Journal of Clinical Neuroscience最新文献

{"title":"The 5-factor modified frailty index as a prognostic factor following stereotactic radiosurgery for metastatic disease to the brain from non-small cell lung cancer: A multi-center cohort analysis","authors":"Sujay Rajkumar ,&nbsp;Trent Kite ,&nbsp;Jay Desai ,&nbsp;Thomas Lucido ,&nbsp;David Mathieu ,&nbsp;Manjul Tripathi ,&nbsp;Navneet Singh ,&nbsp;Narendra Kumar ,&nbsp;Georgios Mantziaris ,&nbsp;Stylianos Pikis ,&nbsp;Jason P. Sheehan ,&nbsp;Rodney E. Wegner ,&nbsp;Matthew J. Shepard","doi":"10.1016/j.jocn.2024.110979","DOIUrl":"10.1016/j.jocn.2024.110979","url":null,"abstract":"<div><h3>Background</h3><div>Non-small cell lung cancer (NSCLC) patients often develop brain metastases (BMs), complicating management. We have shown that increasing frailty is associated with decreased overall survival (OS) and central nervous system progression free survival (PFS) for patients undergoing stereotactic radiosurgery (SRS) to BMs. Leveraging the International Radiosurgery Research Foundation, we sought to expand upon these findings, in NSCLC specifically.</div></div><div><h3>Methods</h3><div>Across four institutions, 193 patients with (≥1) NSCLC derived BMs with minimum 3 months of clinical/radiographic follow-up were analyzed. Primary outcomes included OS and PFS. Patients were stratified utilizing the mFI-5 into pre-frail (0–1), frail (2), and severely frail (3 + ).</div></div><div><h3>Results</h3><div>Increased frailty was associated with diminished OS (frail hazard ratio (HR) = 2.49, 95 % CI [1.61–3.85]; severely frail HR = 2.65, 95 % CI [1.57–4.45]). The 6-month post-SRS survival rate was 86.1 %, 69.5 % and 54.5 % for pre-frail, frail and severely frail patients, respectively (p &lt; 0.001). Frailty was not significantly predictive of time to PFS on multivariate Cox Proportional Hazards analysis although there was a trend towards diminished PFS with increasing frailty (median PFS was 18.4, 8.0, and 7.4 months for pre-frail, frail, and severely frail, respectively (p = 0.11). As age &gt; 65 was also predictive of shorter OS (HR = 1.78, 95 % CI [1.23–2.56]). We generated a novel scoring system incorporating age and frailty status. The median survival of patients that scored 0, 1, 2, and 3 points were 21.1, 18.3, 8.9, and 5.6 months, respectively (p &lt; 0.001). The area under the curve of the validation cohort using a logistic regression model was 0.77.</div></div><div><h3>Conclusions</h3><div>Our results indicate that the MFI-5 is a promising metric with application at the point of care to provide decision support for patients with NSCLC derived BMs.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"132 ","pages":"Article 110979"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824263","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":"Blood transfusions in craniotomy for tumor resection: Incidence, risk factors, and outcomes","authors":"Namrah Aziz ,&nbsp;Usama Waqar ,&nbsp;Muhammad Murtaza Bukhari ,&nbsp;Muhammad Uzair ,&nbsp;Shaheer Ahmed ,&nbsp;Huma Naz ,&nbsp;Muhammad Shahzad Shamim","doi":"10.1016/j.jocn.2024.111009","DOIUrl":"10.1016/j.jocn.2024.111009","url":null,"abstract":"<div><h3>Background</h3><div>Blood transfusions (BT) are often needed in neurosurgical procedures, especially craniotomies for tumor resections, due to risks of anemia, ischemic brain injury, and hemorrhage. However, BT may increase the risk of perioperative complications. This study aimed to determine the incidence, associated factors, and outcomes of BT in patients undergoing craniotomy for intracranial tumor resection.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted using data from the National Surgical Quality Improvement Program (NSQIP). We included adult patients who underwent elective craniotomy for tumor resections from 2005 to 2021. Multivariable logistic regression was used to identify factors associated with BT as well as complications associated with receipt of BT within 30 days of surgery.</div></div><div><h3>Results</h3><div>Among 40,883 patients, 3.65 % required BT. Significant factors associated with BT included age &gt; 60 years (OR 1.28 [95 % CI 1.03–1.60]), female sex (1.41 [1.22–1.62]), underweight body mass index (BMI) (1.81 [1.27–2.57]), American Society of Anesthesiologists (ASA) class 3–4 (1.64 [1.39–1.95]), diabetes (1.23 [1.02–1.48]), chronic obstructive pulmonary disease (COPD) (1.64 [1.20–2.23]), preoperative anemia (2.84 [2.49–3.26]), bleeding disorders (2.37 [1.63–3.46]), preoperative transfusion (16.96 [8.09–35.56]), and meningioma indication (1.28 [1.03–1.60]). Patients with obesity were less likely to require BT (0.82 [0.69–0.98]). Patients requiring BT had higher odds of the following complications: prolonged ventilator use (OR 2.37 [1.60–3.50]), urinary tract infection (1.76 [1.03–3.00]), unplanned reoperation (1.49 [1.14–1.93]), prolonged length of stay (1.88 [1.60–2.21]), major morbidity (1.79 [1.32–2.44]), and all-cause mortality (1.34 [1.16–1.55]).</div></div><div><h3>Conclusion</h3><div>In craniotomy patients for tumor resection, factors associated with BT include age &gt; 60, female sex, underweight BMI, ASA class 3–4, COPD, anemia, bleeding disorders, preoperative transfusion, and meningioma. BT is further associated with higher risks of major morbidity, mortality, longer hospital stays, and unplanned reoperations following surgery.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"132 ","pages":"Article 111009"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894665","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":"Comparison of time perception in individuals between focal and generalized epilepsy","authors":"Fatma Meltem Usteki ,&nbsp;Serkan Aksu ,&nbsp;Semai Bek ,&nbsp;Gulnihal Kutlu","doi":"10.1016/j.jocn.2024.110976","DOIUrl":"10.1016/j.jocn.2024.110976","url":null,"abstract":"<div><h3>Background</h3><div>Numerous cognitive impairments have been documented in patients with epilepsy, particularly in relation to memory and executive functions. However, research on time perception is relatively limited and primarily focuses on temporal lobe epilepsy. The current study seeks to compare time perception performance between patients with focal epilepsy and those with generalized epilepsy.</div></div><div><h3>Methods</h3><div>A total of fifty-one individuals diagnosed with focal epilepsy and fifty-one individuals diagnosed with generalized epilepsy, which were monitored at the Epilepsy and Sleep Center, participated in this study. Initially, participants were asked to complete the Patient Health Questionnaire-9 (PHQ-9). Following this, they underwent computer-based assessments of time perception, which included the Time Estimation Test (TIET) and the Time Interval Production Test (TIPT). The intervals assessed were 4, 7, 32, and 58 s.</div></div><div><h3>Results</h3><div>The mean age of the sample was 32.65 years (±1.28). The sample consisted of 36 male and 66 female participants. The mean number of years of education was 12.3 years, while the mean age at disease onset was 18.7 years, and the mean duration of the disease was 13.8 years. The TIPT ratio was significantly lower in the focal epilepsy group, with recorded values of 4 s (Z = −2.540; p = 0.011) and 7 s (Z = −2.274; p = 0.023). No significant differences were observed in other parameters of time perception.</div></div><div><h3>Conclusions</h3><div>Research has demonstrated notable differences in time perception between individuals diagnosed with focal epilepsy and those with generalized epilepsy. The results suggest that time perception is more profoundly affected in patients with focal epilepsy in comparison to their counterparts with generalized epilepsy. Further comprehensive studies are necessary to explore the neural mechanisms that contribute to this disparity.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"132 ","pages":"Article 110976"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818257","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":"Giant brain Stone: Calcifying pseudoneoplasm of the neuraxis (CAPNON)","authors":"Ajay Jhajharia,&nbsp;Sumit Thakar","doi":"10.1016/j.jocn.2024.111010","DOIUrl":"10.1016/j.jocn.2024.111010","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"132 ","pages":"Article 111010"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894722","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":"Transdural location as a predictor of recurrence in spinal cord meningiomas","authors":"Hyun Jun Jang ,&nbsp;Bong-Ju Moon ,&nbsp;Mina Park ,&nbsp;Bio Joo ,&nbsp;Kyung-Hyun Kim ,&nbsp;Sang Hyun Suh ,&nbsp;Sung Jun Ahn","doi":"10.1016/j.jocn.2024.110975","DOIUrl":"10.1016/j.jocn.2024.110975","url":null,"abstract":"<div><div>Spinal cord meningiomas are typically benign, rare tumors that pose clinical challenges owing to their location and potential for spinal cord compression. This study aimed to assess the radiological features of spinal cord meningiomas and the key factors associated with their recurrence. We conducted a retrospective, single-institution study on 67 patients with pathologically confirmed spinal cord meningiomas who were surgically treated between January 2016 and December 2023. Radiological features, such as tumor size, en plaque growth, tumor signal intensity, and anatomical location, were assessed using preoperative magnetic resonance imaging. Clinical outcomes were evaluated using univariate and multivariate logistic regression analyses to identify risk factors for recurrence. Of the 67 patients, six (9.0 %) experienced a recurrence during a mean follow-up of 31.8 months. Results of univariate analysis suggested that a younger age, high World Health Organization grade, en plaque growth, and transdural location were significantly associated with tumor recurrence (p &lt; 0.05). Multivariate analysis confirmed that a younger age (p = 0.027) and transdural growth (p = 0.006) were significant independent predictors of recurrence. Our study identified younger age and transdural tumor location as significant risk factors for spinal cord meningioma recurrence. A total resection is the primary surgical goal; however, tumors with complex anatomical presentations, especially those exhibiting transdural growth, pose significant challenges. The findings highlight the importance of developing tailored surgical approaches and intensifying postoperative surveillance in high-risk patients to reduce the recurrence likelihood.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"132 ","pages":"Article 110975"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review and meta-analysis on the impact of early vs. delayed pharmacological thromboprophylaxis in patients with traumatic brain injury","authors":"Muhammad Hamza Shuja ,&nbsp;Muhammad Moiz Nasir ,&nbsp;Hasan Mushahid ,&nbsp;Adam Bilal Khan ,&nbsp;Javed Iqbal ,&nbsp;Afia Jawaid ,&nbsp;Syed Husain Farhan ,&nbsp;Fakhar Latif ,&nbsp;Muhammad Ayyan ,&nbsp;Minaam Farooq ,&nbsp;Jawad Ahmed ,&nbsp;Huzaifa Ul Haq Ansari ,&nbsp;Unzela Iqbal ,&nbsp;Sobia Mansoor ,&nbsp;Syed Ali Farhan ,&nbsp;Muhammad Mubariz","doi":"10.1016/j.jocn.2024.110936","DOIUrl":"10.1016/j.jocn.2024.110936","url":null,"abstract":"<div><h3>Background</h3><div>Traumatic brain injury (TBI) poses significant health challenges, often leading to complications such as venous thromboembolism (VTE) and increased mortality rates. The administration of early post-traumatic prophylaxis (PTP) is intended to mitigate these risks and enhance overall patient recovery. This study aims to perform a systematic review and <em>meta</em>-analysis assessing clinical outcomes associated with early versus late pharmacologic thromboprophylaxis in TBI patients.</div></div><div><h3>Methods</h3><div>We conducted a literature search across PubMed and Scopus databases from their inception to March 2024. Data from eligible studies were aggregated using the generic inverse variance method, with outcomes reported as odds ratios (OR).</div></div><div><h3>Results</h3><div>The review encompassed 20 studies involving 87,726 patients. Early PTP was categorized based on the timing of administration: 1) within 24 h, 2) within 48 h, and 3) within 72 h of hospital admission. Our findings indicated that early prophylaxis significantly reduced the incidence of VTE, deep vein thrombosis (DVT), pulmonary embolism (PE), and overall mortality when compared to late administration. Specifically, early PTP was associated with a markedly lower risk of VTE (OR: 0.38; 95 % CI: 0.30 to 0.48; P &lt; 0.00001), DVT (OR: 0.32; 95 % CI: 0.25 to 0.41; P &lt; 0.00001), and PE (OR: 0.39; 95 % CI: 0.31 to 0.49; P &lt; 0.00001). Furthermore, the analysis revealed a significant reduction in all-cause mortality within the early PTP group (OR: 0.71; 95 % CI: 0.53 to 0.97; P = 0.03). However, while statistically significant improvements were observed in the &lt;48-hour subgroup, neither the &lt;24-hour nor &lt;72-hour groups achieved statistical significance.</div></div><div><h3>Conclusion</h3><div>These robust findings highlight the potential of early pharmacologic thromboprophylaxis as a crucial intervention to enhance patient outcomes following traumatic brain injuries.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"132 ","pages":"Article 110936"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812998","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":"Biomechanical analysis of scoliosis correction under the influence of muscular and external forces","authors":"Li Wu,&nbsp;Aiqiang Zheng,&nbsp;Tianmin Guan,&nbsp;Lei Lei","doi":"10.1016/j.jocn.2024.110991","DOIUrl":"10.1016/j.jocn.2024.110991","url":null,"abstract":"<div><div>(1) Background: External force orthopedics and the strengthening of paraspinal muscles through exercise are common orthopedic methods for adolescent scoliosis, yet the synergetic mechanism of the two in orthopedic correction remains unclear. (2) Methods: A three-dimensional finite element model of the scoliotic spine was established to accurately simulate the mechanical properties of tissues such as the spine, intervertebral discs, and ribs. By applying external forces in different directions to the scoliosis model, the orthopedic effects of these forces on scoliosis were analyzed. Furthermore, considering the influence of muscular forces on scoliosis, the role of muscle contraction in the correction of scoliosis was simulated. (3) Results: The applied external forces significantly reduced both the Cobb angle and the vertebral rotation angle of the scoliotic spine. Specifically, the Cobb angle was corrected from 25° to 14°, achieving a scoliosis correction rate of 44%, while the apical vertebral rotation angle was corrected from 10.8° to 8.59°, resulting in a rotation correction rate of 20.46%. Furthermore, with the addition of muscular forces, the scoliosis correction rate increased further to 75.08%, and the apical vertebral rotation correction rate reached 11.39%; (4) Conclusions: Simultaneous exercise of paraspinal muscles while wearing an orthosis to improve muscular imbalance, can further reduce the Cobb angle and enhance the orthopedic effect.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"132 ","pages":"Article 110991"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903257","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":"Questionnaire format of modified frailty index as a predictor for 30-day readmission and length of stay in elderly patients undergoing multi-level lumbar interbody fusion","authors":"Sofia Eva Olsson ,&nbsp;Kendall Montgomery ,&nbsp;Olaide Ajayi","doi":"10.1016/j.jocn.2024.110959","DOIUrl":"10.1016/j.jocn.2024.110959","url":null,"abstract":"<div><h3>Background</h3><div>Frailty is a spectrum describing a demographic more likely to experience adverse events such as falls, disability, and hospital admission which can be quantified by the modified frailty index (mFI). Several studies have associated increased mFI score with higher rates of hospital readmission and length of stay (LOS). This study tests the predictive value of a frailty questionnaire based on the mFI on LOS and 30-day readmission rates.</div></div><div><h3>Methods</h3><div>This retrospective chart review included all patients aged 60 or older who underwent multi-level LIF by 13 surgeons at a single institution. Patients were classified as frail (mFI &gt; 1) or non-frail (mFI ≤ 1). Statistical analysis was performed on Microsoft Excel and included t-testing, linear correlations, and analysis of variance.</div></div><div><h3>Results</h3><div>A total of 213 patients were included in the study with an average frailty score of 2.26. Frail patients had significantly increased LOS (P &lt; 0.001) with no significant difference between vertebral levels (P = 0.27). Linear correlations between frailty score and LOS or readmission rate were positive in all cases with variable strength dependent on number of levels fused. Conclusions</div><div>The frailty questionnaire is an effective method of predicting LOS and risk of 30-day post-operative readmission in elderly patients undergoing multi-level LIF. The questionnaire format will allow for increased ease of obtaining frailty scores, so that improved pre-operative decision-making can be made among clinicians and patients alike. Future studies may be performed to identify the best method of interpreting frailty scores and may be expanded to a multi-institutional level.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"132 ","pages":"Article 110959"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting the biomechanical behavior of lumbar intervertebral Discs: A comparative finite element analysis of a novel artificial disc design","authors":"Ashutosh Khanna ,&nbsp;Pushpdant Jain ,&nbsp;C.P. Paul","doi":"10.1016/j.jocn.2024.110960","DOIUrl":"10.1016/j.jocn.2024.110960","url":null,"abstract":"<div><div>Osseointegration along with better mimicry of natural bone behaviour addresses the long-term performance of artificial intervertebral disc prosthesis. Here the effect of a novel artificial intervertebral disc geometry on stress, deformation and strain on lumbar segments to restore movement of the spine was investigated. The process involved, using CT image data, and solid modelling, simulation-driven design and finite element (FE) analysis, hexahedral mesh sensitivity analysis, implant placements. The range of motion (ROM) was calculated using an ANSYS deformation probe. The intact lumbar spine model established was compared with two implants, replacement at segment L4-L5 level, and biomechanical results were compared using axial loads of 500 N, 800 N, 1000 N and 10Nm moment. The two lumbosacral FE models, a novel implant Titanium Conix (TIC) and another FDA approved SB Charite™ (SBC) implant were considered. Novel TIC implant geometry exhibited comparable ROM values in four physiological motions, which were comparable to as required for restoring natural motion. The result shows that the proposed TIC observed the deformation during flexion, extension, bending and twist as 3.43 mm, 3.19 mm, 3.33 mm and 3.48 mm respectively. Similarly strain of 0.01 during flexion, 0.02 during extension, 0.01 during bending and 0.02 during twist. The implants designed in this study demonstrate the suitability of titanium alloy in endplates and annulus. The FE models in the study with their biomechanical parameters can be considered before clinical implementation of any implants, pre-surgery evaluations, implant placement simulations, postsurgical response, follow-up revisions, implant customization and manufacturing.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"132 ","pages":"Article 110960"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818302","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":"Early-onset stroke-like migraine attacks after radiation therapy syndrome: A case report and review of the literature","authors":"Ariana Chow ,&nbsp;Gabrielle E.A. Hovis ,&nbsp;Farinaz Ghodrati ,&nbsp;Maya Harary ,&nbsp;Khashayar Mozaffari ,&nbsp;Anjali Pradhan ,&nbsp;John Hegde ,&nbsp;Isaac Yang","doi":"10.1016/j.jocn.2024.110983","DOIUrl":"10.1016/j.jocn.2024.110983","url":null,"abstract":"<div><h3>Purpose</h3><div>Stroke-like migraine attacks after radiation therapy (SMART) syndrome is characterized by migraines, seizures, and stroke-like symptoms following brain irradiation. Diagnosis consists of clinical signs, history of brain irradiation, and radiographic evaluation. The latency to onset varies widely among individual patients, ranging from 1 to 35 years. Herein, we review the literature and present a case of SMART syndrome with an onset of five months after stereotactic radiosurgery for a benign meningioma.</div></div><div><h3>Methods</h3><div>A systematic review of the literature was conducted in line with the PRISMA guidelines. The PubMed, Cochrane, and Web of Science databases were searched for cases of SMART syndrome with reported time of onset and radiation dosage. Finally, we report the presentation, history, radiographic findings, and clinical outcomes of a 48-year-old female with suspected SMART syndrome.</div></div><div><h3>Results</h3><div>Of 101 articles reviewed, 23 articles were selected for inclusion in the present study. A total of 27 cases were identified. The mean age at presentation was 43 years (range: 11–70), and 71.4 % of patients were male. The mean latency to onset was 11.2 years after radiation. Based on case descriptions, none of the patients were definitively treated with single fraction radiosurgery.</div></div><div><h3>Conclusion</h3><div>SMART syndrome may present with variations in latency to onset, radiation dose, outcome, and clinical course. The present case of SMART syndrome highlights the variety in clinical presentation of this disease. Further work should be considered to better determine whether clinical and radiographic criteria for diagnosing SMART syndrome diagnosis are sufficient to encompass patients with a non-traditional presentation.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"132 ","pages":"Article 110983"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828850","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}