Brain and Nerve最新文献

[Lumbar Spinal Disease or Peripheral Nerve Disorder? The Role of Neurological Examination in Differential Diagnosis]. 腰椎疾病还是周围神经紊乱？神经学检查在鉴别诊断中的作用[j]。

Brain and Nerve Pub Date : 2026-10-01 DOI: 10.11477/mf.188160960780101089

Keiichi Hokkoku

{"title":"[Lumbar Spinal Disease or Peripheral Nerve Disorder? The Role of Neurological Examination in Differential Diagnosis].","authors":"Keiichi Hokkoku","doi":"10.11477/mf.188160960780101089","DOIUrl":"10.11477/mf.188160960780101089","url":null,"abstract":"Lower-limb numbness, pain, and weakness are common clinical complaints that require differentiation between cauda equina or radicular lesions associated with lumbar spinal disease and peripheral nerve disorders. Because degenerative findings on lumbar imaging are common, particularly among older adults, the responsible lesion should not be determined based on imaging findings alone. In this context, neurological examination contributes to anatomical localization and is central to the differential diagnosis. Particular emphasis is placed on interpreting muscle weakness and sensory disturbance according to myotomal, dermatomal, and peripheral nerve distributions. Other neurological findings, including gait disturbance, neurogenic claudication, bladder or bowel dysfunction, nerve stretch signs, and reflex changes, also provide important clues for localization. This review further addresses common diagnostic challenges encountered in daily practice, including differentiation of L5 radiculopathy from fibular neuropathy in patients with foot drop, distinction between cauda equina lesions and polyneuropathy, recognition of immune-mediated polyradiculoneuropathies, and identification of amyotrophic lateral sclerosis when it mimics lumbar spinal disease. Ancillary tests such as nerve conduction studies, needle electromyography, somatosensory evoked potentials, nerve ultrasound, and imaging should be interpreted in relation to the lesion localization suggested by neurological examination.","PeriodicalId":52507,"journal":{"name":"Brain and Nerve","volume":"78 10","pages":"1089-1096"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Surgical Treatment of Lumbar Spine Lesions: Collaboration with Neurologists from an Orthopedic Surgeon's Perspective]. [腰椎病变的外科治疗：从骨科医生的角度与神经学家合作]。

Brain and Nerve Pub Date : 2026-10-01 DOI: 10.11477/mf.188160960780101097

Hirokazu Inoue, Katsushi Takeshita

{"title":"[Surgical Treatment of Lumbar Spine Lesions: Collaboration with Neurologists from an Orthopedic Surgeon's Perspective].","authors":"Hirokazu Inoue, Katsushi Takeshita","doi":"10.11477/mf.188160960780101097","DOIUrl":"10.11477/mf.188160960780101097","url":null,"abstract":"Surgical indications for lumbar spine disorders should not be determined solely based on degenerative or stenotic magnetic resonance imaging findings. This article discusses how orthopedic spine surgeons evaluate lumbar pathology in collaboration with neurologists. The central issue is whether the patient's symptoms, neurological findings, and imaging abnormalities can be used to identify the responsible lesion that is likely to improve after surgery. Differential diagnoses, including cervical or thoracic myelopathy, peripheral neuropathy, motor neuron disease, vascular claudication, hip disease, tumors, and infection, must be considered, particularly in older patients with multiple coexisting disorders. The article also outlines orthopedic perspectives that influence surgical decision-making, including spinal instability, sagittal and coronal alignment, bone quality, frailty, sarcopenia, walking ability, and postoperative activities of daily living. The choice between decompression alone and decompression with fusion was reviewed together with perioperative management, rehabilitation, patient explanation, and shared decision-making. Complementary collaboration between orthopedic surgeons and neurologists may help clarify the responsible lesion, optimize referral timing, and avoid undertreatment and overtreatment.","PeriodicalId":52507,"journal":{"name":"Brain and Nerve","volume":"78 10","pages":"1097-1105"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Higher Brain Dysfunction Caused by Left Frontal Brain Retraction Injury and Infarction of the Left Genu of the Internal Capsule and Anterior Thalamus: A Case Report of Transient Gerstmann Syndrome Due to Multifocal Lesions]. [左额叶脑回缩损伤及左膝内囊及丘脑前部梗死致高级脑功能障碍：多灶性病变所致一过性Gerstmann综合征1例]。

Brain and Nerve Pub Date : 2026-10-01 DOI: 10.11477/mf.188160960780101137

Masaharu Sawaki, Manaka Yoshida, Osamu Saito, Takahiro Yamauchi, Masahiko Yamamoto

{"title":"[Higher Brain Dysfunction Caused by Left Frontal Brain Retraction Injury and Infarction of the Left Genu of the Internal Capsule and Anterior Thalamus: A Case Report of Transient Gerstmann Syndrome Due to Multifocal Lesions].","authors":"Masaharu Sawaki, Manaka Yoshida, Osamu Saito, Takahiro Yamauchi, Masahiko Yamamoto","doi":"10.11477/mf.188160960780101137","DOIUrl":"10.11477/mf.188160960780101137","url":null,"abstract":"We herein report a case of subarachnoid hemorrhage caused by the rupture of a cerebral aneurysm that was treated by clipping surgery. The patient was a right-handed woman in her 40s who presented with attention disorder and transient Gerstmann syndrome, including left-right disorientation, finger agnosia, acalculia, and agraphia, associated with brain retraction injury in the left inferior frontal gyrus and perforating branch infarction of the horizontal segment of the left anterior cerebral artery. Diffusion tensor tractography was performed to investigate the underlying pathophysiological mechanism of transient Gerstmann syndrome. White matter fibers connecting the frontal lobe to the other lobes such as the left superior longitudinal fasciculus/arcuate fasciculus (SLF/AF), inferior fronto-occipital fasciculus (IFOF), and uncinate fasciculus were compressed by vasogenic and cytotoxic edema without evidence of disconnection. The left thalamic-prefrontal peduncle (TPP), connecting the thalamus and inferior frontal gyrus, was not visualized, whereas left parietal angular-to-supramarginal U-fibers were preserved. These findings suggested that connectional diaschisis involving SLF/AF and IFOF, together with TPP damage, contributed to the development of transient Gerstmann syndrome. Early clinical improvement was expected due to the preservation of multiple association fibers from the frontal lobe to the other lobes without definite disconnection. (Received February 20, 2026; Accepted June 30, 2026; Published October 1, 2026).","PeriodicalId":52507,"journal":{"name":"Brain and Nerve","volume":"78 10","pages":"1137-1147"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Behavioral Features and Neural Basis of Vocal Communication in Mice]. 小鼠声音交流的行为特征和神经基础。

Brain and Nerve Pub Date : 2026-10-01 DOI: 10.11477/mf.188160960780101117

Kouta Kanno

引用次数: 0

[Cervical Lesions or Peripheral Nerve Disorders? How Far Can Neurological Examination Localize the Lesion?] 宫颈病变还是周围神经紊乱？神经学检查能在多大程度上定位病变？］

Brain and Nerve Pub Date : 2026-10-01 DOI: 10.11477/mf.188160960780101071

Tetsuo Ando

引用次数: 0

[Carpal Tunnel Syndrome and Lumbar Spinal Stenosis: When to Suspect Amyloidosis and How to Proceed with the Diagnostic Work-up]. [腕管综合征和腰椎管狭窄：何时怀疑淀粉样变及如何进行诊断检查]。

Brain and Nerve Pub Date : 2026-10-01 DOI: 10.11477/mf.188160960780101107

Mitsuharu Ueda

{"title":"[Carpal Tunnel Syndrome and Lumbar Spinal Stenosis: When to Suspect Amyloidosis and How to Proceed with the Diagnostic Work-up].","authors":"Mitsuharu Ueda","doi":"10.11477/mf.188160960780101107","DOIUrl":"10.11477/mf.188160960780101107","url":null,"abstract":"Transthyretin (TTR) amyloidosis, particularly the wild-type form (ATTRwt), is an age-related systemic disease characterized by the deposition of misfolded TTR in tendons and ligaments. Patients therefore frequently present initially to orthopaedic or hand surgeons with carpal tunnel syndrome (CTS) or lumbar spinal stenosis (LSS) rather than to cardiologists or neurologists. These musculoskeletal manifestations may precede ATTR cardiomyopathy (ATTR-CM) by several years to more than a decade, serving as \"red flags\" that provide an opportunity for early diagnosis, particularly now that disease-modifying therapies (the TTR stabilizers tafamidis and acoramidis and the silencer vutrisiran) are available and are most effective when initiated early. Amyloid is detectable in the flexor tenosynovium or transverse carpal ligament in approximately 10% of unselected patients with CTS and up to approximately 30% of routinely biopsied patients with CTS, and in the ligamentum flavum in approximately half of patients undergoing surgery for LSS, predominantly as ATTRwt. This review summarizes, from the perspective of orthopaedic-neurology collaboration, when to suspect amyloidosis in patients with CTS and LSS and how to proceed with the diagnostic work-up, including intraoperative tissue biopsy with Congo red staining and typing, mandatory exclusion of AL amyloidosis, bone scintigraphy using non-biopsy diagnostic criteria, and TTR genotyping with genetic counseling. The review incorporates recent evidence and our institutional experience.","PeriodicalId":52507,"journal":{"name":"Brain and Nerve","volume":"78 10","pages":"1107-1113"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Decision-Making for Cervical Spine Lesions: An Orthopedic Surgeon's Perspective]. [颈椎病变的决策：骨科医生的观点]。

Brain and Nerve Pub Date : 2026-10-01 DOI: 10.11477/mf.188160960780101079

Yukihiro Matsuyama

引用次数: 0

[Diagnostic Reasoning of Orthopedic Surgeons and Neurologists: Identifying Anatomical Structures and Mapping Neural Pathways]. [骨科医生和神经科医生的诊断推理：识别解剖结构和绘制神经通路]。

Brain and Nerve Pub Date : 2026-10-01 DOI: 10.11477/mf.188160960780101063

Yukio Takeshita

引用次数: 0

[Diagnostic Approaches for Patients with Difficulty Walking]. 【行走困难患者的诊断方法】。

Brain and Nerve Pub Date : 2026-09-01 DOI: 10.11477/mf.188160960780091015

Masayuki Ohira

{"title":"[Diagnostic Approaches for Patients with Difficulty Walking].","authors":"Masayuki Ohira","doi":"10.11477/mf.188160960780091015","DOIUrl":"https://doi.org/10.11477/mf.188160960780091015","url":null,"abstract":"Difficulty walking is a common complaint in neurological practice which may arise from a wide range of disorders of the central nervous system, peripheral nerves, or musculoskeletal system. Because human gait requires the complex integration of multiple neural and biomechanical processes, careful clinical assessment is essential to achieve accurate diagnosis. In this review, we outlined a practical approach for patients presenting with walking difficulties. Emphasis is placed on the importance of detailed history-taking and neurological examination, including observation of gait, posture, gait initiation, and turning. We further summarize the key clinical features of the major organic causes of gait disturbance, such as lower limb weakness, pyramidal tract disorders, and Parkinsonian syndromes. Functional gait disorder is an important and increasingly recognized cause of gait disturbance. Recognizing the positive clinical signs and characteristic variability in symptoms is essential for appropriate diagnosis and management. Careful clinical evaluation remains the cornerstone for assessing gait disorders, and diagnostic tests should be used to confirm the clinical diagnosis based on the history and neurological examination.","PeriodicalId":52507,"journal":{"name":"Brain and Nerve","volume":"78 9","pages":"1015-1020"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[How to Proceed with Diagnosing Memory Loss]. [如何诊断记忆丧失]。

Brain and Nerve Pub Date : 2026-09-01 DOI: 10.11477/mf.188160960780091003

Masaki Ikeda

引用次数: 0