Acta neurologica Belgica最新文献

{"title":"Reliability and validity of the Turkish version of the core lower urinary tract symptom score in multiple sclerosis.","authors":"Humeyra Kiloatar, Aylin Aydogdu Delibay, Cimen Olçay Demir, Dursun Ceylan, Niyazi Uysal","doi":"10.1007/s13760-025-02769-0","DOIUrl":"https://doi.org/10.1007/s13760-025-02769-0","url":null,"abstract":"<p><strong>Background: </strong>In multiple sclerosis, lower urinary tract symptoms are frequently observed depending on the site of involvement. A comprehensive assessment of these symptoms is crucial for their effective management.</p><p><strong>Objective: </strong>This research was designed to evaluate the validity and reliability of the Turkish adaptation of the Core Lower Urinary Tract Symptom Scale (CLSS) in patients with multiple sclerosis (PwMS).</p><p><strong>Methods: </strong>71 PwMS who had an Expanded Disability Status Scale score of 6.5 or below was included. Data collection involved demographic information as well as responses to the CLSS, Overactive Bladder Questionnaire, Interstitial Cystitis Symptom Index, Interstitial Cystitis Problem Index, and International Prostate Symptom Score. To evaluate test-retest reliability, the CLSS was administered again under identical conditions after a 7-day interval.</p><p><strong>Results: </strong>The internal consistency of the questionnaire was assessed, resulting in a Cronbach's alpha coefficient of 0.79. Test-retest reliability for the CLSS sub-items ranged from 0.593 to 0.950. No statistically significant differences were found between the sub-items scores of the test and retest administrations. (p > 0.05). Moreover, the subscales showed significant correlations with the other questionnaires, with correlation coefficients varying between 0.109 and 0.770. Straining, feeling incomplete emptying, and pain in the bladder sub-items did not show a significant correlation with the corresponding sub-items of other questionnaires (r = 0.109, 0.270, and 0.195, respectively).</p><p><strong>Conclusion: </strong>The Turkish adaptation of the CLSS questionnaire has been proven to be a reliable and valid instrument for evaluating lower urinary tract symptoms in PwMS.</p><p><strong>Clinicaltrials: </strong>Gov Number: NCT06599866.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708045","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":"Relationship between lower extremity sensation, physical activity, cognition, body awareness, and fatigue in people with multiple sclerosis: a cross-sectional study.","authors":"Kader Eldemir, Cagla Ozkul, Muhammed Seref Yildirim, Sefa Eldemir, Fettah Saygili, Ceyla Irkec, Arzu Guclu-Gunduz","doi":"10.1007/s13760-025-02768-1","DOIUrl":"https://doi.org/10.1007/s13760-025-02768-1","url":null,"abstract":"<p><strong>Background: </strong>Multiple sclerosis (MS) is a chronic autoimmune disease causing sensory and motor impairments due to central nervous system demyelination. Sensory feedback, essential for balance and gait, is often disrupted in people with MS (PwMS). However, its relationship with fatigue, physical activity, cognitive function, and body awareness remains unclear.</p><p><strong>Aim: </strong>To investigate the relationship between plantar sensation, knee position sense, and clinical factors in PwMS compared to healthy controls (HC).</p><p><strong>Methods: </strong>Thirty-three PwMS and 11 HC participated in this study. Foot sensations including light touch threshold, two-point discrimination, vibration duration, and knee position sense were assessed. In addition, physical activity level, cognitive function, body awareness, and fatigue were assessed as clinical factors.</p><p><strong>Results: </strong>No significant differences were found between PwMS and HC in most sensory measures, except for body awareness, which was higher in HC (p:0.029). In PwMS, light touch thresholds correlated with age (r = 0.454, p = 0.008), vibration duration with walking and physical activity levels (r = 0.392-0.396, p < 0.05), two-point discrimination with EDSS score (r = 0.474, p = 0.005), knee position sense with EDSS (r = 0.385, p = 0.027) and cognitive function (r = 0.382, p = 0.028). In HC, vibration duration correlated negatively with age (r=-0.834, p:0.001), and knee position sense correlated with body mass index (r = 0.764, p:0.006) and cognitive function (r = 0.609-0.736, p < 0.05).</p><p><strong>Conclusion: </strong>These findings highlight the relationship between sensory function and clinical factors in PwMS, emphasizing the importance of age, disability level, physical activity, and cognitive function in preserving the sensory functions of the lower extremity.</p><p><strong>Trial registration: </strong>NCT04548297.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708043","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":"Setting multidisciplinary intervention goals for spinal muscular atrophy patients utilizing the international classification of functioning, disability, and health: a pilot study in a small sample sizes.","authors":"Gabriele Giannotta, Marta Ruggiero, Greta Pirani, Maria Carmela Oliva, Camilla Ferrante, Antonio Trabacca","doi":"10.1007/s13760-025-02771-6","DOIUrl":"https://doi.org/10.1007/s13760-025-02771-6","url":null,"abstract":"<p><strong>Background: </strong>Spinal Muscular Atrophy (SMA) is a genetic neuromuscular disorder causing progressive motor function loss, respiratory and swallowing impairments, and significant limitations in activities of daily living (ADLs) and social participation. While gene therapies have enhanced life expectancy, functional management remains crucial. Despite the International Classification of Functioning Disability and Health for Children and Youth (ICF-CY) being a valuable framework for patient-centered care, its integration in setting multidisciplinary rehabilitation goals for SMA patients is underexplored.</p><p><strong>Objective: </strong>This study aimed to assess the use of the ICF-CY framework in developing multidisciplinary intervention goals for SMA patients.</p><p><strong>Methods: </strong>A cross-sectional study involving 6 SMA patients was conducted at a pediatric neurorehabilitation hospital. Data were collected using a standardized ICF-CY-based case record form and analysed to identify patterns of impairment, activity limitations, and environmental factors.</p><p><strong>Results: </strong>Results demonstrated the multifaceted nature of SMA, with significant impairments in motor function, respiratory function, and swallowing, as well as limitations in activities of daily living and social participation. Environmental factors, particularly social support and accessibility, emerged as crucial determinants of overall well-being.</p><p><strong>Conclusions: </strong>The study underscores the importance of a multidisciplinary approach and the use of ICF-CY framework for developing comprehensive and patient-centered care plans for SMA patients.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708057","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 Cox's hazard model for new development of medication overuse headache in pure chronic migraine patients under migraine prophylaxis.","authors":"Alessandro Viganò, Barbara Petolicchio, Massimiliano Toscano, Giada Giuliani, Nicholas Diani, Marta Altieri, Vittorio Di Piero","doi":"10.1007/s13760-025-02765-4","DOIUrl":"https://doi.org/10.1007/s13760-025-02765-4","url":null,"abstract":"<p><strong>Background: </strong>Medication Overuse Headache (MOH) occurrence during migraine preventive therapy is poorly known. The present study aims at identifying the rate and factors influencing MOH development in patients with Chronic Migraine (CM).</p><p><strong>Methods: </strong>Patients with a diagnosis of CM without MOH were consecutively recruited and followed at least three times for 1 year under preventive therapy. The number of headache days and the use of acute medication were recorded; the occurrence of MOH was considered as the main event. Kaplan-Meier curves were used to determine the time of the event. After the third follow-up patients were censored. Proportional hazards Cox regression was used to identify predictors of MOH among demographic variables (e,g. age), main comorbidities (e.g. sleep disorders, epilepsy, thyroid dysfunctions), migraine features (e.g. aura, number of previous preventive therapies, headache days and number of medications).</p><p><strong>Results: </strong>We recruited 260 first-visit patients with CM. 46 patients (17.70%) developed a new onset of MOH over 1 year, with 35 at the first follow-up. No difference in MOH occurrence was found among different pharmacological groups (Chi-square = 2.99, p = 0.70). About 1/3 of non-responders developed MOH. Monthly headache days, number of acute medications, thyroid dysfunction, epilepsy, and MIDAS score were associated with MOH (Chi-square = 14.08; p = 0.01). Headache days (Wald test: 6.0; p = 0.014) and MIDAS score (Wald test: 4.07, p = 0.04) were the only stand-alone significant factors.</p><p><strong>Conclusions: </strong>The rate of new occurrence of MOH in patients without a previous history is 18%. Monthly number of headache days and MIDAS score are the most important predictors.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708041","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":"The effect of exercise in the treatment of lumbar disc herniation: a systematic review.","authors":"Serpil Arslan, Özlem Ülger","doi":"10.1007/s13760-025-02767-2","DOIUrl":"https://doi.org/10.1007/s13760-025-02767-2","url":null,"abstract":"<p><strong>Background: </strong>Systematic review explores the scientific evidence for the effectiveness of exercise interventions for lumbar disc herniation (LDH). LBP is a major cause of pain and disability worldwide and imposes huge costs on health systems, patients and society, with exercise being an important conservative treatment modality.</p><p><strong>Objectives: </strong>The aim of this review was to assess the effectiveness of different exercise treatments for LDH.</p><p><strong>Methods: </strong>Databases (MEDLINE, Pubmed, Cochrane, Scopus, Web of Science(WoS), ScienceDirect) were systematically searched for full-text articles published from 2018 to 23. Two researchers were involved in the research process. Studies evaluating pain, functional disability, quality of life, and transversus abdominis activation capacity in patients with LDH were included. Only studies published in English were considered. Randomized controlled trials (RCTs) with full-text availability, involving patients diagnosed with LDH who had not undergone surgery and were able to exercise, were included. The PEDro scale was used to assess the quality of evidence. According to the guidelines, the PEDro evaluation was carried out by the authors.</p><p><strong>Results: </strong>Twelve randomized controlled trials (RCTs) were included (PubMed: 8, ScienceDirect: 3, WoS: 1), involving 880 participants and comparing exercise with other approaches. The articles examined core stabilization exercises (CSE), motor control exercises (MCE), clinical Pilates, yoga, and various other types of exercise. Pain, functional disability, quality of life (QoL), and transversus abdominis (TrA) activation capacity were evaluated in patients with LDH. Increased pain, greater disability, decreased QoL, and reduced TrA activation capacity were reported in LDH. The latest search was conducted on November 20, 2023. This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.</p><p><strong>Conclusions: </strong>Quick Response (QR) code home-based exercise intervention and neurodynamic mobilisation and motor control exercises, scored higher than the other trials in terms of methodological quality and quality of evidence.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699327","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":"Circulating miR-223/NLRP3 axis and IL-1β level in functional disease progression of amyotrophic lateral sclerosis.","authors":"Mitra Ansari Dezfouli, Davood Shalilahmadi, Gholamreza Shamsaei, Ashkan Esmaeili, Nastaran Majdinasab, Seyed Khalil Rashidi","doi":"10.1007/s13760-025-02764-5","DOIUrl":"https://doi.org/10.1007/s13760-025-02764-5","url":null,"abstract":"<p><strong>Background: </strong>Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease identified by progressive motor neuron loss. NLRP3 inflammasomes induce inflammation and pyroptosis, which can lead to neurodegeneration, muscle atrophy, and respiratory decline. miR-223 targets NLRP3 and suppresses inflammasome formation. Here, miR-223, NLRP3 and IL-1β levels were evaluated as plasma biomarkers in the incidence and progression of ALS.</p><p><strong>Methods: </strong>32 ALS patients and 32 healthy subjects were assessed. In all patients, the functional disability was determined by Revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R), and the respiratory dysfunction was assessed by the percent predicted forced vital capacity (ppFVC) index in spirometry examination. Plasma levels of miR-223, NLRP3 and IL-1β were assessed in ALS and control groups.</p><p><strong>Results: </strong>Compared to the healthy controls, ALS patients showed decreased miR-223 expression (P < 0.0001), increased NLRP3 expression (P = 0.0002) and increased IL-1β level (P = 0.0003). The areas under the ROC curves for miR-223, NLRP3 and IL-1β were 0.82, 0.76 and 0.75 respectively. The ALSFRS-R and ppFVC values were positively correlated with miR-223 and negatively correlated with NLRP3 and IL-1β levels.</p><p><strong>Conclusion: </strong>Our results indicated that changes in miR-223, NLRP3 and IL-1β levels may correlate with the occurrence and functional progression of ALS. Additionally, therapeutic approaches based on miR-223 and inflammatory mediators can be proposed as effective strategies against disease progression.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646731","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":"Survival outcomes among hospitalized patients with dementia: a propensity score matching analysis.","authors":"Henry Oliveros Rodríguez, Natalia Diaz-Dussan, Yahira Guzmán-Sabogal, Juliana Proaños, Eduardo Tuta-Quintero","doi":"10.1007/s13760-025-02746-7","DOIUrl":"https://doi.org/10.1007/s13760-025-02746-7","url":null,"abstract":"<p><strong>Background: </strong>Hospitalized patients with dementia exhibit high mortality rates, underscoring the importance of investigating variables associated with reduced survival. This study aims to determine the incidence of dementia among hospitalized patients and survival rates at 1 and 3 years post-hospitalization.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using administrative databases from the Ministry of Health of Colombia. One- and three-year survival rates, along with adjusted hazard ratios for survival accounting for comorbidities included in the Charlson Index, were assessed using a Cox proportional hazards model. This analysis was performed for patients with dementia versus a control group without dementia. Additionally, findings were compared with those from an inverse propensity score weighting model.</p><p><strong>Results: </strong>6.769 (1.04%) patients were diagnosed with dementia, and 5798 (85.65%) were over 65 years of age. The unadjusted HR, the HR adjusted using the proportional hazards Cox model, and the HR obtained through propensity score matching (PSM) were 10.32 (95% CI 9.82 to 10.84), 1.69 (95% CI 1.60 to 1.78), and 1.32 (95% CI 1.02 to 1.71), respectively. The 1-year adjusted mortality rates for patients with dementia and those without were 12.5% and 1.31%, respectively, while the corresponding 3-year adjusted mortality rates were 21.25% and 2.76%. Through PSM, we determined that the mean survival time for patients with dementia, in comparison to those without, was - 0.98 months (95% CI: -0.65 to -1.94; p < 0.001).</p><p><strong>Conclusions: </strong>Dementia significantly reduces survival rates of hospitalized patients, regardless of other comorbidities. Specifically, our research revealed that dementia was associated with a decrease in 3-year survival by an average of 0.98 months.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633375","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":"Characterization of nerve biopsy in copper deficiency peripheral neuropathy due to over-treatment of Wilson's disease: A case report.","authors":"Cuilin Peng, Wei Li, Haishan Jiang, Zichang Yin, Zhihua Zhou","doi":"10.1007/s13760-025-02762-7","DOIUrl":"https://doi.org/10.1007/s13760-025-02762-7","url":null,"abstract":"<p><strong>Background: </strong>Copper deficiency peripheral neuropathy caused by excessive treatment in Wilson's disease has been reported. But its pathological characteristics are rarely reported. Here, we report a case of copper deficiency peripheral neuropathy in Wilson's disease and present the characteristics of its nerve biopsy.</p><p><strong>Case description: </strong>A 44-year-old female patient diagnosed with Wilson's disease was on long-term oral administration of zinc gluconate and copper chelators. In June 2022, she developed symptoms of peripheral neuropathy, accompanied by anemia and neutropenia. The 24-hour urinary copper excretion was 53.85 µg. Serum copper was 66.6 µg/L, and ceruloplasmin was 0.01 g/L. Electromyography showed length-dependent axonal damage in peripheral nerves. Sural nerve biopsy showed mainly axonal damage and decreased density of nerve fibres of all classes (large and small myelinated and unmyelinated), accompanied by demyelination. Ultimately, the diagnosis of copper deficiency peripheral neuropathy caused by excessive treatment of Wilson's disease was established. After discontinuing copper chelation therapy, she experienced mild alleviation of symptoms.</p><p><strong>Conclusion: </strong>The pathological features of copper deficiency peripheral neuropathy in Wilson's disease include the formation of axonal vacuoles, the presence of myelin ovoids, and a reduced number of large and small myelinated and unmyelinated nerve fibers. This case emphasizes the importance of monitoring copper metabolism during the stable phase of treatment for patients with Wilson's disease.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633371","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":"Uncovering heterogeneous cognitive trajectories in relapsing-remitting multiple sclerosis: a longitudinal study.","authors":"Frédéric London, Alice De Haan, Zohra Benyahia, Gaëtane Landenne, Thierry Duprez, Vincent van Pesch, Souraya El Sankari","doi":"10.1007/s13760-025-02754-7","DOIUrl":"https://doi.org/10.1007/s13760-025-02754-7","url":null,"abstract":"<p><strong>Background: </strong>Cognitive impairment (CI) frequently occurs in relapsing-remitting multiple sclerosis (RRMS) and is assumed to be irreversible. Recent longitudinal studies highlighted the heterogeneity of CI in RRMS, challenging the traditional view of inevitable progression. Longitudinal studies exploring the baseline determinants of future cognitive decline are limited, and none yet explored the predictive value of patient-reported outcome measures (PROMs).</p><p><strong>Objective: </strong>To explore the evolutionary patterns of cognitive status in a cohort of RRMS patients initiating a new disease modifying treatment, and to determine whether PROMs may have a predictive value for future cognitive decline.</p><p><strong>Methods: </strong>This prospective study is a 36-month follow-up of 59 RRMS patients who underwent yearly a comprehensive, multiparametric assessment combining clinical, neuropsychological, MRI-derived metrics and a set of self-reported questionnaires. Lesion load and brain volumes were analyzed and processed by the automated MSmetrix^® software (Icometrix^®, Leuven, Belgium). A longitudinal logistic regression analysis was performed to investigate baseline predictors of future cognitive decline.</p><p><strong>Results: </strong>A total of 33 (56%) and 17 (35%) patients were defined as cognitively impaired at baseline and at the end of the study, respectively. Of these 33 patients, 20 showed either improvement and/or impairment in fewer cognitive domains at 36-month follow-up. Baseline physical disability as measured by EDSS was the best predictor for future cognitive decline (OR: 2.17; p = 0.03, 95% confidence interval = 1.07-4.38). None of the PROMs variables contributed to predict further cognitive decline.</p><p><strong>Conclusions: </strong>Our findings highlight the importance of considering the evolution of CI in MS as a dynamic phenomenon with a substantial heterogeneity.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633387","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":"Etiologic spectrum and neurological outcomes in pediatric arterial ischemic stroke and cerebral sinovenous thrombosis: A 15-Year retrospective study at a tertiary hospital.","authors":"Hatice Bektaş, Rahşan Göçmen, Kader Karlı Oğuz, Şule Ünal, Selin Aytaç, Fatma Gümrük, Tevfik Karagöz, Göknur Haliloğlu, Dilek Yalnızoğlu","doi":"10.1007/s13760-025-02753-8","DOIUrl":"https://doi.org/10.1007/s13760-025-02753-8","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate clinical and radiological features, risk factors, etiology, treatment approaches, and outcomes of pediatric arterial ischemic stroke (AIS) and cerebral sinovenous thrombosis (CSVT).</p><p><strong>Methods: </strong>Children beyond the neonatal period diagnosed with AIS or CSVT between 2002 and 2017 were retrospectively analyzed. Demographics, clinical presentations, radiological findings, risk factors, etiologies, treatments, and outcomes were reviewed.</p><p><strong>Results: </strong>A total of 94 patients with AIS and 27 with CSVT were included. The median age for AIS patients was 4.1 years (IQR:1.6-9.8). Focal neurological deficits were present in 81.7%, hemiparesis being the most common symptom. Seizures were noted in 30.4%. Cardiac abnormalities (39%) and arteriopathies (38%) were the most common etiologies, with prothrombotic conditions and rare genetic disorders also remarkable underlying risk groups. Antithrombotic therapy was administered without major complications to 89.3%. At a median three-year follow-up, 33.8% had no neurological deficits, 33.8% had moderate to severe deficits or died, 16.2% had epilepsy. For CSVT, the median age was 9.6 years (IQR:3.2-12.6). Diffuse neurological symptoms were present in 77.7%, primarily headaches and vomiting. Seizures occurred in 22.2%. All CSVT patients had at least one risk factor. Chronic systemic conditions (63%) and infections (44%) were the most common risk factors. During follow-up of a median of 43 months, 63.6% had no neurological deficits.</p><p><strong>Conclusions: </strong>Pediatric stroke has a broad spectrum of risk factors. Our study contributes to the existing knowledge on pediatric AIS and CSVT, providing a detailed overview of pediatric AIS and CSVT at a tertiary center, reflecting the growing awareness of physicians in childhood cerebrovascular diseases.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630162","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}