Journal of Clinical Neuroscience最新文献

{"title":"The role of hypercoagulability in ischemic stroke associated with blunt cerebrovascular injury","authors":"Dayna M. Carlson ,&nbsp;Matthew K. Mcintyre ,&nbsp;Joseph Nugent ,&nbsp;Justin L. Regner ,&nbsp;Mitchell B. Sally ,&nbsp;Cassie A. Barton ,&nbsp;James Wright","doi":"10.1016/j.jocn.2025.111572","DOIUrl":"10.1016/j.jocn.2025.111572","url":null,"abstract":"<div><h3>Background</h3><div>Stroke is an infrequent, but potentially devastating outcome that can occur after blunt cerebrovascular injury (BCVI). Assessing coagulation status may allow for more precise risk stratification for initiation of antithrombotic therapy. We sought to evaluate the influence of hypercoagulable state via coagulation profile, including thromboelastography (TEG) and coagulation studies, on ischemic stroke incidence following BCVI.</div></div><div><h3>Methods</h3><div>This retrospective study evaluated patients with BCVI admitted to a tertiary trauma center between 2010 and 2023. Patients who received TEG within 24 h of admission were included. The primary outcome was ischemic stroke in the distribution of BCVI. Receiver operating curves (ROC) with area under the curve (AUC) were constructed for incident strokes.</div></div><div><h3>Results</h3><div>38 patients met inclusion criteria with 22 (57.9 %) being male with a median age of 51 (20.25). The most common mechanism of injury was motor vehicle collision occurring in 17 (44.7 %) patients. Seven (18.4 %) suffered ischemic strokes in the distribution of BCVI. The stroke group were found to have significantly decreased R value (3.7 [2.45–4.15] vs. 4.3 [3.75–4.8], <em>p</em> = 0.040), fibrinogen (197.9 (62.7) vs. 282.1 (103.9), <em>p =</em> 0.049), and aPTT (23.5 [22.8–26.4] vs. 27.8 [26.2–35.0], <em>p</em> = 0.039). On ROC analysis, R value (AUC = 0.75), fibrinogen (AUC = 0.75), and PTT (AUC = 0.76) had high discriminatory value for incident stroke while the highest Biffl grade did not (AUC = 0.48).</div></div><div><h3>Conclusions</h3><div>In this cohort of patients with blunt cerebrovascular injury, those with evidence of hypercoagulation experienced an increased incidence of BCVI-related ischemic stroke in the distribution of injury. While larger studies are necessary, including TEG in the initial workup for BCVI could help identify patients at higher risk for ischemic stroke, allowing for earlier initiation of anti-thrombotic prophylaxis.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"141 ","pages":"Article 111572"},"PeriodicalIF":1.8,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144893838","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":"Methodological concerns regarding “Between sleep and wakefulness: How sleep quality and stress affect isolated sleep paralysis – A cross-sectional survey”","authors":"Yi Ding ,&nbsp;Huimin Su ,&nbsp;Yuanyuan Zou","doi":"10.1016/j.jocn.2025.111575","DOIUrl":"10.1016/j.jocn.2025.111575","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"141 ","pages":"Article 111575"},"PeriodicalIF":1.8,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144878469","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":"Biportal endoscopic spine surgery for removal of pedicle fixation hardware","authors":"Ralph J. Mobbs ,&nbsp;Alison Ma","doi":"10.1016/j.jocn.2025.111580","DOIUrl":"10.1016/j.jocn.2025.111580","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"141 ","pages":"Article 111580"},"PeriodicalIF":1.8,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886978","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":"Letter to the editor: comment on “primary visual cortex impairment due to trans-synaptic degeneration after optic neuritis: a systematic review of neuroimaging studies”","authors":"Jiaqian Chen ,&nbsp;Kepeng Yang","doi":"10.1016/j.jocn.2025.111577","DOIUrl":"10.1016/j.jocn.2025.111577","url":null,"abstract":"<div><div>This letter addresses the systematic review by Hsiao et al. on <em>trans</em>-synaptic degeneration (TSD) in optic neuritis (ON), highlighting several areas for further exploration to optimize clinical management. A significant gap identified is the lack of individualized brain anatomical analysis in evaluating TSD. Future studies should incorporate personalized brain models using techniques like surface-based morphometry and volumetric analysis to better assess TSD and guide personalized treatment strategies. Additionally, the review primarily relies on cross-sectional data, which limits the understanding of TSD progression over time. Longitudinal studies with multiple imaging time points are necessary to track TSD from the acute to chronic phases of ON and determine the optimal timing for intervention. Furthermore, the integration of functional imaging techniques such as functional MRI (fMRI) and visual evoked potentials (VEPs) with structural imaging can provide valuable insights into the functional impairments of the visual cortex and inform treatment decisions. Finally, integrating immune activity with neuroimaging can significantly improve patient management, particularly for those with autoimmune diseases like multiple sclerosis and neuromyelitis optica spectrum disorder. By combining immune marker monitoring with neuroimaging, clinicians can adjust immunosuppressive therapies based on realtime changes in immune activity and visual function. This comprehensive approach will provide a better understanding of TSD and improve clinical outcomes for ON patients.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"141 ","pages":"Article 111577"},"PeriodicalIF":1.8,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144878468","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":"Postoperative outcomes and complications after corpectomy for vertebral osteomyelitis: systematic review and meta-analysis","authors":"Asimina Dominari ,&nbsp;Giorgos D. Michalopoulos ,&nbsp;Konstantinos Katsos ,&nbsp;Sufyan Ibrahim ,&nbsp;Karim R. Nathani ,&nbsp;Patrick Flanigan ,&nbsp;Mohamad Bydon","doi":"10.1016/j.jocn.2025.111565","DOIUrl":"10.1016/j.jocn.2025.111565","url":null,"abstract":"<div><h3>Background</h3><div>While conservative treatment constitutes the mainstay of treatment for vertebral osteomyelitis (VO), aggressive surgical debridement is often warranted. We aim to assess the effectiveness of corpectomy for VO regarding neurological improvement, fusion, and infection recurrence.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted to identify studies investigating outcomes after corpectomy for VO. Random-effects model meta-analysis was performed, with neurological improvement being the primary endpoint. Subgroup analyses were conducted by anatomic location (cervical, thoracic, and lumbar) and cage type (expandable versus nonexpendable).</div></div><div><h3>Results</h3><div>Forty-four studies yielding 140 patients with a mean follow-up of 25.5 months were analyzed. The mean age at surgery was 57.3 years. Preoperative neurological deficits were present in 78.4 % of patients (95 % CI: 63.6 – 91 %); they improved in 71.8 % of these patients (95 % CI: 56.1 – 85.8 %). Complications occurred in 10.4 % (95 %CI: 2.5 – 21.2 %). Preoperative neurological deficits were more common in the cervical compared to the thoracic (p &lt; 0.01) and lumbar (p = 0.02) subgroups. No significant differences were observed regarding neurological improvement (p = 0.1) and complications (p = 0.6) among subgroups. Infection recurrence occurred in 4 patients (2.9 %), and 7 patients required revision (5 %). Subgroup analysis by cage type revealed no differences in preoperative neurological deficits (p = 0.1), neurological improvement (p = 0.9), and complications (p = 0.9).</div></div><div><h3>Conclusions</h3><div>This meta-analysis demonstrated high rates of neurological improvement, and low risk of postoperative complications and revisions among VO patients undergoing corpectomy. These findings highlight the safety and effectiveness of corpectomy in managing medically refractory VO or VO with neurological compromise.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"141 ","pages":"Article 111565"},"PeriodicalIF":1.8,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144878466","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":"Purely endoscopic endonasal resection of extracranial trigeminal schwannomas: a descriptive systematic review and institutional case series","authors":"Eren Yilmaz ,&nbsp;Atakan Emengen ,&nbsp;Ayse Uzuner ,&nbsp;Bedrettin Ozsoy ,&nbsp;Aykut Gokbel ,&nbsp;Ihsan Anik ,&nbsp;Savas Ceylan","doi":"10.1016/j.jocn.2025.111573","DOIUrl":"10.1016/j.jocn.2025.111573","url":null,"abstract":"<div><h3>Background</h3><div>Trigeminal schwannomas (TSs) are uncommon, benign tumors that arise from the trigeminal nerve. They can spread to the middle cranial fossa, posterior fossa, and extracranially (pterygopalatine fossa (PPF), infratemporal fossa, orbita). Among these, extracranial involvement is the least frequent. Before the advent of endoscopic techniques, these tumors were primarily removed using conventional microsurgical approaches. Due to both the rarity of extracranial localization and the increasing use of endoscopic techniques in suitable cases, reports of TSs with extracranial involvement treated via a purely endoscopic endonasal approach (EEA) remain limited, typically appearing as case reports or a small subset within larger case series. This study systematically reviews the literature on extracranial TSs managed exclusively with EEA and presents two illustrative cases from our institution.</div></div><div><h3>Methods</h3><div>A systematic search of the PubMed database was performed in accordance with PRISMA guidelines to identify studies that utilized a purely EEA for extracranial TS cases. Additionally, a retrospective review of 6118 EEA procedures conducted at our institution identified two patients with histopathologically confirmed extracranial TSs. Clinical presentation, surgical approach, outcomes, and complications were analyzed.</div></div><div><h3>Results</h3><div>A total of 147 records were identified through database searches and reference lists. After removing duplicate records, 144 full-text articles were assessed for eligibility. Of these, 124 studies were excluded with justification, resulting in 23 studies being included in the review. When combined with our institutional cases, data from a total of 52 patients were analyzed. Facial numbness was the most common presenting symptom (70.5 %). The mean tumor diameter was 38.6 ± 13.3 mm, and the gross total resection rate was 93.1 %. In our cases, both patients successfully underwent tumor resection via EEA without postoperative neurological deficits.</div></div><div><h3>Conclusions</h3><div>EEA provides a direct, minimally invasive route for managing extracranial TSs while reducing the morbidity associated with transcranial approaches. Although optimal for purely extracranial tumors, lesions extending into the middle or posterior fossa may require a combined approach. Therefore, individualized surgical planning is essential for achieving optimal outcomes in TS management.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"141 ","pages":"Article 111573"},"PeriodicalIF":1.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144878467","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":"Comment on: “ diabetes is associated with a decreased risk of meningiomas: A mendelian randomization study”","authors":"Shaoxiang Huang,&nbsp;Peili Zhang,&nbsp;Xueyu Wang","doi":"10.1016/j.jocn.2025.111578","DOIUrl":"10.1016/j.jocn.2025.111578","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"141 ","pages":"Article 111578"},"PeriodicalIF":1.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144863362","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":"Optical coherence tomography in endovascular neurosurgery: current applications and future directions","authors":"Ioannis Karavolias ,&nbsp;Joanna M. Roy ,&nbsp;Basel Musmar ,&nbsp;Stavropoula I. Tjoumakaris ,&nbsp;M. Reid Gooch ,&nbsp;Robert H. Rosenwasser ,&nbsp;Pascal M. Jabbour","doi":"10.1016/j.jocn.2025.111563","DOIUrl":"10.1016/j.jocn.2025.111563","url":null,"abstract":"<div><div>Optical Coherence Tomography (OCT), initially introduced in 1991, has demonstrated efficacy in diagnosing pathologies of the retina, optic nerve, and coronary vessels. Recently, there has been growing research interest in the application of OCT in endovascular neurosurgery, with studies exploring its utility across a range of intracranial and extracranial endovascular diseases. The current review aims to synthesize available literature on the use of OCT in endovascular neurosurgery, encompassing both clinical and preclinical models. 57 studies met the inclusion criteria and were included in the qualitative analysis. These studies were stratified into different categories based on diseases studied. OCT has been utilized to evaluate the in vivo microanatomy of intracranial and extracranial vasculature, assess treatment efficacy and device apposition, and monitor patient outcomes. The results consistently demonstrate greater accuracy and stronger correlation with patient outcomes compared to contemporary imaging techniques. However, limitations such as the large size of current OCT-integrated probes and the lack of standardized workflows hinder the broader adoption of this technology.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"141 ","pages":"Article 111563"},"PeriodicalIF":1.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144863251","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 missing sixth: congenital aplasia of the abducens nerve confirmed by MRI","authors":"Mehmet H. Atalar ,&nbsp;Serdar Aktı ,&nbsp;Nisa Baspinar","doi":"10.1016/j.jocn.2025.111569","DOIUrl":"10.1016/j.jocn.2025.111569","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"141 ","pages":"Article 111569"},"PeriodicalIF":1.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144863360","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":"Mental health as a prognostic biomarker in aSAH: Toward inclusive screening through digital tools","authors":"Herul Wahyudin ,&nbsp;Nandang Budiman ,&nbsp;Tutut Chusniyah ,&nbsp;Maria Oktasari","doi":"10.1016/j.jocn.2025.111576","DOIUrl":"10.1016/j.jocn.2025.111576","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"141 ","pages":"Article 111576"},"PeriodicalIF":1.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144863361","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}