Journal of Clinical Neuroscience最新文献

{"title":"Choroid plexus metastasis of renal cell carcinoma mimicking intraventricular menengioma","authors":"Hayri Ogul , Ali Koksal","doi":"10.1016/j.jocn.2025.111634","DOIUrl":"10.1016/j.jocn.2025.111634","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"141 ","pages":"Article 111634"},"PeriodicalIF":1.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145060577","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":"Differences in clinical profiles of patients with symptomatic and asymptomatic apoplexy in pituitary neuroendocrine tumors","authors":"Abhijit Goyal-Honavar ,&nbsp;Subhas Konar ,&nbsp;Nishanth Sadashiva ,&nbsp;Shilpa Rao ,&nbsp;Mohammed Nadeem ,&nbsp;A.R. Prabhu Raj ,&nbsp;Jitendra Saini ,&nbsp;A. Arivazhagan ,&nbsp;Dwarkanath Srinivas ,&nbsp;Dhaval Shukla","doi":"10.1016/j.jocn.2025.111625","DOIUrl":"10.1016/j.jocn.2025.111625","url":null,"abstract":"<div><h3>Purpose</h3><div>Pituitary apoplexy results from hemorrhage and/or infarction of a pituitary neuroendocrine tumor (PitNET). Although characterized by an acute clinical syndrome that includes headache, visual deterioration, and cranial nerve palsies, a subset of cases are “asymptomatic”, detected incidentally. No data exists comparing the preoperative characteristics and outcomes of symptomatic and asymptomatic apoplexy. To that end, we aimed to elucidate the differences in clinical profiles of patients with symptomatic and asymptomatic pituitary apoplexy.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed all apoplectic PitNETs that presented to us between 2013 and 2023. Preoperative clinical, hematological, and radiological characteristics were compared among symptomatic and asymptomatic cases. Pathological classification was performed on the basis of hormone immunohistochemistry alone, and differences in outcomes were examined between the groups.</div></div><div><h3>Results</h3><div>The cohort comprised 83 patients, 67 with symptomatic apoplexy 16 with asymptomatic apoplexy. Headache, vomiting and cranial nerve palsies were more frequent among symptomatic apoplexy. Total WBC count and neutrophil:lymphocyte ratio (NLR) were significantly greater among the symptomatic apoplexy group than the asymptomatic apoplexy group (<em>p &lt; 0.001</em> and <em>0.030</em> respectively). Hyponatremia occurred in 42.2 %, more frequent among acute apoplexy, with all cases of moderate-severe hyponatremia due to SIADH and hypocortisolemia. Eight patients developed thrombotic events associated with significantly greater total WBC count and NLR.</div></div><div><h3>Conclusions</h3><div>Symptomatic and asymptomatic pituitary apoplexy represent distinct clinical entities. Significantly greater leukocytosis and NLR are associated with symptomatic apoplexy, as well as with thrombotic events in symptomatic apoplexy. Hyponatremia frequently accompanies pituitary apoplexy, especially in symptomatic cases, with SIADH and hypopituitarism causing moderate-severe hyponatremia.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"141 ","pages":"Article 111625"},"PeriodicalIF":1.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145060576","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 influence of grit on long-term outcomes after lumbar surgery: a pilot study","authors":"Halle Hansen ,&nbsp;Ken Porche ,&nbsp;Erica F. Bisson","doi":"10.1016/j.jocn.2025.111622","DOIUrl":"10.1016/j.jocn.2025.111622","url":null,"abstract":"<div><h3>Background</h3><div>Resilience has been shown to impact surgical outcomes across many diseases. The “Grit Scale score” has been used to quantify a more sustained resilience by examining commitment to long-term goals and perseverance. We assessed the influence of grit on long-term patient-reported outcomes after multilevel lumbar spine surgery for degenerative conditions.</div></div><div><h3>Methods</h3><div>In this cohort study, 21 adults who had ≥3 years of follow-up after lumbar spine surgery were classified as “Gritty” (Grit Scale score ≥3.8) or “Not Gritty” (&lt;3.8). Patient-reported outcomes were measured at baseline and at multiple intervals up to 5 years postoperatively and compared between cohorts.</div></div><div><h3>Results</h3><div>The mean grit scores differed significantly between the two groups (Gritty 4.15 ± 0.25 vs. Not Gritty 3.26 ± 0.33, p &lt; 0.001), and the cohorts were otherwise demographically and clinically comparable. The Gritty group reported significantly greater improvements in EuroQoL-5D scores at 12 months (+28 % vs. −15 %, p = 0.034), 24 months (+34 % vs. −9 %, p = 0.044), and 36 months (+32 % vs. 0 %, p = 0.016). Additionally, back pain scores were lower in the Gritty group at 12 months (p = 0.016). No significant differences were observed for Oswestry Disability Index or rates of minimal clinically important difference achievement. Secondary outcomes, including length of hospital stay, complications, and reoperations, were comparable.</div></div><div><h3>Conclusions</h3><div>Higher grit scores correlated with better long-term quality of life and reduced back pain at selected intervals after lumbar spine surgery, without differences in disability scores or secondary outcomes. Considering the study’s pilot nature and limited sample size, further investigation with larger cohorts is merited to clarify the role of grit in recovery.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"141 ","pages":"Article 111622"},"PeriodicalIF":1.8,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145044963","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":"Timing of aneurysm repair after subarachnoid haemorrhage: a systematic review and meta-analysis of ultra-early and early intervention","authors":"Thenul Munasinghe ,&nbsp;Helen Huang ,&nbsp;Thanh Phan ,&nbsp;Leon Lai","doi":"10.1016/j.jocn.2025.111623","DOIUrl":"10.1016/j.jocn.2025.111623","url":null,"abstract":"<div><h3>Objective</h3><div>The optimal timing of aneurysm repair following aneurysmal subarachnoid haemorrhage (aSAH) remains uncertain. This systematic review and <em>meta</em>-analysis evaluated whether ultra-early (≤6h), early (≤12 h), or standard (≤24 h) treatment influences rebleeding, functional outcome, or mortality.</div></div><div><h3>Methods</h3><div>A systematic search of MEDLINE, EMBASE, and Scopus identified English-language studies published between 2000 and 2024 reporting outcomes after surgical or endovascular intervention within 24 h of aSAH. Pooled odds ratios (ORs) were calculated using random-effects models. Heterogeneity was assessed using the I² statistic. Poor functional outcome was defined as modified Rankin Scale score 3–6 at 6 months.</div></div><div><h3>Results</h3><div>Twenty-one studies comprising 8,108 patients were included. Ultra-early treatment (≤6h) was associated with a reduced risk of rebleeding (OR 0.21; 95 % CI 0.06–0.77), though this was based on two studies and should be interpreted cautiously. No mortality or functional outcome data were available for this subgroup. Early treatment (≤12 h) was associated with increased rebleeding risk (OR 2.36; 95 % CI 1.44–3.89) and no significant difference in functional outcome (OR 1.01; 95 % CI 0.47–2.15). Standard treatment (≤24 h) showed a directionally favourable estimate for functional outcome (OR 0.57; 95 % CI 0.33–1.00), though statistical significance was not reached. Mortality outcomes across all timing thresholds were inconclusive, with substantial heterogeneity observed.</div></div><div><h3>Conclusion</h3><div>Ultra-early aneurysm repair may reduce rebleeding, but current evidence is limited, underpowered, and insufficient to determine effects on survival or recovery. No consistent benefit was observed with early treatment. Further prospective, time-stratified studies are needed to define the optimal intervention window following aSAH.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"141 ","pages":"Article 111623"},"PeriodicalIF":1.8,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145044962","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":"Neuroparacoccidioidomycosis mimicking a calcified brain tumor","authors":"Mayara Pinheiro da Roza ,&nbsp;Pedro Henrique Segatt ,&nbsp;Márcio Luís Duarte ,&nbsp;Leonardo Furtado Freitas ,&nbsp;Eduardo de Oliveira Narvaez","doi":"10.1016/j.jocn.2025.111596","DOIUrl":"10.1016/j.jocn.2025.111596","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"141 ","pages":"Article 111596"},"PeriodicalIF":1.8,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145044964","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":"From optimized to validated: Embedding ethical, analytic, and accessibility screening in neurosurgical video education","authors":"Herul Wahyudin ,&nbsp;Maria Oktasari ,&nbsp;Randi Saputra ,&nbsp;Bagus Julian Hikmy ,&nbsp;Cici Yulia","doi":"10.1016/j.jocn.2025.111626","DOIUrl":"10.1016/j.jocn.2025.111626","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"141 ","pages":"Article 111626"},"PeriodicalIF":1.8,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145044966","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":"Salvage medullary perforating artery revascularization using the muscular branch of the occipital artery following occipital artery-posterior inferior cerebellar artery bypass for trapping a ruptured vertebral artery dissecting aneurysm","authors":"Gahn Duangprasert ,&nbsp;Kosumo Noda ,&nbsp;Sergi Cobos Codina ,&nbsp;Hiroyuki Mizuno ,&nbsp;Tetsuya Kusunoki ,&nbsp;Nakao Ota ,&nbsp;Rokuya Tanikawa","doi":"10.1016/j.jocn.2025.111621","DOIUrl":"10.1016/j.jocn.2025.111621","url":null,"abstract":"<div><div>Vertebral artery dissecting aneurysms (VADAs) presenting with subarachnoid hemorrhage (SAH) are relatively rare. The re-rupture and mortality rates during the acute phase of SAH remain significantly high. Endovascular coil trapping is one of the definitive treatments to prevent re-rupture; however, it carries a potential risk of medullary infarction derived from occlusion of the medullary perforating arteries (Mperf). Here we present a case with poor-grade SAH resulting from a ruptured left VADA affecting the posterior inferior cerebellar artery (PICA). After obtaining informed consent, open surgery was selected. The OA and its muscular branches were preventively harvested in case an additional bypass was required. Following the occipital artery (OA)-PICA bypass, the aneurysm was then trapped using the transcondylar fossa corridor. The lateral Mperf, supplying the lateral medullary surface, arising directly from the VADA and having to be included in the trapped segment, was occluded shortly after the complete trapping. This necessitates additional Mperf revascularization. Consequently, a salvage end-to-side bypass was performed using the muscular branch of the OA to reestablish the flow to the Mperf and prevent medullary infarction. The patient tolerated the procedure well and was discharged without neurological deficits. Postoperative imaging demonstrated complete aneurysm obliteration and bypass patency without ischemic complications.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"141 ","pages":"Article 111621"},"PeriodicalIF":1.8,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145044965","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":"Hidden confounders in the Kidney–Brain–Parkinson’s Axis","authors":"Christian Messina","doi":"10.1016/j.jocn.2025.111620","DOIUrl":"10.1016/j.jocn.2025.111620","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"141 ","pages":"Article 111620"},"PeriodicalIF":1.8,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145009968","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":"Intravascular lymphoma-associated strokes following tumour necrosis factor inhibitor therapy","authors":"Charles Champeaux Depond ,&nbsp;Marc Ferrigno ,&nbsp;Nadia Ajili-Ferté ,&nbsp;Romain Appay","doi":"10.1016/j.jocn.2025.111556","DOIUrl":"10.1016/j.jocn.2025.111556","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"141 ","pages":"Article 111556"},"PeriodicalIF":1.8,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003910","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":"T4-5 transforaminal endoscopic approach for repair of ventral type 1 CSF leaks","authors":"Meng Huang ,&nbsp;Alex Hoang ,&nbsp;Kurt Yaeger ,&nbsp;Insun Chong","doi":"10.1016/j.jocn.2025.111610","DOIUrl":"10.1016/j.jocn.2025.111610","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"141 ","pages":"Article 111610"},"PeriodicalIF":1.8,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003911","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}