Neurologia medico-chirurgica最新文献_第8页

Frequency and Prognostic Impact of CDKN2A/B Alteration in Oligodendrogliomas: Systematic Review and Meta-analysis. CDKN2A/B在少突胶质细胞瘤中的发生率和预后影响：系统综述和荟萃分析

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-12-15 Epub Date: 2024-10-22 DOI: 10.2176/jns-nmc.2024-0105

Satoshi Nakasu, Shoichi Deguchi, Yoko Nakasu

{"title":"Frequency and Prognostic Impact of CDKN2A/B Alteration in Oligodendrogliomas: Systematic Review and Meta-analysis.","authors":"Satoshi Nakasu, Shoichi Deguchi, Yoko Nakasu","doi":"10.2176/jns-nmc.2024-0105","DOIUrl":"10.2176/jns-nmc.2024-0105","url":null,"abstract":"Isocitrate dehydrogenase (IDH) -mutant astrocytomas with homozygous deletion of cyclin-dependent kinase 2A/B (CDKN2A/B-HomoD) are categorized to grade 4 in the new World Health Organization (WHO) classification. However, the clinical implications of CDKN2A/B-HomoD in oligodendrogliomas remain unclear. This study systematically reviewed and meta-analyzed the literature on molecularly defined oligodendrogliomas (mOlig) to find the frequency and prognostic significance of CDKN2A/B gene alterations. Overall survival was worse in patients with CDKN2A/B-HomoD [pooled hazard ratio (pHR) 2.44; 95% confidential interval (CI), 1.59-3.76; P < 0.0001; 7 studies, 1,012 patients] than in those without CDKN2A/B-HomoD. Although the frequency (95% CI) was very low in grade 2 tumors (0.31%; 0.02-0.4) than in grade 3 tumors (9.4%; 6.2-14.0; I2 = 52.0%), pHR of multivariate analyses with covariates of WHO grade and age was still significant (P = 0.017). In contrast, the method in CDKN2A/B evaluation was a significant factor for the heterogeneity in frequency. The pooled frequency of CDKN2A/B-HomoD in grade 3 mOlig by fluorescence in situ hybridization (FISH) (20.3%) was higher than that by other methods (7.3%; P < 0.0006), probably due to the lower threshold for CDKN2A/B-HomoD in FISH studies that was used in this analysis. The frequency (95% CI) of other alterations of the CDKN2A/B gene, i.e., mutation, hemizygous deletion, and promoter methylation, was estimated as 1.48% (0.6-3.5), 15.9% (9.8-24.7), and 20.6% (13.7-29.8), respectively. The clinical significance of these alterations remains unclear due to the immaturity of the investigations.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"442-450"},"PeriodicalIF":2.4,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142504892","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

Real-world Data of Antithrombotic Therapy in Neuroendovascular Therapy: Analysis of JR-NET 4. 神经血管内治疗中抗血栓治疗的真实世界数据：分析 JR-NET 4.

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-12-15 Epub Date: 2024-10-22 DOI: 10.2176/jns-nmc.2024-0144

Nozomi Sasaki, Yukiko Enomoto, Hiroshi Yamagami, Koji Iihara, Akira Ishii, Hirotoshi Imamura, Nobuyuki Sakai, Chiaki Sakai, Tetsu Satow, Yuji Matsumaru, Shinichi Yoshimura

{"title":"Real-world Data of Antithrombotic Therapy in Neuroendovascular Therapy: Analysis of JR-NET 4.","authors":"Nozomi Sasaki, Yukiko Enomoto, Hiroshi Yamagami, Koji Iihara, Akira Ishii, Hirotoshi Imamura, Nobuyuki Sakai, Chiaki Sakai, Tetsu Satow, Yuji Matsumaru, Shinichi Yoshimura","doi":"10.2176/jns-nmc.2024-0144","DOIUrl":"10.2176/jns-nmc.2024-0144","url":null,"abstract":"As the number of neuroendovascular therapies in Japan increases, the current trends in periprocedural antithrombotic therapy must be understood.We retrospectively analyzed data on periprocedural antithrombotic therapy in the Japanese Registry of Neuroendovascular Therapy (JR-NET) 4, a nationwide survey carried out in Japan between January 2015 and December 2019. Details on antithrombotic therapy in neuroendovascular therapy for ruptured cerebral aneurysms, unruptured cerebral aneurysms, and percutaneous transluminal angioplasty or stenting were collected from the JR-NET 4 database. These data were analyzed and compared with those from the JR-NET 2 (January 2008 to December 2009) and JR-NET 3 (January 2010 to December 2014). A total of 36,560 cases were analyzed in the JR-NET 4. The frequency of preprocedural dual antiplatelet therapy (DAPT) significantly increased from the JR-NET 2 to 4 (48.1%, 53.4%, and 62.3%, respectively; P < 0.001), whereas the frequency of monotherapy significantly decreased (15.7%, 13.9%, and 8%, respectively; P < 0.001). Postprocedural antiplatelet therapy exhibited similar trends, and postprocedural anticoagulant therapy was discontinued. Particularly, heparin use significantly decreased from the JR-NET 2 to 4 (23.4% vs. 12.7% vs. 7.9%, respectively; P < 0.001). In terms of periprocedural complications, the incidence of ischemic complications increased from the JR-NET 3 to 4 (5.8% vs. 6.2%; P = 0.05). In the JR-NET 4, severe adverse events and hemorrhagic and all complications were significantly more frequent in the preprocedural triple or more therapy group.The rate of postprocedural anticoagulant therapy decreased, whereas that of antiplatelet therapy increased. Overall, in Japan, periprocedural DAPT has become increasingly common.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"434-441"},"PeriodicalIF":2.4,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142504893","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

Usefulness of Mechanical Thrombectomy in Patients with Cancer Who Developed Cerebral Infarction. 机械血栓切除术在发生脑梗塞的癌症患者中的实用性

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-12-15 Epub Date: 2024-11-06 DOI: 10.2176/jns-nmc.2024-0016

Sayaka Terazono, Yuki Sakaeyama, Yutaka Fuchinoue, Masataka Mikai, Shuhei Kubota, Mitsuyoshi Abe, Kosuke Kondo, Nobuo Sugo, Takaaki Nagao, Masaaki Nemoto

{"title":"Usefulness of Mechanical Thrombectomy in Patients with Cancer Who Developed Cerebral Infarction.","authors":"Sayaka Terazono, Yuki Sakaeyama, Yutaka Fuchinoue, Masataka Mikai, Shuhei Kubota, Mitsuyoshi Abe, Kosuke Kondo, Nobuo Sugo, Takaaki Nagao, Masaaki Nemoto","doi":"10.2176/jns-nmc.2024-0016","DOIUrl":"10.2176/jns-nmc.2024-0016","url":null,"abstract":"Mechanical thrombectomy (MT) is an established treatment for large vessel occlusion in the acute phase of stroke. However, its efficacy and safety in patients with cancer remain unclear. This study aimed to evaluate the therapeutic effect of MT against large vessel occlusion between patients with and without cancer. A total of 71 patients who underwent MT from August 2014 to November 2021 were included in this study. Patients with cancer and/or a history of cancer (n = 16) were included in the with cancer group and the remaining patients in the without cancer group (n = 55). The frequency of preoperative tissue plasminogen activator administration was significantly lower in the with cancer group (n = 2 [12.5%]) than in the without cancer group (n = 24 [43.6%]). However, there were no significant differences between the two groups in terms of treatment time, pass frequency, thrombolysis in cerebral infarction grade, modified Rankin scale score at 1 week after treatment [mRS (1w) ], modified Rankin scale score at discharge [mRS (ENT) ], modified Rankin scale score at 90 days after treatment [mRS (90 days) ], and length of hospital stay (days). In the multivariate analysis, if the objective variables were mRS (1w) and mRS (90 days), the National Institutes of Health Stroke Scale (NIHSS) and preonset mRS scores were considered significant variables. The presence or absence of cancer was not considered an independent factor of mRS (1w), mRS (ENT), or mRS (90 days). Aggressive treatment may be recommended to patients with cancer and/or a history of cancer who present with a systemic condition that can be managed with MT.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"428-433"},"PeriodicalIF":2.4,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591247","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 Current Status of Endovascular Treatment for Extracranial Vertebral Artery Stenosis in Japan: A Subanalysis of the Japanese Registry of Neuroendovascular Therapy 4. 日本颅外椎动脉狭窄的血管内治疗现状：日本神经血管内治疗注册的子分析 4.

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-11-15 Epub Date: 2024-09-26 DOI: 10.2176/jns-nmc.2024-0115

Satoru Fujiwara, Akira Ishii, Tsuyoshi Ohta, Nobuyuki Ohara, Michi Kawamoto, Koji Iihara, Hirotoshi Imamura, Yuji Matsumaru, Chiaki Sakai, Tetsu Satow, Shinichi Yoshimura, Nobuyuki Sakai

{"title":"The Current Status of Endovascular Treatment for Extracranial Vertebral Artery Stenosis in Japan: A Subanalysis of the Japanese Registry of Neuroendovascular Therapy 4.","authors":"Satoru Fujiwara, Akira Ishii, Tsuyoshi Ohta, Nobuyuki Ohara, Michi Kawamoto, Koji Iihara, Hirotoshi Imamura, Yuji Matsumaru, Chiaki Sakai, Tetsu Satow, Shinichi Yoshimura, Nobuyuki Sakai","doi":"10.2176/jns-nmc.2024-0115","DOIUrl":"10.2176/jns-nmc.2024-0115","url":null,"abstract":"Endovascular treatment (EVT) is a potential therapeutic option for extracranial vertebral artery (VA) stenosis; however, its efficacy or optimal procedures remain unknown. This study aimed to investigate the recent status of EVT for extracranial VA stenosis in Japan using a nationwide registry. We conducted a post hoc analysis of the Japanese Registry of Neuroendovascular Therapy 4 that enrolled patients who underwent EVT at 166 hospitals in Japan from 2015 to 2019. The outcomes of this study were as follows: procedural success indicating that the planned procedure was completed, modified Rankin Scale (mRS) score at 30 days, and procedure-related complications evaluated according to the procedure during EVT (percutaneous transluminal angioplasty vs. stenting and with or without the use of embolic protection devices [EPDs]). Of 308 eligible patients, 301 (95%) were treated for atherosclerotic stenosis, predominantly by stenting (74%). EPDs were used in 43%, primarily with the distal balloon (63%). The proportion of procedural success was 98%. Functional independence (mRS of 0-2) at 30 days was achieved in 80% of the total cohort, and there were no differences between patients treated with or without stenting or EPDs (74% vs. 82%, p = 0.12, and 80% vs. 80%, p = 0.93). Procedural complications occurred in 28 (9.1%) patients similarly in each group, with distal embolism and vessel dissection being common. In conclusion, EVT is a reasonable option for extracranial VA stenosis as a daily clinical practice. This study emphasizes the potential of EVT in managing extracranial VA stenosis and the need for further research to refine treatment strategies.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"387-394"},"PeriodicalIF":2.4,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11617352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142350930","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

Impact of Frailty Risk on Functional Outcome after Aneurysmal Subarachnoid Hemorrhage: A Historical Cohort Study. 虚弱风险对动脉瘤性蛛网膜下腔出血后功能预后的影响：历史队列研究

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-11-15 Epub Date: 2024-09-26 DOI: 10.2176/jns-nmc.2023-0251

Yoshinori Yamamoto, Shinsuke Hori, Kenta Ushida, Yuka Shirai, Miho Shimizu, Yuki Kato, Ryo Momosaki

{"title":"Impact of Frailty Risk on Functional Outcome after Aneurysmal Subarachnoid Hemorrhage: A Historical Cohort Study.","authors":"Yoshinori Yamamoto, Shinsuke Hori, Kenta Ushida, Yuka Shirai, Miho Shimizu, Yuki Kato, Ryo Momosaki","doi":"10.2176/jns-nmc.2023-0251","DOIUrl":"10.2176/jns-nmc.2023-0251","url":null,"abstract":"We evaluated the utility of the Hospital Frailty Risk Score (HFRS) as a predictor of adverse events post-hospitalization in a retrospective analysis of patients undergoing neurosurgical procedures due to aneurysmal subarachnoid hemorrhage (SAH). This historical cohort study analyzed the data of patients hospitalized with aneurysmal SAH (n = 1,343) between April 2014 and August 2020 who were registered in the JMDC database. We used HFRS to classify the patients into the low-frailty risk group (HFRS < 5) and high-frailty risk group (HFRS ≥ 5). The primary outcome was a modified Rankin Scale (mRS) score of 0-2 points at discharge. Of 1,343 patients, 1,001 (74.5%) and 342 (25.5%) were in the low- and high-frailty risk groups, respectively. A high-frailty risk was negatively associated with a mRS score of 0-2 at discharge (high-frailty risk group: odds ratio 0.4; 95% confidence interval [CI]: 0.3-0.6) and home discharge (high-frailty risk group: odds ratio 0.5; 95% CI: 0.4-0.7). A high-frailty risk was negatively associated with Barthel Index gain (high-frailty risk group: coefficient -10.4, 95% CI: -14.7 to -6.2) and had a longer length of stay (high-frailty risk group: coefficient 8.4, 95% CI: 5.1-11.7). HFRS could predict adverse outcomes during hospitalization of aneurysmal SAH patients.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"409-417"},"PeriodicalIF":2.4,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11617354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142350928","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

Spatial Cognition Ability in Surgeons Performing Endoscopic Endonasal Transsphenoidal Surgery. 执行内窥镜鼻内镜经蝶手术的外科医生的空间认知能力。

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-11-15 Epub Date: 2024-09-26 DOI: 10.2176/jns-nmc.2024-0080

Juli Yamashita, Takeshi Okuda, Takayuki Tasaki, Jun C Takahashi

{"title":"Spatial Cognition Ability in Surgeons Performing Endoscopic Endonasal Transsphenoidal Surgery.","authors":"Juli Yamashita, Takeshi Okuda, Takayuki Tasaki, Jun C Takahashi","doi":"10.2176/jns-nmc.2024-0080","DOIUrl":"10.2176/jns-nmc.2024-0080","url":null,"abstract":"Endoscopic surgery, including endoscopic endonasal transsphenoidal surgery (ETSS), requires special psychomotor skills from surgeons. The learning curve in the acquisition of psychomotor skills varies among individuals, and studies about laparoscopy indicate that the difference can be predicted using spatial ability tests. We examined the association between the results of such tests and the learning curve in ETSS to determine the need for a personalized curriculum for ETSS skill training. A total of 30 fifth-year medical students from Kindai University School of Medicine (17 men, 13 women; mean age, 26 years) without ETSS experience completed the spatial orientation test (SOT) for the measurement of spatial visualization ability. They performed the dural incision task (DIT) twice on an ETSS training model for surgical psychomotor skill evaluation. The SOT scores (angle errors) exhibited substantial individual differences in spatial visualization ability, whereas the DIT scores significantly improved in the second trial (Wilcoxon signed-rank test, P = 0.0035). However, no significant difference was observed in the DIT scores between the smaller error and larger error groups of the SOT. The results indicated that two DIT trials were sufficient to acquire psychomotor skills for the DIT as the endoscope was almost fixed and learning only one viewpoint and line of sight combination was adequate. In conclusion, a personalized ETSS training program based on the trainee's spatial ability is not necessary for the DIT. Further research is warranted to determine the effect of spatial ability on more complex tasks, such as suturing in cranial base repair.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"395-400"},"PeriodicalIF":2.4,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11617353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142350929","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

Full-endoscopic Spine Surgery for the Treatment of Lumbar Ligamentous Flavum Hematoma. 全内窥镜脊柱手术治疗腰椎韧带瓣血肿。

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-11-15 Epub Date: 2024-09-26 DOI: 10.2176/jns-nmc.2024-0086

Chia-Wei Chang, Ryoji Tominaga, Yasushi Oshima, Hiroki Iwai, Hirohiko Inanami, Hisashi Koga

{"title":"Full-endoscopic Spine Surgery for the Treatment of Lumbar Ligamentous Flavum Hematoma.","authors":"Chia-Wei Chang, Ryoji Tominaga, Yasushi Oshima, Hiroki Iwai, Hirohiko Inanami, Hisashi Koga","doi":"10.2176/jns-nmc.2024-0086","DOIUrl":"10.2176/jns-nmc.2024-0086","url":null,"abstract":"Lumbar ligamentous flavum hematoma (LFH) is a relatively rare pathology, and it is difficult to differentiate it from other cystic lesions. Full-endoscopic spine surgery (FESS), an excellent approach for clear and magnified operative visual field since it allows saline irrigation and minimizes destruction of surrounding tissues, has been applied to the treatment. This study aims to present a case series of patients with lumbar LFH treated by FESS.This case series consists of 17 lumbar LFH cases treated by FESS between May 2018 and November 2021 at a single institution. Patient background and operative data were collected from their medical records. The numerical rating scale (NRS), Oswestry Disability Index (ODI), and European Quality of Life-5 Dimensions (EQ-5D) were recorded preoperatively and postoperatively.Elderly men tend to suffer from lumbar LFH at the L4/5 vertebral level. Discontinuity with facet joint was confirmed under endoscopic visualization in all 17 cases. Blood clots were also observed in all cases under endoscope. The mean operative time was 68.6 min without complication. The patients were discharged at average 1.4 days after FESS with significant improvement of NRS score (P < 0.001). ODI and EQ-5D scores 2-year postoperatively statistically improved (P < 0.001), and there was no recurrence during followup period.The operative outcomes of lumbar LFH treated by FESS were satisfactory. FESS excels not only in the diagnosis but also in the treatment of lumbar LFH.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"401-408"},"PeriodicalIF":2.4,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11617355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142350927","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

Moyamoya Periventricular Choroidal Collateral Registry-A Multicenter Cohort Study of Moyamoya Disease with Choroidal Anastomosis: Study Protocol. Moyamoya 室周脉络膜侧支注册--一项关于脉络膜吻合的 Moyamoya 病的多中心队列研究：研究协议。

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-10-15 Epub Date: 2024-09-07 DOI: 10.2176/jns-nmc.2024-0063

Takeshi Funaki, Susumu Miyamoto

引用次数: 0

Prevalence, Radiological, and Pathological Findings of Ossification and Calcification of the Lumbar Spinal Ligamentum Flavum: A Comparative Study with Thoracic Lesions. 腰椎韧带骨化和钙化的发病率、放射学和病理学发现：与胸椎病变的比较研究。

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-10-15 Epub Date: 2024-09-07 DOI: 10.2176/jns-nmc.2024-0074

Takeaki Endo, Keisuke Takai, Takashi Komori, Yasuhiro Nakata

{"title":"Prevalence, Radiological, and Pathological Findings of Ossification and Calcification of the Lumbar Spinal Ligamentum Flavum: A Comparative Study with Thoracic Lesions.","authors":"Takeaki Endo, Keisuke Takai, Takashi Komori, Yasuhiro Nakata","doi":"10.2176/jns-nmc.2024-0074","DOIUrl":"10.2176/jns-nmc.2024-0074","url":null,"abstract":"This study aimed to determine the prevalence of lumbar ligamentum flavum lesions and identify correlations between radiological and pathological findings. We conducted an observational cross-sectional study of 349 patients (lumbar: n = 296, thoracic: n = 39, lumbar and thoracic: n = 14, mean age: 69 ± 12 years, male: 74%) who underwent posterior surgery for thoracolumbar spinal canal stenosis between January 2008 and April 2023 at our hospital.Computed tomography (CT) revealed that the prevalence of ligamentum flavum lesions defined as a high-density area with a CT value of 200 Hounsfield Unit or higher in the lumbar and thoracic spine was 47% (147/310) and 85% (45/53), respectively. CT showed that most patients had radiologically suspected ossification in the lumbar (90%) and thoracic spine (98%) than radiologically suspected calcification. Lumbar lesions were thinner than the thoracic lesions (2.5 vs 3.7 mm, p < 0.01). Pathological examinations were performed in specimens collected from 34 cases (lumbar: n = 13, thoracic: n = 21), and ossification was found in 62% (8/13) and 95% (20/21) of lumbar and thoracic lesions (p = 0.02), respectively. Lastly, ossification was confirmed pathologically in 72% (8/11) and 95% (19/20) of lumbar and thoracic lesions that showed ossification on imaging (p = 0.13), respectively. The literature review revealed that the prevalence of the lumbar ligamentum flavum lesions varied from 1.5 to 35% and the patient population was mostly asymptomatic.Collectively, we found that the prevalence of lumbar ligamentum flavum lesions in symptomatic patients was greater than previously reported. Histologically confirmed ossification was less common in lumbar lesions than in thoracic lesions.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"369-375"},"PeriodicalIF":2.4,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154695","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

Correlation between Delayed Relief after Microvascular Decompression and Morphology of the Lateral Spread Response in Patients with Hemifacial Spasm-Further Examination with Compound Motor Action Potentials. 面肌痉挛患者微血管减压后延迟缓解与外侧扩展反应形态之间的相关性--复合运动动作电位的进一步研究

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-10-15 Epub Date: 2024-09-07 DOI: 10.2176/jns-nmc.2024-0017

Yuki Amano, Bunsho Asayama, Shusaku Noro, Takenori Abe, Masahiro Okuma, Kaori Honjo, Yoshinobu Seo, Hirohiko Nakamura

{"title":"Correlation between Delayed Relief after Microvascular Decompression and Morphology of the Lateral Spread Response in Patients with Hemifacial Spasm-Further Examination with Compound Motor Action Potentials.","authors":"Yuki Amano, Bunsho Asayama, Shusaku Noro, Takenori Abe, Masahiro Okuma, Kaori Honjo, Yoshinobu Seo, Hirohiko Nakamura","doi":"10.2176/jns-nmc.2024-0017","DOIUrl":"10.2176/jns-nmc.2024-0017","url":null,"abstract":"Although microvascular decompression (MVD) is a reliable treatment for hemifacial spasm (HFS), postoperative delayed relief is one of its main issues. We previously evaluated the morphology of the lateral spread response (LSR) and reported correlation between delayed relief after MVD and polyphasic morphology of the LSR. This study aimed to investigate the morphology of LSR and the course of recovery of the compound motor action potential (CMAP), to better understand the pathophysiology of delayed healing of HFS. Based on the pattern of the initial LSR morphology on temporal and marginal mandibular branches stimulation, patients were divided into two groups: the monophasic and polyphasic groups. The results of MVD surgery and sequential changes in the CMAP were evaluated 1 week, 1 month, 1 year, and final follow-up after the surgery. Significantly higher rates of persistent postoperative HFS were observed in patients with the polyphasic type of initial LSR at 1 week and 1 month after the surgery (P < 0.05, respectively). In the polyphasic group, the amplitude of the CMAP tended to gradually improve with time, while in the monophasic group, the amplitude of the CMAP decreased on the seventh postoperative day, followed by its gradual improvement. There is a significant correlation between delayed relief after MVD and polyphasic morphology of the initial LSR in patients with HFS. In the polyphasic group, CMAP recovered earlier and showed less reduction in amplitude, suggesting segmental demyelination, with less damage to peripheral nerves.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"360-368"},"PeriodicalIF":2.4,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154693","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}

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