Journal of Clinical Neuroscience最新文献

{"title":"Esophageal Injury Following Anterior Cervical Discectomy and Fusion: A Single-institution Retrospective Study","authors":"Abhijith V. Matur ,&nbsp;Sanjit Shah ,&nbsp;Zachary J. Plummer ,&nbsp;Juan C. Mejia-Munne ,&nbsp;Yash Patil ,&nbsp;Michael K. Coffin ,&nbsp;Owoicho Adogwa ,&nbsp;Rani Nasser ,&nbsp;Joseph S. Cheng ,&nbsp;Justin N. Virojanapa","doi":"10.1016/j.jocn.2026.111864","DOIUrl":"10.1016/j.jocn.2026.111864","url":null,"abstract":"<div><h3>Background</h3><div>Esophageal perforation is a known but rare complication of anterior cervical discectomy and fusion (ACDF). Due to its rarity, factors associated with esophageal perforation have not been conclusively identified.</div></div><div><h3>Methods</h3><div>A retrospective study of patients who underwent ACDF at a tertiary care center between September 2016 and September 2021. Patients were identified using CPT codes 22551, 22552, 22554, and 22558. All subaxial cervical interbody fusions utilizing an anterior approach, including both discectomies and corpectomies, were included. Odontoid screws, cervical arthroplasty, and posterior-only fusions were excluded. Patients who were determined to have esophageal perforation were identified based on head and neck surgeon involvement in their hospital admission and ICD-10 code K22.3.</div></div><div><h3>Results</h3><div>A total of 1454 patients met our inclusion criteria, among whom 13 patients were determined to have had a confirmed esophageal perforation (0.89%). There was a statistically significant association between multilevel ACDF and surgery for suspected esophageal perforation (p = 0.04655). There were no statistically significant associations between surgery for suspected esophageal perforation and age, female sex, active smoking status, diabetes, coronary artery disease, chronic obstructive pulmonary disease, or gastroesophageal reflux disease. Perforation occurred because of intraoperative injury in 4 patients and 3 patients underwent initial ACDF for an indication of trauma.</div></div><div><h3>Conclusion</h3><div>This study suggests that there may be an association between multilevel ACDF and esophageal perforation. Further larger studies will be needed to confirm this along with other risk factors for esophageal perforation.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"145 ","pages":"Article 111864"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145979138","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":"Rescue strategy for management of an undeflating dual lumen balloon micro-catheter","authors":"Sunil V. Furtado,&nbsp;Parichay J. Perikal,&nbsp;Potineni Suresh,&nbsp;Vedanth Manjunath","doi":"10.1016/j.jocn.2025.111836","DOIUrl":"10.1016/j.jocn.2025.111836","url":null,"abstract":"<div><h3>Background</h3><div>Intracranial balloon microcatheters are vital in neurointerventions, yet balloon non-deflation has not been previously reported in the cerebral vasculature.</div></div><div><h3>Method</h3><div>We describe a 32-year-old woman undergoing embolization for a parieto-occipital arteriovenous malformation who developed failure of deflation of a dual-lumen balloon microcatheter placed in the posterior cerebral artery, despite standard manoeuvres.</div></div><div><h3>Result</h3><div>Controlled catheter transection distal to the hub, followed by gradual capillary action assisted drainage of diluted contrast, enabled safe balloon collapse and retrieval.</div></div><div><h3>Conclusion</h3><div>This case highlights a rare but critical complication and presents a practical bailout technique when conventional deflation methods fail, ensuring atraumatic intracranial balloon retrieval.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"145 ","pages":"Article 111836"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145882452","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":"Clinical assessment of a Near-Infrared spectroscopy device for rapid triage in traumatic brain injury","authors":"Vedang Bhushan Mahajan ,&nbsp;Vivek Tandon ,&nbsp;Sri Surya Krishna Gour ,&nbsp;Amol Raheja ,&nbsp;Aarosh Dhamija ,&nbsp;Vinamrita Patni ,&nbsp;Deepak Gupta ,&nbsp;Deepak Agrawal ,&nbsp;Atin Kumar ,&nbsp;P Sarat Chandra","doi":"10.1016/j.jocn.2026.111850","DOIUrl":"10.1016/j.jocn.2026.111850","url":null,"abstract":"<div><h3>Background</h3><div>Traumatic Brain Injury (TBI) poses a significant public health challenge in India, with nearly 2 million cases annually and limited CT availability causing delays in diagnosis. This study evaluated CEREBO®, a machine learning-enhanced near-infrared spectroscopy (mNIRS) device, as a rapid, non-invasive triage tool for TBI.</div></div><div><h3>Methodology</h3><div>A prospective quasi-experimental study was conducted at AIIMS, New Delhi, enrolling 202 suspected TBI patients. Participants were divided into control (standard care) and experimental (standard care + CEREBO®) groups. CEREBO® findings were compared with CT as the gold standard. Diagnostic performance (sensitivity, specificity, accuracy), time to preliminary diagnosis, and potential of impact on triage decisions were assessed.</div></div><div><h3>Results</h3><div>CEREBO® demonstrated high diagnostic performance with 98% sensitivity, 90% specificity, and 93.9% accuracy for detecting intracranial pathology. In a post-hoc exploratory simulation, using CEREBO®’s negative result as a hypothetical criterion for deferring CT suggested that CT imaging could have been potentially avoided in 82.1% of red (critical condition) cases and 80.6% of yellow (stable but urgent) cases. These simulations also indicated that CEREBO® may help identify patients whose urgency of care could be underestimated by initial triage classification.</div></div><div><h3>Conclusion</h3><div>The NIRS device demonstrated rapid, non-invasive assessment capability across a broad patient population, supporting its potential utility as an adjunct screening tool in resource-limited trauma settings. These findings suggest that the device may help streamline triage, optimize CT utilization, and improve workflow efficiency in high-volume emergency environments.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"145 ","pages":"Article 111850"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145959594","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":"Safety and effectiveness of bolt-mounted versus tunnelled external ventricular drains: A systematic review, meta-analysis and trial-sequential analysis","authors":"Shaan Patel ,&nbsp;Shiva A. Nischal ,&nbsp;Ayush Sinha ,&nbsp;Kush M. Kale ,&nbsp;Pious D. Patel ,&nbsp;Jack Jallo ,&nbsp;Srinivas K. Prasad","doi":"10.1016/j.jocn.2026.111860","DOIUrl":"10.1016/j.jocn.2026.111860","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;External ventricular drains (EVDs) are fundamental to neurocritical care, yet substantial procedural heterogeneity persists, particularly regarding bolt-mounted versus tunnelled catheter fixation. The relative safety and effectiveness of these approaches remain unclear, with conflicting data from observational studies and a lack of trial-level evidence.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To compare bolt-mounted and tunnelled EVDs across accuracy, reoperation, and key safety outcomes using systematic review, meta-analysis, and trial-sequential analysis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Following PRISMA guidelines, PubMed, Embase, and CENTRAL databases were searched (November 2025) for randomised or observational studies comparing bolt-mounted with tunnelled EVDs in adults. Two reviewers independently screened studies, extracted data, and assessed risk of bias. Primary outcomes were optimal catheter placement (Kakarla Grade I) and reoperation for EVD-related complications. Secondary outcomes included iatrogenic intracranial haemorrhage (ICH), cerebrospinal fluid (CSF) infection, CSF leak, catheter obstruction or malfunction, accidental discontinuation, and drainage duration. Random-effects meta-analyses were conducted using restricted maximum likelihood estimation. Heterogeneity was quantified, and certainty of evidence was assessed using GRADE. Trial-sequential analysis was performed for reoperation to determine whether available data met required information size thresholds.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Ten studies encompassing 2008 patients (800 bolt-mounted, 1208 tunnelled) were included. Bolt-mounted EVDs demonstrated significantly higher optimal catheter accuracy (RR 1.27; 95% CI: 1.06–1.51; &lt;em&gt;P &lt;&lt;/em&gt; 0.01; I&lt;sup&gt;2&lt;/sup&gt; = 29.6 %). Reoperation was numerically lower with bolt-mounted systems (RR 0.51; 95% CI: 0.22–1.36; &lt;em&gt;P =&lt;/em&gt; 0.19; I&lt;sup&gt;2&lt;/sup&gt; = 85 %), although trial-sequential analysis showed the cumulative Z-curve crossed the monitoring boundary without reaching the required information size, indicating insufficient evidence for definitive inference. Bolt-mounted EVDs were associated with lower CSF leak risk (RR 0.13; 95% CI: 0.04–0.47; &lt;em&gt;P &lt;&lt;/em&gt; 0.01) and reduced catheter obstruction (RR 0.46; 95% CI: 0.25–0.83; &lt;em&gt;P&lt;/em&gt; &lt; 0.05). No significant differences were observed in iatrogenic ICH (RR 1.23; 95% CI: 0.54–2.81; &lt;em&gt;P =&lt;/em&gt; 0.62), CSF infection (RR 0.88; 95% CI: 0.71–1.09; &lt;em&gt;P =&lt;/em&gt; 0.23), accidental discontinuation (RR 0.41; 95% CI: 0.11–1.59; &lt;em&gt;P =&lt;/em&gt; 0.20), or drainage duration (MD 0.56 days; 95% CI = -1.02–2.13; &lt;em&gt;P&lt;/em&gt; = 0.49).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Bolt-mounted EVDs were associated with higher catheter accuracy, reduced CSF leak, and improved mechanical reliability without increased infection or haemorrhage. Although reoperation may be lower with bolt-mounted systems, current evidence remains underpowered for firm conclusions. Thes","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"145 ","pages":"Article 111860"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145979080","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":"ICH-FOS for evaluating surgical outcomes in supratentorial spontaneous ICH: Toward precision neurosurgical care","authors":"Wenyu Dong ,&nbsp;Feifei Ma ,&nbsp;Yanfang Li ,&nbsp;Qixuan Guan ,&nbsp;Wenrui Xing ,&nbsp;Huining Chen ,&nbsp;Runhua Zhang ,&nbsp;Xingquan Zhao ,&nbsp;Ruijun Ji","doi":"10.1016/j.jocn.2025.111831","DOIUrl":"10.1016/j.jocn.2025.111831","url":null,"abstract":"<div><h3>Objective</h3><div>Identifying patients with supratentorial spontaneous intracerebral hemorrhage (sICH) who are most likely to benefit from neurosurgical intervention remains challenging. We aimed to assess the value of the Intracerebral Hemorrhage Functional Outcome Score (ICH-FOS) for stratifying baseline risk and evaluating outcomes across risk strata following neurosurgical intervention.</div></div><div><h3>Methods</h3><div>We analyzed two observational ICH cohorts from China: a prospective, multicenter cohort (cohort 1) enrolled from January 2014 to September 2016 and a retrospective, single-center cohort (cohort 2) enrolled from November 2023 to December 2024. Patients were stratified into low (0–4), moderate (5–8), and high (9–16) risk groups based on ICH-FOS. The primary outcome was 1-year favorable functional outcome, defined as a modified Rankin Scale (mRS) score of 0–3. Outcomes were assessed with logistic regression models, adjusting for covariates selected based on clinical relevance and baseline imbalances between groups.</div></div><div><h3>Results</h3><div>Cohort 1 included 1057 patients with 203 (19.2 %) receiving neurosurgical intervention. Cohort 2 included 636 patients with 107 (16.8 %) undergoing surgery. In cohort 1, neurosurgical intervention was associated with better 1-year functional outcomes in high-risk patients (odds ratio [OR], 2.99; 95 % CI, 1.12–7.98), but worse outcomes in low- (OR, 0.24; 95 % CI, 0.09–0.62) and moderate-risk groups (OR, 0.39; 95 % CI, 0.18–0.87). Consistent patterns were observed at 3 months, with surgery associated with worse outcomes in low- (OR, 0.33; 95 % CI, 0.14–0.77) and moderate-risk groups (OR, 0.20; 95 % CI, 0.09–0.44), and no significant functional benefit in high-risk patients (OR, 1.02; 95 % CI, 0.30–3.49), but improved survival in this group. The results of cohort 2 were consistent with those of cohort 1.</div></div><div><h3>Conclusions</h3><div>Among patients with supratentorial sICH, those classified as low- to moderate-risk by the ICH-FOS derived greater benefit from conservative management, whereas high-risk patients experienced improved survival and potential long-term functional benefit with neurosurgical intervention. These findings highlight the value of ICH-FOS in stratifying baseline risk and evaluating potential outcomes across patient subgroups, supporting a precision-medicine perspective in sICH.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"145 ","pages":"Article 111831"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145882455","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":"Comparative analysis of matrix metalloproteinases and growth factors in aneurysmal and perimesencephalic subarachnoid hemorrhage: Evidence for an aneurysm-driven molecular response","authors":"Blanka Nagybanyai-Nagy ,&nbsp;Gábor J. Szebeni ,&nbsp;Fanni Balogh ,&nbsp;P. Neuperger ,&nbsp;Csaba Olah ,&nbsp;Tihamer Molnar ,&nbsp;Attila Schwarcz ,&nbsp;Peter Csecsei","doi":"10.1016/j.jocn.2025.111837","DOIUrl":"10.1016/j.jocn.2025.111837","url":null,"abstract":"<div><h3>Background</h3><div>Aneurysmal subarachnoid hemorrhage (aSAH) and perimesencephalic subarachnoid hemorrhage (PM-SAH) share similar acute clinical presentations but differ markedly in etiology, vascular pathology, and outcome. The molecular mechanisms underlying these differences remain poorly defined.</div></div><div><h3>Methods</h3><div>In this prospective observational study, circulating levels of matrix metalloproteinases (MMP-1, MMP-2, MMP-7, MMP-9, MMP-10) and growth factors (EGF, FGF-2, PDGF-AA, PDGF-AB/BB, TGF-α, VEGF-A) were analyzed in patients with aSAH (n = 38) and PM-SAH (n = 40) within 24 h after ictus. Serum biomarker concentrations were quantified and compared between groups, and inter-marker correlations were evaluated.</div></div><div><h3>Results</h3><div>Serum levels of MMP-1, MMP-7, and MMP-9 were significantly higher in the aSAH group than in the PM-SAH group, whereas MMP-2 and MMP-10 showed no significant difference. Among growth factors, EGF, PDGF-AA, PDGF-AB/BB, and VEGF-A were markedly elevated in aSAH, while FGF-2 and TGF-α levels remained comparable across groups. Distinct correlation patterns between MMPs and growth factors were observed in the two cohorts.</div></div><div><h3>Conclusions</h3><div>The observed biomarker differences between aSAH and PM-SAH likely reflect the presence of an aneurysmal lesion and its associated vascular injury, rather than a generalized response to subarachnoid blood. Elevated MMP and growth factor levels in aSAH point to enhanced extracellular matrix degradation, blood–brain barrier disruption, and a more pronounced aneurysm-associated vascular remodeling and endothelial activation signature, processes not evident in PM-SAH. These findings provide clinical evidence supporting the hypothesis that aneurysm rupture initiates a unique cascade of molecular events contributing to the distinct pathophysiology and poorer outcomes of aSAH.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"145 ","pages":"Article 111837"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917528","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":"Association between health literacy and quality of life in patients with multiple sclerosis","authors":"Walid Al-Qerem ,&nbsp;Sawsan Khdair ,&nbsp;Dunia Basem ,&nbsp;Anan Jarab ,&nbsp;Judith Eberhardt ,&nbsp;Lubna Al-Khareisha ,&nbsp;Alaa Khudair","doi":"10.1016/j.jocn.2025.111820","DOIUrl":"10.1016/j.jocn.2025.111820","url":null,"abstract":"<div><h3>Background</h3><div>Multiple sclerosis (MS) is a chronic autoimmune disease that significantly affects the quality of life (QOL) of patients. Health literacy, employment, and medication adherence are key factors influencing disease management and overall well-being. However, limited research has explored these relationships in Jordanian MS patients.</div></div><div><h3>Objective</h3><div>This study aimed to examine the association between health literacy, employment status, medication adherence, and QOL among MS patients in Jordan.</div></div><div><h3>Method</h3><div>A cross-sectional study was conducted with 307 MS patients (median age 35 years (IQR: 28–44), 68.4 % females) from Al-Bashir Hospital in Amman. Participants completed validated questionnaires, including the Health Literacy Survey-12 (HLS-Q12), the Multiple Sclerosis Impact Scale (MSIS-29), and the Medication Adherence Rating Scale (MARS-5). Disease severity was assessed using the Expanded Disability Status Scale (EDSS) and Language function was evaluated using the Communication and Language Assessment in Multiple Sclerosis (CALMS). Associations between predictor variables and QOL outcomes were assessed using quantile regression analysis.</div></div><div><h3>Results</h3><div>Higher health literacy (HL) was linked to better QOL (per-point HLS-Q12: physical β =  −0.27, 95 % CI − 0.50–−0.05, p = 0.019; psychological β =  −0.31, 95 % CI −0.46–−0.16, p &lt; 0.001). After adding CALMS (Model B), the HL–psychological QOL association remained but weakened (β =  −0.20, 95 % CI − 0.37–−0.02, p = 0.034), while the physical effect lost significance. The influence of non-injectable regimens and age on psychological QOL also diminished. Disability remained the strongest and most consistent predictor (per-point EDSS: physical Model A β = 5.19, 95 % CI [4.57, 5.80], Model B β = 4.29, 95 % CI [2.937, 5.65]; both &lt; 0.001; psychological Model A β = 1.61, 95 % CI [1.24, 1.98], Model B β = 1.17, 95 % CI [0.672, 1.664]; both p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Key drivers of QOL were health literacy, treatment route, and disability. Interventions that raise HL and enable shared selection of non-injectable options, when clinically appropriate, are likely to yield the largest QOL gains.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"145 ","pages":"Article 111820"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145882453","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":"Association between free thyroxine and free triiodothyronine levels with inflammation markers in acute minor and severe ischemic stroke patients","authors":"Omar Khalid Suhail ,&nbsp;Muhtada Ali Challoob ,&nbsp;Hiba Qasim Mahmoud","doi":"10.1016/j.jocn.2025.111827","DOIUrl":"10.1016/j.jocn.2025.111827","url":null,"abstract":"<div><h3>Background</h3><div>Patients with acute ischemic stroke (AIS) frequently exhibit alterations in thyroid function. Though, the association between free thyroxine levels and stroke severity, in addition to the pathophysiological implications of thyroid hormone fluctuations, has not been entirely elucidated and remains unclear in AIS patients.</div></div><div><h3>Aims</h3><div>To assess the association between free thyroxine (fT4) and free triiodothyronine (fT3) levels and both stroke severity and inflammatory markers in patients’ subsequent acute minor and severe ischemic strokes.</div></div><div><h3>Methods</h3><div>This study involved 142 patients with acute minor and severe ischemic stroke (104 males and 38 females). Thyroid hormone levels and inflammatory biomarkers were measured for all contributors. Stroke severity was determined utilising the National Institutes of Health Stroke Scale (NIHSS scores). Multiple regression analysis was conducted to control for potential confounders. Furthermore, a receiver operating characteristic (ROC) curve for fT4 was generated to assess its predictive value for stroke severity.</div></div><div><h3>Results</h3><div>Patients with severe ischemic stroke showed significantly higher fT4 levels and lower fT3 levels in comparison with those who have minor ischemic stroke. Free T3 was negatively correlated with ESR (r = –0.454, P &lt; 0.001), CRP (r = –0.169, P = 0.04), and NIHSS scores (r = –0.547, P &lt; 0.001). In contrast, fT4 was positively correlated with ESR (r = 0.262, P = 0.002), CRP (r = 0.39, P &lt; 0.001), and NIHSS scores (r = 0.418, P &lt; 0.001). Multiple regression analysis displayed that NIHSS scores were independently associated with fT3, whereas both NIHSS scores and CRP were independently associated with fT4. ROC analysis proved that the AUC for fT4 was 0.739 (95 % CI, 0.657–0.822).</div></div><div><h3>Conclusion</h3><div>Higher fT4 and lower fT3 levels are linked with greater stroke severity and elevated inflammatory markers in patients with acute severe ischemic stroke in comparison with those who experienced minor stroke.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"145 ","pages":"Article 111827"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839242","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 novel application of radiomics for the evaluation of transient wall shear stress on the surface of cerebral aneurysms","authors":"Alexandra Lauric,&nbsp;Adel M. Malek","doi":"10.1016/j.jocn.2026.111851","DOIUrl":"10.1016/j.jocn.2026.111851","url":null,"abstract":"<div><h3>Background</h3><div>Intracranial aneurysm evaluation based on computational fluid dynamic (CFD) wall shear stress (WSS) analysis remains an active and evolving research field. We propose a novel application of radiomics for transient CFD, focusing on texture and pattern evaluation of aneurysmal WSS, beyond conventional distribution analysis.</div></div><div><h3>Methods</h3><div>Catheter 3D rotational angiographic volumes were available for 75 aneurysms (33 ruptured). Transient CFD simulations were performed on aneurysmal models across the cardiac cycle, exporting WSS distributions at 25 consecutive time steps. 3D WSS distributions were mapped to 2D by projection to unit sphere, followed by normalization and logarithmic transformation for analysis at extrema. The resulting 2D spatial WSS images over time formed 3D DICOM volumes for radiomics analysis. Uni- and multivariate analysis was used to evaluate radiomics features for rupture status discriminant performance.</div></div><div><h3>Results</h3><div>Compared to unruptured, ruptured aneurysms show increased complexity and heterogeneity in the spatial and temporal domains (higher DifferenceEntropy, JointAverage, JointEntropy), with distinct areas of low and high WSS-derived intensity (lower InverseDifference, higher SumAverage). Ruptured aneurysms showed significantly less uniformity of pattern both in size (higher SizeZoneNonUniformity) and intensity (higher GrayLevelNonUniformity). Multivariate analysis for rupture status discrimination resulted in an area under the curve (AUC) value of 0.81 (sensitivity 0.82, specificity 0.72).</div></div><div><h3>Conclusion</h3><div>Radiomics analysis of transient WSS resulted in strong rupture status discrimination. This novel approach extends the use of radiomics beyond angiographic analysis, enables evaluation of WSS evolution over the entire cardiac cycle, provides insights into rupture characteristics, and opens novel and promising avenues of future research.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"145 ","pages":"Article 111851"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145922478","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":"Building a national repository of dural-based lesions: clinical, pathological, and demographic insights from the Indian population","authors":"Sarvesh Goyal ,&nbsp;Shweta Kedia ,&nbsp;Ritesh Kumar ,&nbsp;Kanwaljeet Garg ,&nbsp;Manoj Phalak ,&nbsp;Mohammed Shahin ,&nbsp;Shailesh Gaikwad ,&nbsp;Savyasachi Jain ,&nbsp;Vaishali Suri ,&nbsp;Debnath Pal ,&nbsp;Dwarkanath Srinivas ,&nbsp;Harsh Deora ,&nbsp;Pravin Salunke ,&nbsp;Awadhesh Jaiswal ,&nbsp;Ankur Bajaj ,&nbsp;Rabi Narayan Sahu ,&nbsp;George C. Vilanilam ,&nbsp;Harpreet Singh ,&nbsp;Shilpa Rao ,&nbsp;Jitender Saini ,&nbsp;A.N. Deepti","doi":"10.1016/j.jocn.2025.111834","DOIUrl":"10.1016/j.jocn.2025.111834","url":null,"abstract":"<div><h3>Background</h3><div>Meningiomas are the most common dural-based intracranial tumors, yet Indian literature is predominantly composed of limited single-center studies, restricting nationwide representation and data-driven decision making. With artificial intelligence (AI) becoming increasingly relevant in neuro-oncology for diagnosis, segmentation, and outcome prediction, the lack of a large, standardized national dataset poses a major barrier. The Medical Imaging Datasets for India (MIDAS) initiative, a collaborative national effort involving ICMR, IISc, and ARTPARK, aims to create high-quality, annotated medical imaging repositories that can support clinical research and AI model development. As a part of this initiative, we developed a multicenter national repository of dural-based lesions.</div></div><div><h3>Methods</h3><div>This ambispective study included patients with radiologically suspected and histopathologically confirmed dural-based lesions from seven neurosurgical centers across India (January 2022–July 2025). Standardized de-identified demographic, clinical, imaging, and pathological data were collected. Imaging was archived in DICOM format and annotated using ITK-SNAP, while histopathology followed WHO-2021 CNS tumor guidelines. Statistical analysis was performed using descriptive and comparative measures.</div></div><div><h3>Results</h3><div>Among 586 patients, women constituted two-thirds of the cohort, with a mean age of 47.2 years. Meningiomas accounted for 98.3 % of cases and were predominantly WHO Grade I, most commonly of transitional and meningothelial subtypes. Convexity, parasagittal, and falcine locations were most frequently involved. A small but important proportion of lesions were non-meningiomatous, including schwannomas, solitary fibrous tumors, granulomatous, and metastatic lesions. Simpson Grade II resection was the most common surgical outcome, and a subset of patients underwent postoperative adjuvant radiosurgery.</div></div><div><h3>Conclusion</h3><div>This MIDAS-linked national repository represents the largest structured dataset of dural-based lesions from India, integrating standardized clinical, imaging, and pathological information across multiple centers. In addition to defining national disease patterns, the availability of curated imaging and volumetric segmentations provides a strong translational platform for future artificial intelligence–based research, including automated segmentation, diagnostic classification, and outcome prediction.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"145 ","pages":"Article 111834"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145922479","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}