European Journal of Neurology最新文献

{"title":"The Relevance of Crystal Clear and Unclear Days to Evaluate Residual Interictal Burden in Patients With Migraine Treated With CGRP Monoclonal Antibodies.","authors":"Marcello Silvestro, Ilaria Orologio, Raffaele Ornello, Francesca Trojsi, Alessandro Tessitore, Simona Sacco, Antonio Russo","doi":"10.1111/ene.70608","DOIUrl":"https://doi.org/10.1111/ene.70608","url":null,"abstract":"<p><strong>Background: </strong>Although treatment goals in migraine prevention have moved beyond the benchmark of a 50% reduction in monthly attacks, residual disease burden is still evaluated based on residual headache frequency. However, migraine-related symptoms can persist despite headache freedom, leading to so-called unclear days that may meaningfully contribute to interictal burden.</p><p><strong>Methods: </strong>In this prospective, real-world study, patients with chronic or high-frequency episodic migraine treated with CGRP-monoclonal antibodies (CGRP-mAbs) were followed for six months. Interictal burden was assessed using the Migraine Interictal Burden Scale (MIBS-4) alongside the monthly unclear and crystal clear days. Patients achieving optimal (< 4 monthly attacks) or modest (4-6 monthly attacks) migraine control were stratified according to the presence of \"residual interictal burden\" (MIBS-4 ≥ 3).</p><p><strong>Results: </strong>Two hundred patients were included. CGRP-mAbs treatment was associated with a reduction in MIBS-4 scores and an increase in crystal clear days (p < 0.001). Despite optimal or modest migraine control, 45.1% of patients at month 3 and 27.2% at month 6 continued to exhibit a substantial \"residual interictal burden\". Patients with \"residual interictal burden\" showed significantly more unclear days and fewer crystal clear days compared with those without residual interictal migraine burden, while no differences were observed in residual headache days, concomitant preventive treatments, or cephalalgiophobia.</p><p><strong>Discussion: </strong>Even when migraine attacks are adequately controlled, residual interictal burden may remain and seems to be predominantly associated with unclear days rather than with residual attacks. Assessing crystal clear and unclear days provides a complementary, patient-centered perspective on treatment response and interictal recovery in migraine.</p>","PeriodicalId":11954,"journal":{"name":"European Journal of Neurology","volume":"33 4","pages":"e70608"},"PeriodicalIF":3.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13108233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diffuse Infiltrating Perisellar Mass Mimicking Polyneuritis Cranialis.","authors":"Paul Philipp Kastner, Pia Lena Niederau, Georgios Pantazis, Katharina Seystahl","doi":"10.1111/ene.70600","DOIUrl":"https://doi.org/10.1111/ene.70600","url":null,"abstract":"<p><strong>Background: </strong>Subacute oculomotor dysfunction encompasses a broad differential diagnosis, including autoimmune, infectious, vascular, and neoplastic etiologies. Primary skull base diffuse large B-cell lymphoma (DLBCL) is a rare but treatable cause of cranial nerve dysfunction and may present subtly on conventional neuroimaging.</p><p><strong>Methods: </strong>We report an 80-year-old man with subacute diplopia, dysfunction of multiple cranial nerves, left-sided ptosis, and headache. Diagnostic workup included cranial imaging, cerebrospinal fluid (CSF) analysis with cytology and flow cytometry, neurophysiological studies, serum diagnostics, and dedicated MRI of the skull base. Transsphenoidal biopsy was performed following identification of an infiltrative lesion.</p><p><strong>Results: </strong>Initial investigations including cranial CT, CSF analysis, and serum diagnostics were unremarkable. Dedicated skull base MRI revealed a diffuse infiltrating mass involving the clivus, petrous bone, occipital condyles, and perisellar/posterior pituitary region, with anatomical correlation to multiple cranial nerves. Mildly elevated prolactin levels suggested a stalk effect. Histological analysis confirmed DLBCL (NOS, GCB type). Treatment with corticosteroids followed by dose-adjusted R-CHOP resulted in complete clinical remission and radiologically confirmed tumor regression.</p><p><strong>Conclusions: </strong>This case illustrates a rare presentation of primary bony skull base DLBCL with perisellar infiltration, highlighting the diagnostic challenges of complex oculomotor dysfunction. Dedicated skull base MRI is essential in the workup of unexplained cranial neuropathy. CSF-based molecular markers may complement the diagnostic approach in similar presentations.</p>","PeriodicalId":11954,"journal":{"name":"European Journal of Neurology","volume":"33 4","pages":"e70600"},"PeriodicalIF":3.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13108237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Optic Nerve Involvement in Multiple Sclerosis Using Optical Coherence Tomography and Magnetic Resonance Imaging.","authors":"Gualco Alessandro, Boffa Giacomo, Razzetta Chiara, Lapucci Caterina, Cipriano Emilio, Nasone Lorenza, Sirito Tommaso, Al Qudsi Sabrina, Garbarino Sara, Saitta Laura, Campi Cristina, Iester Michele, Cellerino Maria, Inglese Matilde","doi":"10.1111/ene.70605","DOIUrl":"10.1111/ene.70605","url":null,"abstract":"<p><strong>Background: </strong>Optic nerve involvement in Multiple Sclerosis (MS) can be detected with Optical Coherence Tomography (OCT) based on intereye difference (IED). We aimed to assess optic nerve involvement in a large real-world MS cohort applying the 2024 McDonald IED cut off criteria, and to investigate OCT-MRI concordance.</p><p><strong>Methods: </strong>OCT measurements of peripapillary-retinal-nerve-fiber-layer (pRNFL) and ganglion-cell-inner-plexiform-layer (GCIPL) thickness were analyzed in 740 MS patients. Clinical histories of optic neuritis (ON) were reviewed. Three-dimensional double inversion recovery MRI sequences for optic nerve assessment were available for 240 patients.</p><p><strong>Results: </strong>The IED cutoff (GCIPL ≥ 4 μm or pRNFL ≥ 6 μm) demonstrated 83% sensitivity and 55% specificity for identifying prior ON. In the MRI subgroup, it yielded 67% sensitivity and 83% specificity for detecting asymptomatic optic nerve lesions. MRI identified lesions in 46% of patients without a prior history of ON, whereas OCT-IED was positive in 40%, resulting in an overall OCT-MRI concordance of 77%. Among asymptomatic patients (n = 164), 25 were OCT-negative/MRI-positive (11 with bilateral optic nerve involvement) and 15 were OCT-positive/MRI-negative, mostly with isolated GCIPL or pRNFL asymmetry.</p><p><strong>Conclusions: </strong>The 2024 McDonald IED cutoff demonstrates high sensitivity for prior ON but reduced sensitivity for subclinical optic nerve involvement. MRI appears slightly more sensitive, with both modalities providing complementary information on optic nerve pathology.</p>","PeriodicalId":11954,"journal":{"name":"European Journal of Neurology","volume":"33 4","pages":"e70605"},"PeriodicalIF":3.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13091724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Digital Tools and Their Implementation Within Patient Care Pathways for Rare Brain Disorders: The Case of Phenylketonuria.","authors":"Sara Cannizzo, Vinciane Quoidbach, Bernadette Sheehan-Gilroy, Tobias Hagedorn, Agata Bak, Suzanne L Dickson, Eileen P Treacy, Alvaro Hermida, Anita MacDonald, Eva Venegas, James O'Byrne, Maurizio Scarpa, Francjan Van Spronsen, Eric Lange, Tim Buckinx, Ahmad Monavari, Stephan Vom Dahl, Leopoldo Trieste, Giuseppe Turchetti","doi":"10.1111/ene.70575","DOIUrl":"10.1111/ene.70575","url":null,"abstract":"<p><strong>Introduction: </strong>The COVID-19 pandemic accelerated the adoption of digital health solutions in healthcare. Phenylketonuria (PKU) is a rare condition requiring chronic management and frequent assessments, making it a useful model for examining how digital health tools support patient and caregiver education, communication with healthcare professionals and facilities, and patient care pathways.</p><p><strong>Methods: </strong>Patient representatives and expert clinicians developed qualitative, co-designed ad hoc surveys during virtual workshops. From October 2023 to March 2024, the surveys were available online through EUSurvey English, Spanish, and German, and distributed to PKU patients in Spain, Germany, and Ireland by national PKU patient associations.</p><p><strong>Results: </strong>The survey co-design process identified crucial topics significant to key stakeholders in rare disease management. Diverse perspectives emerged on the roles and utility of digital tools: (1) rare disease patients may prefer hybrid care models combining face-to-face and digital interactions; (2) digital tools were perceived as particularly useful for supporting information exchange, education, preparation for clinical visits, and patient engagement.</p><p><strong>Conclusions: </strong>This paper examines unmet needs in digital care pathways for PKU from the perspectives of patients, caregivers, and clinicians. Findings provide important insights into the needs of patients with rare diseases and the most effective channels for engaging and communicating with them. Although clinical and cost-effectiveness were not evaluated, these findings could guide future research and policy discussions on incorporating digital solutions into rare diseases patient care pathways.</p>","PeriodicalId":11954,"journal":{"name":"European Journal of Neurology","volume":"33 4","pages":"e70575"},"PeriodicalIF":3.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13062938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel 3D Semi-Automated Full Quantification Technique for Detection of Intraneural Phospho-α-Synuclein in Skin Biopsies.","authors":"Sophia Lonczewski, Verian Bader, Louisa Ortmann, Louisa Basner, Markus Stücker, Ralf Gold, Raphael Scherbaum, Eun Hae Kwon, Konstanze F Winklhofer, Lars Tönges","doi":"10.1111/ene.70525","DOIUrl":"https://doi.org/10.1111/ene.70525","url":null,"abstract":"<p><strong>Background: </strong>Parkinson's disease (PD) and multiple system atrophy (MSA) are synucleinopathies marked by α-synuclein aggregation, while progressive supranuclear palsy (PSP) is a tauopathy. Clinical overlap between these diseases complicates diagnosis. Detection of intraneural S129 phospho-α-synuclein (pαSyn) via immunofluorescence staining (IF) in skin biopsies shows diagnostic promise. However, prior studies rarely addressed differentiation between synucleinopathies and tauopathies and lacked assessment of varying pαSyn burden-particularly relevant for this aim.</p><p><strong>Methods: </strong>In this cross-sectional study, we analyzed skin biopsies from 29 PD, 5 MSA, and 4 PSP patients. Samples obtained at C7 and Th12 were double-immunostained with pαSyn and PGP9.5, a pan-axonal neurite marker.</p><p><strong>Results: </strong>Our novel method digitizes biopsy sections semi-automatically and performs computer-assisted 3D signal reconstruction. The resulting full volumetric quantification of intraneural pαSyn load enables burden-dependent test results based on ROC-derived cut-offs. Applied as a differential diagnostic test, it showed excellent discrimination of synucleinopathies from tauopathies, achieving AUCs of 0.912 (C7) and 0.934 (Th12), with 88.2% sensitivity and 100% specificity. Intraneural pαSyn load was significantly higher in PD and MSA compared to PSP (C7 p = 0.004; Th12 p = 0.002), with no difference between PD and MSA.</p><p><strong>Conclusions: </strong>This novel technique refines IF by increasing objectivity and allowing gradual pαSyn-burden assessment, offering potential as a confirmatory differential biomarker. Validation in larger, neuropathologically confirmed cohorts of these preliminary small-group results is warranted to fully evaluate the diagnostic and prognostic potential.</p>","PeriodicalId":11954,"journal":{"name":"European Journal of Neurology","volume":"33 4","pages":"e70525"},"PeriodicalIF":3.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13088975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Mitochondrial DNA Copy Number in Progressive Supranuclear Palsy Patients: Evidence From a Pilot Study.","authors":"Luigi Citrigno, Annamaria Cerantonio, Monica Gagliardi, Radha Procopio, Alessia Felicetti, Anna Aureli, Maurizio Morelli, Grazia Annesi","doi":"10.1111/ene.70594","DOIUrl":"10.1111/ene.70594","url":null,"abstract":"<p><strong>Background: </strong>Progressive supranuclear palsy (PSP) is a rare neurodegenerative tauopathy characterized by early postural instability and vertical gaze palsy. Mitochondrial dysfunctions have been increasingly implicated in the pathogenesis of neurodegenerative disorders, including PSP. We investigated mitochondrial DNA copy number (mtDNA-CN) alterations in the peripheral blood of PSP patients, assessing its potential as a biomarker for disease onset and progression.</p><p><strong>Methods: </strong>We measured mtDNA-CN in a cohort of clinically diagnosed PSP patients and age-matched healthy controls using quantitative real-time PCR. We evaluated differences across clinical phenotypes and age groups.</p><p><strong>Results: </strong>PSP patients exhibited a significant reduction in ND3-CN compared to healthy controls (p < 0.0001). This depletion remained consistent across age groups, suggesting that mitochondrial impairment in PSP is independent of physiological aging. Although not statistically significant, ND3-CN levels were lower in PSP-parkinsonism (PSP-P) patients compared to those with Richardson's syndrome (PSP-RS). Interestingly, in PSP-RS patients, ND3-CN levels tended to increase with age, potentially reflecting an age-related compensatory mitochondrial response to chronic neuroinflammation.</p><p><strong>Conclusions: </strong>Our findings support the involvement of mitochondrial dysfunction in PSP pathogenesis, suggesting that peripheral mtDNA-CN may serve as a non-invasive biomarker for disease monitoring. Further studies in larger cohorts are warranted to validate its prognostic potential in different PSP phenotypes.</p>","PeriodicalId":11954,"journal":{"name":"European Journal of Neurology","volume":"33 4","pages":"e70594"},"PeriodicalIF":3.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13088284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147698044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Lifestyle Dissonance: A Neurobiological Narrative to Strengthen Preventive Health Behavior.","authors":"Daniela Berg, Mareike Krause, Eva Schaeffer, Gesine Hermann","doi":"10.1111/ene.70606","DOIUrl":"https://doi.org/10.1111/ene.70606","url":null,"abstract":"<p><strong>Background: </strong>Noncommunicable diseases are the leading cause of death and disability worldwide, although many of their detrimental health effects can be prevented by lifestyle changes. Despite growing public and individual recognition of the importance of prevention, adherence to recommended measures is limited. We refer to this discrepancy between knowledge and action, specifically in relation to preventive lifestyle behavior, as lifestyle dissonance.</p><p><strong>Methods: </strong>This paper presents a narrative synthesis and aims to provide a conceptual framework for communication with patients and the public that includes neurobiological and evolutionary perspectives. It discusses interactions between neural reward systems, executive control mechanisms, and contemporary environmental triggers, including nutrition, exercise, sleep, and stress, as examples of the six pillars of lifestyle medicine.</p><p><strong>Results: </strong>We propose that lifestyle dissonance can serve as a didactic label in communication with patients and the public to explain the mismatch between evolved neural mechanisms and the modern environment. Rather than a sole failure of willpower, non-adherence to preventive lifestyle measures is partly founded in a conflict within neural circuitry. Patient education regarding the brain's underlying processes and their influence on behavior has the potential to enable individuals to actively redesign their actions, train their reward systems, and thus reinforce healthy behavior.</p><p><strong>Conclusion: </strong>Integrating a narrative on neurobiological mechanisms into public health and clinical practice strategies should thus be aimed at helping bridge the gap between intention and sustainable preventive behavior. This conceptual framework provides a basis for supporting patients and the public in achieving lifestyle goals and improving the effectiveness of preventive measures.</p>","PeriodicalId":11954,"journal":{"name":"European Journal of Neurology","volume":"33 4","pages":"e70606"},"PeriodicalIF":3.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13098076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trans-Synaptic Retrograde Retinal Degeneration After Post-Chiasmatic Stroke: A Systematic Review of Empirical Evidence.","authors":"Francesca Crespi, Giacomo Guidali, Lisa Melzi, Stefania Bianchi Marzoli, Nadia Bolognini","doi":"10.1111/ene.70566","DOIUrl":"10.1111/ene.70566","url":null,"abstract":"<p><strong>Background: </strong>Retrograde trans-synaptic degeneration (RTSD) refers to the progressive loss of retinal cells following damage to the post-geniculate visual pathway. The advent of optical coherence tomography (OCT) has allowed the measurement and quantification of retinal layers, in turn providing compelling evidence of RTSD in stroke patients and highlighting that assessing the temporal and functional evolution of RTSD has important clinical implications.</p><p><strong>Methods: </strong>We conducted a systematic review up until 7th July 2025 to summarize the OCT evidence on post-stroke RTSD. Eligible articles on this topic were searched in PubMed, Web of Science, and Scopus databases. Twenty-eight papers, involving 888 patients and 624 healthy controls, were included, and their results were systematically described and qualitatively analyzed.</p><p><strong>Results: </strong>Overall, literature shows that RTSD is a frequent outcome of post-chiasmatic strokes. RTSD is operationalized by measuring the thickness of the peripapillary retinal nerve fiber and macular layers. The latter appears to be a more robust structural biomarker, showing more consistent findings across studies, with its magnitude better correlating with patients' visual field defects. RTSD starts early after the stroke's onset and progresses for several years, with severity depending on lesion location and extension. Future investigations are needed to draw more robust conclusions on RTSD temporal dynamics, clarifying the relation between structural and functional loss.</p><p><strong>Conclusions: </strong>Current literature highlights the need to consider the RTSD among the primary outcomes of post-chiasmatic stroke, given its implications on clinical management and neurorehabilitation, making the longitudinal assessment of this degenerative process crucial for prevention.</p>","PeriodicalId":11954,"journal":{"name":"European Journal of Neurology","volume":"33 4","pages":"e70566"},"PeriodicalIF":3.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13045488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147590813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Headache After Coil Embolization for Unruptured Intracranial Aneurysms (Non-Stent-Assisted Versus Stent-Assisted): A Prospective Comparative Cohort Study.","authors":"Seung Pil Ban, O-Ki Kwon, Young Deok Kim, Hwan Seok Shim, Seung Bin Sung, Jae Seung Bang, Si Un Lee, Sang Hyo Lee, Tae Won Choi, Eun-A Jeong, Hye Ju Jeon, Seunghyun Won","doi":"10.1111/ene.70598","DOIUrl":"10.1111/ene.70598","url":null,"abstract":"<p><strong>Background: </strong>The worsening of headaches or the occurrence of new headaches can occur after coil embolization. Although the frequency of headaches is reported to be greater when a stent is used, this phenomenon is poorly understood. Therefore, we aimed to evaluate the incidence and intensity of headache in patients treated with non-stent-assisted coil embolization (NSCE) versus stent-assisted coil embolization (SACE) for unruptured intracranial aneurysms (UIAs).</p><p><strong>Methods: </strong>In this prospective comparative cohort study, a total of 186 patients treated with coil embolization for UIAs between June 2018 and March 2022 were classified into NSCE or SACE groups. A Cox proportional hazards model was used to identify risk factors for occurrence of headache, and changes in headache intensity over time were assessed using a linear mixed-effects model.</p><p><strong>Results: </strong>Headaches occurred in 71.0% (132/186) of patients after coil embolization. During the 3-month follow-up, headaches after coil embolization were more common in patients who underwent SACE (adjusted hazard ratio, 1.57; p = 0.02). Female sex, cilostazol medication use, and pre-existing headache were also independently associated with the occurrence of headache after coil embolization. Changes in numeric rating scale (NRS) scores according to stent placement status and trends in NRS scores over time based on stent placement status were not statistically significant.</p><p><strong>Conclusions: </strong>Patients treated with SACE were more likely to experience headache after coil embolization than those treated with NSCE were. However, changes in headache intensity over time were not significantly different between the groups.</p>","PeriodicalId":11954,"journal":{"name":"European Journal of Neurology","volume":"33 4","pages":"e70598"},"PeriodicalIF":3.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13063114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Letter to Editor: Headache After Sealing of Cerebrospinal Fluid Leaks in Patients With Spontaneous Intracranial Hypotension.","authors":"Adrian Scutelnic, Nedelina Slavova, Eric Morel, Franz Riederer, Tomas Dobrocky, Eike I Piechowiak, Ralph T Schär, Christoph J Schankin","doi":"10.1111/ene.70452","DOIUrl":"https://doi.org/10.1111/ene.70452","url":null,"abstract":"","PeriodicalId":11954,"journal":{"name":"European Journal of Neurology","volume":"33 4","pages":"e70452"},"PeriodicalIF":3.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13088973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}