Neurologia最新文献

{"title":"The discriminative linguistic profiles of progressive supranuclear palsy and Parkinson's disease","authors":"L. Busteed ,&nbsp;A. Horta-Barba ,&nbsp;A. Reig ,&nbsp;C. García-Sánchez ,&nbsp;B. Pascual-Sedano ,&nbsp;I. Gich ,&nbsp;P. Roy Ciffone ,&nbsp;J. Kulisevsky ,&nbsp;J. Pagonabarraga","doi":"10.1016/j.nrl.2023.06.010","DOIUrl":"10.1016/j.nrl.2023.06.010","url":null,"abstract":"<div><h3>Introduction</h3><div>Speech and language disturbances are very frequent in progressive supranuclear palsy (PSP). Therefore, they are part of the diagnostic criteria set forth by the International Parkinson and Movement Disorder Society (MDS) for the disease and are considered a core clinical feature. However, more studies are needed to characterize the linguistic profile of PSP, thus being able to assist in the differential diagnosis. Additionally, studies assessing linguistic differences among PSP phenotypes are needed. The objective of this study is to analyze the language alterations presented by patients with PSP, as well as its different phenotypes, and differentiate them from those presented in patients with Parkinson's disease (PD).</div></div><div><h3>Methods</h3><div>An extensive cognitive and linguistic assessment was administered to 13 PSP patients, 19 PD patients and 19 healthy controls (HC) with similar sociodemographic features. Language assessment included evaluation of: syntactic processing, object naming, and phonetic and semantic fluencies. We included a subgroup of 6 PSP patients, 19 PD patients and 19 HC for further analysis of language. This analysis included, in addition to the general evaluation, the assessment of alternating fluency, comprehension, naming, automatic speech, repetition, object recognition, verbal and written instructions, writing to dictation, and oral expression.</div></div><div><h3>Results</h3><div>We found greater impairment on phonetic, semantic, and alternating fluencies, following verbal instructions, repetition, syntactic processing and writing (without phonetic paragraphia) in the PSP group compared to patients with PD and HC. Distinguishing linguistic features of PSP with a less marked reduction than the previously mentioned features were automatic speech, fluency of speech, and naming. Language analysis did not distinguish between PSP phenotypes.</div></div><div><h3>Conclusions</h3><div>Language disturbances distinguish PSP from PD and HC but were not able to discriminate PSP phenotypes.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"40 9","pages":"Pages 830-839"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145425462","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":"Las cefaleas primarias como motivo de consulta en Atención Primaria: un estudio prospectivo","authors":"I. Rivera ,&nbsp;N. Fontanillas ,&nbsp;L. Cadelo ,&nbsp;J. Pascual","doi":"10.1016/j.nrl.2023.07.002","DOIUrl":"10.1016/j.nrl.2023.07.002","url":null,"abstract":"<div><h3>Objectives</h3><div>To prospectively study the rate of consultation, diagnoses, burden and historical management patterns of those patients attending due to primary headache in Primary Care.</div></div><div><h3>Patients and methods</h3><div>We included 200 patients with primary headache in a semi-urban health center. To study the consultation impact, 100 patients were consecutively recruited in one Primary Care quota. For every patient we obtained demographic data, comorbidities, rate of consultation, absenteeism, impact in quality of life (MIDAS and HIT-6 scales) and previous patterns of referral and treatment.</div></div><div><h3>Results</h3><div>A total of 2.2% of the demand consultations were due to primary headache. Migraine (60%) was the most frequent reason, followed by tension-type headache (38.5%) and trigeminal autonomic headaches (1.5%). In 58% of cases the diagnosis was incomplete or incorrect. Between 33% (MIDAS) and 50.8% (HIT-6) of cases showed at least a moderate decrease in their quality of life, which was higher for migraine (40.8% and 72.5%, respectively). There was absenteeism in 12% of patients the last year (in 87.5% of cases due to migraine). More than half (57%) of cases had been referred to neurology and preventive treatments had been initiated in Primary Care in only 5.5% of patients.</div></div><div><h3>Conclusions</h3><div>Primary headaches, and mainly migraine, are a frequent reason for consultation in Primary Care. Even though migraine induces a significant absenteeism and damages quality of life, there is a clear room for improvement in their management. Primary headaches should be included in the health plans of Primary Care.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"40 9","pages":"Pages 849-854"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145425490","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":"Deshidratación, circulación colateral y pronóstico funcional en pacientes con ictus isquémico tratados mediante trombectomía mecánica","authors":"M. Guasch-Jiménez ,&nbsp;P. Camps-Renom ,&nbsp;C. Toscano-Prat ,&nbsp;D. Guisado-Alonso ,&nbsp;A. Martínez-Domeño ,&nbsp;L. Prats-Sánchez ,&nbsp;A. Ramos-Pachón ,&nbsp;I. Fernández-Cadenas ,&nbsp;J.P. Martínez-González ,&nbsp;I. Fernández-Pérez ,&nbsp;C. Avellaneda-Gómez ,&nbsp;E. de Celis-Ruiz ,&nbsp;J. Rodríguez-Pardo ,&nbsp;M. del Mar Freijo ,&nbsp;A. Luna ,&nbsp;F. Moniche ,&nbsp;B. Pardo-Galiana ,&nbsp;J. Ortega-Quintanilla ,&nbsp;J.F. Arenillas ,&nbsp;E. Cortijo ,&nbsp;J. Martí-Fàbregas","doi":"10.1016/j.nrl.2023.04.007","DOIUrl":"10.1016/j.nrl.2023.04.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Dehydration in patients with acute ischemic stroke (AIS) is associated with poor outcome. Our aim is to investigate whether dehydration is associated with collateral circulation (CC) and functional outcome in patients with AIS treated with mechanical thrombectomy (MT).</div></div><div><h3>Method</h3><div>Prospective multicenter study of patients with anterior circulation AIS treated with MT (January 2020–June 2021). Dehydration was assessed with two formulas: plasma osmolarity and urea/creatinine (U/C) ratio. CC was quantified with an automated software (Brainomix Ltd.) on baseline computed tomography angiography. The primary outcome was the association between CC (expressed numerically as the percentage of change between hemispheres) and dehydration (osmolarity ≥295<!--> <!-->mmol/L, U/C ≥80). Secondary outcomes included disability at discharge and at three months of follow-up, assessed using the modified Rankin scale (poor outcome: 3–6). Multivariable logistic and ordinal regression analyses were performed.</div></div><div><h3>Results</h3><div>Two hundred sixty patients were included. 65.8% were dehydrated according to osmolarity and 2.9% according to U/C. There was no association between CC score and dehydration [71% in dehydrated vs 73% in non-dehydrated; <em>p</em> <!-->=<!--> <!-->0.875]. 64.3% of dehydrated patients vs. 46.7% of non-dehydrated patients had a poor outcome at discharge (<em>p</em> <!-->=<!--> <!-->0.026). In multivariable logistic regression analysis, dehydration was an independent predictor of poor outcome at discharge (OR 2.50; <em>p</em> <!-->=<!--> <!-->0.011) and at three months of follow-up (OR 2.27; <em>p</em> <!-->=<!--> <!-->0.046).</div></div><div><h3>Conclusions</h3><div>Dehydration on admission is associated with poor outcome in patients with AIS treated with MT, but it is not related to CC.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"40 9","pages":"Pages 822-829"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145425461","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":"Evaluation of autonomic dysfunction in hereditary transthyretin amyloidosis","authors":"F. Martínez-Valle ,&nbsp;C. Casasnovas-Pons ,&nbsp;M. Romero-Acebal ,&nbsp;L. Galán-Dávila","doi":"10.1016/j.nrl.2023.04.010","DOIUrl":"10.1016/j.nrl.2023.04.010","url":null,"abstract":"<div><h3>Background</h3><div>Autonomic dysfunction is a common manifestation of hereditary transthyretin (ATTRv) amyloidosis that frequently appears early and has a major impact on disease severity, survival, and quality of life. Early detection of autonomic symptoms is paramount to avoid delayed diagnosis or misdiagnosis of ATTRv amyloidosis and thereby achieve timely interventions with novel therapies. We thus require a better understanding and recognition of the warning signs of autonomic nervous system involvement in patients with ATTRv amyloidosis.</div></div><div><h3>Development</h3><div>According to the literature and the expertise of key opinion leaders on ATTRv amyloidosis, early signs and symptoms of autonomic dysfunction often include orthostatic hypotension, gastrointestinal disturbances, and cardiac and sudomotor sympathetic denervation. Assessment methods for a rapid and accurate diagnostic thus comprise blood pressure monitoring, nutritional status evaluation, cardiac imaging techniques, and pathological and neurophysiological tests assessing small fiber function. The COMPASS-31 and Norfolk QOL-DN tests allow assessment of the severity of autonomic dysfunction and its impact on quality of life, respectively.</div></div><div><h3>Conclusion</h3><div>The screening strategy for autonomic dysfunction should involve diverse neurological and non-neurological tests to encompass the wide variety of potential manifestations of autonomic dysfunction in ATTRv amyloidosis. Further studies addressing the correlations among different tests and their prognostic value in different TTR variants are required to establish a single standardized method or the minimum set of tests needed to assess autonomic dysfunction in ATTRv amyloidosis patients.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"40 9","pages":"Pages 915-923"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145425493","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":"Recommendations for the critical reading of clinical trials on disease-modifying drugs for multiple sclerosis","authors":"A. Rivero-de-Aguilar ,&nbsp;M. Mascareñas-García ,&nbsp;M. Pérez-Ríos ,&nbsp;M.A. Llaneza-Gonzalez ,&nbsp;P. Mulero ,&nbsp;M. Mendibe ,&nbsp;À. Rovira ,&nbsp;V. Meca-Lallana ,&nbsp;A.J. García-Ruiz ,&nbsp;L. Landete ,&nbsp;J.R. Vizoso Hermida ,&nbsp;P. Carrascal Rueda ,&nbsp;A. Ruano-Raviña ,&nbsp;M. Puente-Hernandez ,&nbsp;L. Varela-Lema","doi":"10.1016/j.nrl.2023.07.004","DOIUrl":"10.1016/j.nrl.2023.07.004","url":null,"abstract":"<div><h3>Introduction</h3><div>In recent years there has been an increase in the number of disease-modifying drugs (DMDs) approved for multiple sclerosis (MS). The evidence of their safety and efficacy has been obtained through several phase III and IV clinical trials. Acquiring the skills for their appraisal is indispensable for clinicians to assess the most pertinent treatment for patients. The objective of this study is to provide guidance in the critical reading of these trials.</div></div><div><h3>Methods</h3><div>A three-round e-Delphi study was carried out. In the preparatory phase, a multidisciplinary expert panel was established. Panel members were selected based on their scientific credentials and experience, seeking to include people involved in MS diagnosis, treatment and research. A semi-open questionnaire was developed based on key generic and MS-specific methodological instruments identified through a scoping bibliographic search. The experts were required to identify essential aspects for critically appraising clinical trials on DMDs for MS.</div></div><div><h3>Results</h3><div>The expert panel consisted of nine independent leading Spanish experts with long-standing experience with MS (five neurologists, a neuroradiologist, a pharmacologist, a research methodologist and an MS community representative). The e-Delphi study resulted in consensus recommendations intended to help readers in answering five major questions: “Is the study free of bias?”; “Are the included patients adequate?”; “Are the outcome measures appropriate?”; “Are the results relevant?”; and “Is the study transparent?”.</div></div><div><h3>Conclusion</h3><div>This study proposes consensus recommendations intended to guide neurologists in the critical reading of phase III and IV clinical trials on DMDs for MS.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"40 9","pages":"Pages 875-883"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145425491","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":"Impacto de la fatiga en la calidad de vida en los adultos con esclerosis múltiple remitente recurrente","authors":"R. Piñar-Morales ,&nbsp;P.A. Guirado Ruíz ,&nbsp;F.J. Barrero Hernández","doi":"10.1016/j.nrl.2023.06.011","DOIUrl":"10.1016/j.nrl.2023.06.011","url":null,"abstract":"<div><h3>Introduction</h3><div>Fatigue in multiple sclerosis (MS) is defined as the lack of physical and/or mental energy perceived by the individual that interferes with normal activities. It is the most common symptom in MS, present up to 90% of people with MS. Fatigue along with disability, depression, cognitive impairment, and disease-modifying therapy (DMT) affect quality of life (QoL).</div></div><div><h3>Method</h3><div>We designed a prospective observational study in patients with MS and DMT of moderate efficacy to assess the association between fatigue and the epidemiological, clinical, and pharmacological aspects that influence in the QoL. We analyzed variables related to patients, disability, fatigue (MFIS), clinical and radiological activity, depression (BDI), cognitive impairment (SDMT), and QoL (EQ-5D).</div></div><div><h3>Results</h3><div>We included 91 people, 65.9% women, mean age 43.9 years. The DMT were: 27.4% interferon-β, 15.38% glatiramer acetate, 9.89% teriflunomide, and 47.25% dimethyl fumarate. The median of the EDSS was 1.5 points. 40.9% have presented fatigue, 36.3% cognitive deterioration and 30.7% of the patients depression.</div></div><div><h3>Conclusions</h3><div>Patients with fatigue are older, more disabled, have a higher prevalence of depression and worse QoL. Evolution time, relapses, MRI lesion load, and DMTs are not associated with fatigue. Fatigue is a frequent symptom in patients with MS that influences in the QoL, hence the importance of its diagnosis and treatment.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"40 9","pages":"Pages 864-874"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145425489","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":"Tendencia de la mortalidad por esclerosis múltiple según sexo: Chile 1997-2019","authors":"J. Arriagada Opazo ,&nbsp;V. Farah González ,&nbsp;M. González Delgadillo ,&nbsp;L. Núñez-Franz ,&nbsp;C. Morales Garcia ,&nbsp;P. Jiménez Rodríguez","doi":"10.1016/j.nrl.2023.04.008","DOIUrl":"10.1016/j.nrl.2023.04.008","url":null,"abstract":"<div><h3>Background</h3><div>An increasing trend has been observed in the prevalence of Multiple Sclerosis (MS) globally. It is estimated that a total of 2.8 million people live with MS worldwide. In 2008, Chile started a pilot program for the Modifying Therapy of MS, and its clinical practice guideline.</div></div><div><h3>Aim</h3><div>This study aims to analyze the trend of the MS mortality rate in Chile from 1997 to 2019 disaggregated by sex and latitude.</div></div><div><h3>Methods</h3><div>MS mortality data (ICD-10, G35) from 1997-2019 were extracted from the Department of Health Statistical Information and population data from the National Institute of Statistics. Standardized mortality rates (SMRs) by age were calculated. The trend of the SMR was analyzed using Joinpoint and with RiskDiff the effect of the risk of dying, the structure, and the size of the population on the crude mortality rate was evaluated.</div></div><div><h3>Results</h3><div>The trend of the TME has been decreasing significantly since 2005. When disaggregating by sex the decrease was not significant. According to latitude, the north and center south have a significant decreasing trend; in the south, the decreasing trend is not significant. There is an increase of 25% in the crude mortality rate due to the change in the structure of the population and a decrease of 25.46% is attributed to the risk of dying.</div></div><div><h3>Conclusion</h3><div>The SMR due to MS in Chile during 1997-2019 has decreased, in addition, a decreasing SMR is evidenced only in the northern zone. The crude rate has increased as a consequence of changes in the population, however, the risk of dying has decreased, especially in men.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"40 9","pages":"Pages 840-848"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145425463","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":"Psychological resilience mediates the relationship between perceived neuropsychological impairment and quality of life in a sample of patients with multiple sclerosis","authors":"Y. Broche-Pérez ,&nbsp;R.M. Jiménez-Morales ,&nbsp;L.O. Monasterio-Ramos ,&nbsp;J. Bauer","doi":"10.1016/j.nrl.2023.03.008","DOIUrl":"10.1016/j.nrl.2023.03.008","url":null,"abstract":"<div><h3>Introduction</h3><div>The impact of subjective cognitive concerns (SCCs) on the quality of life (QoL) of patients with multiple sclerosis (PwMS) has practically not been studied.</div></div><div><h3>Objectives</h3><div>In this study, the relationship between subjective cognitive concerns and quality of life in PwMS was explored. Furthermore, to explore whether psychological resilience acts as a mediator in the relationship between SCCs and QoL.</div></div><div><h3>Methods</h3><div>A total of 214 PwMS were surveyed using the Multiple Sclerosis Quality of Life Inventory, the Multiple Sclerosis Neuropsychological Questionnaire (MSNQ) and the Connor-Davidson Resilience Scale.</div></div><div><h3>Results</h3><div>Our results showed that, SCCs is a predictor of levels of perceived QoL in PwMS. Patients who report higher scores on the MSNQ also showed a worse quality of life in global terms. The results also showed that resilience mediates the relationship between SCCs and QoL, both for the physical dimension of quality of life (physical health composite) and for the mental health dimension (mental health composite). In our patients, as resilience levels increase, the negative impact of SCCs on QoL decreases.</div></div><div><h3>Conclusions</h3><div>Considering that resilience is a modifiable protective factor, the implementation of interventions aimed at enhancing resilience can have a favorable impact on the psychological well-being and quality of life of patients with multiple sclerosis.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"40 8","pages":"Pages 753-761"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190000","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":"Neuronopatía sensitiva en paciente con anticuerpos anti-FGFR3 y adenocarcinoma de pulmón, ¿casualidad o causalidad?","authors":"L. Fernández-Llarena,&nbsp;A. Moreno-Estébanez,&nbsp;A. Gonzalez-Eizaguirre,&nbsp;A. Jauregi-Barrutia","doi":"10.1016/j.nrl.2024.08.001","DOIUrl":"10.1016/j.nrl.2024.08.001","url":null,"abstract":"","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"40 8","pages":"Pages 807-810"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189991","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 single institution series of intravascular lymphoma: Neurological manifestations and neuroimaging findings","authors":"J. Corroza ,&nbsp;C. Alburquerque ,&nbsp;L. Martínez-Martínez ,&nbsp;I. Gastón ,&nbsp;L. Torné ,&nbsp;M.C. Gil-Alzueta ,&nbsp;J. Oteiza ,&nbsp;T. Cabada ,&nbsp;M.C. Viguria ,&nbsp;A. Panizo ,&nbsp;M.E. Erro","doi":"10.1016/j.nrl.2023.11.009","DOIUrl":"10.1016/j.nrl.2023.11.009","url":null,"abstract":"<div><h3>Background</h3><div>Intravascular lymphoma (IVL) is a diffuse large B-cell lymphoma characterized by occlusion of small vessels of organs by malignant cells with special tropism for the nervous system. Our purpose has been to describe a series of IVL diagnosed in our center and to compare the results with those of the literature.</div></div><div><h3>Methods</h3><div>A retrospective review of the clinical, imaging, and pathological data of consecutive patients with IVL in the last 20 years was performed. Pathology department database was the source of patient identification.</div></div><div><h3>Results</h3><div>We identified six cases (three males and three females), with a median age at diagnosis of 54.64 (interquartile range (IR) 51.93–59.67). Five of them (83.3%) debuted with neurological manifestations. The median time to diagnosis was 3.77 months. On cranial magnetic resonance imaging, the findings consisted of multiple white matter and corpus callosum lesions (some of them with enhancement or hemorrhagic foci) and multifocal infarcts with hemorrhagic transformation. One patient displayed leptomeningeal branch aneurysms. A proton emission tomography with fluorodeoxyglucose (PET-FDG) was performed in five patients showing areas of elevated metabolism in all of them. Four patients underwent targeted biopsy, which allowed the diagnosis of IVL to be established in three. Four of the five patients who received treatment remained in complete remission with a median progression-free survival of 69.62 months (IR 49.11–162.82).</div></div><div><h3>Conclusions</h3><div>IVL begins frequently with neurological manifestations, which must alert the neurologist to be aware of this entity. PET-FDG helps to identify biopsy-accessible lesions and facilitate early diagnosis of IVL.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"40 8","pages":"Pages 768-776"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189627","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}