Neurologia i neurochirurgia polska最新文献

{"title":"Intraoperative Transit Time Flowmetry for Unruptured Middle Cerebral Artery Aneurysms.","authors":"Vladimir Priban, Jiri Dostal, Jan Mracek","doi":"10.5603/pjnns.105338","DOIUrl":"https://doi.org/10.5603/pjnns.105338","url":null,"abstract":"<p><strong>Aim of the study: </strong>Clipping of the middle cerebral artery (MCA) aneurysms presents significant anatomical challenges, requiring precise occlusion while preserving the integrity of adjacent vessels. Narrowing or occlusion of MCA branches can lead to strokes and severe neurological deficits. Intraoperative transit time flowmetry (ITTF) provides quantitative real-time measurements of cerebral blood flow, potentially reducing ischemic complications. This study evaluates whether ITTF monitoring during unruptured MCA aneurysm clipping improves postoperative outcomes compared to a control group without ITTF.</p><p><strong>Material and methods: </strong>A retrospective review of a prospectively maintained institutional database was performed. A retrospective cohort study was conducted involving two groups of patients who underwent clipping for unruptured MCA aneurysms between 2010 and 2019. The monitored group (n = 34) received intraoperative ITTF monitoring, while the control group (n = = 20) did not. Intraoperative flow measurements were performed before and after clip placement, allowing for real-time clip adjustment if flow restriction exceeded 25%. All patients were monitored using motor-evoked potentials and indocyanine green video angiography. Postoperative outcomes were assessed using the modified Rankin Scale (mRS) at 30 and 90 days.</p><p><strong>Results: </strong>In the ITTF-monitored group, postoperative morbidity was 3% compared to 5% in the non-monitored group. Clip repositioning was required in two ITTF-monitored cases to restore blood flow, despite normal indocyanine green video angiography and motor evoked potential findings. The odds ratio for postoperative neurological deficits was 5.05 when comparing the ITTF-monitored group to a hypothetical non-monitored scenario (13.6% morbidity); however, this difference was not statistically significant.</p><p><strong>Conclusions: </strong>Despite the lack of statistical significance, ITTF monitoring may still play a valuable role in enhancing surgical safety, as it enabled clip repositioning in two cases where standard modalities (ICG and MEPs) showed no abnormalities. Further research is needed to confirm its clinical benefit and define its role in intraoperative decision-making.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145337322","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 and genetic characteristics of CANVAS patients - a single-center experience.","authors":"Mariusz Kwarciany, Kamila Boike, Filip Tomczuk, Bartosz Karaszewski, Riccardo Curro","doi":"10.5603/pjnns.105982","DOIUrl":"https://doi.org/10.5603/pjnns.105982","url":null,"abstract":"","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145337346","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":"Use of the serratus anterior muscle flap for reconstruction of an anterior cranial fossa after a gunshot wound.","authors":"Kristýna Procházková, Vladimír Mařík, Jiří Fiedler","doi":"10.5603/pjnns.105904","DOIUrl":"https://doi.org/10.5603/pjnns.105904","url":null,"abstract":"","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145302489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between smoking and Huntington's disease symptom onset and progression - results from Enroll-HD: The observational cohort study of people with Huntington's disease.","authors":"Grzegorz Witkowski, Daniel Zielonka, Rafał Rola, Halina Sienkiewicz-Jarosz","doi":"10.5603/pjnns.107176","DOIUrl":"https://doi.org/10.5603/pjnns.107176","url":null,"abstract":"<p><strong>Aim of the study: </strong>To assess the impact of tobacco smoking on the onset of Huntington's disease (HD) and the progression of its motor and cognitive symptoms.</p><p><strong>Clinical rationale of the study: </strong>HD is an incurable neurodegenerative disorder. Therefore, identifying lifestyle factors with an impact of its progression is of particular interest. Tobacco smoking influences the course of neurodegenerative disorders. It has been shown to be a risk factor for dementia, but, on the contrary, seems to have a protective role in Parkinson's disease.</p><p><strong>Material and methods: </strong>This study used Periodic Dataset 4 of the Enroll-HD database, from which a cohort of 2,438 HD subjects (799 presymptomatic) with four consecutive annual visits (three years of observation) was extracted. Logistic regression models were used to assess the effect of lifetime smoking on progression to the symptomatic phase. In the premanifest, Cox proportional regression model was applied to estimate the hazard ratio of HD diagnosis for smokers and nonsmokers during the three-year observation period. Multivariate linear regression models were used to investigate the relationship between smoking and the progression of HD clinical measures.</p><p><strong>Results: </strong>It was found that current female smokers were at a higher risk of progressing to the symptomatic phase of HD than nonsmokers [hazard ratio (HR): 1.35, p = 0.023, 95% confidence interval (CI): 1.04-1.56]. For the symptomatic HD cohort, regardless of sex, smoking was associated with faster progression of motor symptoms, as measured by the Total Motor Score (p = 0.035, 95% CI: 0.04-0.9), as well as cognitive impairment, as measured by the Stroop Word Reading test (p = 0.04, 95% CI: 0.1-0.9).</p><p><strong>Conclusions and clinical implications: </strong>It was presented that lifetime and current smoking are environmental factors that may be associated with an increased risk of HD progression, particularly in female HD gene carriers. This supports the recommendation that HD mutation carriers avoid smoking.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286587","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":"Cerebrovascular manifestation of tick-borne encephalitis virus infection.","authors":"Dariusz Dziubek, Karolina Dziubek, Marcelina Stodolak","doi":"10.5603/pjnns.107709","DOIUrl":"https://doi.org/10.5603/pjnns.107709","url":null,"abstract":"","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239226","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":"Long-term neurological and psychiatric complications and vocational outcome after cerebral venous sinus thrombosis.","authors":"Sławomir Budrewicz, Michał Szyszka, Alicja Dąbrowska, Jakub Mastalerz, Marta Nowakowska-Kotas","doi":"10.5603/pjnns.104674","DOIUrl":"https://doi.org/10.5603/pjnns.104674","url":null,"abstract":"<p><strong>Introduction: </strong>Cerebral venous sinus thrombosis (CVST) is present in up to 1% of stroke patients and primarily affects young adults. The outcome is considered good in the majority of cases. However, long-term neurological, cognitive, and psychiatric complications may have a substantial impact on quality of life and employment status. We aimed to review those complications and vocational outcomes after CVST comprehensively.</p><p><strong>Material and methods: </strong>A systematic literature review was conducted using PubMed and Embase, focusing on long-term neurological, cognitive, psychiatric, and vocational outcomes after CVST, with predefined inclusion and exclusion criteria.</p><p><strong>Results: </strong>Persistent headaches were present in up to 59% of the CVST survivors, while nearly 11% of patients developed late epileptic seizures. Residual focal motor or sensory deficits, visual disturbances and recurrent CVST were also present at follow-up. About 14-34% of CVST patients revealed abnormal findings in neuropsychological testing, while up to 30% of patients suffered from post-CVST depression. Between 20 and 40% of patients did not manage to resume full-time work. Given the frequent occurrence of the complications mentioned above, it is crucial to include screening of headaches, cognitive abilities, and depression in the follow-up period to provide suitable intervention.</p><p><strong>Conclusions: </strong>Analysis of literature revealed a high percentage of non-motor symptoms among survivors of CVST, such as head- -aches, seizures, cognitive deficits, and mental health issues, which impact patients' quality of life and functional independence.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239299","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":"End-to-end reanastomosis for a ruptured middle cerebral artery fusiform aneurysm.","authors":"Marek Grubhoffer, Jiri Fiedler","doi":"10.5603/pjnns.105806","DOIUrl":"https://doi.org/10.5603/pjnns.105806","url":null,"abstract":"","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232743","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":"Oropharyngeal dysphagia in Parkinson's disease - voice as a window into swallowing function.","authors":"Iwona Sarzyńska-Długosz","doi":"10.5603/pjnns.108657","DOIUrl":"https://doi.org/10.5603/pjnns.108657","url":null,"abstract":"","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232811","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":"Association between the degree of Parkinson's disease progression and the oral environment.","authors":"Airi Yamamoto, George Umemoto, Shinsuke Mizutani, Shinsuke Fujioka, Yoshio Tsuboi, Haruhiko Kashiwazaki","doi":"10.5603/pjnns.106300","DOIUrl":"https://doi.org/10.5603/pjnns.106300","url":null,"abstract":"<p><strong>Introduction: </strong>Aim of this study was to examine the relationship between the degree of Parkinson's disease (PD) progression and the oral environment in patients with PD.</p><p><strong>Material and methods: </strong>Fifty patients with PD [mean age, 64.9 ± 8.5 years old; mean Hoehn and Yahr (HY) stage, 3.2 ± 0.8] were recruited. The patients were divided into a mild/moderate group (HY stage 2-3) and a severe group (HY stage 4-5), and the oral environment was assessed using the Oral Health Assessment Tool (OHAT) score.</p><p><strong>Results: </strong>The OHAT scores for all participants were positively correlated with the age (rho = 0.27, p < 0.05), disease duration (rho = 0.28, p < 0.05), and MMSE score (rho = -0.28, p < 0.05). Multiple linear regression analyses showed that, among the OHAT items, \"tongue,\" \"saliva,\" and \"lips\" were associated with the age, disease duration, and MMSE, respectively (β = 0.021, p = 0.008; β = 0.027, p = 0.010; β = -1.974, p = 0.041, respectively).</p><p><strong>Conclusions: </strong>The results of this study suggest the possibility of an association between the degree of PD progression, such as age and disease duration, and the deterioration of the oral environment. These results encourage specialized personnel to pay attention to the tongue and dry mouth condition, especially for older PD patients with a long disease duration.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113841","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":"Echocardiographic evaluation of cardiac function in patients with myotonic dystrophy - is the right ventricular dysfunction observed? One academic center experience.","authors":"Olga Zdończyk, Katarzyna Kurnicka, Anna Łusakowska, Piotr Bienias, Michał Ciurzyński, Biruta Kierdaszuk, Katarzyna Janiszewska, Maksymilian Bielecki, Anna Kostera-Pruszczyk, Piotr Pruszczyk","doi":"10.5603/pjnns.103481","DOIUrl":"https://doi.org/10.5603/pjnns.103481","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to analyze echocardiographic parameters of the right and left ventricular function in patients with genetically confirmed myotonic dystrophy (DM).</p><p><strong>Clinical rationale for the study: </strong>Cardiac complications remain a major cause of morbidity and mortality in DM; however, up until now, data on the right ventricular function is scarce.</p><p><strong>Material and methods: </strong>We analyzed echocardiograms of 83 consecutive DM patients referred to our center for comprehensive clinical neurological and cardiac assessment and compared them to echocardiograms in 46 controls. Patients with diagnosed coronary artery disease or with significant valvular lesions were not included.</p><p><strong>Results: </strong>The study group consisted of 83 DM patients (41 females; aged 15-69 years), including 42 with DM type 1 (DM1) (13 females; aged 15-64 years) and 41 with DM type 2 (DM2) (28 females; aged 18-69 years). 44% of DM2 and 4.8% of DM1 patients suffered from hypertension, 4.9% and 12% had type 2 diabetes. TAPSE and RV S' medians were lower in DM than in controls (p < 0.001 and p = 0.01, respectively), with lower values in DM1 than in DM2 (p = 0.009 and p = 0.02). TAPSE < 17mm was observed only in DM patients (8.4%, p = 0.049). RV S' < 9.5 cm/s was found only in DM1, not in DM2. Right ventricular systolic dysfunction defined as TAPSE < 17 mm or RV S' < 9.5 cm/s was observed in 12.1% DM patients (19% DM1 vs. 4.9% DM2, p = 0.09) and 2.2% of controls (p = 0.1). Left ventricular systolic dysfunction defined by LVEF < 50% was found in 3.6% of DM patients and was threefold less frequent than right ventricular systolic dysfunction (p = 0.04). Diastolic dysfunction was found in 24.1% DM patients (21% DM1 and 27% DM2, p = 0.75), and in 6.6% controls (p = 0.02), more frequently in older patients with hypertension. Systolic parameters of both ventricles were similar in patients with and without comorbidities. The echocardiographic findings did not correlate with the disease duration or neurological status.</p><p><strong>Conclusions: </strong>Right ventricular systolic function is impaired in DM patients, especially in DM1, irrespectively of neurological impairment, disease duration, and presence of comorbidities. In our study, left ventricular systolic dysfunction was rare and less prevalent than right; however, future studies with larger cohorts of patients are needed. Our findings underline the need for close cardiac follow-up with detailed echocardiographic assessment of both ventricles in DM.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113492","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}