Neurology International最新文献

{"title":"Rehabilitation Outcomes in Patients Who Regained Consciousness.","authors":"Elena Aidinoff, Almothana Khatib, Anna Oksamitni, Ilana Gelernter, Lilach Front, Amiram Catz, Sharon Shaklai, Marina Motin, Corinne Serfaty, Deborah Rubin-Asher","doi":"10.3390/neurolint18080158","DOIUrl":"10.3390/neurolint18080158","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Patients with prolonged disorder of consciousness (PDOC) who regained consciousness in intensive care for consciousness rehabilitation (ICCR) were referred to further brain rehabilitation (FBR). The current retrospective cohort study evaluated the functional and cognitive outcomes of FBR. <b>Methods</b>: We assessed outcomes in 258 PDOC patients during FBR and used multivariate regression analyses to examine the influence of demographic and clinical characteristics on outcomes. <b>Results</b>: During FBR, Functional Independence Measure (FIM) motor, cognitive, and total scores improved from 21 ± 11, 11 ± 10, and 32 ± 15 to 43 ± 26, 18 ± 7, and 61 ± 32, respectively (<i>p</i> < 0.001). Dynamic Lowenstein Occupational Therapy Cognitive Assessment (DLOTCA) total scores increased from 57 ± 29 to 82 ± 36, and the average 6-min-walk (6MW) distances improved from 295 to 374 m (<i>p</i> < 0.001). Higher discharge FIM and DLOTCA scores were associated with younger age, traumatic etiology of the brain injury, shorter time to regaining consciousness, and higher FIM and DLOTCA scores at admission to FBR (<i>p</i> < 0.05). <b>Conclusions</b>: We observed functional and cognitive improvement in the examined patients. The improvement was associated with factors that may mainly reflect the severity of brain damage. The findings support continuing rehabilitation before and after emerging from PDOC.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13516453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148830315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral Vein of Trolard Thrombosis Presenting with Seizure and Minimal Deficits: A Rare Case Report.","authors":"Balaganesh Natarajan, Mahika Khurana, Mariam Gabadadze, Ahmed Abd Elazim, Eman Elmasry Eldamarany Khalifa","doi":"10.3390/neurolint18080155","DOIUrl":"10.3390/neurolint18080155","url":null,"abstract":"<p><p>Isolated cortical vein thrombosis is a rare subtype of cerebral venous thrombosis with highly variable clinical and radiologic manifestations that frequently delay diagnosis. Bilateral thrombosis of the veins of Trolard is exceptionally uncommon, with only a few cases reported in the literature. We report a 64-year-old right-handed man who presented after being found unresponsive with suspected seizure. Although his neurological examination was normal at evaluation (NIHSS 0), noncontrast CT demonstrated subtle bilateral cortical vein hyperdensities (cord sign). Subsequent MRI and MR venography confirmed bilateral thrombosis of the veins of Trolard with associated venous congestion and a small sulcal subarachnoid hemorrhage. The patient was treated with therapeutic anticoagulation and levetiracetam. The patient achieved an excellent functional outcome (modified Rankin Scale score of 0). At 3-month follow-up, he remained neurologically intact without recurrent seizures. Follow-up MRI demonstrated improvement of the cortical FLAIR abnormality, and MR venography showed significant interval improvement in the bilateral vein of Trolard thromboses with residual short-segment nonocclusive filling defects, consistent with partial venous recanalization. This case expands the recognized clinical spectrum of the bilateral vein of Trolard thrombosis by demonstrating that extensive bilateral cortical venous involvement may present predominantly with seizure despite a normal neurological examination (NIHSS 0). Early recognition of subtle CT findings, confirmation with dedicated venous imaging, and prompt anticoagulation can result in excellent clinical recovery and favorable radiographic evolution.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13516342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148831243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spinal Cord Ischemia After Thoracoabdominal Aortic Aneurysm Repair: Pathophysiology, Detection, and Management.","authors":"Janak Patel, Stephanie Liang, Mirza Bulic, May Kim-Tenser, Tatsuhiro Fuji, Sukgu Han, Benjamin Emanuel, Fawaz Philip Tarzi","doi":"10.3390/neurolint18080156","DOIUrl":"10.3390/neurolint18080156","url":null,"abstract":"<p><p>Thoracoabdominal aortic aneurysm (TAAA) is a complex vascular disorder involving both thoracic and abdominal segments of the aorta and remains associated with substantial morbidity and mortality. One of the most serious complications after thoracoabdominal aortic aneurysm (TAAA) repair is spinal cord ischemia (SCI), which may progress to spinal cord infarction and result in irreversible neurologic deficits including paraplegia, neurogenic bladder dysfunction, and bowel dysfunction. The incidence of SCI after TAAA repair varies with the extent of aneurysmal involvement, operative duration, and patient comorbidities. The primary pathophysiologic mechanism involves interruption of radiculomedullary arterial flow, compounded by systemic hypotension and limited collateral circulation. Because SCI profoundly affects functional recovery and long-term quality of life, prevention and early recognition are central to perioperative management. Established neuroprotective strategies emphasize maintenance of spinal cord perfusion through meticulous hemodynamic optimization, cerebrospinal fluid (CSF) drainage, and temperature modulation. Intraoperative neuromonitoring using motor and somatosensory-evoked potential facilitates early detection, while newer modalities such as near-infrared spectroscopy and CSF lactate monitoring may offer additional insight. When SCI occurs despite prophylaxis, rapid initiation of rescue measures including CSF drainage, hemodynamic augmentation, and other discussed treatments may improve neurologic outcomes. Long-term care focuses on rehabilitation, symptom management, and psychological support. Therefore, this review aims to consolidate medical evidence to improve the prevention, detection, and treatment of spinal cord infarction associated with thoracoabdominal aortic aneurysm repair.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13516104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148830563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamics of Circulating Brain-Derived Neurotrophic Factor and Selenoprotein P in Subacute Stroke Patients Undergoing High-Intensity Interval Training-Based Neurorehabilitation: A Pilot Observational Study.","authors":"Hunor-Pál Fodor, Beáta Albert, Pál Salamon","doi":"10.3390/neurolint18080154","DOIUrl":"10.3390/neurolint18080154","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Brain-derived neurotrophic factor (BDNF) and antioxidant networks mediated by Selenoprotein P (SEPP1) are core drivers of structural neuroplasticity and blood-brain barrier integrity, yet their co-regulatory behavior during subacute stroke neurorehabilitation remains poorly understood. This pilot study quantified concurrent changes in serum BDNF and SEPP1 during rehabilitation. <b>Methods:</b> Sixteen subacute post-stroke patients with mild stroke severity were assigned to an intensive multi-modal neurorehabilitation protocol incorporating high-intensity interval training (Treated, <i>n</i> = 7) or standard care (Control, <i>n</i> = 9); the biomarker sampling window averaged 73.4 days. Fasting venous blood was collected at baseline and post-intervention and analyzed by ELISA. <b>Results:</b> BDNF changes (ΔBDNF) differed significantly between arms (U = 57.0, <i>p</i> = 0.0081): the Treated cohort showed a uniform decrease (mean Δ: -0.240 ± 0.103 ng/mL), while Controls showed stabilization or a slight increase (mean Δ: +0.118 ± 0.339 ng/mL). ΔBDNF and ΔSEPP1 were significantly, positively correlated across the cohort (ρ = 0.596, <i>p</i> = 0.015). <b>Conclusions:</b> The BDNF decline in the Treated group is consistent with the \"central sink\" hypothesis, but may more plausibly reflect stress/cortisol-mediated suppression induced by the high training intensity, contrasting with increases typically reported after moderate-intensity subacute-phase exercise. The collinear coupling with SEPP1 suggests a link between neurotrophic synthesis and antioxidant buffering during post-stroke tissue remodeling, though this correlational finding does not by itself establish a single, coordinated mechanism.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13516591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148831156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative Density of Residual Hematoma Is a Predictor of Chronic Subdural Hematoma Recurrence-A Single-Center Retrospective Study.","authors":"Faisal Sawab, Tim Lampmann, Haitham Alenezi, Lars Eichhorn, Mohammed Banat, Hartmut Vatter, Marcus Thudium, Motaz Hamed","doi":"10.3390/neurolint18080157","DOIUrl":"10.3390/neurolint18080157","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Chronic subdural hematoma (cSDH) is one of the most common neurosurgical disorders in older adults and remains associated with a relevant recurrence rate despite standardized surgical treatment. Identifying postoperative factors that predict recurrence may improve postoperative surveillance and surgical strategy. We therefore investigated whether the density of the residual hematoma on early postoperative computed tomography (CT) is associated with recurrence after burr-hole trepanation. <b>Methods</b>: We retrospectively analyzed all consecutive patients who underwent burr-hole trepanation for cSDH at our institution between 2016 and 2021. Residual hematoma density was measured in Hounsfield units (HU) on postoperative CT scans. Recurrence was defined as symptomatic hematoma reaccumulation requiring reoperation. <b>Results</b>: A total of 223 patients met the inclusion criteria. The overall recurrence rate was 20.2%. Mean residual hematoma density was significantly higher in the recurrence group than in the non-recurrence group (23.2 ± 13.1 HU vs. 19.0 ± 9.1 HU; <i>p</i> = 0.005). ROC analysis identified an optimal cutoff value of 19 HU (AUC 0.578, 95% CI 0.511-0.645; <i>p</i> = 0.022) with sensitivity of 57.8%, and a specificity of 57.9%. Patients with residual hematoma density ≥19 HU had a significantly higher recurrence rate than those with lower density (25.7% vs. 15.6%; <i>p</i> = 0.043). In multivariable logistic regression, higher residual density remained an independent predictor of cSDH recurrence (<i>p</i> = 0.008, OR 1.9; 95% CI 1.2-3.0). <b>Conclusions</b>: Higher postoperative residual hematoma density is an independent predictor of recurrence after burr-hole trepanation for cSDH. Residual density on early postoperative CT may serve as a simple and clinically accessible imaging marker of incomplete hematoma clearance and may help refine postoperative risk assessment. Nevertheless, the low AUC limits interpretation of predictive performance.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13516401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Visual Symptoms and Deficits Among Inpatients with Acquired Brain Injury.","authors":"Camilla Biering Lundquist, Lars Evald, Simon Svanborg Kjeldsen, Lis Viborg, Rasmus Langelund Jørgensen, Jesper Fabricius","doi":"10.3390/neurolint18080153","DOIUrl":"10.3390/neurolint18080153","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the prevalence of visual deficits among inpatients with acquired brain injury, to examine the agreement between objective screenings and patient-reported visual deficits, and to investigate patient characteristics associated with visual deficits.</p><p><strong>Methods: </strong>This cross-sectional study included data on screened and patient-reported visual deficits in patients with acquired brain injury admitted for inpatient rehabilitation. The screenings were conducted by occupational therapists. Visual acuity and visual field were assessed in 2014-2023, and complemented by assessment of ocular motility and patient-reported deficits in 2021-2023. Predictive values were calculated for the agreement between screening results and patient-reported symptoms. Logistic regression models were applied to investigate the association between clinical characteristics and visual deficits.</p><p><strong>Results: </strong>2814 patients were screened, 65% were men, the median age was 64 years, and the most common diagnosis was stroke (66%). In screened patients 32% had reduced visual acuity, 18% had ocular motility deficits, and 15% had visual field deficits. Of 975 patients providing self-reports, 38% reported vision problems. A total of 28% of patients who did not report visual deficits, had visual deficits in the objective screening. Lower functional level was associated with greater odds of having any visual deficits. Traumatic and anoxic brain injuries were associated with lower odds of visual field deficits compared with stroke.</p><p><strong>Conclusions: </strong>The high proportion of patients with visual deficits underlines that these are common consequences following acquired brain injury. Objective screening and patient-reported deficits offer overlapping yet distinct insights into visual deficits. Knowledge of clinical characteristics associated with visual deficits may help recognize high-risk subgroups.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13516685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148830162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Ulnar Neuropathy at the Elbow: Clinical, Electrodiagnostic, and Ultrasonographic Findings.","authors":"Vasudeva G Iyer, Lisa B E Shields, Smita Ghare, Christopher B Shields","doi":"10.3390/neurolint18080152","DOIUrl":"10.3390/neurolint18080152","url":null,"abstract":"<p><strong>Background/objectives: </strong>Ulnar nerve neuropathy at the elbow (UNE) is the second most common focal neuropathy of the upper extremity and often results from entrapment of the ulnar nerve as it traverses the elbow with insidious onset and gradual progression. This study describes the clinical, electrodiagnostic (EDX), and ultrasound (US) findings in a cohort of patients presenting with acute UNE.</p><p><strong>Methods: </strong>This is a review of 103 patients with clinical features of UNE with acute onset who underwent EDX and US studies over a 25-year period (2010-2026) at our Neurodiagnostic Center.</p><p><strong>Results: </strong>Of the 103 patients with acute UNE, all experienced paresthesia in the ulnar nerve distribution. A total of 27 (26.2%) patients had elbow pain, and 99 (96.1%) had decreased pinprick sensation in the ulnar nerve distribution. Weakness of the following muscles was detected: abductor digiti minimi (ADM) (94 [91.3%]), FDI (first dorsal interosseous) (91 [88.3%]), and FDPu (flexor digitorum profundus-ulnar) (76 [73.8%]). Most patients had a clinical grade of 3 (severe: sensory and motor abnormalities as well as atrophy of the FDI and ADM muscles) (93 [90.3%]). Perioperative injuries were the most common etiology of acute UNE, consisting of 65 (63.1%) patients. The perioperative injury was noted after surgical procedures at varied locations, most frequently at the shoulder in 23 (35.4%) followed by coronary artery bypass in 9 (13.8%) and knee joint surgery in 8 (12.3%). Non-iatrogenic injuries affected 11 (10.7%) patients. The US study revealed cysts and tumors such as a Schwannoma in 14/76 (18.4%) patients. Focal demyelination was observed by EDX studies in 95 (92.2%) patients, and a conduction block was detected in 24 (23.3%). Motor and sensory axonal involvement was identified in 81 (78.6%) and 86 (83.5%) patients, respectively. Of the 76 patients who underwent an US study, 68 (90.6%) had an increase in the cross-sectional area of the ulnar nerve and 51 (68.0%) had a hypoechoic ulnar nerve at the elbow.</p><p><strong>Conclusions: </strong>In this study, the most common cause of acute UNE was periprocedural injury, most frequently following shoulder surgery. Acute UNE may also occur without a history of antecedent trauma or a surgical procedure. EDX and US studies provide complementary data to determine the severity and the etiology of acute UNE and guide further management.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13516233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148831222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute and Chronic Cerebral Hypoperfusion After Flow-Diverter Placement: Is There a Role for Extra-Intracranial Bypass? A Case Series and Narrative Literature Review.","authors":"Alessandro Tozzi, Valentina Caldiera, Giuseppe Ganci, Paolo Ferroli, Marco Schiariti, Matteo Milani, Isabella Canavero, Benedetta Storti, Anna Bersano, Francesco Acerbi, Elisa Francesca Maria Ciceri","doi":"10.3390/neurolint18080151","DOIUrl":"10.3390/neurolint18080151","url":null,"abstract":"<p><p><b>Background:</b> Flow diverters (FDs) are widely used to treat intracranial aneurysms. Although effective, FD-related thrombosis or progressive stenosis may lead to acute or delayed cerebral hypoperfusion with significant neurological morbidity. Management options are limited when medical or endovascular rescue strategies fail. This study aims to evaluate the role of extracranial-intracranial bypass (EC-IC bypass) as a rescue strategy across the spectrum of FD-related cerebral hypoperfusion. <b>Methods:</b> We retrospectively reviewed all patients who underwent EC-IC bypass for FD-related cerebral hypoperfusion over a 10-year period in our institution. Both acute and chronic presentations were included. Clinical status was assessed using the modified Rankin Scale (mRS). Imaging evaluation included digital subtraction angiography (DSA), computed tomography angiography (CTA), magnetic resonance angiography (MRA) and quantitative magnetic resonance imaging for bypass flow assessment. Surgical technique, antiplatelet therapy, timing of intervention and clinical outcomes were analysed. <b>Results:</b> Five patients with FD-related cerebral hypoperfusion who underwent superficial temporal artery-middle cerebral artery bypass (STA-MCA bypass) were identified. Two distinct patterns emerged. Three patients developed early hypoperfusion within the first month of FD placement, presenting with acute neurological deficits and treated by emergent or urgent bypass under dual antiplatelet therapy. Two patients developed late hypoperfusion years after the procedure, presenting with progressive haemodynamic symptoms and treated by elective flow-augmentation bypass under aspirin monotherapy. At discharge, only one patient had an mRS ≥ 3. At one-year follow-up, a favourable outcome (mRS ≤ 2) was observed in all patients with available data. Follow-up data were missing for one patient. <b>Conclusions:</b> EC-IC bypass represents a feasible rescue strategy for FD-related cerebral hypoperfusion when medical or endovascular treatments fail. In our experience, though limited, STA-MCA bypass can provide sufficient cerebral reperfusion, even in urgent settings and under dual antiplatelet therapy, leading to favourable neurological outcomes.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13516732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148831236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated Hypoglossal Nerve Palsy Associated with Internal Carotid Artery Dissection: A Systematic Review.","authors":"Pasquale Frisina, Valeria Panebianco, Filippo Valentini, Antonio Iacuzio, Carlo Cavaliere, Umberto Romeo, Iacopo Carbone, Lucia Borghetti, Daniela Messineo","doi":"10.3390/neurolint18080150","DOIUrl":"10.3390/neurolint18080150","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Background&lt;/b&gt;: Isolated hypoglossal nerve palsy is a rare neurological condition with a broad differential diagnosis. Although neoplastic disorders are the most common cause, internal carotid artery dissection (ICAD) is an uncommon but clinically important and potentially reversible vascular etiology that is frequently underrecognized. This systematic review synthesized the available evidence regarding the clinical presentation, imaging findings, pathophysiological mechanisms, treatment, and outcomes of isolated hypoglossal nerve palsy associated with ICAD through a standardized patient-level descriptive analysis. &lt;b&gt;Methods&lt;/b&gt;: This systematic review was conducted according to the PRISMA 2020 guidelines and prospectively registered in PROSPERO (CRD420261364863). PubMed, Scopus, Web of Science, and the Cochrane Library were searched from inception to April 2026. Manual reference screening and forward citation tracking were also performed. Studies reporting original, patient-level data on isolated hypoglossal nerve palsy associated with ICAD were eligible. Clinical, imaging, treatment, and outcome data were extracted and synthesized descriptively. In hybrid publications combining original case reporting with a narrative literature review, only eligible, original patient data were included in the quantitative synthesis, whereas the narrative review components were used for citation tracking and contextual comparison. &lt;b&gt;Results&lt;/b&gt;: A total of 26 standalone primary publications were included, comprising 23 case reports and 3 case series. Two additional hybrid publications each contributed one eligible patient. One hybrid publication contained an original case-report component, whereas the other reported two original cases and was therefore considered to contain a case-series component, although only one of its patients fulfilled the eligibility criteria. Overall, the 28 publications contributed 32 eligible patients to the patient-level quantitative synthesis. The narrative review components of the two hybrid publications were used solely for citation tracking and contextual comparison. Patients were predominantly male (28/32, 87.5%), with a median age of 47 years. Tongue deviation (28/28, 100%) and tongue weakness (30/30, 100%) were the hallmark clinical features, followed by dysarthria (26/26, 100%) and dysphagia (18/22, 81.8%). All patients presented with isolated hypoglossal nerve palsy at presentation, without Horner syndrome or additional lower cranial nerve involvement. MRI was the most frequently reported imaging modality (29/32, 90.6%), whereas CTA was commonly used to characterize luminal abnormalities. Intramural hematoma (25/26, 96.2%), luminal stenosis (23/26, 88.5%), and external arterial enlargement (22/24, 91.7%) were the most consistent neuroradiological findings. Conservative medical management predominated (31/32, 96.9%). The available evidence was more consistent with a compressive mechanism related to subadventitial a","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13517042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148831168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual Reality Training for Post-Stroke Upper Limb Hemiparesis.","authors":"Kanta Kitabayashi, Naoki Yoshioka","doi":"10.3390/neurolint18080149","DOIUrl":"10.3390/neurolint18080149","url":null,"abstract":"<p><p>In recent years, the application of virtual reality (VR) in rehabilitation medicine has gained increasing attention. VR is generally classified into two types: non-immersive and immersive systems. Non-immersive VR allows patients to interact with virtual environments through screens while maintaining a connection with the real world. Several studies have reported that the combined application of non-immersive VR and adjunctive technologies such as transcranial direct current stimulation and hand exoskeleton devices could facilitate functional recovery of hemiparetic limbs after stroke. In contrast, immersive VR is applied with the use of head-mounted displays to encompass the user's visual field, providing a high level of immersion and an enhanced sense of presence. This enhanced experience has been shown to promote patients' attention and motivation, which are important factors in motor learning. Emerging evidence suggests that immersive VR is effective for improving upper limb motor function in post-stroke hemiparetic patients. Furthermore, rehabilitative training performed in immersive virtual environments may facilitate the transfer of acquired motor skills to real activities of daily living. Future research should aim to generate high-quality evidence through large-scale, multicenter randomized controlled trials to better establish the clinical efficacy and optimal implementation of VR-based interventions in stroke rehabilitation.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13516541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148830774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}