Revista de neurologia最新文献

{"title":"Cognitive Sensory Motor Training Therapy in Stroke Patients: A Systematic Review.","authors":"Mirari Ochandorena-Acha, Sandra Rierola-Fochs, Jose Antonio Merchán-Baeza, Manuel González-Sánchez, David Pérez-Cruzado","doi":"10.31083/RN50584","DOIUrl":"10.31083/RN50584","url":null,"abstract":"<p><strong>Background: </strong>Stroke patients' sensorimotor function is often affected, leading them to experience limitations in daily living activities. Cognitive sensorimotor training therapy, or Perfetti's method, is designed to recuperate both motor and sensory aspects through activating cognitive processes. The purpose of the study was to determine the effectiveness of cognitive sensorimotor training therapy compared with other interventions in enabling the recovery of upper-limb function after a stroke.</p><p><strong>Methods: </strong>A systematic literature review was conducted on Perfetti's method from the first available publication to January 2026, consulting the PubMed, Web of Science, and Scopus databases. Two independent authors performed the search. The Physiotherapy Evidence Database (PEDro) scale was used to assess the internal validity.</p><p><strong>Results: </strong>Four studies with a variety of methodological design were included. Eight outcome variables related to upper limb's recovery were analyzed. Upper-limb function was the most studied outcome, but only one study showed statistically significant differences between groups. Overall, participants undergoing Perfetti's method tended to show greater post-intervention improvements compared with control interventions; however, between-group differences were generally not statistically significant.</p><p><strong>Conclusions: </strong>The included studies show heterogeneity regarding duration and intensity, among others, and it is difficult to draw robust conclusions. However, the results indicate some clinical benefits of Perfetti's method, although further well-designed studies are needed.</p>","PeriodicalId":21281,"journal":{"name":"Revista de neurologia","volume":"81 6","pages":"50584"},"PeriodicalIF":0.6,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13339781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148397517","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":"The Dual Role of VEGF in Intracerebral Haemorrhage: From Pathological Mechanisms to Therapeutic Opportunities.","authors":"Yunlian Niu, Xiaoqian Wang, Yichen Huang, Xuemei Zhang, Yijie You, Peiyuan Ding, Fengbing Sun, Jian Zhang","doi":"10.31083/RN51435","DOIUrl":"10.31083/RN51435","url":null,"abstract":"<p><p>An intracerebral haemorrhage (ICH) is a general type of haemorrhage in the brain, which arises due to the rupture of cerebral blood vessels. Many molecules have been investigated for their potential ability to modify hemostasis and blood-brain barrier function in ICH. Vascular endothelial growth factor (VEGF) is highly expressed in some diseases and helps induce angiogenesis. VEGF serves as a key mediator of the angiogenic pathway and is now recognized as a major contributor to cerebrovascular diseases; many promising results have been obtained in animal therapeutic experiments. VEGF promotes blood vessel growth (angiogenesis) to increase oxygen and nutrient supply in damaged tissues, and exerts neuroprotective effects in processes including inflammation, apoptosis, neurotrophy, and protein clearance. This review examines the dual roles of VEGF in the pathology of ICH and explores therapeutic targets of VEGF pathways for this disease.</p>","PeriodicalId":21281,"journal":{"name":"Revista de neurologia","volume":"81 6","pages":"51435"},"PeriodicalIF":0.6,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13339787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148397672","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":"EEG Quantification: A New Dawn for an Old Tool.","authors":"Jesús Pastor","doi":"10.31083/RN52778","DOIUrl":"10.31083/RN52778","url":null,"abstract":"","PeriodicalId":21281,"journal":{"name":"Revista de neurologia","volume":"81 6","pages":"52778"},"PeriodicalIF":0.6,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13339776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148397657","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":"¹⁸F-FDG PET/MRI Multiparametric Imaging Features for Predicting MYCN Amplification Status in Children With High-Risk Neuroblastoma.","authors":"Jiangtao Liang, Feng Li, Zhongxiang Ding, Bing Yan, Yanfang Zhu, Fangxiao Wang, Weiling Xuan","doi":"10.31083/RN51030","DOIUrl":"10.31083/RN51030","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to explore the value of multiparameter imaging features of ¹⁸F-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging (¹⁸F-FDG PET/MRI) in predicting <i>MYCN</i> amplification status in children with high-risk neuroblastoma (HR-NB) and to construct a combined predictive model.</p><p><strong>Methods: </strong>A retrospective analysis of the clinical and PET/MRI imaging data of 121 children with HR-NB who were examined at our center between December 2018 and December 2025. According to the tumor <i>MYCN</i> amplification status, patients were divided into amplification (MNA group) and non-amplified (MYCN-NA group) groups. The differences in clinical characteristics and PET/MRI parameters between the two groups were also compared. Multivariate logistic regression analysis was used to identify the independent predictive factors. The predictive performance of each parameter and the combined model was evaluated using receiver operating characteristic (ROC) curves, calibration curves, and decision curves. The combined model was visualized using nomograms.</p><p><strong>Results: </strong>The imaging-defined risk factor (IDRF) positivity rate, proportion of stage M cases, and detection rates of tumor necrosis and hemorrhage were significantly higher in the MNA group than in the MYCN-NA group (all <i>p</i> < 0.05). The MNA group demonstrated a significantly larger mean diameter, higher maximum standardized uptake value (SUV_max), mean standardized uptake value (SUV_mean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG), and a significantly lower mean apparent diffusion coefficient (ADC_mean) (all <i>p</i> < 0.001). Multivariate regression analysis showed that SUV_max (odds ratio (OR) = 1.71, 95% CI: 1.02-2.86, <i>p</i> = 0.042), MTV (OR = 1.075, 95% CI: 1.009-1.145, <i>p</i> = 0.026), and ADC_mean (OR = 0.34, 95% CI: 0.16-0.72, <i>p</i> = 0.004) were independent predictors of <i>MYCN</i> amplification. The combined model predicted <i>MYCN</i> amplification with an AUC of 0.916 (95% CI: 0.867-0.965), sensitivity of 83.3%, and specificity of 81.0%, outperforming all single parameters. Calibration and decision curve analyses indicated good calibration and clinical utility of the combined model.</p><p><strong>Conclusion: </strong>The predictive model constructed by combining SUV_max, MTV, and ADC_mean can noninvasively distinguish <i>MYCN</i> amplification status in HR-NB patients.</p>","PeriodicalId":21281,"journal":{"name":"Revista de neurologia","volume":"81 6","pages":"51030"},"PeriodicalIF":0.6,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13339796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148397606","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 Immunotherapy and Generalization in Ocular Myasthenia Gravis as a Function of Antibody Status.","authors":"Siyu Xie, Ran Guo, Bo Jin, Wenting Guo, Yifan Cheng, Wenli Song, Chunrong Li, Manman Zhang, Yiqi Wang","doi":"10.31083/RN50142","DOIUrl":"10.31083/RN50142","url":null,"abstract":"<p><strong>Background: </strong>Ocular myasthenia gravis (OMG) is an autoimmune disorder characterized by weakness of the extraocular muscles. This study was developed to investigate the relationship between immunotherapy efficacy and OMG generalization as a function of antibody status, and to explore the efficacy of different immunotherapies in preventing OMG generalization.</p><p><strong>Methods: </strong>This retrospective study included 60 patients admitted to our hospital with initial OMG who were followed for more than two years. Time to generalization was calculated from symptom onset. The proportional hazards assumption was tested using time-dependent covariates, employing Cox regression and Kaplan-Meier analyses to analyze associations for this patient cohort.</p><p><strong>Results: </strong>Among the 60 patients (28 converted OMG; 32 pure OMG), the median time to generalization was 52 months (interquartile range (IQR): 16-117). Antibody positivity was an independent risk factor for generalization (hazard ratio (HR) = 3.89, 95% confidence interval [CI]: 1.26-12.01, <i>p</i> = 0.018). In antibody-positive patients, immunotherapy significantly reduced generalization risk (HR = 0.17, 95% CI: 0.04-0.62, <i>p</i> = 0.008).</p><p><strong>Conclusion: </strong>The time from OMG onset to generalization can be prolonged. While antibody positivity was independently associated with generalization risk in this study cohort, immunotherapy was linked to a time-stable reduction in this risk among antibody-positive patients. These findings provide a preliminary basis for antibody-status-based individualized treatment in OMG.</p>","PeriodicalId":21281,"journal":{"name":"Revista de neurologia","volume":"81 6","pages":"50142"},"PeriodicalIF":0.6,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13339795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148397586","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":"Systematic Review and Meta-Analysis of the Efficacy of Fecal Microbiota Transplantation in Parkinson's Disease: An Exploration Based on UPDRS and Cognitive Scores.","authors":"Benyao Liang, Jie Zou, Xiangyu Mao, Ning Xie, Zhaohui Liang","doi":"10.31083/RN50106","DOIUrl":"10.31083/RN50106","url":null,"abstract":"<p><strong>Background: </strong>Parkinson's disease (PD) is a common neurodegenerative disorder that has been increasingly linked to gut-brain axis dysfunction. Fecal microbiota transplantation (FMT), a microbiome-targeted intervention, has shown theoretical and preliminary clinical potential in PD, but randomized clinical evidence remains limited. This review aimed to systematically evaluate the effects of FMT on motor, non-motor, and cognitive outcomes in patients with PD.</p><p><strong>Methods: </strong>A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-compliant systematic review and meta-analysis of randomized controlled trials (RCTs) comparing FMT with placebo or conventional care in PD was conducted. Two reviewers independently screened studies, extracted data, and assessed risk of bias. Pooled analyses were performed using a random-effects model, and the certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach.</p><p><strong>Results: </strong>Five RCTs involving 226 participants were included. No statistically significant differences were observed between the FMT and control groups in Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Parts I-III, Montreal Cognitive Assessment (MoCA), or Mini-Mental State Examination (MMSE) scores at any assessed follow-up time, with heterogeneity generally low to moderate across outcomes.</p><p><strong>Conclusions: </strong>Based on current evidence from five small RCTs, FMT did not demonstrate a statistically significant benefit for motor, daily living, or cognitive outcomes in PD. However, these findings should be interpreted cautiously, given the limited sample size, short follow-up duration, and between-study differences in intervention protocols. Larger, well-designed RCTs with standardized FMT protocols and longer follow-up are needed. The PROSPERO Registration: This systematic review was registered in the PROSPERO database under registration number CRD420251121443, https://www.crd.york.ac.uk/PROSPERO/view/CRD420251121443.</p>","PeriodicalId":21281,"journal":{"name":"Revista de neurologia","volume":"81 6","pages":"50106"},"PeriodicalIF":0.6,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13339778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148397624","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":"Anti-Melanoma Differentiation-Associated Gene 5 Antibody-Positive Juvenile Dermatomyositis Presenting With Predominant Joint Contractures.","authors":"Qiyun Liu, Ke Zheng, Ruifang Bai, Qiaoqiao Cui, Lizhen Wang, Jianli Wang, Dan Liu, Juan Wang, Wei Zhang, Xueli Chang","doi":"10.31083/RN51324","DOIUrl":"10.31083/RN51324","url":null,"abstract":"<p><strong>Introduction: </strong>Anti-melanoma differentiation-associated gene 5 (MDA5) positive juvenile dermatomyositis (JDM) (anti-MDA5+ JDM) is a distinct subtype of JDM characterized by marked clinical heterogeneity. Although cutaneous manifestations and interstitial lung disease (ILD) are well recognized, atypical musculoskeletal presentations may lead to diagnostic delay.</p><p><strong>Clinical case: </strong>We report a 16-year-old male with anti-MDA5+ JDM who presented with progressive joint contractures as the predominant manifestation over a 2-year period. The patient also exhibited restricted mouth opening, with a classical dermatomyositis (DM) cutaneous rash absent or only mild, and proximal muscle weakness, mild to moderate. Laboratory evaluation revealed high-titer anti-MDA5 antibodies and a markedly elevated serum immunoglobulin E (IgE) level. Magnetic resonance imaging (MRI) demonstrated periarticular and soft-tissue involvement, and muscle biopsy confirmed pathological features consistent with DM. Treatment with systemic glucocorticoids in combination with methotrexate resulted in substantial improvement in joint mobility, with good tolerability during follow-up.</p><p><strong>Conclusions: </strong>Progressive contractures can occasionally become the predominant presenting manifestation in anti-MDA5+ JDM and contribute to diagnostic delay. This case underscores the importance of early evaluation for idiopathic inflammatory myopathies (IIM), including myositis-specific antibody (MSA) testing and muscle biopsy, in adolescents with unexplained progressive joint contractures.</p>","PeriodicalId":21281,"journal":{"name":"Revista de neurologia","volume":"81 6","pages":"51324"},"PeriodicalIF":0.6,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13339786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148397553","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":"[Effectiveness and Risk of Recurrence of Pulsed Radiofrequency in Trigeminal Neuralgia and Chronic Cluster Headache].","authors":"Marta Domínguez, Alicia Gonzalez-Martinez, Sonia Quintas, Carmen Montero, Iris Fernández-Lázaro, Elena Rojo, Manuel Muñoz, Dolores Ochoa, Concepción Pérez, José Vivancos, Ana Beatriz Gago-Veiga","doi":"10.31083/RN51129","DOIUrl":"10.31083/RN51129","url":null,"abstract":"<p><strong>Introduction: </strong>Percutaneous pulsed radiofrequency (PPRF) is a minimally invasive neuromodulation technique used in chronic pain management. Our aim was to evaluate its effectiveness and safety in refractory cases of trigeminal neuralgia (TN) and chronic cluster headache (CH).</p><p><strong>Methods: </strong>We conducted a retrospective study of patients with TN and CH diagnosed according to the International Classification of Headache Disorders, 3rd edition (ICHD-3) criteria and treated with PPRF (Gasserian ganglion for TN and sphenopalatine ganglion for CH) over an 8-year period. Effectiveness at 3 months was assessed by evaluating reduction in the number of pain days in TN and number of attacks in CH, ≥50% response rate, visual analogue scale (VAS), Patient Global Impression of Improvement (PGI-I), and pain recurrence.</p><p><strong>Results: </strong>Twenty-five patients met the inclusion criteria, including 19 with TN and 6 with CH, with a mean age of 76 and 52 years, respectively. Clinical improvement was observed in 14/19 (73.6%) patients with TN and 5/6 (83.3%) patients with CH. A ≥50% response rate was achieved in 11/14 (78.6%) patients with TN and 4/6 (66.7%) patients with CH. VAS scores decreased at 3 months in both groups (<i>p</i> < 0.0001 in TN; <i>p</i> = 0.06 in CH). PGI-I was rated as \"better\" or \"much better\" in 10/19 (52.6%) patients with TN and 5/6 (83.3%) patients with CH. Pain recurrence occurred in 13/14 (92.8%) patients with TN and 5/5 (100%) patients with CH, mainly after 1 year following the first procedure (7/13 TN and 2/5 CH). No major adverse events were reported.</p><p><strong>Conclusions: </strong>In our series, PPRF appears to be an effective and safe treatment for refractory TN and CH. Although the study is retrospective and the sample size is limited, particularly in CH, these findings should be considered preliminary but clinically relevant. Despite the high recurrence rate, given its low complication profile, it may represent a treatment option for patients who are not candidates for surgical procedures.</p>","PeriodicalId":21281,"journal":{"name":"Revista de neurologia","volume":"81 5","pages":"51129"},"PeriodicalIF":0.6,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13221675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148056492","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":"P300 Event-Related Potentials as Cognitive Biomarkers in Neurological and Neuropsychiatric Disorders: A Systematic Review.","authors":"Evgenia Gkintoni, Apostolos Vantarakis, Philippos Gourzis","doi":"10.31083/RN49664","DOIUrl":"10.31083/RN49664","url":null,"abstract":"<p><strong>Background: </strong>Neurological and neuropsychiatric disorders constitute a major global health challenge. The P300 event-related potential, an electroencephalography-derived measure of cognitive processing, has emerged as a promising biomarker for diagnosis, treatment monitoring, and outcome prediction. This systematic review examines P300's role across neurological and neuropsychiatric disorders, evaluating how P300 latency (processing speed) and amplitude (attentional resource allocation) may reflect neurocognitive dysfunction.</p><p><strong>Methods: </strong>Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, we searched PubMed, Scopus, and Web of Science for randomized controlled trials and controlled studies published January 2020-August 2025. Six research domains were examined: dementia spectrum disorders (Research Question, RQ1), acquired brain injury and disorders of consciousness (RQ2), mood and anxiety disorders (RQ3), neurodevelopmental disorders (RQ4), psychotic disorders and addiction (RQ5), and chronic neurological conditions (RQ6). Risk of bias was assessed using a modified Cochrane tool. Of 125 records identified, 52 studies met the inclusion criteria.</p><p><strong>Results: </strong>P300 emerged as a promising transdiagnostic biomarker. Prolonged latency and reduced amplitude consistently characterized clinical populations versus controls (pooled standardized mean difference [SMD] = -0.72, 95% confidence interval [CI]: -0.89 to -0.55; I² = 67.3%). In dementia spectrum disorders, P300 latency distinguishes mild cognitive impairment from healthy aging. In disorders of consciousness, the emergence of the P300 waveform provided objective indices of residual cognitive capacity. In mood disorders, baseline amplitude predicted therapy outcomes. In addition, P300 correlated with craving severity. Neuromodulation (transcranial direct current stimulation [tDCS], repetitive transcranial magnetic stimulation [rTMS]) produced the most robust normalization effects across categories. P300 changes occurred within 3 days to 6 weeks of treatment, potentially enabling earlier detection of response than conventional assessments. Portable electroencephalography (EEG) systems demonstrated adequate sensitivity for clinical applications.</p><p><strong>Conclusions: </strong>P300 shows promise as a non-invasive biomarker for cognitive dysfunction across neuropsychiatric disorders. Its diagnostic utility, treatment responsiveness, and prognostic potential support clinical translation. Near-term applications include consciousness assessment, cognitive screening in dementia, and treatment monitoring. However, standardization of protocols, multi-site validation, and scalable technologies require further development. Advancing P300 research through interdisciplinary collaboration may contribute to precision psychiatry and population-level mental health strategies.</p>","PeriodicalId":21281,"journal":{"name":"Revista de neurologia","volume":"81 5","pages":"49664"},"PeriodicalIF":0.6,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13221677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148056544","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":"Surgical Treatment of an Aneurysm in the Subacute Stage of Hemorrhagic Moyamoya Disease: Aneurysm Resection Combined With STA-MCA Bypass: A Case Report.","authors":"Yuezhu Cai, Jiancong Zheng, Jinghui Lin, Jie Wei, Pengyu Lin, Tao Feng, Jiaqi Lin, Haitao Xu","doi":"10.31083/RN50491","DOIUrl":"10.31083/RN50491","url":null,"abstract":"<p><strong>Introduction: </strong>There is no consensus on the optimal management of intracranial aneurysms in patients with moyamoya disease. Here, we report a case of a patient in the subacute hemorrhagic stage of moyamoya disease with a presumed pseudoaneurysm detected on interval imaging, who was treated with aneurysm resection combined with superficial temporal artery (STA)-middle cerebral artery (MCA) bypass. This report illustrates a feasible individualized surgical approach for similar cases.</p><p><strong>Case report: </strong>A 27-year-old male without a prior history of cerebrovascular disease was admitted for a right temporal intracerebral hemorrhage following external ventricular drainage. Initial computed tomography angiography (CTA) at admission showed no aneurysm. One week later, follow-up CTA revealed a newly developed 10 × 9 mm aneurysm in the right MCA region. Subsequent digital subtraction angiography (DSA) demonstrated occlusion of the right MCA M1 segment with the development of characteristic moyamoya collateral networks. The patient underwent microsurgical resection of the aneurysmal lesion, combined with a right STA-MCA bypass. Postoperative imaging demonstrated complete obliteration of the aneurysm, patency of the bypass, and a reduction in moyamoya collateral vessels. Histopathological examination revealed a red blood cell clot surrounded by fibrous connective tissue without definitive evidence of a preserved arterial wall, consistent with a presumed pseudoaneurysm. The patient recovered well, with improved neurological function on follow-up imaging.</p><p><strong>Conclusions: </strong>In patients with moyamoya disease, a peripheral aneurysmal lesion may become detectable on interval imaging after an initially negative CTA and may represent an unstable hemorrhage-related vascular lesion. In carefully selected cases, lesion resection combined with STA-MCA bypass during the subacute phase may be a feasible individualized treatment strategy, particularly when direct lesion treatment and hemodynamic revascularization are both required. However, longer clinical and imaging follow-up is needed before any firm conclusions can be drawn regarding outcome improvement, or prevention of rebleeding.</p>","PeriodicalId":21281,"journal":{"name":"Revista de neurologia","volume":"81 5","pages":"50491"},"PeriodicalIF":0.6,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13221674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148056537","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}