Journal of Clinical Neuroscience最新文献

{"title":"Flow diverter is valid for aneurysms with incorporated branch vessels: Adding coil embolization and incorporated branch vessel diameter are predictors of treatment efficacy","authors":"Kenichiro Suyama ,&nbsp;Ichiro Nakahara ,&nbsp;Shoji Matsumoto ,&nbsp;Jun Morioka ,&nbsp;Tetsuya Hashimoto ,&nbsp;Junpei Koge ,&nbsp;Jun Tanabe ,&nbsp;Akiko Hasebe ,&nbsp;Sadayoshi Watanabe ,&nbsp;Takeya Suzuki ,&nbsp;Yuichi Hirose","doi":"10.1016/j.jocn.2025.111192","DOIUrl":"10.1016/j.jocn.2025.111192","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to determine the efficacy of flow diverters (FDs) for small/medium (≤10 mm) aneurysms and analyzed the factors that prevent aneurysm occlusion.</div></div><div><h3>Methods</h3><div>This retrospective single-center study evaluated the angiographic and clinical data of consecutive patients between June 2020 and February 2023.</div></div><div><h3>Results</h3><div>Overall, 121 small/medium aneurysms were observed in 106 patients treated with FDs. The median dome diameter was 6.1 (5.1–7.2) mm. Symptomatic thromboembolic complications were observed in four (3.7 %) patients, and none showed a major ischemic stroke. Intracranial hemorrhage was detected using postprocedural computed tomography in one (0.9 %) patient with asymptomatic subarachnoid hemorrhage. The rate of permanent neurological deficits was 1.8 %, and the mortality rate was 0 %. No delayed ischemic or hemorrhagic complications were observed during follow-up. Angiographic follow-up revealed complete and adequate occlusion (O’Kelly–Marotta grades C and D) rates of 77.5 % and 90.8 %, respectively. On multivariate analysis, incomplete occlusion was only associated with the presence of a branch vessel from the aneurysm dome (P &lt; 0.01). In aneurysms with incorporated branch vessels, univariate analysis revealed that coil usage was a predictor of complete occlusion (P = 0.03). Moreover, even without using coils, effective occlusion was achieved when the branch vessel diameter was small (P = 0.03).</div></div><div><h3>Conclusions</h3><div>FDs are an effective and safe treatment option for small/medium aneurysms. The presence of incorporated branch vessels can predict incomplete occlusion. Even in aneurysms with incorporated branch vessels, FD can obtain therapeutic effects by adding coil embolization or treating with only FD if the branch vessel diameter is small.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111192"},"PeriodicalIF":1.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669969","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":"Artificial intelligence in academic writing: Enhancing or replacing human expertise?","authors":"Ria Resti Fauziah ,&nbsp;Ari Metalin Ika Puspita ,&nbsp;Ivo Yuliana ,&nbsp;Fiena Saadatul Ummah ,&nbsp;Siti Mufarochah ,&nbsp;Erfan Ramadhani","doi":"10.1016/j.jocn.2025.111193","DOIUrl":"10.1016/j.jocn.2025.111193","url":null,"abstract":"<div><div>This letter discusses findings from a recent study comparing AI-generated and humanwritten neurosurgery articles. The study reveals that AI-generated articles exhibit higher readability scores (Lix: 35 vs. 26, Flesch-Kincaid: 10 vs. 8) but may lack depth in analysis. Evaluators could correctly identify AI authorship with 61 % accuracy, and preferences were nearly even between AI-generated (47 %) and human-written (44 %) articles. While AI improves accessibility and efficiency in academic writing, its limitations in clinical experience, originality, and nuanced analysis highlight the need for human oversight. The integration of AI should be as a complementary tool rather than a replacement for human expertise. Future research should focus on refining AI’s analytical capabilities and ensuring ethical use in scientific publishing.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111193"},"PeriodicalIF":1.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669963","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 biomarkers to brain imaging: Refining early diagnosis of mild cognitive impairment","authors":"Reswita,&nbsp;Sri Wahyuni,&nbsp;Ramtia Darma Putri,&nbsp;Erfan Ramadhani","doi":"10.1016/j.jocn.2025.111187","DOIUrl":"10.1016/j.jocn.2025.111187","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111187"},"PeriodicalIF":1.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669965","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":"Predictors of withdrawal of life-sustaining therapies in older adults with TBI and a modified frailty index score","authors":"John J. Francis ,&nbsp;Ahmed I. Kashkoush ,&nbsp;Vanessa P. Ho ,&nbsp;Mary J. Roach ,&nbsp;Michael L. Kelly","doi":"10.1016/j.jocn.2025.111191","DOIUrl":"10.1016/j.jocn.2025.111191","url":null,"abstract":"<div><h3>Background</h3><div>Withdrawal-of-life-sustaining-therapies (WLST) in patients with traumatic brain injury (TBI) is a complex decision-making process. The clinical factors related to WLST in older adults with TBI are currently poorly understood. The present study aims to determine the clinical predictors of WLST in older patients with TBI.</div></div><div><h3>Methods</h3><div>All patients ≥ 65 years old with TBI (Head Abbreviated Injury Scale Score ≥ 3) were identified from the Geriatric TBI Database, a prospective registry of patients admitted to 45 trauma centers nationwide with TBI between 2017–2019. We collected factors related to past medical history, baseline demographic data, clinical presentation, TBI sub-type, neurosurgical interventions, and do-not-attempt-resuscitation (DNAR) orders. The primary outcome measure was WLST. Binary logistic regression was subsequently performed to determine factors independently associated with WLST.</div></div><div><h3>Results</h3><div>A total of 1600 patients were identified. The median age was 80 years old and 48.6 % of patients were male. In this cohort, 120 patients (7.5 %) underwent WLST. A logistic regression model revealed that Glasgow Coma Scale (GCS) (OR 0.82; 95 %-CI 0.77––0.87), cerebral edema (3.2; 1.5–7.0), craniotomy/craniectomy (2.5; 1.4–4.4), and DNAR (8.8; 5.5–14.3) were all independently associated with WLST. This model demonstrated excellent discrimination ability with a concordance statistic of 0.935.</div></div><div><h3>Conclusions</h3><div>This study demonstrates that patients ≥ 65 years old with poor initial GCS, cerebral edema, craniotomy/craniectomy, and DNAR were all independently associated with WLST. Pre-injury frailty was not associated with WLST. Further studies are needed to evaluate the prognostic value of frailty indices in the management of patients with TBI.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111191"},"PeriodicalIF":1.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143642800","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":"Integrating adaptive digital health and family education: A new approach to assessing psychomotor development in malnourished children","authors":"Monica Widyaswari ,&nbsp;Ali Fakhrudin","doi":"10.1016/j.jocn.2025.111186","DOIUrl":"10.1016/j.jocn.2025.111186","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111186"},"PeriodicalIF":1.9,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633645","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":"Intracranial meningioma with intratumoral hemorrhage: A systematic review of associated features and outcomes","authors":"Dillon H. Putzler ,&nbsp;Mohammad Faizan Khan ,&nbsp;Frishan O. Paulo ,&nbsp;Lauren A. Nguyen ,&nbsp;Christine Galang ,&nbsp;Erin Rauber ,&nbsp;Ryan Gensler ,&nbsp;Julian Gendreau ,&nbsp;Gina Watanabe ,&nbsp;Paolo Palmisciano","doi":"10.1016/j.jocn.2025.111188","DOIUrl":"10.1016/j.jocn.2025.111188","url":null,"abstract":"<div><div>Intratumoral hemorrhage (ITH) is a rare clinical entity associated with gliomas and rarely with meningiomas. The hemorrhage risk of ITH in meningiomas remains poorly described. Literature suggests that patient age, tumor location, and histology may play some role. In this study, we aim to address ITH risk factors by evaluating patient and tumor characteristics, symptoms, and outcomes of ITH associated with meningioma. PubMed, Web of Science, Ovid EMBASE, and Scopus databases were searched from database inception to December 2024 for cases of meningioma with ITH based on PRISMA guidelines. Patient demographics, presenting symptoms, tumor characteristics, treatments, and survival outcomes were extracted and analyzed. 107 cases from 68 studies were collected. Patients were mostly female (61 %), with an average age of 56 years. The most common comorbidity was hypertension (19 %). Patients often presented awake (47 %) with headache (22 %) or weakness (20 %), 21 % were comatose on admission. Most tumors were WHO grade 1 (85 %), located on the convexity (56 %) with meningothelial histotype (34 %). Single-stage resection with hematoma evacuation was the most common treatment modality (91 %). Embolization (2 %) was rarely performed. 59 % of patients had complete resolution of symptoms, and 88 % survived to last follow-up. Current management favors single-stage resective surgery and hematoma evacuation; pre-operative embolization has a limited role. Postoperatively, the role of anticoagulation for VTE prophylaxis is unclear. Most patients survive with complete resolution of symptoms after operative intervention.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111188"},"PeriodicalIF":1.9,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143628172","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":"Survey on the impact of WHO 2021 classification of brain tumors on adult glioma management in Africo-Asian region","authors":"Sarvesh Goyal ,&nbsp;Shweta Kedia ,&nbsp;Sonal Jain ,&nbsp;Hemlata Jangir ,&nbsp;Nenkimun Dirting Bakwa ,&nbsp;Bipin Chaurasia ,&nbsp;Claire Karekezi ,&nbsp;James A Balogun ,&nbsp;Lynne Lourdes N. Lucena ,&nbsp;Mahnaaz Sultana Azeem ,&nbsp;Mabel Banson ,&nbsp;Santanu Kumar Bora ,&nbsp;Selfy Oswari ,&nbsp;Vaishali Suri ,&nbsp;Vasundhara Rangan","doi":"10.1016/j.jocn.2025.111174","DOIUrl":"10.1016/j.jocn.2025.111174","url":null,"abstract":"<div><div>The 2021 WHO classification of central nervous system (CNS) tumors introduced significant changes based on molecular and biological tumor characteristics, aiming to improve prognostication and enable more precise treatment approaches. This study investigated the awareness, adoption, and impact of the new classification on adult glioma management among healthcare professionals in Africo-Asian region. Through a structured survey questionnaire distributed across these regions, assessment of the level of awareness, diagnostic changes, challenges faced, and future perspectives among respondents was done. The survey received responses from 56 participants. Findings revealed that while 67.85% of respondents from Asia and 32.15% from Africa reported awareness of the new classification, both groups faced significant challenges in accessing molecular diagnostics, with financial constraints limiting widespread implementation. This paper provides insights into the current state of brain glioma management in resource-limited settings and discusses the potential need for further refinements in the WHO classification of CNS tumors and adult glioma management guidelines to address these disparities.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111174"},"PeriodicalIF":1.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143621178","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":"Validation of data capture in the Australasian shunt registry with a prospectively maintained institutional database","authors":"Michael J. Stuart ,&nbsp;Alison Wray ,&nbsp;Mark Dexter ,&nbsp;Robert AJ. Campbell","doi":"10.1016/j.jocn.2025.111179","DOIUrl":"10.1016/j.jocn.2025.111179","url":null,"abstract":"<div><h3>Background</h3><div>The Australasian Shunt Registry was established in 2016 with the aim of providing safety and quality data in addition to enhancing capacity for research to improve health outcomes for patients with cerebrospinal fluid shunts. The Queensland Children’s Hospital is the largest single contributor of paediatric patient data to the Registry and maintains an independent institutional shunt database. The aim of this study was to validate the demographic data and outcomes captured by the Registry against that institutional database.</div></div><div><h3>Methods</h3><div>Data from the institutional database and a sample of data from the same institution held by the Australasian Shunt Registry were acquired from the period of 1 January 2017 to 1 October 2024. Patients ≤ 18 years of age undergoing placement of a new ventriculoperitoneal shunt system were included. Revision and mortality data were acquired from the Australasian Shunt Registry and Queensland statewide electronic medical records independently. Comparison was made between demographic and mortality data captured by each database. The primary outcome of time to shunt revision (shunt survival) in each sample was assessed through the generation of Kaplan-Meier curves and analysis by both Wilcoxon and log-rank tests.</div></div><div><h3>Results</h3><div>Over the study period the shunt registry reported a full or partial opt-out rate of 9.5 %. 344 patients were identified and included from the institutional database, and 294 patients were included from the Registry. The identified patient samples were demographically similar with a mean age of 5 years, and 44 % female in both groups. The most common aetiologies of hydrocephalus in both cohorts were congenital (28 % vs 28 %, p = 0.49), tumour (33 % vs 27 %, p = 0.08) and haemorrhage (25 % vs 18 %, p = 0.02). Mortality during followup was consistent across both samples (13 % vs 11 %, p = 0.27). Similarly, binary revision status during the followup period was similar (34 % vs 32 %, p = 0.3). Kaplan-Meier analysis of time to revision (shunt survival) estimated shunt survival to be 4.82 years (95 % CI 4.42––5.22 years) in the institutional database and 5.25 (95 % CI 4.81–5.69 years) in the Registry with no significant differences between the samples on Wilcoxon, p = 0.3 or late Log-Rank, p = 0.36 tests.</div></div><div><h3>Conclusions</h3><div>The Australasian Shunt Registry appears to capture a valid sample which is representative of the demographics and clinical outcomes of patients treated at one large contributing institution. Ongoing efforts to ensure comprehensive data capture at all participating sites are justified to ensure that future findings derived from Registry data are representative of the studied population.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111179"},"PeriodicalIF":1.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143621177","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":"Endoscopic endonasal pituitary transposition trans-tuber-cinereum for resection of the third ventricle craniopharyngioma","authors":"Xie Tao ,&nbsp;Yang Zijiang ,&nbsp;Yang Liangliang ,&nbsp;Li Zeyang ,&nbsp;Liu Tengfei ,&nbsp;Zhang Xiaobiao","doi":"10.1016/j.jocn.2025.111176","DOIUrl":"10.1016/j.jocn.2025.111176","url":null,"abstract":"<div><div>Endoscopic endonasal approach (EEA) to craniopharyngioma has been widely used in the last decade. However, intrinsic third ventricle craniopharyngioma is still a difficult type for EEA. Endoscopic endonasal suprachiasmatic <em>trans</em>-lamina terminalis approach is an alternative solution. In consideration of the origin of intra-third ventricle craniopharyngioma is tuberoinfundibular area in the floor of the third ventricle, the suprachiasmatic <em>trans</em>-lamina terminalis approach is limited in exposing this area from anterior-superior direction. In this technical note, we describe our surgical technique for resection of the third ventricle craniopharyngioma by using endoscopic endonasal pituitary transposition <em>trans</em>-tuber-cinereum approach. The surgical technique includes posterior clinoidectomy, pituitary transposition, and opening the tuber cinereum. This described approach was performed in two patients with intrinsic third ventricle craniopharyngiomas, both of them achieved gross total resection. Transient pituitary deficiency was replaced with hormones. No other complications were occurred. Endoscopic endonasal pituitary transposition <em>trans</em>-tuber-cinereum approach is a safe and effective for this special type of craniopharyngioma.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111176"},"PeriodicalIF":1.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143621180","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":"Swahili translation and cultural adaptation of the National Institutes of Health Stroke Scale","authors":"Peter Kuria Waweru ,&nbsp;Samwel Maina Gatimu ,&nbsp;Elijah Yulu ,&nbsp;Stella Kibet ,&nbsp;Dalphine Ndiema ,&nbsp;Adam Mang’ombe ,&nbsp;Sarah Shali Matuja ,&nbsp;Innocent Kitandu Paul ,&nbsp;Matilda K Basinda ,&nbsp;Sospeter Berling ,&nbsp;Gladness Xavier ,&nbsp;Nassiuma Manakhe ,&nbsp;Christine Tunkl ,&nbsp;Patrick Lyden","doi":"10.1016/j.jocn.2025.111182","DOIUrl":"10.1016/j.jocn.2025.111182","url":null,"abstract":"<div><h3>Background</h3><div>The severity of early neurologic deficits after stroke is the single most important predictor of post-stroke outcomes. Of all stroke severity scales, the National Institutes of Health Stroke Scale (NIHSS) is the most widely used. Despite being freely accessible, however, this tool remains underutilized in sub-Saharan Africa (SSA) likely due to absence of culturally adapted translations. For this reason, we translated the NIHSS to Swahili in a bid to promote its local use as an initial measure in the standardization of stroke care in the East African region. Swahili remains among the 10 most commonly spoken languages in the world, with over 200 million speakers, mostly centred in East Africa.</div></div><div><h3>Methods</h3><div>The NIHSS was translated into Swahili by a team of native Swahili speakers composed of two stroke physicians, two speech therapists and one nurse, and three independent translators in collaboration with the tool’s developer. Two Swahili translators performed forward translations of the original document from English to Swahili while a third independent translator performed backward translations to English, which was followed by clinician and cognitive reviews. Afterwards, reviewers from Kenya and Tanzania reviewed the tool for cross-cultural adaptation and international harmonisation. We further reconciled and generated a draft tool that was validated in Kenya and Tanzania.</div></div><div><h3>Results</h3><div>The NIHSS was translated into Swahili, a process that involved broad modifications of the tool including alterations of images, words and phrases to more locally familiar scenes and items. The results of validation of the Swahili version of the NIHSS in Kenya and Tanzania showed no significant differences with the original tool; with good interrater reliability in most domains.</div></div><div><h3>Conclusions</h3><div>The result of this process is a Swahili translation of the NIHSS that reflects the original tool. We expect the tool to help advance stroke care in Swahili-speaking regions.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111182"},"PeriodicalIF":1.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143628173","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}