Neurologia medico-chirurgica最新文献

{"title":"The Feasibility of Early Shunting for Hydrocephalus after Subarachnoid Hemorrhage.","authors":"Naoki Nishizawa, Tomohiko Ozaki, Tomoki Kidani, Nobuyuki Izutsu, Shin Nakajima, Yonehiro Kanemura, Toshiyuki Fujinaka","doi":"10.2176/jns-nmc.2023-0300","DOIUrl":"https://doi.org/10.2176/jns-nmc.2023-0300","url":null,"abstract":"<p><p>The feasibility of early shunting for hydrocephalus after the occurrence of subarachnoid hemorrhage has not yet been explored. We investigated factors associated with the development of hydrocephalus and the risk of shunt obstruction or infection in patients undergoing early shunt surgery. All cases of hydrocephalus after subarachnoid hemorrhage managed at our institution between January 2010 and December 2020 were included. Patients were classified based on the timing of shunt implantation after hemorrhage onset into either the early shunt group (≤28 days) or the late shunt group (>28 days). Of 138 subarachnoid hemorrhage patients managed during the recruitment period, 53 underwent shunt surgery, with 15 in the early shunt group and 38 in the late shunt group. The severity of subarachnoid hemorrhage, presence of Sylvian hematoma, and placement of an external ventricular and/or cisternal drain were significantly associated with the development of hydrocephalus. There was no significant difference between the early and late groups in terms of the rate of shunt obstruction or infection. In the early group, preoperative cerebrospinal fluid cell count was significantly higher in those who developed obstruction than those who did not (307.3 ± 238.2/3 μL vs. 73.8 ± 95.7/3 μL; p = 0.0364). This retrospective study showed no significant difference between early and late shunt implantation in the rate of shunt obstruction and infection. These findings suggests that planning shunt surgery in the early phase after subarachnoid hemorrhage might be feasible, depending on cerebrospinal fluid test results.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493113","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 Role and Reliability of Unruptured Intracranial Aneurysm Treatment Score in Decision-making in Surgical Indications for Unruptured Intracranial Aneurysms Based on the Results at a Japanese Single Center.","authors":"Shigeo Yamashiro, Ken Uekawa, Masatomo Kaji, Toshihiro Amadatsu, Hiroaki Matsuzaki, An Murai, Akitake Mukasa, Toru Nishi","doi":"10.2176/jns-nmc.2024-0255","DOIUrl":"https://doi.org/10.2176/jns-nmc.2024-0255","url":null,"abstract":"<p><p>To clarify the role and reliability of unruptured intracranial aneurysm treatment score in the treatment indications of unruptured intracranial aneurysm for Japanese patients, we performed a retrospective comparative analysis of our actual decision-making and unruptured intracranial aneurysm treatment score judgment. The unruptured intracranial aneurysm treatment score was applied to each of 208 Japanese patients with diagnosis of unruptured intracranial aneurysm for a year. The patients included were classified into 4 groups by integrating actual decisions with the scoring of unruptured intracranial aneurysm treatment score. Of 94 patients treated, unruptured intracranial aneurysm treatment score recommended repair for 64 (68.1%, \"appropriately treated\") and observation for 5 (5.3%, \"possible over-treated\"). Among 114 patients under observation, unruptured intracranial aneurysm treatment score recommended repair for 19 (16.7%, \"possible under-treated\") and observation for 29 (25.4%, \"appropriately conservative\"). In the remaining 91 patients judged as \"not definitive\" by the unruptured intracranial aneurysm treatment score, 66 (72.5%) were determined as conservative follow-up. From the perspective of the unruptured intracranial aneurysm treatment score, its sensitivity and specificity were 85.3% and 88.6%, respectively. Our findings suggest that in Japanese patients with unruptured intracranial aneurysm, unruptured intracranial aneurysm treatment score is a reliable tool for guiding treatment decisions for unexpertized clinicians; however, the final judgment should be made by a trained neurosurgeon, especially in cases categorized as not definitive.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493114","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":"Outcome after Endovascular Treatment of Patients with Acute Ischemic Stroke with Large Vessel Occlusion over 90 Years of Age.","authors":"Fuminori Shimizu, Kazutaka Uchida, Hiroto Kakita, Sou Sawamura, Akihiro Kanbara, Yuji Kitada, Yoshinori Akiyama, Takashi Yoshida, Satoru Fujiwara, Hirotoshi Imamura, Chiaki Sakai, Manabu Shirakawa, Shinichi Yoshimura, Nobuyuki Sakai","doi":"10.2176/jns-nmc.2024-0232","DOIUrl":"https://doi.org/10.2176/jns-nmc.2024-0232","url":null,"abstract":"<p><p>The effectiveness of endovascular therapy for patients aged 90 years and over (≥90 years) is still not well understood. We compared the patients aged ≥90 years with those aged 85-89 years, 80-84 years, and <80 years using data from the Japanese Registry of NeuroEndovascular Therapy that enrolled acute large vessel occlusion patients from January 2015 to December 2019. The primary outcome was the rate of return of the modified Rankin Scale to at least the premorbid modified Rankin Scale after 30 days. Secondary outcomes were the incidences of intracranial hemorrhage and mortality.Among 13,540 patients, patients aged ≥90 years, 85-89 years, 80-84 years, and <80 years were 1,104, 1,925, 2,477, and 8,034. The prevalence of female gender, the premorbid Rankin Scale, and the National Institutes of Health Stroke Scale score before endovascular therapy were highest in the patients aged ≥90 years (n [%], 819 [74.2]; median [interquartile range]; 2 [0-3], and 21 [15-26]). The primary outcome of the adjusted odds ratio (95% confidence intervals) for the patients aged 85-89 years, 80-84 years, and <80 years for ≥90 years was 0.89 (0.72-1.10), 0.95 (0.77-1.16) and 1.07 (0.89-1.28). However, the incidence of symptomatic intracranial hemorrhage was lower in patients aged ≥90 years compared with patients aged 85-89 years and <80 years (adjusted odds ratio [95% confidence intervals]; 1.86 [1.16-2.98] and 1.71 [1.11-2.64]). The return of the modified Rankin Scale to at least the premorbid modified Rankin Scale after 30 days in patients aged ≥90 years with large vessel occlusion was not significantly different in other groups but symptomatic intracranial hemorrhage was less observed than in younger patients.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493112","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":"Quality-adjusted Life Years and Costs of Mechanical Thrombectomy for Very Elderly Patients with Acute Ischaemic Stroke.","authors":"Takeshi Inaba, Mio Sakuma, Fumihiro Sakakibara, Kazutaka Uchida, Takeshi Morimoto","doi":"10.2176/jns-nmc.2024-0157","DOIUrl":"10.2176/jns-nmc.2024-0157","url":null,"abstract":"<p><p>This study aimed to evaluate the cost-effectiveness of mechanical thrombectomy (MT) in patients aged 90 years and older with acute ischaemic stroke (AIS). We developed a cost-effectiveness model to compare MT with standard medical care (SMC) to SMC alone. The model, incorporating parameters for the effectiveness and costs of MT with SMC and SMC alone, was simulated until the cohort reached 100 years of age. The parameters were estimated from the prospective cohort study of the RESCUE-Japan Registry 2, claims databases, and published literature, with the perspective being Japan's public healthcare system. In the base-case model for an 8-year simulation period, the quality-adjusted life years (QALYs) for MT with SMC and SMC alone were 1.463 and 1.054 years, respectively. The expected costs were 14,553,772 Yen and 13,732,646 Yen, respectively. The incremental cost-effectiveness ratio (ICER) of MT with SMC compared to SMC alone was 2,009,744 Yen per QALY. A probabilistic sensitivity analysis showed a 66% probability that MT with SMC would be below the ICER threshold of 5,000,000 Yen per QALY. The cost-effectiveness analyses demonstrated that performing MT in addition to SMC for AIS in patients aged 90 years and older was acceptable from a cost-effectiveness perspective.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"52-60"},"PeriodicalIF":2.4,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896478","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":"Comparison of Early-onset Efficacy of Anti-calcitonin Gene-related Peptide Monoclonal Antibodies for Patients with Migraine in Real-world Clinical Practice: Study Protocol for an Exploratory Clinical Trial.","authors":"Takafumi Tanei, Satoshi Maesawa, Yusuke Nishimura, Tomotaka Ishizaki, Yoshitaka Nagashima, Miki Hashida, Shun Yamamoto, Masahiko Ando, Yachiyo Kuwatsuka, Atsushi Hashizume, Toshihiko Wakabayashi, Ryuta Saito","doi":"10.2176/jns-nmc.2024-0201","DOIUrl":"10.2176/jns-nmc.2024-0201","url":null,"abstract":"<p><p>Three anti-calcitonin gene-related peptide monoclonal antibodies (CGRP-mAbs) are available in Japan: galcanezumab, fremanezumab, and erenumab. Early-onset efficacy has been demonstrated for each CGRP-mAb in comparison with placebo, but differences among the drugs are unclear. Only galcanezumab requires 2 doses at the initial injection. This study is a multicenter, open-label, randomized, two-group comparison trial, consisting of the random selection of a CGRP-mAb and 6 consecutive injections, and then discontinuation of the CGRP-mAb after 6 injections. The primary outcome is a comparison of early-onset efficacy between galcanezumab and both fremanezumab and erenumab after the initial injection. The secondary outcomes are comparisons between galcanezumab and both fremanezumab and erenumab, and between fremanezumab and erenumab as follows: weekly number of headache days, migraine days, and acute medication use are compared to baseline during one month after initial injection; time of subjectively perceiving onset of effect after initial injection; monthly changes in headache status from baseline to after third (3rd) injections; effective rates after initial and 3rd injections; improvement rates of depression scores between baseline and after 3rd injections; changes in number of absenteeism and presenteeism days in each month from baseline to after 3rd injections; proportion of ineffective cases after 3rd injections; recurrence rates and time to recurrence after CGRP-mAb discontinuation; effective rates of CGRP-mAb re-injections; detection of clinical factors associated with effectiveness after the initial and 3rd injections. The aim of this study is to investigate differences in early-onset efficacy among the CGRP-mAbs, and when and to what extent headache symptoms recur after discontinuation.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"71-80"},"PeriodicalIF":2.4,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813890","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":"Development of Machine-learning Model to Predict Anticoagulant Use and Type in Geriatric Traumatic Brain Injury Using Coagulation Parameters.","authors":"Gaku Fujiwara, Yohei Okada, Eiichi Suehiro, Hiroshi Yatsushige, Shin Hirota, Shu Hasegawa, Hiroshi Karibe, Akihiro Miyata, Kenya Kawakita, Kohei Haji, Hideo Aihara, Shoji Yokobori, Motoki Inaji, Takeshi Maeda, Takahiro Onuki, Kotaro Oshio, Nobukazu Komoribayashi, Michiyasu Suzuki, Naoto Shiomi","doi":"10.2176/jns-nmc.2024-0066","DOIUrl":"10.2176/jns-nmc.2024-0066","url":null,"abstract":"<p><p>This study aimed to investigate the patterns of anticoagulation therapy and coagulation parameters and to develop a prediction model to predict the type of anticoagulation therapy in geriatric patients with traumatic brain injury. A retrospective analysis was performed using the nationwide neurotrauma database of Japan. Elderly patients (≥65 years) with traumatic brain injury. Patients were divided into 3 groups based on their daily anticoagulant medication (none, direct oral anticoagulant [DOAC], and vitamin K antagonist [VKA]), and coagulation parameters were compared in each group. We then developed a machine-learning model to predict the anticoagulant using coagulation parameters and visualized the pattern using a heat map. A total of 495 patients were enrolled and divided into 3 groups: none (n = 439), DOACs (n = 37), and VKA (n = 19). Comparing none to DOAC and DOAC to VKA for prothrombin time-international normalized ratio (PT-INR), the mean difference and 95% confidence intervals (CIs) were 0.38 (95% CI: 0.59-0.17) and 1.56 (95% CI: 1.21-1.90), and for activated partial thromboplastin time (APTT), the mean difference between none to DOAC and DOAC to VKA was 3.46 (95% CI: 0.98-5.94) and 95% CI was 7.39 (95% CI: 3.29-11.48). A prediction model for the type of anticoagulant used by PT-INR and APTT was developed using machine-learning methods, and a heat map visually revealed their relationship with acceptable predictive ability. This study revealed the characteristic patterns of coagulation parameters in anticoagulants and a pilot model to predict anticoagulant use.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"61-70"},"PeriodicalIF":2.4,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896477","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":"Correlation between Delayed Relief after Microvascular Decompression and Morphology of the Lateral Spread Response in Patients with Hemifacial Spasm-Temporal versus Mandibular Branch Stimulation.","authors":"Yuki Amano, Bunsho Asayama, Shusaku Noro, Takenori Abe, Masahiro Okuma, Kaori Honjo, Yoshinobu Seo, Hirohiko Nakamura","doi":"10.2176/jns-nmc.2024-0062","DOIUrl":"10.2176/jns-nmc.2024-0062","url":null,"abstract":"<p><p>Although microvascular decompression (MVD) is a reliable treatment for hemifacial spasm (HFS), delayed postoperative relief is one of its main issues. We previously evaluated the morphology of the lateral spread response (LSR) and reported the correlation between delayed relief after MVD and polyphasic morphology of the LSR. The purpose of this study was to investigate the correlation between the morphology of the LSR with stimulation of the temporal and mandibular branches of the facial nerve and delayed relief of persistent HFS after MVD. We retrospectively analysed and compared data from 49 of 205 consecutive patients who underwent MVD for HFS at our hospital between January 2015 and March 2022. Based on the pattern of the initial LSR morphology, patients were divided into 4 groups (LSR with temporal branch stimulation/LSR with mandibular branch stimulation; polyphasic/polyphasic group, polyphasic/monophasic group, monophasic/polyphasic group, monophasic/monophasic group). The results of MVD surgery for HFS were evaluated 1 week, 1 month and 1 year postoperatively, by evaluating whether or not the symptoms of HFS persisted at the time of each follow-up. We found significant differences in residual postoperative HFS 1 week postoperatively among the 4 groups (p < 0.05), as assessed using m*n Yates chi-square test. There is a significant correlation between delayed relief after MVD and polyphasic morphology of the initial LSR in patients with HFS. The LSR with temporal rather than mandibular branch stimulation might be useful for predicting delayed relief following MVD in HFS patients.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"45-51"},"PeriodicalIF":2.4,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813891","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":"Prediction of Seizure Outcome Using Combinations of Four Noninvasive Presurgical Modalities in Magnetic Resonance Imaging-negative Focal Intractable Epilepsy.","authors":"Rofat Askoro, Kota Kagawa, Go Seyama, Akitake Okamura, Akira Hashizume, Tae Onari, Yutaka Hirokawa, Koji Iida, Nobutaka Horie","doi":"10.2176/jns-nmc.2024-0194","DOIUrl":"10.2176/jns-nmc.2024-0194","url":null,"abstract":"<p><p>In focal epilepsy cases, precise identification and resection of the epileptogenic zone increase the likelihood of achieving a seizure-free outcome. Nevertheless, localizing the source of epilepsy in magnetic resonance imaging-negative epilepsy cases presents significant challenges for clinicians. In this study, we evaluated the diagnostic efficacy and impact on the seizure outcome by using 4 noninvasive modalities, including scalp video electroencephalography, magnetoencephalography, fluorodeoxyglucose-positron emission tomography, and iomazenil single-photon emission computed tomography, in a cohort of patients with magnetic resonance imaging-negative focal epilepsy who underwent resective surgery. The concordance status of each modality was assessed relative to the lobar resection area, and surgical outcome was assessed by Engel Classification at least 1 year after surgery. Comparison and diagnostic analyses were calculated for each individual and all possible combinations of scalp video electroencephalography, magnetoencephalography, fluorodeoxyglucose-positron emission tomography, and single-photon emission computed tomography with respect to Engel class I outcome. Eighteen patients (66.6%, 18/27) had Engel class I outcomes. Patients with at least 2 concordant modalities were associated with Engel class I outcome (p = 0.0262). For individual modality, fluorodeoxyglucose-positron emission tomography achieved the highest yield of sensitivity (72.2%) compared to scalp video electroencephalography, magnetoencephalography, and single-photon emission computed tomography (50.0%, 61.1%, and 61.6%, respectively). Scalp video electroencephalography, magnetoencephalography, and single-photon emission computed tomography showed similar specificities of 77.7%, while fluorodeoxyglucose-positron emission tomography showed a specificity of 55.5%. Combined modalities were able to achieve the highest sensitivity of 83.3% when there were at least 2 concordant modalities and a specificity of 100% with various multiple combinations. Our study showed that lobar concordance from multiple modalities increases the sensitivity and specificity for a seizure-free outcome in magnetic resonance imaging-negative focal epilepsy patients who underwent resective surgery.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"81-91"},"PeriodicalIF":2.4,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813892","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":"A Novel Approach to Study Cranial Shape in Children with Normal and Sagittal Synostosis: An Application of Geometric Morphometrics.","authors":"Tadashi Miyagawa, Akira Yamaura","doi":"10.2176/jns-nmc.2024-0168","DOIUrl":"10.2176/jns-nmc.2024-0168","url":null,"abstract":"<p><p>To provide appropriate treatment, neurosurgeons and pediatricians must understand the chronological changes of the cranial morphology in normal children and the differences between normal and sagittal synostosis children. However, this issue has remained unresolved due to the traditional methods of analyzing cranial morphology. Therefore, we applied a new and precise method, geometric morphometrics, to understand cranial morphology in children with normal and sagittal synostosis. This study analyzed morphological differences in the cranium of 30 control children and 14 children with sagittal synostosis using geometric morphometrics and the landmark method on the lateral view of the three-dimensional computed tomography of the skull. The results showed that morphological changes in the cranium of normal children with age could be visualized (p < 0.01), with the parietooccipital and suboccipital areas being the main areas of change. Morphological analysis revealed different cranial morphologies among the control, scaphocephalic sagittal synostosis, and non-scaphocephalic sagittal synostosis groups (p < 0.01), as evidenced by a fan-like spread and reduced cranial height in the sagittal synostosis group compared to the control cranium. Visualization in wireframes could reveal morphological differences, even if small, with statistical differences. This study clarified 3 issues regarding the cranial morphology in normal and sagittal children. The study showed evident age-related differences and changes in the cranial morphology in normal children. Differences in cranial morphologies among the 3 groups were identified. Finally, the study demonstrates that geometric morphometrics is a precise and appropriate method for analyzing morphological differences and changes.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"92-101"},"PeriodicalIF":2.4,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813889","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":"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":"https://doi.org/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":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}