Journal of Clinical Neuroscience最新文献

{"title":"Factors associated with ICU stays after endovascular treatments for unruptured intracranial aneurysms: A review study","authors":"Nicholas Kendall ,&nbsp;Abdelrahman M Hamouda ,&nbsp;Mark Cwajna ,&nbsp;Aryan Gajjar ,&nbsp;Mohamed Derhab ,&nbsp;Sherief Ghozy ,&nbsp;Kogulavadanan Arumaithurai ,&nbsp;David F Kallmes","doi":"10.1016/j.jocn.2025.111090","DOIUrl":"10.1016/j.jocn.2025.111090","url":null,"abstract":"<div><h3>Background</h3><div>For unruptured intracranial aneurysms (UIAs), conservative management is often possible. However, when direct treatment is warranted, endovascular treatments (EVTs) provide an effective minimally invasive approach. These procedures still necessitate careful patient monitoring, frequently in the Intensive Care Unit (ICU). The factors leading to ICU admission for these patients remains an area of debate.</div></div><div><h3>Objective</h3><div>This systematic review aims to highlight existing literature and identify gaps in understanding the factors contributing to ICU admission following EVTs for UIAs.</div></div><div><h3>Methods</h3><div>We utilized the Nested Knowledge Autolit semi-automated software to gather studies published before April 2024. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and included studies that met predetermined population, intervention, control, and outcomes (PICO) criteria. Statistical analysis was performed using R software.</div></div><div><h3>Results</h3><div>We retrieved 181 studies and 9 met our inclusion criteria. There was significant variability across these studies on what factors they reported. Across included studies there were 8,189 patients, with 5,620 being placed in the ICU following EVTs for UIAs. Analysis revealed that anterior aneurysm location, aneurysm-related symptoms, and procedure length were significant factors associated with ICU admission. The overall ICU admission rate was approximately 24.61 per 100 patients.</div></div><div><h3>Conclusion</h3><div>This review underscores the need for further research to understand the factors we found associated with ICU admission following EVTs for UIAs. Additional studies are needed that use a standardized approach to collect data on patient demographics, aneurysm characteristics, procedural details, and postoperative outcomes. Such studies will allow for concrete recommendations to be made on ICU needs and prognostic calculators to be developed in order to support clinical decisions and lower healthcare costs.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"134 ","pages":"Article 111090"},"PeriodicalIF":1.9,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065673","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":"Artificial intelligence for brain neuroanatomical segmentation in magnetic resonance imaging: A literature review","authors":"Mitchell Andrews ,&nbsp;Antonio Di Ieva","doi":"10.1016/j.jocn.2025.111073","DOIUrl":"10.1016/j.jocn.2025.111073","url":null,"abstract":"<div><h3>Purpose</h3><div>This literature review aims to synthesise current research on the application of artificial intelligence (AI) for the segmentation of brain neuroanatomical structures in magnetic resonance imaging (MRI).</div></div><div><h3>Methods</h3><div>A literature search was conducted using the databases Embase, Medline, Scopus, and Web of Science, and captured articles were assessed for inclusion in the review. Data extraction was performed for the summary of the AI model used, and key findings of each article, advantages and disadvantages were identified.</div></div><div><h3>Results</h3><div>Following full-text screening, 21 articles were included in the review. The review covers models for segmentation models applied to the whole brain, cerebral cortex, subcortical structures, the cerebellum, blood vessels, perivascular spaces, and the ventricles. Accuracy of segmentation was generally high, particularly for segmenting neuroanatomical structures in healthy cohorts.</div></div><div><h3>Conclusion</h3><div>The use of AI for automatic brain segmentation is generally highly accurate and fast for all regions of the human brain. Challenges include robustness to anatomical variability and pathology, largely due to difficulties with accessing sufficient training data.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"134 ","pages":"Article 111073"},"PeriodicalIF":1.9,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breaking barriers: The impact of felt stigma on stroke survivors’ quality of life and pathways to holistic rehabilitation","authors":"Paul Arjanto","doi":"10.1016/j.jocn.2025.111078","DOIUrl":"10.1016/j.jocn.2025.111078","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"133 ","pages":"Article 111078"},"PeriodicalIF":1.9,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064665","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":"Revolutionizing spine health: Bridging lifestyle interventions and inclusive care for global well-being","authors":"Paul Arjanto ,&nbsp;Mint Husen Raya Aditama","doi":"10.1016/j.jocn.2025.111060","DOIUrl":"10.1016/j.jocn.2025.111060","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"133 ","pages":"Article 111060"},"PeriodicalIF":1.9,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059213","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":"Intraoperative electrophysiological balloon test occlusion (BTO): A novel Solution to an inconclusive conventional BTO","authors":"Aanchal Datta,&nbsp;Ila Katyayan,&nbsp;Kuntal Kanti Das,&nbsp;Nidhi Singh,&nbsp;Pooja Tataskar,&nbsp;Arun Kumar Srivastava,&nbsp;Awadhesh Kumar Jaiswal","doi":"10.1016/j.jocn.2025.111044","DOIUrl":"10.1016/j.jocn.2025.111044","url":null,"abstract":"<div><div>Parent Artery Occlusion (PAO) is a valid treatment choice in giant internal carotid artery (ICA) aneurysms of the cavernous segment when the preoperative balloon test occlusion (BTO) demonstrates an adequate cross circulation from the contralateral side. A high flow arterial bypass is, however, mandatory if the result suggests otherwise or is indeterminate. We present here a case of a 72-year lady where the BTO results were inconclusive. Rather than proceeding for the ICA ligation and a high flow bypass straight away, we replicated the BTO in the operation theatre, using intraoperative electrophysiologic neuromonitoring under the general anaesthesia. A temporary clip was applied on the ICA followed by gradual reduction of the blood pressure up to 30% from the baseline and sustained for 30 min. The motor evoked potential (MEP) and somatosensory evoked potential (SSEP) monitoring did not show ipsilateral hemispheric ischemia. Assured by this electrophysiologic evidence, we proceeded with ligation of the cervical ICA. The patient recovered from surgery without any neurological deficits and remains functionally intact at 4-years follow-up. Based on this case, this novel method can be considered a further refinement of the conventional BTO, allowing clarification of the inconclusive results that may sometimes be encountered.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"133 ","pages":"Article 111044"},"PeriodicalIF":1.9,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046076","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":"The development of an international partnership for cranial neurosurgery in The Gambia","authors":"Saksham Gupta ,&nbsp;Ebrima K. Manneh ,&nbsp;Momodou G. Bah ,&nbsp;Sabina Kangakan ,&nbsp;Anwar AlKhateeb ,&nbsp;Sheikh Sadibou ,&nbsp;Camejo Sánchez ,&nbsp;Ryan Chrenek ,&nbsp;Zsombor T. Gal ,&nbsp;Cherno S. Jallow ,&nbsp;Mohammad A. Aziz-Sultan ,&nbsp;Kingsley Isaac Olatunde ,&nbsp;Ajibola Daniel ,&nbsp;Aji Jahou Bah ,&nbsp;Lamin Janneh ,&nbsp;Hinna Malik ,&nbsp;Mustapha Bittaye ,&nbsp;Timothy R. Smith ,&nbsp;John N. Jabang","doi":"10.1016/j.jocn.2025.111063","DOIUrl":"10.1016/j.jocn.2025.111063","url":null,"abstract":"<div><h3>Background</h3><div> <!-->There is a considerable burden of pituitary and other skull base diseases in low-and-middle-income countries that often go unaddressed. In this study, we describe the development of an institutional partnership between Mass General Brigham (MGB) and the Edward Francis Small Teaching Hospital (EFSTH; The Gambia) to develop the capacity to perform complex cranial neurosurgery with a focus on pituitary surgery.</div></div><div><h3>Methods</h3><div> <!-->This is a case series of 5 operations performed at EFSTH from September 17–19, 2024.</div></div><div><h3>Results</h3><div>5 operations were performed, including 3 for pituitary macroadenoma, 1 for giant falcine meningioma, and 1 for postcentral gyrus tuberculoma. Operative times ranged from 3 to 9 h and estimated blood loss ranged from 200 to 800 cc. There were no intraoperative complications, though one patient suffered a delayed venous infarction that caused transient weakness and inability to ambulate. All patients were discharged home, and all patients’ preoperative symptoms improved by final follow-up. The crude long-term cost efficacy of performing pituitary surgery was approximated to be $21 US dollars (USD) in productivity gained for every $1 spent.</div></div><div><h3>Conclusions</h3><div>We describe the early development of a new global neurosurgery partnership between EFSTH and MGB, which includes the country’s first pituitary operation.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"133 ","pages":"Article 111063"},"PeriodicalIF":1.9,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143135550","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":"Proton pump inhibitor use and all-cause mortality in stroke survivors on antiplatelet therapy: An NHANES analysis","authors":"Yong He ,&nbsp;Guangpeng Xiang ,&nbsp;Tieshi Zhu","doi":"10.1016/j.jocn.2025.111056","DOIUrl":"10.1016/j.jocn.2025.111056","url":null,"abstract":"<div><h3>Introduction</h3><div>Stroke is a leading cause of death and disability worldwide. Antiplatelet therapy is essential for preventing ischemic stroke recurrence, but it carries a risk of gastrointestinal (GI) bleeding. Proton pump inhibitors (PPIs) are often prescribed to mitigate this risk, but their long-term use has been linked to increased all-cause mortality. Limited research exists on the impact of PPI use on mortality in stroke survivors receiving antiplatelet therapy. This study aims to evaluate the association between PPI use and all-cause mortality in this population.</div></div><div><h3>Methods</h3><div>Data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018 were used. A total of 335 stroke survivors on antiplatelet therapy were included and classified based on PPI use. All-cause mortality was determined by linkage to the National Death Index. Weighted Cox regression models were used to assess the association between PPI use and all-cause mortality, adjusting for key covariates such as age, sex, race, socioeconomic status, and comorbidities.</div></div><div><h3>Results</h3><div>Among 335 participants, 78 used PPIs. No significant association was found between PPI use and all-cause mortality across all models (HR 0.98, 95 % CI 0.67–1.42, p = 0.95). Subgroup analysis indicated that PPIs use was not associated with all-cause mortality risk in any of the subgroups. Kaplan-Meier curves showed no significant difference in survival between PPI and non-PPI groups (p = 0.79).</div></div><div><h3>Conclusion</h3><div>PPI use in stroke survivors on antiplatelet therapy was not associated with increased all-cause mortality. The decision to use PPIs should involve a careful evaluation of the potential benefits and risks.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"133 ","pages":"Article 111056"},"PeriodicalIF":1.9,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143038959","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":"Evaluation of adherence to the Preferred Reporting of CasE Series in Surgery (PROCESS) 2020 guideline in case series describing endovascular management of vein of Galen malformation demonstrates suboptimal reporting practices","authors":"Samuel J. White ,&nbsp;Joseph Douvartzidis ,&nbsp;Johnny Lo ,&nbsp;Kartik Bhatia","doi":"10.1016/j.jocn.2025.111061","DOIUrl":"10.1016/j.jocn.2025.111061","url":null,"abstract":"<div><h3>Background</h3><div>Interventional neuroradiology is a dynamic field with technological advancements constantly driving evolution in clinical practice. Case series provide interventional neuroradiologists the opportunity to describe the clinical implications of novel equipment and techniques almost in real-time, informing broader adoption and directing future research. Complete reporting in case series is vital in enabling readers to detect bias, determine the generalizability of results and replicate study methodology. The aim of this study was to assess the quality of reporting in case series describing endovascular management of vein of Galen malformations.</div></div><div><h3>Methods</h3><div>A systematic search for case series describing endovascular management of vein of Galen malformations in paediatric patients was conducted using a previously published search strategy in Medline, Embase and Web of Science in February 2024. Screening and data extraction were performed by two independent reviewers with disagreements resolved by consensus discussion. Quality of reporting was assessed using adherence to the Preferred Reporting of CasE Series in Surgery (PROCESS) 2020 checklist.</div></div><div><h3>Results</h3><div>We included 19 case series representing a broad range of approaches and endovascular techniques for management of vein of Galen malformations. Overall adherence to the PROCESS 2020 guideline was moderate with a mean of 7.0/13 (54%; range 5.2 – 9.7/13; SD 1.1) items reported. The most consistently reported items related to characteristics of the clinical cohort and details regarding the specific image-guided intervention(s) provided. Items relating to study design, source of funding, pre-intervention patient optimisation, clinical follow-up and potential complications and alternatives for novel techniques/devices were less frequently reported.</div></div><div><h3>Conclusions</h3><div>The quality of reporting in case series describing endovascular management of vein of Galen malformation is suboptimal. Measures to improve the quality of reporting in neurointerventional case series include mandating adherence to reporting guidelines in journal instructions for authors and requiring submission of completed copies of relevant reporting guidelines alongside manuscripts.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"133 ","pages":"Article 111061"},"PeriodicalIF":1.9,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Echocardiogram utilization in hospitalized adults with isolated traumatic brain injury: Propensity-matched analysis of the national inpatient sample 2016–2020","authors":"Michael K. Meno ,&nbsp;Osayd Assad ,&nbsp;Julie Pham ,&nbsp;Nophanan Chaikittisilpa ,&nbsp;Taniga Kiatchai ,&nbsp;Sue Duval ,&nbsp;Karen Segar ,&nbsp;Monica S. Vavilala ,&nbsp;Koichiro Nandate ,&nbsp;Vijay Krishnamoorthy ,&nbsp;Younghoon Kwon ,&nbsp;Abhijit V. Lele","doi":"10.1016/j.jocn.2025.111058","DOIUrl":"10.1016/j.jocn.2025.111058","url":null,"abstract":"<div><h3>Background</h3><div>Early left ventricular systolic dysfunction is common after moderate-severe traumatic brain injury (TBI). Echocardiography (Echo) can evaluate cardiac function across various clinical scenarios; however, its utilization in isolated TBI remains poorly understood. To address this gap, we aim to examine Echo utilization in hospitalized adults with isolated TBI.</div></div><div><h3>Methods</h3><div>Using a propensity-matched cohort based on All Patient Refined Diagnosis Related Group severity of illness, we performed a multivariable logistic regression analysis (adjusting for demographics, admitting hospital characteristics, TBI characteristics, cardiac comorbidities, and cardiac complications) to examine factors associated with Echo utilization in patients with isolated TBI in the US National Inpatient Sample (2016–2020). We reported adjusted odds ratio (aOR) and 95% confidence intervals.</div></div><div><h3>Results</h3><div>In 4874 patients matched by APR-DRG severity of illness, the factors associated with Echo utilization were as follows: Older age compared to 18–44 years, Urban teaching hospital: aOR 1.44 [1.05;1.98], TBI associated with syncope: 3.29 [2.68;4.07], ICP monitoring: 2.26 [1.18, 4.45), hypertension: 1.35 [1.18, 1.54], myocardial infarction: 2.89 [2.14, 3.94], atrial fibrillation:1.38 [1.10, 1.74], heart failure: 1.57 [1.31, 1.87], ventricular tachycardia: 1.85 [1.28, 2.71), and pulmonary embolism: 2.61 [1.51, 4.66].</div></div><div><h3>Conclusions</h3><div>Echo utilization was associated with TBI etiology, pre-existing cardiac comorbidities, and in-hospital cardiac complications. These findings need validation in prospective studies.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"133 ","pages":"Article 111058"},"PeriodicalIF":1.9,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023791","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":"Retinal vasculature changes as indicators of imaging signs of cerebral small vessel disease: A community-based, cross-sectional study of older adults","authors":"Xirui Zhou ,&nbsp;Tao Li ,&nbsp;Yucun Chen ,&nbsp;Yi Zhang ,&nbsp;Qianqian Kong ,&nbsp;Ziyue Wang ,&nbsp;Hao Huang ,&nbsp;Wensheng Qu ,&nbsp;Zhiyuan Yu ,&nbsp;Xiang Luo","doi":"10.1016/j.jocn.2025.111057","DOIUrl":"10.1016/j.jocn.2025.111057","url":null,"abstract":"<div><h3>Objectives</h3><div>This study investigated the correlation between retinal vasculature and cerebral small vessel disease (CSVD) imaging markers, providing new evidence for the retina-brain association.</div></div><div><h3>Methods</h3><div>Two hundred and thirty-nine participants aged 55–85 were enrolled in the study. CSVD indicators, encompassing white matter hyperintensities (WMHs), lacunes (LAs), cerebral microbleeds (CMBs), and enlarged perivascular spaces (EPVSs), were assessed. The vascular density (VD) of the superficial vascular plexus (SVP) and deep vascular plexus (DCP) was evaluated using optical coherence tomography angiography (OCTA). Furthermore, the software automatically calculated SVP’s small vessel density (sVD). Finally, the area, perimeter, circularity index (CI), and VD-300 μm of the foveal avascular zone (FAZ) were assessed utilizing OCTA. The mean values of binocular OCTA parameters were used for data analysis. The association between OCTA parameters and CSVD imaging markers was evaluated using binary logistic regression analysis.</div></div><div><h3>Results</h3><div>The median age was 68 (64–71) years with 40.2 % of the participants being male. In the binary logistic regression analysis, WMHs exhibited a negative association with the SVP-VD, DCP-VD, and FAZ VD-300 μm (P &lt; 0.05); LAs displayed a negative correlation with the SVP-sVD and SVP-VD (P &lt; 0.05); and EPVSs indicated a negative correlation with both the area and perimeter of the FAZ (P &lt; 0.05); however, CMBs did not demonstrate any significant correlation with OCTA indicators (P &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>The study demonstrated that different CSVD indicators are associated with distinct OCTA markers. OCTA may be a valuable tool for monitoring CSVD-related indicators.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"133 ","pages":"Article 111057"},"PeriodicalIF":1.9,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028921","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}