Neurologia medico-chirurgica最新文献

{"title":"Detection of Cerebrospinal Fluid-venous Fistulas Using Digital Subtraction Myelography in Refractory Spontaneous Intracranial Hypotension: A Single-center Study in an Asian Population.","authors":"Shigeta Miyake, Yasunobu Nakai, Shun Ishikawa, Kagemichi Nagao, Tadashi Ogura, Souichiro Nomura, Masamichi Shinonaga, Timo Krings, Tetsuya Yamamoto","doi":"10.2176/jns-nmc.2025-0298","DOIUrl":"10.2176/jns-nmc.2025-0298","url":null,"abstract":"<p><p>Cerebrospinal fluid-venous fistulas are increasingly recognized as a cause of spontaneous intracranial hypotension, particularly in patients who do not respond to conventional therapies. Although widely reported in Western populations, their prevalence and diagnosis in Asian cohorts remain underexplored. This study aimed to evaluate the utility of digital subtraction myelography in diagnosing cerebrospinal fluid-venous fistulas in Japanese patients with refractory spontaneous intracranial hypotension. We retrospectively analyzed adult patients with spontaneous intracranial hypotension who underwent digital subtraction myelography at our hospital between December 2024 and July 2025. The inclusion criterion was failure of 3 or more epidural blood patches. Digital subtraction myelography was performed using a standardized protocol with tilt-table positioning and contrast-enhanced imaging. The clinical and imaging data were reviewed. Ten patients (15 digital subtraction myelography studies) were included. Cerebrospinal fluid-venous fistulas were detected in 6 of 7 spinal longitudinal epidural collections-negative patients (85.7%). Spinal longitudinal epidural collections-positive patients (3/10) did not have cerebrospinal fluid-venous fistulas. Computed tomography after digital subtraction myelography demonstrated contrast accumulation in the renal pelvis in 88.9% of the cases with positive cerebrospinal fluid-venous fistula or spinal longitudinal epidural collection findings. One illustrative patient underwent Onyx embolization, resulting in marked symptom improvement. In this pilot study, cerebrospinal fluid-venous fistulas were found to be a relevant and treatable cause of refractory spontaneous intracranial hypotension in Asian patients. Digital subtraction myelography proved to be a valuable diagnostic tool, particularly in the absence of spinal longitudinal epidural collections on initial imaging.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"179-184"},"PeriodicalIF":2.3,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145959790","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}

{"title":"Prognostic Impact of Clinical Diagnosis-based Treatment in Glioblastoma Patients Aged ≥80 Years: A Single-center Cohort Study Focused on Performance Status Maintenance.","authors":"Takahiro Ono, Ayana Saito, Masamichi Abe, Hiroshi Nanjo, Hiroaki Shimizu","doi":"10.2176/jns-nmc.2025-0254","DOIUrl":"10.2176/jns-nmc.2025-0254","url":null,"abstract":"<p><p>In aging societies such as Japan, the number of patients aged ≥80 years with glioblastoma who are unsuited for surgery is rapidly increasing. At our institution, we adopted a therapeutic strategy based on clinical diagnosis without histological confirmation when surgery was not feasible. This study aimed to retrospectively evaluate the short-term outcomes and clinical value of surgical intervention and histological confirmation in this population. Patients aged ≥80 years diagnosed with glioblastoma between 2011 and 2025 were reviewed. Clinical diagnosis was applied when patients were unfit for surgery. Patient data, including age, sex, Karnofsky performance status, extent of resection, treatment options, and complications, were analyzed for associations with overall survival, Karnofsky performance status improvement, and discharge home. Among 203 cases, 31 patients (15.3%) were included. Their mean age was 84 years; the median Karnofsky performance status scores at admission and discharge were 50 and 60, respectively. Six patients underwent resection, 14 biopsy, and 11 clinical diagnosis. The clinical diagnosis group showed better functional outcomes, including improved Karnofsky performance status, shorter hospitalization, and higher discharge home rates than the biopsy group. Bevacizumab contributed significantly to these outcomes. Perioperative complications occurred in 4 patients; none recovered functionally or were discharged home. Low Karnofsky performance status at discharge was the only independent predictor of poor overall survival. Surgical intervention did not significantly affect the functional and survival outcomes. In conclusion, clinical diagnosis-based treatment, particularly with bevacizumab, could help preserve function and facilitate discharge in very elderly patients with glioblastoma. Biopsies might negatively impact the outcomes in the present cohort.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"116-126"},"PeriodicalIF":2.3,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145959883","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}

{"title":"Full-endoscopic Laminotomy Is Effective for Lumbar Spinal Stenosis with Low-grade Spondylolisthesis: A Comparative Cohort Study.","authors":"Kyohei Kin, Ryoji Tominaga, Kento Takebayashi, Hiroki Iwai, Hirohiko Inanami, Hisashi Koga","doi":"10.2176/jns-nmc.2025-0130","DOIUrl":"10.2176/jns-nmc.2025-0130","url":null,"abstract":"<p><p>The optimal management of lumbar spinal canal stenosis with spondylolisthesremains controversial, particularly when choosing between decompression alone or decompression with fusion. Current evidence is based on conventional open or endoscopy-assisted surgeries, with limited data on full-endoscopic decompression. This study aimed to assess the impact of spondylolisthesis on outcomes after full-endoscopic laminotomy by evaluating back pain-related disability scores in patients with lumbar spinal canal stenosis, with and without spondylolisthesis. A retrospective analysis was conducted at Iwai Orthopaedic Hospital, Japan. Patients with lumbar spinal canal stenosis who underwent full-endoscopic laminotomy between January 2021 and December 2022 were included and categorized into those without spondylolisthesis and those with spondylolisthesis. Postoperative Oswestry Disability Index scores at 2 years were compared in the groups using multivariable linear regression, adjusting for confounding factors. Exploratory analyses were also conducted to identify factors affecting the Oswestry Disability Index in the patients with lumbar spinal canal stenosis with spondylolisthesis group. Statistical significance was set at p < 0.05. The study included 80 patients, with 40 in each group. Both groups showed improved postoperative Oswestry Disability Index. There was no significant association between spondylolisthesis and postoperative Oswestry Disability Index. However, cauda equina redundancy negatively affected postoperative Oswestry Disability Index improvement in the patients with lumbar spinal canal stenosis with spondylolisthesis group. Full-endoscopic laminotomy is an effective surgical option for lumbar spinal canal stenosis, leading to significant alleviation of disability and improvements in quality of life, regardless of spondylolisthesis. Full-endoscopic laminotomy may offer similar functional improvements regardless of the presence of low-grade spondylolisthesis, supporting its role as a less invasive alternative to fusion.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"107-115"},"PeriodicalIF":2.3,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145959820","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}

{"title":"Usefulness of a 3 Dimensional-printed Head Model with Two-layered Dura and Cerebellar Tentorium for Transpetrosal Approach Training.","authors":"Yuki Sakaeyama, Shuhei Kubota, Mitsuyoshi Abe, Ryo Matsuzaki, Sayaka Terazono, Nobuo Sugo","doi":"10.2176/jns-nmc.2025-0310","DOIUrl":"10.2176/jns-nmc.2025-0310","url":null,"abstract":"<p><p>The combined transpetrosal approach provides effective exposure to the petroclival region and ventral brainstem, although its technical demands necessitate advanced neurosurgical expertise. Proficiency in skull base drilling and meticulous separation of the dual dural layers is crucial. Recently, three-dimensional printing has gained attention as a tool for surgical training. To evaluate its potential in transpetrosal approach education, we developed a three-dimensional head model that reproduces the soft brain tissue, cranial nerves, vasculature, and tumors. A petrotentorial meningioma case was selected, and a corresponding three-dimensional model was generated using computed tomography and magnetic resonance imaging data. The skull base was printed using a three-dimensional printer. Liquid rubber-coated kitchen paper simulated the dura mater, wool yarn represented blood vessels, and rubber bands were used for cranial nerves. Ultra-soft polyurethane resin was employed to replicate the brain, brainstem, cerebellum, and tumor. Neurosurgeons practiced the combined transpetrosal approach on the model and completed a questionnaire evaluating anatomical accuracy and operative usability. Thirteen neurosurgeons participated. No statistically significant differences were found between those with experience in ≥5 combined transpetrosal approach and those with less experience. All participants gave favorable evaluations regarding the model's anatomical accuracy and its value for preoperative planning and surgical training. The model supported essential transpetrosal approach steps, including skull base drilling, dual-layer dural dissection, and tentorial incision, allowing for thorough practice of the combined approach. It offers a practical, realistic training platform that closely resembles actual surgical conditions.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"127-134"},"PeriodicalIF":2.3,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145959833","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}

{"title":"Comparison of Anterior Lateral Ventricular Index with Evans Index, Callosal Angle, and Disproportionately Enlarged Subarachnoid-space Hydrocephalus in Postoperative Evaluation of Idiopathic Normal Pressure Hydrocephalus.","authors":"Ebru Doruk, Feyza Karagöz Güzey, İlker Güleç, Murat Kahraman, Ömer Can Durmuş","doi":"10.2176/jns-nmc.2025-0250","DOIUrl":"10.2176/jns-nmc.2025-0250","url":null,"abstract":"<p><p>This study aimed to compare the anterior lateral ventricular index with established radiological markers, including the Evans Index, callosal angle, and disproportionately enlarged subarachnoid-space hydrocephalus, in evaluating postoperative radiological improvement in patients with idiopathic normal pressure hydrocephalus. A retrospective analysis was conducted on 46 patients who underwent ventriculoperitoneal shunt surgery between January 2019 and February 2025. Pre- and postoperative cranial computed tomography and magnetic resonance imaging scans were used to measure Evans Index, anterior lateral ventricular index, callosal angle and the presence of disproportionately enlarged subarachnoid-space hydrocephalus was assessed. Clinical parameters, including gait performance (10-meter walking and 360° turning steps) and urinary continence, were compared with radiological changes. Both Evans Index and anterior lateral ventricular index significantly decreased postoperatively (Evans Index: 0.388→0.336, p < 0.001; anterior lateral ventricular index: 0.552→0.479, p < 0.001), while callosal angle significantly increased (85.3°→99.7°, p < 0.05). Anterior lateral ventricular index reduction correlated moderately with Evans Index reduction (r = 0.37, p = 0.011) and weakly with callosal angle increase (r = 0.26, p = 0.080). Gait performance improved significantly (p < 0.001), and urinary incontinence resolved in 40.9% of affected patients. Anterior lateral ventricular index reduction showed stronger correlations with gait improvement (r = -0.45, p = 0.002) and continence recovery (r = -0.33, p = 0.024) compared with Evans Index or callosal angle. Disproportionately enlarged subarachnoid-space hydrocephalus positivity was not significantly associated with postoperative outcomes. These findings suggest that anterior lateral ventricular index may provide a more sensitive and clinically relevant linear measure than traditional indices and can serve as a complementary parameter to Evans Index and callosal angle in the postoperative evaluation of idiopathic normal pressure hydrocephalus.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"145-151"},"PeriodicalIF":2.3,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100304","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}

{"title":"Outcomes of Postnatal Myelomeningocele Repair in a Japanese Single-center Cohort: A Comparison with the Management of Myelomeningocele Study Trial.","authors":"Kenichi Usami, Seiji Wada, Katsusuke Ozawa, Haruhiko Sago, Hideki Ogiwara","doi":"10.2176/jns-nmc.2025-0281","DOIUrl":"10.2176/jns-nmc.2025-0281","url":null,"abstract":"<p><p>Fetal surgery for myelomeningocele is not yet standard practice in Japan. To establish baseline data for the outcomes of standard postnatal care for patients eligible for fetal surgery, we compared the results from our large, single-institution cohort with those of the Management of Myelomeningocele Study trial's postnatal group. We retrospectively reviewed 65 patients who underwent postnatal myelomeningocele repair at our center between 2002 and 2021. In our cohort, the myelomeningocele lesion level was thoracic in 18% of patients, L1-L2 in 12%, and L3 or below in 69%. Key outcomes, including the rate of cerebrospinal fluid shunt placement at 12 months and ambulation status at 30 months, were compared to the published data from the Management of Myelomeningocele Study postnatal cohort. The rate of cerebrospinal fluid shunt placement in our cohort (88%) and ambulation rates at 30 months (28%) showed no statistically significant difference from the Management of Myelomeningocele Study postnatal group (83%, p = 0.39, and 20%, p = 0.29, respectively). Our cohort had a significantly lower rate of shunt infection (0% vs. 9%, p = 0.02). However, the rates of surgery for symptomatic Chiari II malformation (18% vs. 5%, p = 0.01) and for tethered cord syndrome (9% vs. 1%, p = 0.03) were significantly higher in our cohort. The outcomes of modern postnatal myelomeningocele repair at a major Japanese center are largely consistent with the international benchmark set by the Management of Myelomeningocele Study trial. This study provides an essential baseline of data that will be indispensable for counseling families and for the objective evaluation of fetal surgery as it is introduced in Japan.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"185-191"},"PeriodicalIF":2.3,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100298","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}

{"title":"Association between Early Diagnosis, Surgery and Prognosis in Patients with High-Grade Glioma: Retrospective Analysis of a Real-World Healthcare Claims Database in Japan.","authors":"Daisuke Fukui, Yuko Hirose, Nanae Sunahara, Yoshitaka Narita, Yuzo Horibuchi","doi":"10.2176/jns-nmc.2024-0280","DOIUrl":"10.2176/jns-nmc.2024-0280","url":null,"abstract":"<p><p>High-grade gliomas, especially glioblastoma, are associated with poor prognosis. We investigated the prognostic impact of first visiting a neurosurgery department or other departments among patients with high-grade gliomas in real-world clinical practice in Japan. We analyzed health insurance claims data from the Japan Medical Data Centre Claims Database for 540 patients with records of C71 (malignant neoplasm of the brain), surgery, radiotherapy, and temozolomide, indicative of high-grade gliomas. The median age was 54 years, 70.9% of the patients were aged <60 years, and 63.0% of the patients were male. Among 375 evaluable patients who first visited a hospital different to the one where the surgery was performed, the most common department visited was general internal medicine (43.0%); 13.0% visited a neurosurgical department. The median interval from the initial visit to surgery was 35.0 days and 19.0 days for patients who first visited a general internal medicine and a neurosurgery department, respectively. The proportions of patients who underwent surgery within 21 days of the initial visit to a general internal medicine and a neurosurgery department were 37.5% and 62.2%, respectively. The 3-year overall survival rates were numerically greater in patients who first visited a neurosurgery department (72.7%) than in patients who first visited other departments (57.7%), but not significantly (log-rank p = 0.39). Our results suggest that the treatment of high-grade gliomas was delayed if patients first visited non-neurosurgery departments, leading to poor outcomes. Our findings suggest that early neurosurgery consultation and surgery may improve the outcomes of patients with high-grade gliomas.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"152-161"},"PeriodicalIF":2.3,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100390","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}

{"title":"Predicting Cerebral Aneurysm Recurrence after Coil Embolization: A Novel Deep Learning Approach Using Time-of-flight Magnetic Resonance Angiography.","authors":"Shoko Fujii, Tatsuhiko Anzai, Kyohei Fujita, Mariko Ishikawa, Keigo Shigeta, Masataka Yoshimura, Shin Hirota, Yoshikazu Yoshino, Kenji Yamada, Satoru Takahashi, Sakyo Hirai, Kunihiko Takahashi, Kazutaka Sumita","doi":"10.2176/jns-nmc.2025-0288","DOIUrl":"10.2176/jns-nmc.2025-0288","url":null,"abstract":"<p><p>The recurrence of cerebral aneurysms after coil embolization remains a significant concern in clinical practice. This study introduced a novel approach that combines machine learning with deep learning techniques using time-of-flight magnetic resonance angiography to predict aneurysm recurrence. A retrospective multicenter analysis was conducted on 154 patients with coil-embolized unruptured cerebral aneurysms. Three prediction models were developed: a logistic regression model, a neural network model using clinical data, and a combined deep learning model incorporating both clinical and imaging data obtained from 3-dimensional reconstructed time-of-flight magnetic resonance angiography. The combined model was created in 2 versions: 1 trained exclusively with pre-operative images and the other using both pre- and post-operative images. All models were evaluated using leave-one-out cross-validation to assess the area under the receiver operating characteristic curve, accuracy, sensitivity, and specificity. Among the 154 cases, 46 (29.9%) demonstrated recurrence. The combined model that incorporated both pre- and post-operative time-of-flight magnetic resonance angiography images achieved the best discriminative performance, with an area under the receiver operating characteristic curve of 0.822 and sensitivity of 0.848, indicating a reliable capacity to identify patients at risk of recurrence. The version that used only pre-operative images showed relatively high accuracy (0.766) and specificity (0.833) but a lower overall area under the receiver operating characteristic curve. These results highlight the value of integrating time-of-flight magnetic resonance angiography data into artificial intelligence-driven predictive models to improve the assessment of recurrence risk after coil embolization. The improved performance of the combined model, particularly when including post-operative images, demonstrates potential for more precise, individualized risk prediction and may contribute to better patient management.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"170-178"},"PeriodicalIF":2.3,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145959855","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}

{"title":"Postoperative Magnetic Resonance Imaging Signal Patterns Predict the Shrinkage of Aneurysms in Large and Giant Intracranial Aneurysms.","authors":"Hiroki Akiyama, Takeshi Mikami, Shouhei Noshiro, Katsuya Komatsu, Nobuhiro Mikuni","doi":"10.2176/jns-nmc.2025-0122","DOIUrl":"10.2176/jns-nmc.2025-0122","url":null,"abstract":"<p><p>This study aimed to evaluate whether postoperative T2-weighted magnetic resonance imaging signal patterns can predict aneurysm shrinkage after surgery for large and giant intracranial aneurysms. We retrospectively analyzed 17 patients with large (10-24 mm) or giant (≥25 mm) cerebral aneurysms treated by clipping, trapping, or proximal ligation between 2009 and 2023. Postoperative aneurysmal signal intensity on T2-weighted magnetic resonance imaging was classified as homogeneous or heterogeneous. Aneurysm shrinkage was defined as a ≥50% reduction in maximum diameter at 2 years compared with the preoperative size. Changes in aneurysm diameter and signal patterns were assessed at 6 months, 1 year, and 2 years postoperatively. Statistical analyses included the Mann-Whitney U test for shrinkage rate and Fisher's exact test for categorical variables. In total, 13 aneurysms (76.5%) showed shrinkage, and 4 (23.5%) did not. The homogeneous group demonstrated a significantly greater reduction in aneurysm diameter than the heterogeneous group at 6 months (p = 0.002) and 1 year (p = 0.006), with a similar trend at 2 years (p = 0.051). Some aneurysms initially showing heterogeneous intensity later became homogeneous and subsequently decreased in size. In contrast, persistent heterogeneous signals were associated with poor shrinkage and, in 1 case, regrowth. Postoperative homogeneous signal intensity on T2-weighted magnetic resonance imaging was associated with aneurysm shrinkage, whereas heterogeneous intensity indicated incomplete thrombus organization and limited reduction. Postoperative magnetic resonance imaging signal patterns may serve as a simple imaging biomarker for evaluating thrombus stability and treatment efficacy after surgery for large and giant cerebral aneurysms.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"162-169"},"PeriodicalIF":2.3,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145959902","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}

{"title":"Reconsidering the Pathophysiological Interpretation of Polyphasic LSRs in Hemifacial Spasm.","authors":"Jongsuk Choi","doi":"10.2176/jns-nmc.2025-0188","DOIUrl":"https://doi.org/10.2176/jns-nmc.2025-0188","url":null,"abstract":"","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147434365","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}