Neurologia medico-chirurgica最新文献_第9页

Statistical Analysis of the Factors that Affect Postoperative Length of Hospital Stay after Unruptured Intracranial Aneurysm Treatment in Japan: A 20-year Nationwide Multicenter Study. 日本未破裂颅内动脉瘤术后住院时间影响因素的统计分析：一项为期 20 年的全国多中心研究。

IF 1.9 4区医学

Neurologia medico-chirurgica Pub Date : 2024-04-15 Epub Date: 2024-02-15 DOI: 10.2176/jns-nmc.2023-0142

Yuhei Hoshikuma, Takeshi Shimizu, Shingo Toyota, Tomoaki Murakami, Takamune Achiha, Motohide Takahara, Kazuhiro Touhara, Tatsuya Hagioka, Maki Kobayashi, Haruhiko Kishima

{"title":"Statistical Analysis of the Factors that Affect Postoperative Length of Hospital Stay after Unruptured Intracranial Aneurysm Treatment in Japan: A 20-year Nationwide Multicenter Study.","authors":"Yuhei Hoshikuma, Takeshi Shimizu, Shingo Toyota, Tomoaki Murakami, Takamune Achiha, Motohide Takahara, Kazuhiro Touhara, Tatsuya Hagioka, Maki Kobayashi, Haruhiko Kishima","doi":"10.2176/jns-nmc.2023-0142","DOIUrl":"10.2176/jns-nmc.2023-0142","url":null,"abstract":"Treatment strategies for unruptured intracranial aneurysms (UIAs) should be carefully considered with reference to rupture and complication rates. It is also important to minimize the length of hospital stay (LOS) and to ensure a high quality of medical care. In this study, we aim to clarify the factors that affect the LOS of patients treated for UIAs using the Inpatient Clinico-Occupational Database of the Rosai Hospital Group (ICOD-R). This was a nationwide-multicenter study based on ICOD-R data from 2000 to 2019. Patients diagnosed with UIAs who were treated with clipping or coiling were included in the study. Multivariate analysis was performed to identify the factors affecting LOS. LOS was also compared between groups classified by surgical procedure or treatment period. We identified 3294 patients on the database who underwent clipping or coiling of UIAs during the study period. Multivariate analysis revealed hospital admission during the early 2000s and the late 2010s, age, and treating institution to be significantly correlated with LOS (p < 0.05). There was a significant difference between the mean LOS of the clipping group (20.3 days) and the coiling group (9.65 days) (p < 0.001). Compared by treatment period, LOS significantly shortened over time. Our results suggest that the type of treatment, time of treatment, patient age, and the treating institution affect postoperative LOS for UIAs. Although coiling was found to lead to a lower average LOS than clipping, treatment selection should take the characteristics of each patient's aneurysm into consideration.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"154-159"},"PeriodicalIF":1.9,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11099163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139735703","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

Temporal Muscle Swelling after Clipping Surgery with Frontotemporal Craniotomy Is Associated with Immediate Postcraniotomy Headache. 额颞部开颅削骨手术后颞肌肿胀与开颅术后即刻头痛有关。

IF 1.9 4区医学

Neurologia medico-chirurgica Pub Date : 2024-04-15 Epub Date: 2024-02-15 DOI: 10.2176/jns-nmc.2023-0228

Yoshiro Ito, Hisayuki Hosoo, Aiki Marushima, Yuji Matsumaru, Eiichi Ishikawa

{"title":"Temporal Muscle Swelling after Clipping Surgery with Frontotemporal Craniotomy Is Associated with Immediate Postcraniotomy Headache.","authors":"Yoshiro Ito, Hisayuki Hosoo, Aiki Marushima, Yuji Matsumaru, Eiichi Ishikawa","doi":"10.2176/jns-nmc.2023-0228","DOIUrl":"10.2176/jns-nmc.2023-0228","url":null,"abstract":"Immediate postcraniotomy headache frequently occurs within the first 48 h after surgery. The mechanisms underlying immediate postcraniotomy headache are not yet fully understood, and effective treatments are not yet established. This study aimed to identify the factors associated with immediate postcraniotomy headache in patients who underwent clipping surgery with frontotemporal craniotomy and to examine the effects of these factors on postcraniotomy headache. A total of 51 patients were included in this study. Immediate postcraniotomy headache was defined as pain with numerical rating scale score ≥4 on postoperative day 7. Sixteen patients (31.4%) had immediate postcraniotomy headache. The headache-positive group had a higher incidence of preoperative analgesic use (50.0% vs. 5.7%, respectively, p < 0.001), increased temporal muscle swelling ratio (137.0%±30.2% vs. 112.5%±30.5%, respectively, p = 0.01), and higher postoperative analgesic use (12.9±5.8 vs. 6.7±5.2, respectively, p < 0.001) than the headache-negative group. The risk factors independently associated with immediate postcraniotomy headache were preoperative analgesic use and temporal muscle swelling by >115.15% compared with the contralateral side in the receiver operating characteristic analysis. Postcraniotomy headache was significantly more common in patients with preoperative analgesic use and temporal muscle swelling than in those without (p < 0.001 and p = 0.002, respectively). Altogether, patients with immediate postcraniotomy headache had greater preoperative analgesic use, greater temporal muscle swelling ratio, and higher postoperative analgesic use than those without. Thus, temporal muscle swelling is a key response to immediate postcraniotomy headache.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"168-174"},"PeriodicalIF":1.9,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11099162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139735704","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

Clinical Significance of Carotid Endarterectomy and Carotid Artery Stenting in Older Patients Over 80. 80 岁以上老年患者颈动脉内膜剥脱术和颈动脉支架植入术的临床意义。

IF 1.9 4区医学

Neurologia medico-chirurgica Pub Date : 2024-04-15 Epub Date: 2024-02-26 DOI: 10.2176/jns-nmc.2023-0245

Daina Kashiwazaki, Emiko Hori, Naoki Akioka, Kunitaka Maruyama, Shusuke Yamamoto, Naoya Kuwayama, Kyo Noguchi, Satoshi Kuroda

{"title":"Clinical Significance of Carotid Endarterectomy and Carotid Artery Stenting in Older Patients Over 80.","authors":"Daina Kashiwazaki, Emiko Hori, Naoki Akioka, Kunitaka Maruyama, Shusuke Yamamoto, Naoya Kuwayama, Kyo Noguchi, Satoshi Kuroda","doi":"10.2176/jns-nmc.2023-0245","DOIUrl":"10.2176/jns-nmc.2023-0245","url":null,"abstract":"As the average life expectancy increases, neurosurgeons are likely to encounter patients aged 80 years and above with carotid stenosis; however, whether old age affects clinical post-treatment outcomes of carotid endarterectomy (CEA) or carotid artery stenting (CAS) remains inconclusive. Thus, this study aimed to evaluate the outcomes following CEA or CAS in patients aged 80 years and above. This study included older over 80 years (n = 34) and younger patients (<80 years; n = 222) who underwent CEA or CAS between 2012 and 2022. All of them were followed up for a mean of 55 months. All-cause mortality, the incidence of vascular events, ability to perform daily activities, and nursing home admission rates were assessed. During follow-up periods, 34 patients (13.3%) died due to coronary artery disease, malignancy, and pneumonia, and the incidence was significantly higher in the elderly group than in the younger group (P = 0.03; HR, 3.01; 95% CI, 1.53-5.56). The incidence of vascular events did not differ between the older group (29.5%) and the younger group (26.9%, P = 0.58); however, the incidence was significantly higher in patients with high-intensity plaques than in those without that (P = 0.008; HR, 2.83, 95%CI, 1.27-4.87). The decline in the ability to perform daily activities and increased nursing home admission rates were high in elderly patients (P < 0.01). Although the mortality rate was higher in the elderly group, subsequent vascular events were comparable to that in the younger group. The results suggest that CEA and CAS are safe and useful treatments for carotid stenosis in older patients, especially to prevent ipsilateral ischemic stroke.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"147-153"},"PeriodicalIF":1.9,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11099164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139972854","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

Reconsideration of Surgical Indication for Prolactin-producing Pituitary Tumor Focusing on Visual Impairment. 重新考虑产生催乳素的垂体瘤的手术指征，重点关注视觉障碍。

IF 1.9 4区医学

Neurologia medico-chirurgica Pub Date : 2024-04-15 Epub Date: 2024-02-15 DOI: 10.2176/jns-nmc.2023-0184

Kosaku Amano, Yuichi Oda, Yasufumi Seki, Kaoru Yamashita, Kanako Bokuda, Atsuhiro Ichihara, Takakazu Kawamata

{"title":"Reconsideration of Surgical Indication for Prolactin-producing Pituitary Tumor Focusing on Visual Impairment.","authors":"Kosaku Amano, Yuichi Oda, Yasufumi Seki, Kaoru Yamashita, Kanako Bokuda, Atsuhiro Ichihara, Takakazu Kawamata","doi":"10.2176/jns-nmc.2023-0184","DOIUrl":"10.2176/jns-nmc.2023-0184","url":null,"abstract":"Prolactin-producing pituitary tumor (PRLoma) is the most prevalent functional pituitary tumor. If the tumor becomes large, vision can be impaired. In contrast to other pituitary tumors, cabergoline (CAB) is extremely effective for PRLoma and has become the first-line treatment. In this study, we examined our experience with the pharmacological and surgical management of PRLomas with visual impairment (VI) to determine whether VI could be a surgical indication. Further, we discussed the function of surgery in situations where the gold standard of PRLoma treatment was CAB administration. Of the 159 patients with PRLomas (age, 13-77 [mean = 36.3] years; men, 29; women, 130) at Tokyo Women's Medical University Hospital from 2009 to 2021, 18 (age, 15-67 [mean = 35.8] years; men, 12; woman, 6) had VI (subjectively, 12; objectively, 6). They started CAB treatment immediately (maximum dose: 0.5 to 6 mg/week; average: 2.17 mg/week). VI improved in 16 patients (88.9%) but did not improve in 2 (11.1%) requiring surgeries. One of the two patients had a parenchymal tumor resistant to CAB, and the other had a cystic tumor due to intratumoral bleeding. Consequently, CAB is the first-line treatment for PRLomas with VI because of its significantly high rate of improvement. However, close and rigorous surveillance is necessary for cases resistant to CAB, and the correct decision is required regarding surgical interventions at proper timing and appropriate surgical approaches considering the purpose of surgery.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"160-167"},"PeriodicalIF":1.9,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11099161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139735702","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 Usefulness of Surgical Titanium Microclips for Mucosal Repair in the Frontal Sinus Using ORBEYE: A Technical Note. 使用 ORBEYE 手术钛微夹修复额窦粘膜的实用性：技术说明。

IF 1.9 4区医学

Neurologia medico-chirurgica Pub Date : 2024-03-15 Epub Date: 2024-01-31 DOI: 10.2176/jns-nmc.2023-0175

Motohide Takahara, Tomoaki Murakami, Shingo Toyota, Shuki Okuhara, Kazuhiro Touhara, Yuhei Hoshikuma, Shuhei Yamada, Takamune Achiha, Maki Kobayashi, Haruhiko Kishima

{"title":"The Usefulness of Surgical Titanium Microclips for Mucosal Repair in the Frontal Sinus Using ORBEYE: A Technical Note.","authors":"Motohide Takahara, Tomoaki Murakami, Shingo Toyota, Shuki Okuhara, Kazuhiro Touhara, Yuhei Hoshikuma, Shuhei Yamada, Takamune Achiha, Maki Kobayashi, Haruhiko Kishima","doi":"10.2176/jns-nmc.2023-0175","DOIUrl":"10.2176/jns-nmc.2023-0175","url":null,"abstract":"Bifrontal craniotomy frequently involves opening the frontal sinus and mucosal injury. We report a new technique for mucosal repair in the frontal sinus using surgical titanium microclips. Six consecutive patients who underwent bifrontal craniotomy with frontal sinus exposure and mucosal injury underwent mucosal repair using surgical titanium microclips between April 2019 and August 2022. In all cases, the frontal sinus mucosa was peeled from the inner walls of the frontal sinus to ensure sufficient mucosal margin for clipping using ORBEYE. The repair was accomplished with the microclips in all cases. We also sealed the mucosal wound using fibrin glue and sufficiently filled the frontal sinus with bone debris, resulting in zero incidence of postoperative liquorrhea in all cases. Repairing the mucosa using surgical titanium microclips using ORBEYE may be a simple and quick technique when the frontal sinus mucosa is injured during craniotomy.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"131-135"},"PeriodicalIF":1.9,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10992985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139723487","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

Characteristics of MicroRNA Expression Depending on the Presence or Absence of Meningioma in Patients with Neurofibromatosis Type 2: A Secondary Analysis. 神经纤维瘤病 2 型患者脑膜瘤存在或不存在时的 MicroRNA 表达特征：二次分析

IF 1.9 4区医学

Neurologia medico-chirurgica Pub Date : 2024-03-15 Epub Date: 2024-01-24 DOI: 10.2176/jns-nmc.2023-0200

Takeshi Imura, Takafumi Mitsuhara, Nobutaka Horie

{"title":"Characteristics of MicroRNA Expression Depending on the Presence or Absence of Meningioma in Patients with Neurofibromatosis Type 2: A Secondary Analysis.","authors":"Takeshi Imura, Takafumi Mitsuhara, Nobutaka Horie","doi":"10.2176/jns-nmc.2023-0200","DOIUrl":"10.2176/jns-nmc.2023-0200","url":null,"abstract":"Meningioma is the second most frequent tumor in patients with neurofibromatosis type 2 (NF2). The presence of meningioma is believed to be a negative prognostic marker in these patients. However, the molecular mechanisms involved in the tumorigenesis of NF2-associated meningioma are not well characterized. Epigenetic regulation, including microRNAs (miRNAs), may be involved in the development of different tumor types in patients with NF2. The objective of this study is to explore the different characteristics of serum miRNA expression depending on the presence or absence of meningioma in patients with NF2. Nine patients with NF2 who were treated at the Department of Neurosurgery, Hiroshima University Hospital, were included. Total RNA (including small RNAs) was extracted from serum samples for the preparation of a small RNA library for next-generation sequencing analysis. Differentially expressed miRNAs (DEMs) were analyzed using the DESeq2 package to compare the characteristic miRNA expression profiles of patients with and without meningioma. In small RNA sequencing analysis, out of a total of 1,879 miRNAs registered in the database, the expressions of 657 miRNAs were observed. In DEM analysis, the expressions of four miRNAs, namely, hsa-miR-664b, hsa-miR-7706, hsa-miR-590, and hsa-miR-6513, were downregulated in patients with NF2 with meningioma compared with patients with NF2 without meningioma. Hsa-miR-193a was identified as the only upregulated miRNA in patients with NF2 with meningioma. In conclusion, we identified different circulating miRNA expression characteristics depending on the presence or absence of meningioma in patients with NF2.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"116-122"},"PeriodicalIF":1.9,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10992986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139545137","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

Is Phantom Limb Awareness Necessary for the Treatment of Phantom Limb Pain? 幻肢意识是治疗幻肢痛的必要条件吗？

IF 1.9 4区医学

Neurologia medico-chirurgica Pub Date : 2024-03-15 Epub Date: 2024-01-24 DOI: 10.2176/jns-nmc.2023-0206

Huixiang Yang, Takufumi Yanagisawa

{"title":"Is Phantom Limb Awareness Necessary for the Treatment of Phantom Limb Pain?","authors":"Huixiang Yang, Takufumi Yanagisawa","doi":"10.2176/jns-nmc.2023-0206","DOIUrl":"10.2176/jns-nmc.2023-0206","url":null,"abstract":"Phantom limb pain is attributed to abnormal sensorimotor cortical representations. Various feedback treatments have been applied to induce the reorganization of the sensorimotor cortical representations to reduce pain. We developed a training protocol using a brain-computer interface (BCI) to induce plastic changes in the sensorimotor cortical representation of phantom hand movements and demonstrated that BCI training effectively reduces phantom limb pain. By comparing the induced cortical representation and pain, the mechanisms worsening the pain have been attributed to the residual phantom hand representation. Based on our data obtained using neurofeedback training without explicit phantom hand movements and hand-like visual feedback, we suggest a direct relationship between cortical representation and pain. In this review, we summarize the results of our BCI training protocol and discuss the relationship between cortical representation and phantom limb pain. We propose a treatment for phantom limb pain based on real-time neuroimaging to induce appropriate cortical reorganization by monitoring cortical activities.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"101-107"},"PeriodicalIF":1.9,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10992984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139545185","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

Long-term Outcomes of Combined Revascularization Surgery for Moyamoya Disease in the Elderly: A Single Institute Experience. 联合血管重建手术治疗老年人莫亚莫亚病的长期疗效：单一研究所的经验。

IF 1.9 4区医学

Neurologia medico-chirurgica Pub Date : 2024-03-15 Epub Date: 2024-01-24 DOI: 10.2176/jns-nmc.2023-0219

Kota Kurisu, Masaki Ito, Haruto Uchino, Taku Sugiyama, Miki Fujimura

{"title":"Long-term Outcomes of Combined Revascularization Surgery for Moyamoya Disease in the Elderly: A Single Institute Experience.","authors":"Kota Kurisu, Masaki Ito, Haruto Uchino, Taku Sugiyama, Miki Fujimura","doi":"10.2176/jns-nmc.2023-0219","DOIUrl":"10.2176/jns-nmc.2023-0219","url":null,"abstract":"The opportunity to treat older patients with Moyamoya disease (MMD) is increasing. However, the surgical outcomes after combined direct and indirect revascularization for elderly patients with MMD are not fully understood, especially for those ≥60 years old. This retrospective study examined 232 consecutive hemispheres of 165 adults with MMD who underwent combined revascularization. Clinical features and surgical outcomes were compared between the elderly (≥60 years) and nonelderly group (<60 years). Thirteen (5.6%, 64.4 ± 4.0 years old) and 219 hemispheres (94.4%, 40.2 ± 10.8 years old) were included in the elderly and nonelderly group, respectively. The proportion of clinical presentations before surgery did not differ. However, the prevalence of hypertension and hyperlipidemia was significantly higher in the elderly group than in the nonelderly group. Meanwhile, hyperthyroidism was observed only in the nonelderly group. No significant intergroup differences were observed in the incidence of perioperative complications occurring within four weeks postsurgery. Notably, the elderly group was more prone to develop perioperative intracerebral hemorrhage (odds ratio (OR) 3.14, 95% confidence interval (CI) 0.45-13.5) than the nonelderly group. During a median follow-up period of 7.8 years, the incidence of stroke recurrence occurring later than four weeks postsurgery was not significantly different between the groups (hazard ratio, 1.19; 95% CI 0.133-10.6). The prevalence of independent outcomes (76.9% vs. 90.4%, P = 0.14) and mortality (7.7% vs. 1.4%, P = 0.21) did not differ significantly between the elderly and nonelderly groups, respectively. Perioperative intracerebral hemorrhage may be common in the elderly and should be considered to achieve a favorable surgical outcome.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"108-115"},"PeriodicalIF":1.9,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10992987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139545453","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

Factors Associated with Early and Late Seizure Related to Aneurysmal Subarachnoid Hemorrhage. 动脉瘤性蛛网膜下腔出血早期和晚期癫痫发作的相关因素

IF 1.9 4区医学

Neurologia medico-chirurgica Pub Date : 2024-03-15 Epub Date: 2024-01-31 DOI: 10.2176/jns-nmc.2023-0201

Shota Nakashima, Hiroki Nishibayashi, Rie Yako, Masamichi Ishii, Naotsugu Toki, Masaki Tomobuchi, Toshihito Nakai, Hiromi Yamoto, Yoko Nakanishi, Naoyuki Nakao

{"title":"Factors Associated with Early and Late Seizure Related to Aneurysmal Subarachnoid Hemorrhage.","authors":"Shota Nakashima, Hiroki Nishibayashi, Rie Yako, Masamichi Ishii, Naotsugu Toki, Masaki Tomobuchi, Toshihito Nakai, Hiromi Yamoto, Yoko Nakanishi, Naoyuki Nakao","doi":"10.2176/jns-nmc.2023-0201","DOIUrl":"10.2176/jns-nmc.2023-0201","url":null,"abstract":"Post-stroke epilepsy may occur after aneurysmal subarachnoid hemorrhage (aSAH). Both early and late seizures could cause severe neurocognitive deficits if administration of appropriate antiseizure medication is delayed. Therefore, it is important to elucidate the risk factors for early and late seizures, which could be shared with medical teams to promptly manage seizures. There are aspects of both hemorrhage and ischemia in aSAH, and thus, numerous risk factors are considered for early and late seizures. We examined factors associated with aSAH-related early and late seizures. Among 297 patients who had aSAH and underwent direct or endovascular surgery, 25 had early seizures and 20 had late seizures. Patients who did not experience any seizures in at least 2-years of follow-up (n = 81) were used as the control group. Early seizures were associated with older age and acute severe nonneurological infection, whereas late seizures were associated with intraparenchymal lesion volume >10 mL and shunt placement. In patients with late seizures, consistency was frequently observed between electroencephalogram and the presence of intraparenchymal lesions. The frontopolar electrode on electroencephalogram was highly sensitive to abnormality in early seizures. Early seizures were induced by the patient's systemic factors, which may lower the threshold for cortical excitability. Patients with intraparenchymal lesions who undergo shunt placement should be carefully followed up for late seizures.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"123-130"},"PeriodicalIF":1.9,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10992983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139723486","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

Utilizing Excitatory and Inhibitory Activity Derived from Interictal Intracranial Electroencephalography as Potential Biomarkers for Epileptogenicity. 利用发作间期颅内脑电图得出的兴奋和抑制活动作为潜在的致痫生物标志物

IF 1.9 4区医学

Neurologia medico-chirurgica Pub Date : 2024-02-15 Epub Date: 2024-01-15 DOI: 10.2176/jns-nmc.2023-0207

Keisuke Nagata, Naoto Kunii, Seijiro Shimada, Nobuhito Saito

{"title":"Utilizing Excitatory and Inhibitory Activity Derived from Interictal Intracranial Electroencephalography as Potential Biomarkers for Epileptogenicity.","authors":"Keisuke Nagata, Naoto Kunii, Seijiro Shimada, Nobuhito Saito","doi":"10.2176/jns-nmc.2023-0207","DOIUrl":"10.2176/jns-nmc.2023-0207","url":null,"abstract":"Epileptogenic zones (EZs), where epileptic seizures cease after resection, are localized by assessing the seizure-onset zone using ictal electroencephalography (EEG). Owing to the difficulty in capturing unpredictable seizures, biomarkers capable of identifying EZs from interictal EEG are anticipated. Recent studies using intracranial EEG have identified several potential candidate biomarkers for epileptogenicity. High-frequency oscillation (HFO) was initially expected to be a robust biomarker of abnormal excitatory activity in the ictogenic region. However, HFO-guided resection failed to improve seizure prognosis. Meanwhile, the regularity of low-gamma oscillations (30-80 Hz) indicates inhibitory interneurons' hypersynchronization, which could be used to localize the EZ. Besides resting-state EEG assessments, evoked potentials elicited by single-pulse electrical stimulation, such as corticocortical evoked potentials (CCEP), became valuable tools for assessing epileptogenic regions. CCEP responses recorded in the cortex remote from the stimulation site indicate functional connectivity, revealing increased internal connectivity within the ictogenic region and elevated inhibitory input from the non-involved regions to the ictogenic region. Conversely, large responses close to the stimulation site reflect local excitability, manifesting as an increased N1 amplitude and overriding HFO. Further research is required to establish whether these novel electrophysiological methods, either individually or in combination, can function as robust biomarkers of epileptogenicity and hold promise for improving seizure prognosis.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"65-70"},"PeriodicalIF":1.9,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10918453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139466896","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