Neurologist最新文献_第6页

Ischemic Stroke Associated With Pulmonary Arteriovenous Malformations: Two Case Reports and a Literature Review. 缺血性脑卒中伴肺动静脉畸形：2例报告及文献复习。

IF 1 4区医学

Neurologist Pub Date : 2026-01-01 DOI: 10.1097/NRL.0000000000000645

Gabriel García-Alcántara, Rocío Vera-Lechuga, Beatriz Martínez-García, Cristina Moreno-López, Rodrigo López-Rebolledo, Vicente Gómez Del Olmo, Antonio Cruz-Culebras, Sebastián García-Madrona, María Consuelo Matute, Jaime Masjuan, Alicia De Felipe

{"title":"Ischemic Stroke Associated With Pulmonary Arteriovenous Malformations: Two Case Reports and a Literature Review.","authors":"Gabriel García-Alcántara, Rocío Vera-Lechuga, Beatriz Martínez-García, Cristina Moreno-López, Rodrigo López-Rebolledo, Vicente Gómez Del Olmo, Antonio Cruz-Culebras, Sebastián García-Madrona, María Consuelo Matute, Jaime Masjuan, Alicia De Felipe","doi":"10.1097/NRL.0000000000000645","DOIUrl":"10.1097/NRL.0000000000000645","url":null,"abstract":"Introduction: Pulmonary arteriovenous malformations (PAVMs) are infrequently associated with ischemic stroke. PAVMs rarely cause large vessel occlusions (LVO), whereas medium (MeVOs) and distal vessel occlusions (DVOs) are more common. Isolated PAVMs are uncommon but may cause paradoxical embolisms.Case reports: We describe 2 clinical cases of patients with ischemic stroke associated with PAVMs. One patient suffered a stroke caused by a MeVO and was successfully treated with intravenous thrombolysis (IVT). Transcranial Doppler ultrasound (TCD) with bubble test revealed a right-to-left shunt, but transesophageal echocardiography (TEE) ruled out a patent foramen ovale (PFO) in both patients. The presence of PAVMs was confirmed by pulmonary computed tomography angiography (CTPA), and they were successfully treated with embolization. The patients received antiplatelet therapy for secondary prevention, and no recurrence of ischemic events occurred during the follow-up period (12 mo for case 1 and 24 mo for case 2).Conclusions: Pulmonary arteriovenous malformations are rarely associated with ischemic stroke. Embolization is considered the treatment of choice for these patients. After the procedure, antiplatelet therapy is generally recommended, although anticoagulation may be indicated in selected patients.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"22-25"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145402577","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}

引用次数: 0

Acute Bilateral Hearing Loss: An Unheard of Thalamic Syndrome. 急性双侧听力损失：闻所未闻的丘脑综合征。

IF 1 4区医学

Neurologist Pub Date : 2026-01-01 DOI: 10.1097/NRL.0000000000000644

Kathleen Graveran-Perez, Lizabeth Kaminoff, Cleo Zarina Reyes, Timothy Ambrose, Elan Miller

{"title":"Acute Bilateral Hearing Loss: An Unheard of Thalamic Syndrome.","authors":"Kathleen Graveran-Perez, Lizabeth Kaminoff, Cleo Zarina Reyes, Timothy Ambrose, Elan Miller","doi":"10.1097/NRL.0000000000000644","DOIUrl":"10.1097/NRL.0000000000000644","url":null,"abstract":"Introduction: Despite the involvement of the thalamus in the auditory pathway, hearing loss is not commonly recognized as a sequela of thalamic hemorrhage. Interestingly, only a few case reports in the literature describe thalamic hemorrhage as a cause of sudden sensorineural hearing loss (SSHL). The use of brainstem evoked potentials (BAEPs) to evaluate hearing loss in these patients has not been reported in the literature.Case report: A 56-year-old man presented to the emergency room for an acute onset of hearing loss and left perioral and foot numbness. On neurological examination, he was found to have mild left hemiparesis, sensory deficit, ataxia, and complete hearing loss. His National Institutes of Health Stroke Scale was 6. Initial noncontrast head computed tomography (CT) showed a focal acute parenchymal hemorrhage in the right thalamus and posterior limb of the internal capsule. Magnetic resonance imaging (MRI) of the brain confirmed the presence of the right thalamocapsular hematoma, and the gradient echo sequence demonstrated remote hematoma in the left lentiform nucleus. Otolaryngology was consulted and diagnosed the patient with idiopathic sudden sensorineural hearing loss. Given the unclear etiology, BAEPs were pursued and revealed an intact brainstem auditory pathway and suggested reduced activity in thalamic auditory regions. He was discharged on prednisone taper and referred for formal outpatient audiometry testing.Conclusions: This case highlights sensorineural hearing loss as a potential thalamic syndrome and the utilization of BAEPs as diagnostic tools in suspected central origin of hearing impairment.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"18-21"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304238","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}

引用次数: 0

Efficacy of Carotid Artery Stenting Without Embolic Protection Device for Carotid Stenosis: A Retrospective Cohort Study from a Major Neurointerventional Center. 无栓塞保护装置的颈动脉支架置入治疗颈动脉狭窄的疗效：一项来自主要神经介入中心的回顾性队列研究。

IF 1 4区医学

Neurologist Pub Date : 2026-01-01 DOI: 10.1097/NRL.0000000000000642

Seyedbahaadin Siroos, Morteza Taheri, Aryoobarzan Rahmatian, Kavous Firouznia, Mojtaba Khazaei, Hossein Ghanaati

{"title":"Efficacy of Carotid Artery Stenting Without Embolic Protection Device for Carotid Stenosis: A Retrospective Cohort Study from a Major Neurointerventional Center.","authors":"Seyedbahaadin Siroos, Morteza Taheri, Aryoobarzan Rahmatian, Kavous Firouznia, Mojtaba Khazaei, Hossein Ghanaati","doi":"10.1097/NRL.0000000000000642","DOIUrl":"10.1097/NRL.0000000000000642","url":null,"abstract":"Objectives: This study aims to assess the effectiveness and safety of carotid artery stenting (CAS) as a method for reducing the risk of stroke in patients with carotid stenosis (CS).Methods: This retrospective cohort study analyzed all patients with internal carotid artery (ICA) stenosis who underwent CAS at a single neurointerventional center from January 2016 to September 2022. Patients with concurrent intracranial stenosis, previous CEA, interfering neurological disorders, or incomplete data were excluded. Preoperative evaluations included comprehensive clinical assessments, and CAS procedures were conducted without embolic protection devices (EPDs). Postoperative monitoring involved intensive care unit (ICU) observation and MRI in selected cases.Results: The study included 91 patients (mean age 69.2±10.2 y, 65.9% male). The right ICA was involved in 46 patients and the left in 45 patients. The degree of stenosis significantly decreased from 80.58±12.53% to 16.61±9.54% post-CAS. Early neurological complications were observed in 5.4% of patients. Transient bradycardia during the procedure was common but resolved with atropine. One patient experienced prolonged bradycardia, but it resolved without lasting effects. Two patients had transient contralateral paresis postprocedure; one showed diffusion restriction on MRI but both recovered fully. Severe complications included one death due to intracranial hemorrhage and one case of hemiplegia with partial recovery over 3 months. Follow-up ultrasound in 30 patients showed no instances of restenosis.Conclusions: CAS significantly reduces CS and potentially aids in stroke prevention. The findings suggest that CAS without EPDs may achieve similar early outcomes, particularly in regions with limited EPD access.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"14-17"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145702736","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}

引用次数: 0

The Effects of Transcranial Direct Current Stimulation on Acute Ischemic Stroke-A Randomized, Double-blind, Sham-Controlled Study. 经颅直流电刺激对急性缺血性脑卒中的影响——一项随机、双盲、假对照研究。

IF 1 4区医学

Neurologist Pub Date : 2026-01-01 DOI: 10.1097/NRL.0000000000000643

Seong-Hoon Kim, Taewon Kim, Jaseong Koo, Okjin Park, Hyeonseok Jeong, In-Uk Song

{"title":"The Effects of Transcranial Direct Current Stimulation on Acute Ischemic Stroke-A Randomized, Double-blind, Sham-Controlled Study.","authors":"Seong-Hoon Kim, Taewon Kim, Jaseong Koo, Okjin Park, Hyeonseok Jeong, In-Uk Song","doi":"10.1097/NRL.0000000000000643","DOIUrl":"10.1097/NRL.0000000000000643","url":null,"abstract":"Objectives: Transcranial direct current stimulation (tDCS) is a noninvasive neuromodulation technique that has shown potential in enhancing motor recovery and cognitive function in chronic stroke patients. However, the application of tDCS in the acute setting of ischemic stroke remains largely unexplored.Methods: This randomized, double-blind, sham-controlled study enrolled 60 acute ischemic stroke patients within 2 days of onset. Participants were randomly assigned to receive either real tDCS or sham stimulation for 5 sessions over 7 days. The primary outcomes were changes in the Fugl-Meyer (FM) motor scale, National Institutes of Health Stroke Scale (NIHSS) scores, incidence of early neurological deterioration, and favorable functional outcome (modified Rankin Scale ≤2) at 3 months poststroke.Results: Early neurological deterioration occurred in 6.7% of the tDCS group and 26.7% of the sham group, but this difference did not reach statistical significance ( P =0.065). No significant differences were observed between the tDCS and sham groups in terms of FM scores, NIHSS scores, or favorable functional outcomes at 3 months. No significant group-by-time interactions were found for FM scores ( P =0.481) or NIHSS scores ( P =0.157).Conclusions: This study demonstrates that tDCS can be safely administered in the acute phase of ischemic stroke. While no significant effects on motor function or neurological outcomes were observed compared with sham stimulation, the trend toward reduced early neurological deterioration warrants further investigation.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"1-5"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356511","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}

引用次数: 0

Extracorporeal Counterpulsation Therapy Enhances Neurological Outcomes in Patients Experiencing Acute Ischemic Stroke. 体外反搏治疗提高急性缺血性脑卒中患者的神经预后。

IF 1 4区医学

Neurologist Pub Date : 2025-11-01 DOI: 10.1097/NRL.0000000000000616

Jiaxuan Li, Xinhui Jia, Xinyi Chen, Jie Hu, Xun He, Yueyu Zhang, Yi Tang, Juncang Wu

{"title":"Extracorporeal Counterpulsation Therapy Enhances Neurological Outcomes in Patients Experiencing Acute Ischemic Stroke.","authors":"Jiaxuan Li, Xinhui Jia, Xinyi Chen, Jie Hu, Xun He, Yueyu Zhang, Yi Tang, Juncang Wu","doi":"10.1097/NRL.0000000000000616","DOIUrl":"10.1097/NRL.0000000000000616","url":null,"abstract":"Objective: The aim of this study was to assess the effects of extracorporeal counterpulsation therapy (ECP) on the short-term outcomes of patients with acute ischemic stroke in the mid-stroke phase.Methods: A total of 171 patients with acute ischemic stroke from the Department of Neurology at our hospital were selected and randomly assigned to 2 groups: 84 patients in the ECP group and 87 patients in the control group. Both groups received standard medication and rehabilitation. In addition, extracorporeal counterpulsation was incorporated into the treatment for the ECP group. At the conclusion of the treatment and after 90 days, both groups were evaluated based on the NIHSS and MRS scores.Results: No statistically significant differences were detected between the NIHSS and MRS scores of the 2 groups before and following treatment ( P >0.05). However, on the 90th day, the NIHSS and MRS scores of the ECP group were significantly lower than those of the comparison group ( P <0.05). The difference in the proportion of patients with NIHSS scores ≤1 between the 2 groups was 20.8%, whereas the absolute difference in MRS scores was 14.1%.Conclusion: Extracorporeal counter therapy effectively enhances neurological function in patients with ischemic stroke, thereby improving their ability to perform activities of daily living and overall prognosis.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"349-354"},"PeriodicalIF":1.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12573677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659422","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

Unilateral Weakness Caused By Spinal Cord Infarction in a Renal Transplant Recipient. 肾移植受者脊髓梗死引起的单侧虚弱。

IF 1 4区医学

Neurologist Pub Date : 2025-11-01 DOI: 10.1097/NRL.0000000000000611

Seul Bi Kim, Seung Min Kim, Byoung-Soo Shin, Hyun Goo Kang

{"title":"Unilateral Weakness Caused By Spinal Cord Infarction in a Renal Transplant Recipient.","authors":"Seul Bi Kim, Seung Min Kim, Byoung-Soo Shin, Hyun Goo Kang","doi":"10.1097/NRL.0000000000000611","DOIUrl":"10.1097/NRL.0000000000000611","url":null,"abstract":"Introduction: Spinal cord infarction has various clinical presentations, depending on the vascular territory involved at the spinal cord level. The most common symptom is bilateral weakness. However, unilateral hemiparesis can occur if the sulcal artery is involved. Stroke is the most common and serious cerebrovascular complication associated with kidney transplantation. Clinically asymptomatic renal transplant recipients may experience increased intima-media thickening, which is significantly associated with an increased prevalence of cerebrovascular diseases.Case report: Herein, we report the case of a 64-year-old adult male with a history of kidney transplantation who presented with sudden-onset right-sided hemiparesis. The patient presented with right shoulder pain, right fingertip paresthesia, and recent dysuria, necessitating catheterization. T2-weighted magnetic resonance imaging at the C2-C3 level revealed hyperintensity corresponding to the right sulcal artery. Diffusion-weighted imaging revealed hyperintensities corresponding to T2 signal abnormalities, with a decreased apparent diffusion coefficient. The patient was diagnosed with cervical spinal cord infarction involving the right sulcal artery at the C2-C3 level. Subsequently, pulsed intravenous methylprednisolone and dual antiplatelet treatment (aspirin and clopidogrel) were administered. The patient showed a rapid and marked improvement in neurological function within 3 days.Conclusion: The patient in this case report initially presented with unilateral hemiparesis. The symptoms mimicked those of stroke, making accurate diagnosis challenging. This case highlights the need to consider spinal cord infarction in the differential diagnosis of patients presenting with unilateral hemiparesis. In addition, our findings suggest that spinal cord infarction may be a long-term complication in kidney transplant recipients.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"373-375"},"PeriodicalIF":1.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12573674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659401","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

Efficacy of Human Urinary Kallidinogenase in Real-world Patients With Acute Ischemic Stroke: A Matched Comparison. 人尿钾碱二原酶在现实世界急性缺血性脑卒中患者中的疗效：一项匹配比较。

IF 1 4区医学

Neurologist Pub Date : 2025-11-01 DOI: 10.1097/NRL.0000000000000623

Yue Zhang, Xintong Luo, Xiujuan Song, Jiamin Li, Yonggang Liu, Lina Wang, Guojun Tan

{"title":"Efficacy of Human Urinary Kallidinogenase in Real-world Patients With Acute Ischemic Stroke: A Matched Comparison.","authors":"Yue Zhang, Xintong Luo, Xiujuan Song, Jiamin Li, Yonggang Liu, Lina Wang, Guojun Tan","doi":"10.1097/NRL.0000000000000623","DOIUrl":"10.1097/NRL.0000000000000623","url":null,"abstract":"Objectives: We aimed to investigate the efficacy and safety of human urinary kallidinogenase (HUK) in real-world patients with acute ischemic stroke (AIS).Methods: AIS patients with prospective follow-up between April 2019 and June 2022 were enrolled in this study. Based on their treatment, the eligible patients were separated into 2 groups: the HUK group and the non-HUK group. Propensity score matching (PSM) analysis was used to reduce the biases from the unequal distribution of initial characteristics. The validated clinical composite scoring system was used to evaluate the neurological recovery. The safety outcomes include stroke recurrence, all-cause mortality, and major complications.Results: A total of 312 patients were enrolled in each of the 2 groups, and there were no significant differences in baseline characteristics between them. After treatment, both groups of AIS patients achieved favorable neurological outcomes. The National Institute of Health Stroke Scale (NIHSS) scores at discharge (3.47±3.41 vs. 4.37±2.85) demonstrated better neurological recovery in the HUK group. At the 90-day assessment, patients in the HUK group exhibited a higher incidence of favorable functional outcome (modified Rankin Scale score of 0 to 2, 74.68% vs. 60.58%), and lower risk of stroke recurrence (2.88% vs. 6.73%). The all-cause mortality (1.60% vs. 2.24%) was not significantly different between both groups.Conclusions: HUK improved neurological and functional outcomes in patients with AIS in a large real-world population and had an acceptable safety profile.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"335-340"},"PeriodicalIF":1.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12573676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095464","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

Exploring Seizure Risks in Cerebral Venous Sinus Thrombosis Based on Thrombosis Site. 基于血栓部位探讨脑静脉窦血栓形成的癫痫发作风险。

IF 1 4区医学

Neurologist Pub Date : 2025-11-01 DOI: 10.1097/NRL.0000000000000625

Ali Amini Harandi, Helia Jafari Khaljiri, Nafiseh Jahangiri Zarkani, Hossein Pakdaman, Nika Khalili

{"title":"Exploring Seizure Risks in Cerebral Venous Sinus Thrombosis Based on Thrombosis Site.","authors":"Ali Amini Harandi, Helia Jafari Khaljiri, Nafiseh Jahangiri Zarkani, Hossein Pakdaman, Nika Khalili","doi":"10.1097/NRL.0000000000000625","DOIUrl":"10.1097/NRL.0000000000000625","url":null,"abstract":"Objectives: Cerebral venous sinus thrombosis (CVST) often leads to seizures, potentially worsening prognosis. This study aimed to assess the relationship between specific occlusion sites and seizure occurrence.Methods: We retrospectively analyzed 154 patients diagnosed with CVST in 3 major hospitals in Tehran. Medical records detailing sinus involvement, seizure occurrence, and baseline characteristics were reviewed. Statistical analyses included the χ 2 or the Fisher exact tests, followed by binomial logistic regression to identify independent predictors. Model performance was evaluated using receiver operating characteristic (ROC) curves.Results: The study included 102 women (66.2%) and 52 men (33.8%), with a mean age of 36.4±10.8 years. A total of 35 patients (22.7%) experienced seizures, predominantly generalized tonic-clonic (85.7%). Superior sagittal sinus (SSS) involvement was strongly associated with seizures (odds ratio=3.056, P =0.006), while left transverse sinus involvement showed a marginally significant inverse relationship in univariate analysis ( P =0.027), which became nonsignificant in the multivariate model ( P =0.056). Trolard vein thrombosis was rare but associated with a high seizure rate (3/4 cases). The ROC for the final model showed moderate predictive ability (AUC=0.676).Conclusion: SSS thrombosis significantly predicted seizures in Iranian CVST patients. Although rare, trolard vein involvement may carry a substantial seizure risk. These findings underscore the importance of precise imaging and individualized treatment plans for high-risk CVST patients. By illuminating the role of SSS and trolard vein, this study highlights the need for prospective trials to refine clinical decision-making.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"360-364"},"PeriodicalIF":1.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796836","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}

引用次数: 0

Diagnostic Yield of Pelvic MRV in Patients With Embolic Stroke of Undetermined Source (ESUS): A Scoping Review and Metanalysis. 骨盆MRV对不明来源栓塞性卒中（ESUS）患者的诊断率：一项范围回顾和荟萃分析。

IF 1 4区医学

Neurologist Pub Date : 2025-11-01 DOI: 10.1097/NRL.0000000000000638

Mohammed Q Al-Sabbagh, Emanuele Camerucci, Syed Muhammad Abbas Hussain, Sai Kumar Reddy Pasya, Tuqa Asedi, Elyse Vetter, Rachel Dukes, Dina M Al-Nuaimi, Sibi Thirunavukkarasu, Prasanna Eswaradass

{"title":"Diagnostic Yield of Pelvic MRV in Patients With Embolic Stroke of Undetermined Source (ESUS): A Scoping Review and Metanalysis.","authors":"Mohammed Q Al-Sabbagh, Emanuele Camerucci, Syed Muhammad Abbas Hussain, Sai Kumar Reddy Pasya, Tuqa Asedi, Elyse Vetter, Rachel Dukes, Dina M Al-Nuaimi, Sibi Thirunavukkarasu, Prasanna Eswaradass","doi":"10.1097/NRL.0000000000000638","DOIUrl":"10.1097/NRL.0000000000000638","url":null,"abstract":"Background: There is a controversy in the literature regarding the role of pelvic venous abnormalities screening through Magnetic Resonance Venogram (MRV) in patients with Embolic Stroke of Undetermined Source (ESUS) and Patent Foramen Ovale (PFO). We aimed to describe diagnostic yield of pelvic MRV in ESUS patients.Review summary: A systematic search was carried out using PubMed, ScienceDirect, and Google Scholar on the 5th of January of 2024, following PRISMA guidelines. We retrieved 6 cross-sectional and cohort studies, 2 case series, as well as 12 case reports with a total of 1321 patients and a mean age of 51 years. Only cross-sectional and cohort studies were included in the qualitative synthesis. The diagnostic yield of pelvic MRV in all included ESUS patients was 10% (95% CI: 8-12). In ESUS patients with a negative lower extremity DVT, the diagnostic yield was 9% (95% CI: 7-10). Patients with ESUS and PFO had significantly higher prevalence of abnormal pelvic MRV findings, OR=3.63 (95% CI: 1.53-8.61, P <0.01). All reviewed studies utilized pelvic MRV, except 4 reports, which used pelvic CTV and MRA.Conclusion: Pelvic venous abnormalities are relatively common findings in ESUS patients with a PFO and negative lower extremity DVT. Pelvic MRV can be considered in these situations. Future research should strive to provide clear guidance on clinical decision-making and cost-effectiveness of utilizing this valuable tool using randomized, controlled, and comparative studies.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"376-384"},"PeriodicalIF":1.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856902","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}

引用次数: 0

Study on the Effects of Early Nasoenteric Tube Nutritional Support Assisted by Gastroscopy on Aspiration and Prognosis in Patients With Hypertensive Cerebral Hemorrhage. 胃镜辅助下早期鼻肠管营养支持对高血压脑出血患者误吸及预后影响的研究。

IF 1 4区医学

Neurologist Pub Date : 2025-11-01 DOI: 10.1097/NRL.0000000000000639

Miao Guo

{"title":"Study on the Effects of Early Nasoenteric Tube Nutritional Support Assisted by Gastroscopy on Aspiration and Prognosis in Patients With Hypertensive Cerebral Hemorrhage.","authors":"Miao Guo","doi":"10.1097/NRL.0000000000000639","DOIUrl":"10.1097/NRL.0000000000000639","url":null,"abstract":"Objective: To evaluate the impact of early gastroscopy-assisted nasoenteric tube nutritional support on aspiration and prognosis in patients with hypertensive cerebral hemorrhage.Methods: A total of 150 patients with hypertensive cerebral hemorrhage (December 2021-December 2023) were randomized into a control group (n=75) receiving nasogastric tube nutritional support and a study group (n=75) receiving gastroscopy-assisted nasoenteric tube nutritional support. Outcomes included the incidence of aspiration and aspiration pneumonia, aspiration risk (assessed by the ICU aspiration risk scale), nutritional indicators (hemoglobin, albumin, pre-albumin, and transferrin), and prognostic scores (GCS and APACHE II).Results: The study group had significantly lower incidence rates of aspiration (8.00%) and aspiration pneumonia (6.67%) compared with the control group (33.33% and 20.00%, respectively, P <0.05). Preintervention measures showed no significant differences between groups ( P >0.05). Postintervention (weeks 1 and 2), the study group exhibited significantly improved aspiration risk scores, higher nutritional indicator levels, and better prognostic outcomes (higher GCS scores and lower APACHE II scores) compared with the control group ( P <0.05).Conclusions: Gastroscopy-assisted nasoenteric tube nutritional support reduces aspiration risk and incidence in patients with hypertensive cerebral hemorrhage, enhancing nutritional status and improving prognosis.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"355-359"},"PeriodicalIF":1.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823062","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}

引用次数: 0