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Comparison of the Tigertriever and Self-expanding Stent Retrievers for Mechanical Thrombectomy of Acute Ischemic Stroke: A Single-center Experience. tigertriver与自扩支架取栓器在急性缺血性脑卒中机械取栓中的比较:单中心研究。
IF 2.4 4区 医学
Neurologia medico-chirurgica Pub Date : 2025-05-15 Epub Date: 2025-03-21 DOI: 10.2176/jns-nmc.2024-0297
Koichiro Shindo, Kazutaka Uchida, Manabu Shirakawa, Shoichiro Tsuji, Shuntaro Kuwahara, Yoji Kuramoto, Shinichi Yoshimura
{"title":"Comparison of the Tigertriever and Self-expanding Stent Retrievers for Mechanical Thrombectomy of Acute Ischemic Stroke: A Single-center Experience.","authors":"Koichiro Shindo, Kazutaka Uchida, Manabu Shirakawa, Shoichiro Tsuji, Shuntaro Kuwahara, Yoji Kuramoto, Shinichi Yoshimura","doi":"10.2176/jns-nmc.2024-0297","DOIUrl":"10.2176/jns-nmc.2024-0297","url":null,"abstract":"<p><p>Stent retrievers, including the novel Tigertriever, are important in mechanical thrombectomy for acute ischemic stroke due to a proximal large-vessel occlusion within the anterior circulation. We aimed to assess the efficacy and safety of the Tigertriever compared to self-expanding stent retrievers like EmboTrap, Solitaire, Trevo, or Tron. Patients treated at a stroke center for intracranial vessel occlusion in the anterior circulation between August 2022 and August 2024 were evaluated. The primary outcome was a modified first-pass effect, defined as a modified thrombolysis in cerebral infarction grade of 2b-3 after the first pass. Secondary outcomes included the first-pass effect, device-related serious adverse events, embolization in new territory, and hemorrhagic complications within 24 hours post-procedure. Data from 104 hemispheres in 103 patients were analyzed (24 in the Tigertriever group and 80 in the stent-retriever group). The Tigertriever group demonstrated a higher modified first-pass effect (70.8% vs. 52.5%; adjusted odds ratio 3.17; 95% confidence interval 1.06-9.47; p = 0.02). Although not statistically significant, vessel dissection (0% vs. 3.8%), subarachnoid hemorrhage (20.8% vs. 32.5%), and symptomatic intracranial hemorrhage (4.2% vs. 12.5%) within 24 hours post-procedure were lower in the Tigertriever group. No significant differences were observed in the first-pass effect or embolization in the new territory between the 2 groups. The Tigertriever might be effective for anterior circulation intracranial vessel occlusion, achieving a higher rate of modified first-pass effect. It might also be associated with minimal serious procedural complications, indicating its safety profile.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"247-254"},"PeriodicalIF":2.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700571","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}
引用次数: 0
Comparison of Surgical Outcomes in Microscopic and Fully Endoscopic Microvascular Decompression for Hemifacial Spasm. 显微与全内窥镜下微血管减压治疗面肌痉挛手术效果比较。
IF 2.4 4区 医学
Neurologia medico-chirurgica Pub Date : 2025-05-15 Epub Date: 2025-03-21 DOI: 10.2176/jns-nmc.2024-0245
Kyosuke Matsunaga, Norio Ichimasu, Nobuyuki Nakajima, Michihiro Kohno
{"title":"Comparison of Surgical Outcomes in Microscopic and Fully Endoscopic Microvascular Decompression for Hemifacial Spasm.","authors":"Kyosuke Matsunaga, Norio Ichimasu, Nobuyuki Nakajima, Michihiro Kohno","doi":"10.2176/jns-nmc.2024-0245","DOIUrl":"10.2176/jns-nmc.2024-0245","url":null,"abstract":"<p><p>Fully endoscopic microvascular decompression is increasingly being used to treat hemifacial spasm; however, its efficacy must be validated by comparing it with conventional microscopic microvascular decompression. In this study, we aimed to compare the surgical outcomes of microsurgical and endoscopic microvascular decompression for hemifacial spasm and discuss the usefulness and risks of endoscopic treatment. A total of 40 patients with hemifacial spasm were retrospectively evaluated at a single institution between 2016 and 2022, including 33 patients who underwent microscopic microvascular decompression (microvascular decompression group) and 7 patients who underwent fully endoscopic microvascular decompression group, which was chosen for patients with sufficient space in the cerebellopontine cistern for endoscopic manipulation. Statistical analyses of the microvascular decompression group and the endoscopic microvascular decompression group were performed to compare patient background and surgical outcomes. No significant differences in age, sex, or affected side were observed between the 2 groups. At the 6-month follow-up, substantial improvement was observed in more than 85% of the patients in each group. Delayed facial palsy and mild lower cranial nerve palsy, such as hoarseness, were more common in the endoscopic microvascular decompression group than in the microvascular decompression group, although there were no significant differences in the rate of complications between the 2 groups. All complications were alleviated within 3 months after surgery. During endoscopic microvascular decompression, interference between the endoscope and instruments can cause neural damage owing to the limited space along the petrosal surface of the cerebellum. Our results suggest that endoscopic procedures cannot always be used as a substitute for conventional microscopic microvascular decompression.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"230-238"},"PeriodicalIF":2.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700637","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}
引用次数: 0
Prospects of BRAF/MEK Inhibitor Therapy in Papillary Craniopharyngiomas with the BRAF V600E Mutation: A Scoping Review. BRAF/MEK抑制剂治疗BRAF V600E突变乳头状颅咽管瘤的前景:范围综述
IF 2.4 4区 医学
Neurologia medico-chirurgica Pub Date : 2025-05-15 Epub Date: 2025-03-21 DOI: 10.2176/jns-nmc.2024-0246
Shingo Fujio, Rafi Ilmansyah, Ryutaro Makino, Tareq A Juratli, Jun Sugata, Yuriz Bakhtiar, Ryosuke Hanaya
{"title":"Prospects of BRAF/MEK Inhibitor Therapy in Papillary Craniopharyngiomas with the BRAF V600E Mutation: A Scoping Review.","authors":"Shingo Fujio, Rafi Ilmansyah, Ryutaro Makino, Tareq A Juratli, Jun Sugata, Yuriz Bakhtiar, Ryosuke Hanaya","doi":"10.2176/jns-nmc.2024-0246","DOIUrl":"10.2176/jns-nmc.2024-0246","url":null,"abstract":"<p><p>Craniopharyngiomas are locally aggressive, rare tumors that pose significant treatment challenges and often result in permanent neurological deficits. Since the discovery of the BRAF V600E driver mutation in papillary craniopharyngioma, several case reports have reported on the efficacy of BRAF inhibitors or the combination of BRAF and MEK inhibitors in treating papillary craniopharyngiomas with this mutation. However, the efficacy, safety, and optimal utilization of this emerging therapy for craniopharyngiomas remain unclear. We conducted a systematic review of published articles in PubMed, Scopus, and the Cochrane Library-CENTRAL, focusing on the efficacy and safety of BRAF/MEK inhibitor therapy in papillary craniopharyngiomas with the BRAF V600E mutation, covering publications from inception through June 2024. A total of 20 case reports and series involving 22 patients were included in the analysis. Combination therapy with BRAF/MEK inhibitors was employed in 81.8% of cases. Significant tumor reduction (≥80%) was observed in 18 of 21 cases, regardless of radiation therapy history, pretargeted therapy tumor volume, and tumor composition. The duration of tumor minimization ranged from 1 to 24 months (median: 5 months). Fever was the most commonly reported adverse event (28.6%), followed by dermatological symptoms (19%). Tumor recurrence was noted in 4 of 6 patients who did not receive additional treatment following the completion of targeted therapy; however, targeted therapy was effective in the cases in which it was resumed. This study provides critical insights into optimizing treatment strategies for papillary craniopharyngiomas and underscores the potential role of targeted therapies in enhancing patient outcomes.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"217-229"},"PeriodicalIF":2.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700760","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}
引用次数: 0
Comparison of ELAPSS Score and Computational Fluid Dynamics for Predicting Growth of Small Unruptured Cerebral Aneurysms. ELAPSS评分与计算流体力学预测未破裂脑小动脉瘤生长的比较
IF 2.4 4区 医学
Neurologia medico-chirurgica Pub Date : 2025-05-15 Epub Date: 2025-04-07 DOI: 10.2176/jns-nmc.2024-0289
Masanori Tsuji, Fujimaro Ishida, Ryuta Yasuda, Yoichi Miura, Takenori Sato, Kazuhiro Furukawa, Takeshi Okada, Keiji Fukazawa, Yasuyuki Umeda, Naoki Toma, Hidenori Suzuki
{"title":"Comparison of ELAPSS Score and Computational Fluid Dynamics for Predicting Growth of Small Unruptured Cerebral Aneurysms.","authors":"Masanori Tsuji, Fujimaro Ishida, Ryuta Yasuda, Yoichi Miura, Takenori Sato, Kazuhiro Furukawa, Takeshi Okada, Keiji Fukazawa, Yasuyuki Umeda, Naoki Toma, Hidenori Suzuki","doi":"10.2176/jns-nmc.2024-0289","DOIUrl":"10.2176/jns-nmc.2024-0289","url":null,"abstract":"<p><p>ELAPSS score is commonly utilized for predicting the growth of unruptured cerebral aneurysms. However, its application is unsuitable for small aneurysms with high demand for growth prediction. Consequently, we investigated the diagnostic accuracy of semi-quantitative assessment using the ELAPSS score and hemodynamic parameters using computational fluid dynamics in small aneurysms. A prospective observational study from January 2013 to February 2022 included 185 patients with 215 unruptured aneurysms with a maximum diameter of 3-5 mm. Aneurysms were classified into stable (186 aneurysms) and growth (29 aneurysms) groups based on repeated images. We calculated high shear area ratios, high shear concentration ratios, and flow concentration ratios as hemodynamic parameters that we have already reported to be associated with small aneurysm growth in our previous study. The characteristics associated with the growth of small aneurysms were statistically investigated with morphological variables and hemodynamic parameters. The ELAPSS score was also calculated for the same aneurysm group to determine whether the growth risk was sufficiently assessed. In morphological variables, no significant differences were observed between the 2 groups. As for the hemodynamic parameters, the growth group had a significantly lower flow concentration ratio (0.61 vs 0.66, p = 0.016), lower high shear area ratio (0.28 vs 0.33, p < 0.001), and a higher high shear concentration ratio (6.39 vs 5.01, p < 0.001). However, there were no significant differences in the ELAPSS scores between the 2 groups. When limited to small aneurysms, computational fluid dynamics may offer more enhanced predictive capabilities compared to the ELAPSS score for identifying growth tendencies.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"239-246"},"PeriodicalIF":2.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795821","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}
引用次数: 0
In Which Cases Is Additional Direct Surgery Useful for Mechanical Thrombectomy Failure? 在哪些情况下直接手术对机械取栓失败是有用的?
IF 2.4 4区 医学
Neurologia medico-chirurgica Pub Date : 2025-05-15 Epub Date: 2025-04-07 DOI: 10.2176/jns-nmc.2024-0295
Takao Koiso, Nakao Ota, Kenichi Haraguchi, Hiroyuki Mizuno, Kosumo Noda, Sadahisa Tokuda, Rokuya Tanikawa
{"title":"In Which Cases Is Additional Direct Surgery Useful for Mechanical Thrombectomy Failure?","authors":"Takao Koiso, Nakao Ota, Kenichi Haraguchi, Hiroyuki Mizuno, Kosumo Noda, Sadahisa Tokuda, Rokuya Tanikawa","doi":"10.2176/jns-nmc.2024-0295","DOIUrl":"10.2176/jns-nmc.2024-0295","url":null,"abstract":"<p><p>Clinical evidence for adding direct surgery to the management of patients with large vessel occlusion after mechanical thrombectomy failure is limited. We investigated which patients would benefit from the additional surgery. We retrospectively examined factors influencing mechanical thrombectomy success and the outcomes of patients receiving additional direct surgery. Direct surgery was performed in patients younger than 75 years with modified Rankin Scale 0-2 and with Diffusion-Weighted Imaging-Clinical mismatch in the middle cerebral artery area on post-mechanical thrombectomy magnetic resonance imaging. To convert the hyperdense artery sign into an objective index, the ratio of the occluded to the normal vessel in Hounsfield Units was calculated (defined as the hyperdense artery sign ratio). A total of 152 patients were included in this study; the median patient age was 77.0 years; 13 patients (8.5%) had posterior circulation occlusion, and effective recanalization was confirmed in 124 patients (82.8%). Multivariable analysis showed the factors significantly associated with successful recanalization to be male gender (p = 0.0020) and a higher hyperdense artery sign ratio (p = 0.0012). The cut-off value of the hyperdense artery sign ratio was 1.05. Additional direct surgery was performed in 6 of 28 patients with mechanical thrombectomy failure. In 5 of these patients, recanalization was not successful even with direct embolectomy, and bypass was added. Patients who underwent direct surgery had better modified Rankin Scale scores at discharge than those who did not (p = 0.0405). The hyperdense artery sign ratio was a predictor of mechanical thrombectomy success; if the hyperdense artery sign ratio was less than 1.05, mechanical thrombectomy was often unsuccessful, and an early conversion to direct surgery was deemed beneficial.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"255-261"},"PeriodicalIF":2.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795836","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}
引用次数: 0
Table-top Microscope Mounted on Flexible Monitor Arm Using a Customized Multipurpose Metal Plate for Microsurgical Training: Technical Note. 使用定制的多用途金属板安装在柔性监测臂上的台式显微镜用于显微外科训练:技术说明。
IF 2.4 4区 医学
Neurologia medico-chirurgica Pub Date : 2025-04-26 DOI: 10.2176/jns-nmc.2025-0001
Satoshi Yamaguchi, Jangbo Lee, Prabin Shrestha, Satoka Shidoh, Kyongsong Kim
{"title":"Table-top Microscope Mounted on Flexible Monitor Arm Using a Customized Multipurpose Metal Plate for Microsurgical Training: Technical Note.","authors":"Satoshi Yamaguchi, Jangbo Lee, Prabin Shrestha, Satoka Shidoh, Kyongsong Kim","doi":"10.2176/jns-nmc.2025-0001","DOIUrl":"https://doi.org/10.2176/jns-nmc.2025-0001","url":null,"abstract":"<p><p>Despite the recognized usefulness of a portable table-top microscope in microsurgical training, its effectiveness is limited when training involves anatomical models and long surgical instruments. This limitation arises from the microscope's exclusive mobility to an up-and-down direction and the restricted working space beneath it. To address these challenges, we customized the table-top microscope by attaching its scope body and focusing rack to a Visual Electronics Standards Association (San Jose, CA, USA) monitor arm, originally designed for mounting computer monitors. A multipurpose metal plate, known as a \"cheese plate\" and designed for use with photography cameras, was customized to function as an adapter between the microscope and the monitor arm. The plate has Visual Electronics Standards Association-standard screw holes, which allowed the connection between the microscope focusing rack and the Visual Electronics Standards Association monitor arm. This assembly, referred to as a focusing rack-adapter plate complex, was then mounted on the Visual Electronics Standards Association monitor arm. To evaluate the modified microscope, its view was compared with that of a traditional microscope using concentric circles and gauze on the slope models. The modified microscope, mounted on the Visual Electronics Standards Association monitor arm, exhibited remarkable flexibility in its working area, height, and angles. The total cost of the modification was approximately $140. The advantages of the modified microscope over the traditional one, shown by a comparative study, were primarily attributed to the enhanced mobility of the modified microscope. With its simple modification process and affordable cost, this upgraded microscope has the potential to greatly benefit neurosurgeons who undergo microsurgical training.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064302","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}
引用次数: 0
Association between RNF213 p.R4810K and Progression of Cerebral Artery Negative Remodeling in Moyamoya Disease. RNF213 p.R4810K与烟雾病脑动脉负性重构进展的关系
IF 2.4 4区 医学
Neurologia medico-chirurgica Pub Date : 2025-04-26 DOI: 10.2176/jns-nmc.2025-0019
Haruto Uchino, Masaki Ito, Taku Sugiyama, Kota Kurisu, Noriyuki Fujima, Miki Fujimura
{"title":"Association between RNF213 p.R4810K and Progression of Cerebral Artery Negative Remodeling in Moyamoya Disease.","authors":"Haruto Uchino, Masaki Ito, Taku Sugiyama, Kota Kurisu, Noriyuki Fujima, Miki Fujimura","doi":"10.2176/jns-nmc.2025-0019","DOIUrl":"https://doi.org/10.2176/jns-nmc.2025-0019","url":null,"abstract":"<p><p>Negative remodeling, characterized by a decrease in the outer diameter of the terminal (C1) segment of the internal carotid artery and the proximal (M1) segment of the middle cerebral artery, is a hallmark of moyamoya disease. However, the role of the disease-susceptibility gene RNF213 in negative remodeling in moyamoya disease remains unclear. This study investigated the effect of RNF213 p.R4810K polymorphism on the degree of negative remodeling in moyamoya disease. We analyzed 70 hemispheres of 38 adult patients with moyamoya disease who underwent RNF213 p.R4810K gene analysis. Vascular outer diameters of the distal C1 and proximal M1 segments were measured using constructive interference in steady-state images obtained from 3-tesla magnetic resonance imaging. Suzuki stages were determined via cerebral angiography, and comparisons were made between RNF213-mutant and wild-type hemispheres. Among the analyzed hemispheres, 39 (56%) were RNF213-mutant, and 31 were wild-type. Suzuki stages were distributed as follows: 0 in 8 hemispheres, 1-2 in 15, 3-4 in 40, and 5-6 in 7. At stage 3-4, the C1 outer diameter was significantly smaller in RNF213-mutant hemispheres compared to wild-type (median 2.1 vs 2.6 mm, p < 0.05). A significant reduction in vascular outer diameters in the advanced disease stage was observed only in the mutant group between stages 0 and 3-4 (C1: median 3.0 vs 2.1 mm, p < 0.05; M1: median 2.2 vs 1.5 mm, p < 0.001). These findings suggest the association between RNF213 p.R4810K polymorphism and the progression of negative remodeling at the carotid fork in advanced disease stages of moyamoya disease.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046186","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}
引用次数: 0
Severity of Clinical Symptoms of Supplementary Motor Area Syndrome Correlates with the Extent of Tumor Resection in the Brain. 辅助运动区综合征临床症状的严重程度与脑内肿瘤切除程度相关
IF 2.4 4区 医学
Neurologia medico-chirurgica Pub Date : 2025-04-15 Epub Date: 2025-02-10 DOI: 10.2176/jns-nmc.2024-0090
Akiko Kakuta, Manabu Tamura, Taiichi Saito, Shunsuke Tsuzuki, Shunichi Koriyama, Takakazu Kawamata, Hidetaka Wakabayashi, Yoshihiro Muragaki
{"title":"Severity of Clinical Symptoms of Supplementary Motor Area Syndrome Correlates with the Extent of Tumor Resection in the Brain.","authors":"Akiko Kakuta, Manabu Tamura, Taiichi Saito, Shunsuke Tsuzuki, Shunichi Koriyama, Takakazu Kawamata, Hidetaka Wakabayashi, Yoshihiro Muragaki","doi":"10.2176/jns-nmc.2024-0090","DOIUrl":"10.2176/jns-nmc.2024-0090","url":null,"abstract":"<p><p>A unified view on recovery from supplementary motor area syndrome after glioma resection is lacking. This study retrospectively examined the relationship between motor function, higher brain function, the ability to perform activities of daily living, and social reintegration and the extent of tumor resection in patients who underwent resection of tumors near the supplementary motor area. We assigned 24 consecutive patients into 3 groups according to the depth of tumor resection: resection involving (A) only the supplementary motor area (5 patients); (B) the supplementary motor area and cingulate gyrus (11 patients); and (C) the supplementary motor area, cingulate gyrus, and corpus callosum (8 patients). Motor paralysis, language function, and the ability to perform activities of daily living were evaluated perioperatively and 2 months postoperatively, whereas successful social reintegration was examined retrospectively. In group C, 62% of patients developed severe paralysis after surgery, with slow recovery and delayed ambulation (p = 0.0869). Patients with tumors in the left hemisphere, specifically those extending to the cingulate gyrus and corpus callosum, showed decreased scores for postoperative word recall; however, recovery was observed after 2 months. The Functional Instrumental Measure score, which indicates the activity of daily living ability, showed the largest difference preoperatively and postoperatively in group C. The World Health Organization tumor grade (p = 0.0445) and extent of tumor resection (p = 0.0011) were inversely correlated with social reintegration 6 months postoperatively. Overall, the findings suggest that early social reintegration is influenced by the World Health Organization tumor grade (2021 World Health Organization classification) and the extent of tumor resection.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"167-176"},"PeriodicalIF":2.4,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382869","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}
引用次数: 0
Contralateral Progression after Unilateral Surgery for Bilateral Chronic Subdural Hematoma: A Prospective Observational Study. 双侧慢性硬膜下血肿单侧手术后对侧进展:一项前瞻性观察研究。
IF 2.4 4区 医学
Neurologia medico-chirurgica Pub Date : 2025-04-15 Epub Date: 2025-03-21 DOI: 10.2176/jns-nmc.2024-0308
Kenji Yagi, Yasukazu Hijikata, Yoshifumi Tao, Yoshihiro Sunada, Ryunosuke Haruta, Masato Maruno, Yukari Minami, Hisanori Edaki, Satoshi Hirai, Satoshi Inoue, Tomohito Hishikawa, Masaaki Uno
{"title":"Contralateral Progression after Unilateral Surgery for Bilateral Chronic Subdural Hematoma: A Prospective Observational Study.","authors":"Kenji Yagi, Yasukazu Hijikata, Yoshifumi Tao, Yoshihiro Sunada, Ryunosuke Haruta, Masato Maruno, Yukari Minami, Hisanori Edaki, Satoshi Hirai, Satoshi Inoue, Tomohito Hishikawa, Masaaki Uno","doi":"10.2176/jns-nmc.2024-0308","DOIUrl":"10.2176/jns-nmc.2024-0308","url":null,"abstract":"<p><p>Bilateral chronic subdural hematoma is treated by burr-hole surgery. Patients may undergo simultaneous bilateral surgery, or unilateral surgery which occasionally necessitates subsequent contralateral surgery due to the contralateral chronic subdural hematoma progression. Contralateral chronic subdural hematoma progression is not well understood, and an optimal surgical strategy for bilateral chronic subdural hematoma remains undefined. This study aimed to identify predictors for contralateral chronic subdural hematoma progression following unilateral surgery in patients with bilateral chronic subdural hematoma, specifically examining contralateral chronic subdural hematoma presented as membranous (indicating an older hematoma) and the contralateral hematoma volume. In this prospective observational study, 39 patients with bilateral chronic subdural hematoma requiring surgery were included between February 2020 and July 2024. All patients initially underwent unilateral burr-hole surgery. Additional surgery was performed if contralateral chronic subdural hematoma progression occurred. The preoperative predictors of contralateral chronic subdural hematoma progression were investigated. Among the 39 patients, 16 (41%) experienced contralateral chronic subdural hematoma progression, necessitating contralateral surgery. Of the 12 patients with membranous-type chronic subdural hematoma on the contralateral side, contralateral chronic subdural hematoma progression developed in one patient (8%), whereas 15 (56%) of the 27 patients with non-membranous type had contralateral chronic subdural hematoma progression. Logistic regression analyses revealed that membranous-type hematoma was negatively associated with the risk of contralateral chronic subdural hematoma progression, with an odds ratio of 0.07 (95% confidence interval: 0.01-0.65). Additionally, preoperative hematoma volume on the contralateral side was identified as a risk factor for contralateral chronic subdural hematoma progression, with an odds ratio of 1.58 (95% confidence interval: 1.04-2.40) per 10 mL increase. The membranous type and small volume of contralateral chronic subdural hematoma were associated with a lower risk of contralateral chronic subdural hematoma progression after unilateral surgery in bilateral chronic subdural hematoma. We suggest applying unilateral surgery selectively to bilateral chronic subdural hematoma with these characteristics.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"195-202"},"PeriodicalIF":2.4,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700832","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}
引用次数: 0
The Feasibility of Early Shunting for Hydrocephalus after Subarachnoid Hemorrhage. 蛛网膜下腔出血后脑积水早期分流治疗的可行性。
IF 2.4 4区 医学
Neurologia medico-chirurgica Pub Date : 2025-04-15 Epub Date: 2025-02-22 DOI: 10.2176/jns-nmc.2023-0300
Naoki Nishizawa, Tomohiko Ozaki, Tomoki Kidani, Nobuyuki Izutsu, Shin Nakajima, Yonehiro Kanemura, Toshiyuki Fujinaka
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