Journal of Clinical Neuroscience最新文献

{"title":"Evaluating the brain injury guidelines (BIG) in an Australian trauma centre: A retrospective cohort analysis","authors":"William Chelepy,&nbsp;Timothy Williamson,&nbsp;Rumal Jayalath","doi":"10.1016/j.jocn.2025.111092","DOIUrl":"10.1016/j.jocn.2025.111092","url":null,"abstract":"<div><h3>Background</h3><div>The Brain Injury Guidelines (BIG) were developed to improve resource utilisation for patients with traumatic brain injury (TBI). The original BIG have never been validated outside the USA. The unique challenges facing Australian healthcare warrant validation of the BIG in this setting. This study aimed to evaluate the current standard of TBI management, safety of the BIG, and hypothetical resource savings resulting from their implementation.</div></div><div><h3>Methods</h3><div>A single institution, retrospective cohort study. Patients were identified by searching the database of radiology reports for computerised tomography (CT) studies, for patients presenting to the Princess Alexandra Hospital emergency department (ED) from 1 January 2018 to 1 January 2023. Chart review of the medical record was performed and patients were classified into BIG1, BIG2 or BIG3 based on neurological examination, intoxication, antiplatelet/anticoagulant use, and CT findings. The primary outcome was the need for neurosurgical intervention. Secondary outcomes were worsening neurological examination within 24 h of admission, progression on repeat head CT (RHCT) and post-discharge ED visits and 30-day readmissions. The guidelines were considered to fail if any BIG1 or BIG2 patient required neurosurgical intervention or ICU admission.</div></div><div><h3>Results</h3><div>878 patients were included, of which 106 (12.1 %) were BIG1, 113 (12.9 %) BIG2, and 659 (75.1 %) BIG3. Subdural and subarachnoid haemorrhage were the most common intracranial haemorrhage (ICH) in all groups. No BIG1 or BIG2 patient showed neurological deterioration or required intervention. Radiological progression was seen in 7 % and 3.4 % of RHCT for BIG1 and BIG 2 patients respectively; in no case did this change management. There was 1 (0.9 %) post-discharge ED visit in the BIG1 group. There were no 30-day readmissions in the BIG1 or BIG2 group. All patients needing intervention or readmission were BIG3. Current practice is not in line with the BIG, with excessive intervention performed in 97.2 % of BIG1 patients and 96.5 % of BIG2 patients. Agreement between the assigned and verified therapeutic plan was perfect (k = 1.00), meaning no patient failed the BIG. Adoption of the BIG could have saved 101 RHCT, 208 neurosurgical consultations and 189 inpatient days.</div></div><div><h3>Conclusion</h3><div>The BIG are safe in Australia and would significantly improve healthcare resource utilisation. Current practice regularly deviates from the BIG, suggesting significant resource saving to be realised. Future studies should prospectively validate the BIG so widespread adoption can be supported and implemented. Integration with allied health, long-term outcomes and potential modifications to the BIG remain to be explored.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"134 ","pages":"Article 111092"},"PeriodicalIF":1.9,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074342","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":"Prospective evaluation of modified Cincinnati Prehospital Stroke Severity Scale for identifying large vessel occlusion","authors":"Lingwen Zhang ,&nbsp;Xiaoqing Bu ,&nbsp;Juan Liao ,&nbsp;Yonghong Yang ,&nbsp;Zhao Yang ,&nbsp;Ting Liu ,&nbsp;Shudong Liu ,&nbsp;Libo Zhao ,&nbsp;Li Liu ,&nbsp;Deyu Yang","doi":"10.1016/j.jocn.2025.111077","DOIUrl":"10.1016/j.jocn.2025.111077","url":null,"abstract":"<div><h3>Objective</h3><div>To develop a novel, straightforward diagnostic scale for predicting large vessel occlusion (LVO) and anterior circulation LVO (ALVO) in the emergency setting, evaluating its validity against existing scales.</div></div><div><h3>Methods</h3><div>We prospectively enrolled patients with suspected stroke presenting consecutively at the National Comprehensive Stroke Centre’s emergency department between February 20, 2022, and November 11, 2022. Emergency physicians assessed each patient using the modified Cincinnati Prehospital Stroke Severity Scale (mCPSSS) and the National Institutes of Health Stroke Scale (NIHSS). The study analyzed the mCPSSS and other prevalent stroke scales to evaluate their efficacy in detecting LVO and ALVO, employing receiver operating characteristic curve (ROC) analysis and area under the curve (AUC) statistics to assess the scales’ sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy.</div></div><div><h3>Results</h3><div>A total of 383 patients with suspected stroke were included in this study. The performance in identifying LVO in the emergency setting was greatest for mCPSSS ≥ 2 with a sensitivity of 0.802 and specificity of 0.770, PPV of 0.644, NPV of 0.882, and accuracy of 0.781. mCPSSS ≥ 2 was 0.766 sensitive, 0.733 specific, PPV of 0.564, NPV of 0.886, and accuracy of 0.749 in predicting ALVO. The mCPSSS identified LVO and ALVO with an optimal cut-off value of 2, exhibiting AUC superior to those of other widely used stroke scales, with AUC values of 0.824 for LVO and 0.790 for ALVO.</div></div><div><h3>Conclusion</h3><div>The mCPSSS could serve as an effective and straightforward scale for identifying LVOs in emergency settings.</div><div>Clinical Trial Registration information: <span><span>https://www.chictr.org.cn/</span><svg><path></path></svg></span> (ChiCTR2200056776).</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"134 ","pages":"Article 111077"},"PeriodicalIF":1.9,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074345","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":"2-Hydroxyglutarate magnetic resonance spectroscopy for preoperative IDH molecular profiling – A review of the literature and real-world clinical translation in a busy neurosurgical neuro-oncology unit","authors":"Frances Anne McHugh ,&nbsp;James Jiang ,&nbsp;Heidi Luton ,&nbsp;Jonathan Parkinson ,&nbsp;Raymond Cook ,&nbsp;Allison Newey ,&nbsp;Chungo Choi ,&nbsp;Marina Kastelan ,&nbsp;Patrick Horsley ,&nbsp;Michael Back ,&nbsp;James Drummond","doi":"10.1016/j.jocn.2025.111062","DOIUrl":"10.1016/j.jocn.2025.111062","url":null,"abstract":"<div><div>2-hydroxyglutarate (2HG), a metabolic by-product that accumulates in IDH-mutated (IDHmut) glioma cells, can be quantified through magnetic resonance spectroscopy (MRS) offering a non-invasive method to determine molecular subtype. Incorporation of 2HG MRS into standard pre-operative MR protocol offers an adjunct to surgical decision making but limitations in post-processing and barriers exist to its integration into routine clinical practice. Our study explored the real-world translation of 2HG MRS into a busy neuro-oncology surgical unit at the Royal North Shore Hospital campus.</div><div>69 Spectra were acquired and reported prospectively between March 2018 and March 2024 in patients with suspected glioma using a 3 T Siemens Vida MRI, in addition to standard clinical magnetic resonance imaging and assessment. SV PRESS MRS was acquired with optimised parameters and the spectroscopic waveform analysed externally by a single center. The MRS voxel was localised on 3D FLAIR sequencing. Immunohistochemistry and genomic analysis were available for 30 patients to validate 2HG outcomes against standard ex vivo methods.</div><div>Utilising 1.2 mM as threshold calculated sensitivity was 80.9 %, specificity 77.8 %. Positive predictive value was 89.5 % and negative predictive value was 63.6 %.<!--> <!-->Utilising 3 mM as threshold calculated specificity 100 % given the absence of false negatives but sensitivity was significantly reduced &lt;10 %.</div><div>2HG/Cr ratio with a cutoff of 0.085 for positivity yielded sensitivity 94.7%, specificity 66.67% and accuracy 85.7%</div><div>Our experience re-demonstrates the potential of 2HG MRS in preoperative imaging in suspected IDHmut gliomas in a busy neuro-oncology unit but highlights the limitations of real-world clinical translation, technical complexities and difficulty in standardization.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"133 ","pages":"Article 111062"},"PeriodicalIF":1.9,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143135919","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 outcomes of adults with intracranial grade 1 and 2 ganglioglioma","authors":"Dana L. Hutton ,&nbsp;Janhavi Kulkarni ,&nbsp;Khaja Syed ,&nbsp;Ian Scott ,&nbsp;Michael D. Cearns ,&nbsp;Samantha J. Mills ,&nbsp;Michael D. Jenkinson","doi":"10.1016/j.jocn.2025.111088","DOIUrl":"10.1016/j.jocn.2025.111088","url":null,"abstract":"<div><div>Ganglioglioma is a rare primary brain tumour that most frequently occurs in children and young adults. They are generally low-grade and have a favourable prognosis, but there is limited literature to guide the optimal management. The aim of this study was to investigate the clinical outcomes of adults with intracranial ganglioglioma, and to determine the frequency and duration of radiological follow-up. Thirteen adult patients with CNS WHO grade 1 and 2 ganglioglioma were identified retrospectively from case records at a tertiary neurosurgical centre between 2010 and 2022. Patient characteristics, magnetic resonance imaging (MRI) features, and clinical outcomes were obtained. Surgery was classified as gross total (GTR) or subtotal (STR) resection. 84.6 % (n = 11) of patients had temporal lobe tumours, with most (69.2 %) presenting with seizures, at a median age of 29.0 years. GTR and STR were achieved in nine and five patients, respectively. No patients received adjuvant radiotherapy. During the median follow-up period of 8.9 years there was no radiological recurrence after GTR, and only one recurrence after STR at 65 months that did not require treatment. There was no patient mortality. Two patients continued to have seizures at last clinical follow-up. Low grade adult intracranial ganglioglioma has an excellent prognosis, with a recurrence rate below 10 % in this series. Long-term surveillance is not necessarily required if GTR has been achieved and patients can be considered for discharge after annual MRI for 5 years. In patients where only STR is achieved, annual MRI is required although the progression/recurrence rate remains low and asymptomatic.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"134 ","pages":"Article 111088"},"PeriodicalIF":1.9,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065650","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":"Survival in elderly glioblastoma patients: The often overlooked role of radiotherapy and chemotherapy","authors":"Rizky Andana Pohan,&nbsp;Khairiyah Khadijah,&nbsp;Putri Bunga Aisyah Pohan,&nbsp;Ronal Surya Aditya,&nbsp;Erfan Ramadhani,&nbsp;Rikas Saputra,&nbsp;Ririn Dwi Astuti","doi":"10.1016/j.jocn.2025.111091","DOIUrl":"10.1016/j.jocn.2025.111091","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"133 ","pages":"Article 111091"},"PeriodicalIF":1.9,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065503","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":"Corrigendum to “Impact of anesthesia type on surgical outcomes and medical complications in chronic subdural hematoma surgery” [J. Clin. Neurosci. 129 (2024) 110876]","authors":"Stephen Ahn ,&nbsp;Jae Sung Park ,&nbsp;Chul Bum Cho ,&nbsp;Seung Ho Yang ,&nbsp;Young Il Kim","doi":"10.1016/j.jocn.2025.111087","DOIUrl":"10.1016/j.jocn.2025.111087","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"133 ","pages":"Article 111087"},"PeriodicalIF":1.9,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064669","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":"Imaging findings of pulmonary and sellar histoplasmosis","authors":"Diogo Goulart Corrêa ,&nbsp;Luiz Celso Hygino da Cruz Jr.","doi":"10.1016/j.jocn.2025.111079","DOIUrl":"10.1016/j.jocn.2025.111079","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"134 ","pages":"Article 111079"},"PeriodicalIF":1.9,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065752","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":"Impact of continuous positive airway pressure therapy on restless legs syndrome in patients with coexistent obstructive sleep apnea: A qualitative systematic review","authors":"Narat Srivali ,&nbsp;Charat Thongprayoon ,&nbsp;Wisit Cheungpasitporn ,&nbsp;Andrey Zinchuk ,&nbsp;Brian B. Koo","doi":"10.1016/j.jocn.2025.111075","DOIUrl":"10.1016/j.jocn.2025.111075","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Obstructive sleep apnea (OSA) is characterized by repetitive episodes of complete or partial upper airway collapse during sleep. Restless legs syndrome (RLS) is a sleep-related movement disorder characterized by an uncomfortable urge to move the legs, especially during inactivity and evenings. Both OSA and RLS are common with significant overlap: RLS is present in up to 36% of those with OSA. Treatment of OSA with continuous positive airway pressure (CPAP) therapy may influence RLS outcomes. We performed a systematic review to evaluate the impact of CPAP therapy on RLS symptoms and RLS medication usage in individuals with both OSA and RLS.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;A comprehensive literature search was conducted in MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews from inception to December 7, 2024. The outcomes of interest were the improvement in RLS symptom severity, as measured by standardized scales such as the International RLS Study Group RLS Severity Scale (IRLS), and changes in the usage of RLS medications. The review included clinical trials and observational studies. Inclusion criteria were: studies with a control group or comparison period before CPAP usage, adult participants diagnosed with OSA and RLS, measurements of RLS severity using standardized scales such as the IRLS, and reports on medication usage before and after CPAP therapy. Data extraction included study characteristics, participant demographics, exposure and outcome measurements, and adjusted effect estimates. Exclusion criteria included non-primary research articles such as reviews, editorials, commentaries, letters, studies without standardized assessments of RLS symptoms, and non-English articles. The quality of included studies was assessed using the Newcastle-Ottawa Quality Scale (NOS), and the risk of bias was evaluated using the ROBINS-I tool. The systematic review was registered in PROSPERO (ID: CRD42024550240).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The search identified 2,046 articles, with 291 undergoing full-text review, and three studies (3 observational, 0 RCTs) meeting the inclusion criteria, which included 479 patients. CPAP therapy was associated with improvements in RLS symptoms and a reduction in medication usage among patients with coexistent RLS and OSA. The magnitude of these effects varied, with some studies reporting significant improvements while others showed probable changes. The variability in results can be attributed to differences in study designs, sample sizes, and adjustments for confounding factors. These factors highlight the need for more rigorous research to evaluate the benefits of CPAP therapy in patients with coexistent RLS and OSA.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;CPAP therapy appears beneficial for improving RLS symptoms and reducing medication usage in patients with coexistent OSA and RLS. However, further research with stand","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"133 ","pages":"Article 111075"},"PeriodicalIF":1.9,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064664","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":"Sodium fluorescein video Angiography–Assisted clipping of intracranial Aneurysms: A systematic review and Meta-Analysis","authors":"Leonardo Januário Campos Cardoso ,&nbsp;Marcio Yuri Ferreira ,&nbsp;Rodrigo Twardowski Scherer ,&nbsp;Christian Ken Fukunaga ,&nbsp;Jhon E. Bocanegra-Becerra ,&nbsp;Ahmet Günkan ,&nbsp;Christian Ferreira ,&nbsp;Jason Ellis ,&nbsp;Yafell Serulle ,&nbsp;David Langer","doi":"10.1016/j.jocn.2025.111081","DOIUrl":"10.1016/j.jocn.2025.111081","url":null,"abstract":"<div><h3>Objectives</h3><div>Ensuring aneurysm exclusion while maintaining vessel patency is crucial during intracranial aneurysm clipping. Although digital subtraction angiography (DSA) is the gold standard for intraoperative vascular imaging, some centers have reported using fluorescein sodium video angiography (FNa-VA). However, a synthesis of these findings is still lacking. We aim to evaluate the safety and efficacy of FNa-VA in identifying aneurysm remnants and vessel stenosis post-clipping.</div></div><div><h3>Methods</h3><div>PubMed, Embase, Cochrane, and Web of Science databases were searched for studies reporting on FNa-VA for intraoperative aneurysm clipping assessment. We assessed the rate of mis-clippings identified by FNa-VA, false negatives, and procedure-related side effects. A diagnostic assessment analyzed FNa-VA’s sensitivity, specificity, PPV, and NPV. Single proportion analysis with 95% confidence intervals under a random effects model was used, with heterogeneity examined via I2 and leave-one-out analysis.</div></div><div><h3>Results</h3><div>Eight studies involving 280 patients with 311 aneurysms were included. FNa-VA identified mis-clippings that eluded visual inspection in 11.94 % of cases (95 % CI: 5.83–18.05, I² = 59 %), with false negatives in 2.15 % (95 % CI: 0–5.13, I² = 44 %). It has demonstrated a sensitivity of 50 % and a specificity of 93 %, with PPV and NPV of 52 % and 93 %, respectively. Procedure-related side effects were yellow skin and green urine for 2–3 days following the procedure.</div></div><div><h3>Conclusion</h3><div>FNa-VA may reduce the risk of mis-clipping during aneurysm surgery, however, it is still prone to false negatives and should be considered a complementary tool rather than used alone. Additionally, it appears to have a safe profile with only mild and transitory side effects.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"134 ","pages":"Article 111081"},"PeriodicalIF":1.9,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065860","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":"Juhn Atushi Wada (1924–2023) and the history of the Wada test","authors":"Janis B. Li ,&nbsp;Jeffrey M. Katz ,&nbsp;Brendan Huang","doi":"10.1016/j.jocn.2025.111074","DOIUrl":"10.1016/j.jocn.2025.111074","url":null,"abstract":"<div><div>Epilepsy is one of the most common neurologic conditions in the world. Surgical treatment for refractory<!--> <!-->epilepsy is a method to optimize the quality of life for patients. Throughout his medical career, Dr. Wada examined the underlying mechanism of epilepsy and developed procedures to improve outcomes for his patients. A literature search of articles was conducted via PubMed and Google Scholar to chronicle the personal and professional life of Juhn Atsushi Wada. The review focused on Dr. Wada’s epilepsy research and the development of the carotid amytal injection, today known as the Wada test. In 1924, Juhn Atsushi Wada was born in Tokyo, Japan where he eventually attended Hokkaido Imperial University for his medical education. After completing his medical degree in 1947, Dr. Wada began his neurology and neurosurgery career in a war-torn Japan at the Hokkaido Imperial University Hospital. He developed the Wada test, an intracarotid sodium amytal injection, and published his landmark manuscript in 1949 that featured the observed benefits of the procedure and its suggested mechanisms of epilepsy. Wada would later move to North America, where he would disseminate his technique and lead the field in treating and understanding epilepsy. The contributions of Juhn Atsushi Wada earned him recognition as a leader in the fields of epilepsy neurosurgery and neurology.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"134 ","pages":"Article 111074"},"PeriodicalIF":1.9,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065771","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}