Naoko Takaku, Koji Hayashi, Mamiko Sato, Rei Asano, Kouji Hayashi, Toyoaki Miura, Norimichi Shirafuji, Tadanori Hamano, Yasutaka Kobayashi
{"title":"Intravascular Large B-Cell Lymphoma Diagnosed After Recurrent Stroke: Case Report and Literature Review.","authors":"Naoko Takaku, Koji Hayashi, Mamiko Sato, Rei Asano, Kouji Hayashi, Toyoaki Miura, Norimichi Shirafuji, Tadanori Hamano, Yasutaka Kobayashi","doi":"10.3390/neurolint17050068","DOIUrl":"10.3390/neurolint17050068","url":null,"abstract":"<p><p><b>Background/Objectives</b>: We describe a case of intravascular large B-cell lymphoma (IVLBCL) presenting with recurrent cerebral infarctions and review similar reported cases. Our aim is to explore potential early diagnostic markers and discuss their prognostic implications. <b>Methods/Results</b>: A 79-year-old man with a history of hypertension, hyperuricemia, and postoperative bladder cancer presented with five to six cerebral infarctions over an 11-month period, despite successive changes in antiplatelet and anticoagulant medications. Neurological examination revealed decreased pain sensation, bilateral hearing loss, and right thenar atrophy. Laboratory studies showed elevated inflammatory markers and soluble IL-2 receptor. CSF analysis revealed elevated protein, β2-microglobulin, IL-6, and IL-10 levels. A skin biopsy was performed to investigate suspected IVLBCL. Histopathological examination of the skin biopsy revealed large pleomorphic CD20-positive cells within the vasculature, confirming a diagnosis of IVLBCL. The patient was treated with chemotherapy, including dose-adjusted R-CHOP and high-dose methotrexate, and achieved complete remission. No recurrence of cerebral infarction was observed during a two-year follow-up period. <b>Conclusions</b>: This case highlights the importance of considering IVLBCL in patients with recurrent strokes of unknown etiology, especially when laboratory or imaging findings suggest systemic involvement. Early recognition and appropriate tissue diagnosis, such as skin biopsy, are essential for timely treatment and favorable prognosis.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 5","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12114279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151218","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":"The Association of Cerebral Blood Flow Measured Using Extracranial Carotid Ultrasound with Functional Outcomes in Patients with Anterior Circulation Large Vessel Occlusion After Endovascular Thrombectomy-A Retrospective Study.","authors":"Xin-Hong Lin, Kuan-Wen Chen, Chung-Fu Hsu, Ting-Wei Chang, Chao-Yu Shen, Hsin-Yi Chi","doi":"10.3390/neurolint17050067","DOIUrl":"10.3390/neurolint17050067","url":null,"abstract":"<p><p><b>Background</b>: Endovascular mechanical thrombectomy (EVT) is regarded as the standard treatment for acute ischemic stroke with large vessel occlusion. Few studies have examined the evolution of cerebral flow after the acute stage of ischemic stroke. In this study, we examined the association of functional outcomes with cerebral blood flow by extracranial carotid sonography during the subacute phase after EVT and multiple prognostic variables. <b>Methods</b>: We conducted a single-center, retrospective, observational study between January 2018 and June 2023. Patients with acute stroke resulting from anterior circulation large vessel occlusion who underwent EVT were included. All patients underwent carotid sonography in the second week after EVT. Patients with fair (modified Rankin Scale [mRS]: 0-3) and poor outcomes (mRS: 4-6) were compared to determine the association between and identify the predictors of these factors and functional outcomes. <b>Results</b>: A total of 89 patients were included (female: 38 (42.7%); mean age: 69.45 ± 13.59 years). Multivariable logistic regression analysis revealed that three factors were independent predictors of fair outcomes: (1) the Alberta Stroke Program Early CT Score (odds ratio [OR]: 1.79; 95% confidence interval [CI]: 1.16-2.78; <i>p</i> = 0.009); (2) Thrombolysis in Cerebral Infarction 2b to 3 (OR: 4.91; 95%CI: 1.10-21.89; <i>p</i> = 0.037); (3) the ratio of treatment-side blood flow between the internal carotid artery and common carotid artery (QTI/QTC, OR: 45.35; 95% CI: 1.11-1847.51; <i>p</i> = 0.04). <b>Conclusions</b>: The ratio of QTI/QTC is a clinically relevant parameter as a potential predictor of favorable outcomes. This parameter can be used to formulate patient prognostic scores and help clinicians determine whether adequate cerebral perfusion is maintained during the subacute phase.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 5","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12113688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151226","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}
Tirso Zúñiga-Santamaría, Blanca Estela Pérez-Aldana, Ingrid Fricke-Galindo, Margarita González-González, Zoila Gloria Trujillo-de Los Santos, Marie Catherine Boll-Woehrlen, Rosalía Rodríguez-García, Marisol López-López, Petra Yescas-Gómez
{"title":"Variants in Neurotransmitter-Related Genes Are Associated with Alzheimer's Disease Risk and Cognitive Functioning but Not Short-Term Treatment Response.","authors":"Tirso Zúñiga-Santamaría, Blanca Estela Pérez-Aldana, Ingrid Fricke-Galindo, Margarita González-González, Zoila Gloria Trujillo-de Los Santos, Marie Catherine Boll-Woehrlen, Rosalía Rodríguez-García, Marisol López-López, Petra Yescas-Gómez","doi":"10.3390/neurolint17050065","DOIUrl":"10.3390/neurolint17050065","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Several genetic factors are related to the risk of Alzheimer's disease (AD) and the response to cholinesterase inhibitors (ChEIs) (donepezil, galantamine, and rivastigmine) or memantine. However, findings have been controversial, and, to the best of our knowledge, admixed populations have not been previously evaluated. We aimed to determine the impact of genetic and non-genetic factors on the risk of AD and the short-term response to ChEIs and memantine in patients with AD from Mexico. <b>Methods</b>: This study included 117 patients from two specialty hospitals in Mexico City, Mexico. We evaluated cognitive performance via clinical evaluations and neuropsychological tests. Nineteen variants in <i>ABCB1</i>, <i>ACHE</i>, <i>APOE</i>, <i>BCHE</i>, <i>CHAT</i>, <i>CYP2D6</i>, <i>CYP3A5</i>, <i>CHRNA7</i>, <i>NR1I2</i>, and <i>POR</i> were assessed through TaqMan assays or PCR. <b>Results</b>: Minor alleles of the <i>ABCB1</i> rs1045642, <i>ACHE</i> rs17884589, and <i>CHAT</i> rs2177370 and rs3793790 variants were associated with the risk of AD; meanwhile, <i>CHRNA7</i> rs6494223 and <i>CYP3A5</i> rs776746 were identified as low-risk variants in AD. <i>BCHE</i> rs1803274 was associated with worse cognitive functioning. None of the genetic and non-genetic factors studied were associated with the response to pharmacological treatment. <b>Conclusions</b>: We identified potential genetic variants related to the risk of AD; meanwhile, no factor was observed to impact the response to pharmacological therapy in patients with AD from Mexico.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 5","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12114220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151238","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}
Fumine Tanaka, Maki Umino, Megumi Matsukawa, Seiya Kishi, Ryota Kogue, Norikazu Kawada, Ken Kagawa, Takaya Utsunomiya, Hiroyuki Kajikawa, Hidehiro Ishikawa, Yuichiro Ii, Akihiro Shindo, Hajime Sakuma, Masayuki Maeda
{"title":"Iatrogenic Cerebral Amyloid Angiopathy After Childhood Brain Surgery: Novel Findings of MRI and CT.","authors":"Fumine Tanaka, Maki Umino, Megumi Matsukawa, Seiya Kishi, Ryota Kogue, Norikazu Kawada, Ken Kagawa, Takaya Utsunomiya, Hiroyuki Kajikawa, Hidehiro Ishikawa, Yuichiro Ii, Akihiro Shindo, Hajime Sakuma, Masayuki Maeda","doi":"10.3390/neurolint17050064","DOIUrl":"10.3390/neurolint17050064","url":null,"abstract":"<p><p><b>Background/Objectives</b>: A subtype of cerebral amyloid angiopathy (CAA), iatrogenic CAA (iCAA), has been increasingly reported. iCAA occurs primarily in patients who underwent surgery during childhood and is caused by the prion-like propagation of amyloid beta. This subtype of CAA tends to develop at a younger age than age-related CAA, usually before the age of 55. After a latency period of 20-40 years following surgery, it manifests as lobar intracerebral hemorrhage (ICH), cognitive impairment, or transient focal neurological episodes. Between 2023 and 2024, we observed four cases of possible iCAA, all of which had a history of neurosurgery during childhood. <b>Case presentation</b>: MRI findings for all cases revealed multiple lobar microbleeds. Two cases also showed cortical superficial siderosis and lobar ICH. Notably, contrast-enhanced 3D FLAIR demonstrated sulcal enhancement in two cases, and CT demonstrated cortical calcification in the bilateral posterior lobes in one case. <b>Conclusions</b>: Sulcal enhancement on contrast-enhanced 3D FLAIR and cortical calcification in the bilateral posterior lobes on CT may suggest advanced CAA in the present cases.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 5","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12114373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151211","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}
Boulenouar Mesraoua, Bassel Abou-Khalil, Bernhard Schuknecht, Hassan Al Hail, Musab Ali, Majd A AbuAlrob, Khaled Zammar, Ali A Asadi-Pooya
{"title":"Epilepsy Diagnosis When the Routine Ancillary Tests Are Normal.","authors":"Boulenouar Mesraoua, Bassel Abou-Khalil, Bernhard Schuknecht, Hassan Al Hail, Musab Ali, Majd A AbuAlrob, Khaled Zammar, Ali A Asadi-Pooya","doi":"10.3390/neurolint17050066","DOIUrl":"10.3390/neurolint17050066","url":null,"abstract":"<p><p><b>Background/Objectives:</b> In a patient suspected of having epilepsy, routine EEG primarily contributes to the recording of interictal epileptiform discharges (IEDs). Similarly, magnetic resonance imaging (MRI) has become the gold standard imaging technique for identifying epileptogenic structural brain abnormalities. Various EEG and MRI tools to improve epilepsy diagnosis will be presented. <b>Methods:</b> When the initial EEG fails to record IEDs, various EEG measures that can improve EEG performance are presented; a comprehensive epilepsy-targeted MRI protocol to identify, localize, and characterize an epileptogenic lesion will also be described. <b>Results:</b> Studies show that the initial routine EEG fails to record IEDs in approximately 47-50% of epileptic patients. To improve the yield of EEG, subsequent EEG recording should include sleep deprivation, sleep recording, prolonged hyperventilation, optimized light stimulation, addition of an inferior temporal electrode chain, extended EEG duration, and continuous video-EEG monitoring, all measures known to activate IEDs. Furthermore, MRI is interpreted as \"normal\" in many epilepsy patients, even when performed according to an epilepsy-specific protocol and evaluated by a specialized MRI reader. In such case, the use of the Harmonized Epilepsy Structural Sequence Imaging (HARNESS-MRI) protocol and other imaging tools will improve the detection of potential epileptic lesions, as described in this study. <b>Conclusions:</b> In a patient with a clinical diagnosis of epilepsy but a normal EEG and brain MRI, several options can improve the performance of subsequent EEG and MRI examinations, the subjects of this review.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 5","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12113856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151076","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}
Ivana Sretenović, Srećko Potić, Goran Nedović, Gordana Odović, Ljiljana Šimpraga
{"title":"Functional Mobility Assessment in People with Multiple Sclerosis.","authors":"Ivana Sretenović, Srećko Potić, Goran Nedović, Gordana Odović, Ljiljana Šimpraga","doi":"10.3390/neurolint17050063","DOIUrl":"10.3390/neurolint17050063","url":null,"abstract":"<p><strong>Background/objectives: </strong>Functional mobility includes gait and balance. People with multiple sclerosis often experience gait impairment and difficulties with walking, as well as an increased risk of falling. The aim of the research was to assess functional mobility and to examine the relationship between gait and balance in people with multiple sclerosis, as well as the impact of falls on these two variables.</p><p><strong>Methods: </strong>The study sample consisted of 92 people with multiple sclerosis, with an average age of 45.10 (SD = 9.57) years, and both sexes (82.6% were female). The Activities-specific Balance Confidence Scale was used to assess an individual's confidence in maintaining balance throughout daily activities, and the 12-item Multiple Sclerosis Walking Scale was employed to evaluate the impact of multiple sclerosis on walking ability. Descriptive statistics, measures of central tendency, Pearson's correlations, and partial correlations were applied to the data.</p><p><strong>Results: </strong>The results indicated moderate gait impairment and a high level of function in people with multiple sclerosis. There was a correlation between confidence in maintaining balance and walking ability.</p><p><strong>Conclusions: </strong>The results of this study can be used to develop appropriate treatments and support programs for individuals with multiple sclerosis.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 5","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12113744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151208","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":"Identifying Factors Associated with the Efficacy of Lasmiditan 50 mg as an Acute Treatment for Migraine Attacks Under Various Dosing Conditions in Real-World Clinical Practice.","authors":"Takafumi Tanei, Shun Yamamoto, Satoshi Maesawa, Yusuke Nishimura, Tomotaka Ishizaki, Yoshitaka Nagashima, Yoshiki Ito, Miki Hashida, Takahiro Suzuki, Hajime Hamasaki, Toshihiko Wakabayashi, Ryuta Saito","doi":"10.3390/neurolint17050062","DOIUrl":"10.3390/neurolint17050062","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Lasmiditan is a newly developed drug for the acute treatment of migraine attacks, but factors associated with its efficacy remain unclear. This study aimed to confirm the efficacy of lasmiditan started at 50 mg under various dosing conditions and identify factors associated with its efficacy. <b>Methods</b>: There are four reasons for prescribing lasmiditan: as an add-on to triptan, if triptan is ineffective, if triptan produces side effects, and when triptan is contraindicated. Lasmiditan was administered at a dose of 50 mg. The efficacy of lasmiditan was defined as the disappearance of headache or a 50% or greater reduction in headache intensity within two hours after dosing. This study included 108 patients with migraines who took lasmiditan. <b>Results</b>: The results for efficacy and the side effects of lasmiditan were as follows: effective without side effects (22), effective with mild side effects (32), ineffective (14), and severe side effects (40). The efficacy rate of lasmiditan 50 mg was 50.0% (54/108). The following factors were found to be associated with lasmiditan's efficacy: sex, migraine classification, calcium channel blockers, and anti-calcitonin gene-related peptide monoclonal antibody (CGRP-mAb) treatment. The overall incidence of side effects was 66.7%, and the dropout rate was 37.0%. Somnolence was more prevalent in the effective group, and other side effects were more prevalent in patients who dropped out due to the side effects of lasmiditan. <b>Conclusions</b>: Lasmiditan is likely to be effective in males with severe migraine classification and receiving CGRP-mAb treatment. If mild somnolence is a side effect, the drug can be continued and may be effective.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 5","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12114562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151214","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":"Estrogen-Mediated Neural Mechanisms of Sex Differences in Burning Mouth Syndrome.","authors":"Takahiko Nagamine","doi":"10.3390/neurolint17040061","DOIUrl":"https://doi.org/10.3390/neurolint17040061","url":null,"abstract":"<p><strong>Background/objectives: </strong>Burning mouth syndrome (BMS) is a chronic pain disorder of the oral cavity in the absence of organic disease and is prevalent among menopausal women. Estrogen may be involved in the formation of nerves involved in pain.</p><p><strong>Methods: </strong>This paper presents an inferred mechanism for the relationship between estrogen and BMS based on a synthesis and interpretation of findings from a selection of published studies.</p><p><strong>Results: </strong>Estrogen influences the formation of neural circuits in BMS by dividing the complex pain circuit into the following three components: the peripheral pain circuit, brain network pain circuit, and memorized pain circuit.</p><p><strong>Conclusions: </strong>The development of BMS may be influenced by the formation of neural circuits by sex hormones.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 4","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12030133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040367","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}
Rahul R Karamchandani, Liang Wang, Dale Strong, Alexis A Mulvaney, Jonathan D Clemente, Jeremy B Rhoten
{"title":"Very Early Rehabilitation After Treatment with Intravenous Thrombolysis for Mild Acute Ischemic Stroke.","authors":"Rahul R Karamchandani, Liang Wang, Dale Strong, Alexis A Mulvaney, Jonathan D Clemente, Jeremy B Rhoten","doi":"10.3390/neurolint17040060","DOIUrl":"https://doi.org/10.3390/neurolint17040060","url":null,"abstract":"<p><strong>Background/objectives: </strong>The optimal timing of rehabilitation after acute ischemic stroke is unclear. We studied neurological outcomes and safety of early mobilization (EM) within 24 h for patients receiving intravenous thrombolysis.</p><p><strong>Methods: </strong>This was a retrospective analysis of patients treated at a single Comprehensive Stroke Center from 6/2020-10/2024 with EM versus usual care. Patients were eligible for EM if they were treated with intravenous thrombolysis and had post-treatment National Institutes of Health Stroke Scale scores ≤ 5, and later, ≤10. Ordinal regression was performed to determine factors associated with a 90-day functional outcome benefit in the full cohort. Propensity scores were calculated for matched sample pairs to determine any shift towards better outcomes with EM.</p><p><strong>Results: </strong>Groups of 165 and 73 patients were treated with EM and usual care, respectively. Treatment with EM was not associated with improved 90-day neurological outcome (odds ratio [OR] for higher mRS 0.746, <i>p</i> = 0.265). The groups also had comparable rates of symptomatic intracranial hemorrhage, length of stay, and discharge disposition. In the propensity score analysis of 73 matched pairs, EM was comparable to usual care with respect to 90-day functional outcome (OR for higher mRS 0.891, <i>p</i> = 0.7).</p><p><strong>Conclusions: </strong>Mobilization within 24 h resulted in comparable rates of 90-day neurological function, symptomatic intracranial hemorrhage, and hospital length of stay in patients with mild ischemic stroke treated with intravenous thrombolysis. Future trials may further investigate the safety and efficacy of EM in alternate and larger patient cohorts.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 4","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12029658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972955","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}
Andrea Calandrino, Gaia Cipresso, Marcella Battaglini, Samuele Caruggi, Irene Bonato, Paolo Massirio, Chiara Andreato, Francesco Vinci, Alessandro Parodi, Mariya Malova, Marta Bertamino, Elisabetta Amadori, Mariasavina Severino, Martina Resaz, Andrea Rossi, Pasquale Striano, Luca Antonio Ramenghi
{"title":"Neonatal Perforator Stroke: Timing, Risk Factors, and Neurological Outcome from a Single-Center Experience.","authors":"Andrea Calandrino, Gaia Cipresso, Marcella Battaglini, Samuele Caruggi, Irene Bonato, Paolo Massirio, Chiara Andreato, Francesco Vinci, Alessandro Parodi, Mariya Malova, Marta Bertamino, Elisabetta Amadori, Mariasavina Severino, Martina Resaz, Andrea Rossi, Pasquale Striano, Luca Antonio Ramenghi","doi":"10.3390/neurolint17040059","DOIUrl":"https://doi.org/10.3390/neurolint17040059","url":null,"abstract":"<p><p><b>Background and purpose:</b> Perforator stroke (PS) is a subtype of perinatal arterial ischemic stroke (PAIS), in which injuries occur in the territory of the perforator branches of the main cerebral arteries. This study aims to explore the incidence, timing, risk factors, and clinical presentation of PS in both preterm and full-term neonates. <b>Material and methods:</b> We retrospectively analyzed data about all the neonatal brain MRIs carried out in our hospital from March 2012 to March 2023. Criterium of inclusion was the radiologically confirmed diagnosis of perforator stroke involving one or more arterial districts. <b>Results:</b> A total of 1928 patients underwent brain MRIs during the period considered. PAIS was present in 50 patients, of which 19 had PS (38%). Among the patients with PS, nine were preterm babies (47%), and six suffered from perinatal asphyxia (31.5%). PS cUS diagnosis preceded MRI diagnosis in 88% of preterm babies. The mean age at cUS diagnosis was 20 ± 7 days. Preterm babies were often asymptomatic, whereas term babies showed neurological symptoms (mainly seizures). The outcome was favorable as long as PS was isolated. <b>Conclusions:</b> PS is surprisingly frequent among PAIS. It represents the most common form of PAIS in preterm babies and in babies suffering from birth asphyxia. Prenatal and perinatal factors suggesting a possible thromboembolic etiology leading to PAIS are rare in our population of preterm babies, in which the diagnosis was always preceded by negative cUS. These assumptions suggest a postnatal development of PS in premature babies more than a perinatal one.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 4","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12029835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995593","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}