间盘突出的基准手术入路:回顾性数据库研究
IF 1.6 4区 医学
Clinical Neurology and Neurosurgery Pub Date : 2025-08-09 DOI: 10.1016/j.clineuro.2025.109100
Pranav Kumar , Eric Z. Herring , Rohit Mauria , Collin M. Labak , Tianqi Xiao , Manish K. Kasliwal
{"title":"Benchmarking surgical approaches to thoracic disc herniation: A retrospective database study","authors":"Pranav Kumar ,&nbsp;Eric Z. Herring ,&nbsp;Rohit Mauria ,&nbsp;Collin M. Labak ,&nbsp;Tianqi Xiao ,&nbsp;Manish K. Kasliwal","doi":"10.1016/j.clineuro.2025.109100","DOIUrl":"10.1016/j.clineuro.2025.109100","url":null,"abstract":"<div><h3>Background</h3><div>Thoracic disc herniations are a relatively uncommon form of degenerative disc disease, comprising an estimated 0.1–3 % of all spinal disc herniations. Surgical treatment may utilize an anterior, lateral, or posterior/posterolateral approach, and approach selection is based on a number of factors.</div></div><div><h3>Objective</h3><div>This study investigated national trends in surgical approach utilization as well as patient characteristics predictive of receiving a specific surgical approach.</div></div><div><h3>Methods</h3><div>This was a retrospective study querying the TriNetX national database. Patients were identified through specific ICD-9 coding for degenerative thoracic disc herniation and CPT coding for thoracic spinal procedures.</div></div><div><h3>Results</h3><div>Of 3009 total patients meeting inclusion criteria, 2703 patients (89.8 %) underwent decompression through a posterior or posterolateral approach, 222 (7.4 %) via anterior approach, and 84 (2.8 %) via lateral extracavitary approach. The number of posterior or posterolateral operations notably increased from 43 cases in 2010 to over 240 cases per year from 2022 to 2024. In contrast, anterior approach procedures reached a peak of 27 cases in 2017 and declined to 13 or fewer cases per year since.</div></div><div><h3>Conclusion</h3><div>Most thoracic disc herniation patients in the TriNetX database received surgical decompression via a posterior or posterolateral approach. Although the annual number of surgeries performed for thoracic disc herniation patients increased after 2017, there was a decreased utilization of anterior approaches. This study demonstrates the widespread utilization of posterolateral-based approaches in the surgical management of thoracic disc herniations.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"257 ","pages":"Article 109100"},"PeriodicalIF":1.6,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144827855","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
Corrigendum to “Timing of external ventricular drain placement and its effects on in-hospital outcomes in traumatic brain injury: A propensity score-matched analysis” [Clin. Neurol. Neurosurg. 257 (2025) 109044] 外脑室引流放置时机及其对外伤性脑损伤住院预后的影响:倾向评分匹配分析[临床。神经。神经外科。257(2025)109044]。
IF 1.6 4区 医学
Clinical Neurology and Neurosurgery Pub Date : 2025-08-08 DOI: 10.1016/j.clineuro.2025.109095
Sam H. Jiang , Hadeel M. Mansour , Michael Edgar , Gabriel S. Gonzales-Portillo , Zayed Almadidy , Ankit I. Mehta
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引用次数: 0
Retraction notice to “Fractionated stereotactic re-irradiation for recurrent glioblastoma: A systematic review and meta-analysis” [Clinical Neurology and Neurosurgery 229 (2023) 107728] “分次立体定向再照射治疗复发性胶质母细胞瘤:一项系统综述和荟萃分析”[临床神经病学和神经外科229(2023)107728]。
IF 1.6 4区 医学
Clinical Neurology and Neurosurgery Pub Date : 2025-08-08 DOI: 10.1016/j.clineuro.2025.109061
Tingfan Luo , Jin Feng , Pengfei Sun
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引用次数: 0
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