Acta neurologica Belgica最新文献

{"title":"Neuroprotective effect of Glibenclamide in stroke: a systematic review and meta-analysis of randomized controlled trials.","authors":"Guilherme José da Costa Borsatto, Heitor Pereira Vale da Costa, Laís Silva Santana, Mauri Brandão de Medeiros Neto, Victor Zanetti Strutz, Pedro Henrique Mouty Rabello, Vitor Nagai Yamaki, João Paulo Mota Telles, Eberval Gadelha Figueiredo","doi":"10.1007/s13760-025-02837-5","DOIUrl":"https://doi.org/10.1007/s13760-025-02837-5","url":null,"abstract":"<p><strong>Background: </strong>Stroke is a leading cause of death and disability, with cerebral edema contributing to poor outcomes. Glibenclamide, a sulfonylurea with potential neuroprotective properties, has shown effect in reducing cerebral edema in preclinical studies. This meta-analysis aimed to evaluate its efficacy in functional outcomes, cerebral edema, and mortality in patients with acute ischemic stroke (AIS), intracerebral hemorrhage (ICH), and aneurysmal subarachnoid hemorrhage (aSH).</p><p><strong>Methods: </strong>A systematic review and meta-analysis of randomized controlled trials (RCTs) comparing Glibenclamide to standard care in the acute management of stroke was conducted. Outcomes included functional status (mRS 0-3 at 3 months), cerebral edema (midline shift at 72-96 h), mortality, and hypoglycemia events.</p><p><strong>Results: </strong>Seven RCTs involving 1,225 patients met inclusion criteria. Glibenclamide did not improve functional status at 3 months in AIS and aSH but showed modest functional benefits in ICH (RR = 1.16; 95% CI: 1.04-1.28). No significant reduction in cerebral edema was observed in AIS (mean difference = 1.36 mm; 95% CI: -4.21 to 1.48). Mortality rates remained unchanged at discharge in aSH (RR = 0.78; 95% CI: 0.41-1.48) or at 3 months in AIS (RR = 0.97; 95% CI: 0.53-1.79). However, Glibenclamide increased hypoglycemia risk (RR = 3.57; 95% CI: 1.19-10.68).</p><p><strong>Conclusion: </strong>This meta-analysis found no significant benefits in functional outcomes, cerebral edema, or mortality with Glibenclamide in acute stroke. Despite an increased hypoglycemia risk, encouraging results in individual trials suggest potential benefits in specific subgroups. Further research should focus on identifying these subpopulations to refine Glibenclamide's role as a neuroprotective therapy.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590223","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 case series of functional movement disorders in paediatric population-phenomenology and clinical characteristics.","authors":"Ajith Cherian, Divya Kalikavil Puthanveedu, Amod R, Soumya Sundaram","doi":"10.1007/s13760-025-02836-6","DOIUrl":"https://doi.org/10.1007/s13760-025-02836-6","url":null,"abstract":"<p><strong>Background: </strong>Literature on functional movement disorders (FMD) in paediatric age group is scarce.</p><p><strong>Objectives: </strong>To study the phenomenology and characteristics of FMDs in paediatric age group.</p><p><strong>Methods: </strong>The study included 13 children (8 girls and 5 boys) from a tertiary-care centre. Assessment of FMD was based on Fahn and Williams criteria. Data included phenomenology, socioeconomic background, electrophysiological, and imaging investigations.</p><p><strong>Results: </strong>Mean age of onset was 12.1 ± 2.3 years. Sudden onset and triggers like minor injuries and stressors were common precipitants. 68% of the children were from urban areas, 61% belonged to low socioeconomic status and 61.5% had intellectual disability. 72% had a precipitating factor. The most common phenomenology was myoclonus (38%), followed by tremor (30%), dystonia (23%), and abnormal gait (15%). Clues to suggest a functional etiology were, isolated or predominant involvement of the dominant upper limb, distractibility, and entrainment in the case of tremor. Significant variability in frequency, amplitude, and distribution of the FMD by distracting manoeuvres were helpful in establishing the diagnosis. Tremor and dystonia predominated in girls, while myoclonus manifested more often in boys. Ten subjects (76%) presented with an isolated movement disorder, while 3 patients (24%) had a combination of ≥ 2. Nine patients had other sensory symptoms most commonly headache.</p><p><strong>Conclusions: </strong>FMDs were more common in children with intellectual disability than in those with normal IQ. Myoclonus was the most observed phenomenology. Among other comorbidities headache was the most common and depression followed by generalised anxiety were the most common psychiatric associations. Complete recovery is often possible with early intervention.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574674","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 methylphenidate and amantadine co-administration on functional outcome of patients with blunt traumatic brain injury: A randomized controlled trial.","authors":"Amirmohammad Farrokhi, Reza Mosaed, Hosseinali Khalili, Amin Niakan, Seyed Shahab Ghazi Mirsaeed","doi":"10.1007/s13760-025-02803-1","DOIUrl":"https://doi.org/10.1007/s13760-025-02803-1","url":null,"abstract":"<p><strong>Introduction: </strong>Traumatic brain injury (TBI) poses a large burden and cost on the patients, being among the most prevalent causes for emergency department visits. One of the major issues with TBI is the long-term functional outcome of patients, causing disabilities affecting the patient and the surrounding members of society. Several attempts have been made in order to address functional outcomes via means such as pharmacotherapy, physical therapy, and newer methods. In this study, we aimed to conduct a double-blinded, randomized controlled trial with the administration of methylphenidate and amantadine, two drugs proven effective separately in previous studies, to evaluate the functional outcome of patients with blunt TBI.</p><p><strong>Methods: </strong>Patients with blunt TBI were randomly assigned into treatment and control groups. Patients in the treatment group received 100 mg of amantadine and 20 mg of methylphenidate twice daily while patients in the control group received similarly shaped placebos. The patients age, gender, GCS, ICU and hospital length of stay and GOSE were evaluated and calculated for evaluation of outcome and initial condition. The main target was GOSE evaluated 6 months after discharge.</p><p><strong>Results: </strong>A total of 184 patients were included in our study, randomly and equally divided into the treatment and control groups. The mean age of patients was 40.63 ± 17.46, and 84.8% of patients were male. There was no significant difference between the two groups' age, gender, and initial GCS. Regarding outcome measures, there was no statistical difference between the groups in hospital and ICU length of stay. GOSE was significantly higher in patients in the treatment group (6.22 ± 2.06 vs. 5.37 ± 2.54, p = 0.014).</p><p><strong>Conclusion: </strong>Co-administering methylphenidate and amantadine could help patients with blunt TBI, especially in long-term settings, regarding their functional outcome.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574675","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":"National survey of current practices and attitudes regarding discharge disposition for older adults with mild traumatic brain injury and traumatic intracranial hemorrhage","authors":"Juliette A. L. Santing,&nbsp;Robert Croese,&nbsp;Joukje van der Naalt,&nbsp;Heleen den Hertog,&nbsp;Korné Jellema","doi":"10.1007/s13760-025-02834-8","DOIUrl":"10.1007/s13760-025-02834-8","url":null,"abstract":"<div><h3>Background</h3><p>Older patients with traumatic intracranial hemorrhage (tICH) following mild traumatic brain injury (mTBI) are commonly seen by neurologists in clinical practice. Due to the lack of clear evidence on optimal management, most guidelines recommend hospital admission for these patients. However, some studies have shown that selected low-risk patients can be safely discharged from the Emergency Department (ED). In light of these differing opinions and a lack of Class 1 evidence, we aimed to explore current management practices and attitudes toward tICH in older mTBI patients in the Netherlands.</p><h3>Methods</h3><p>A national online survey, involving the disposition strategies for five case vignettes of tICH, was sent to neurology residents and neurologists to explore current variations in clinical practice. We evaluated patient and hemorrhage characteristics influencing decisions regarding the discharge disposition of a patient from the ED.</p><h3>Results</h3><p>The survey was completed by 113 respondents, including 36 (32%) residents and 77 (68%) neurologists. In all the cases, over 70% of respondents preferred hospital admission over ED discharge for older mTBI patients with tICH. There was substantial variation in the respondents’ willingness to participate in a randomized trial evaluating the necessity of hospital admission after mTBI with tICH. Factors influencing admission varied between cases. A secondary deterioration risk of 1–2% was considered acceptable by the majority (53%) to allow direct ED discharge.</p><h3>Conclusion</h3><p>Our findings demonstrate limited willingness among clinicians to discharge older mTBI patients with tICH directly from the ED. To support safe and consistent decision-making, high-quality evidence is urgently needed to guide disposition decisions for older mTBI patients with tICH.</p></div>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":"125 4","pages":"1073 - 1081"},"PeriodicalIF":2.1,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s13760-025-02834-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551652","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":"Egocentric mental rotation in individuals with multiple sclerosis: relationship with disability and cognitive parameters.","authors":"Merve Ünal, Ayla Fil Balkan, Nazire Pınar Acar Özen, Aslı Tuncer, Yeliz Salcı","doi":"10.1007/s13760-025-02827-7","DOIUrl":"https://doi.org/10.1007/s13760-025-02827-7","url":null,"abstract":"<p><strong>Background: </strong>This study aims to examine whether egocentric-based mental rotation is affected in individuals with Multiple Sclerosis (MS) and to analyze its relationship with disability, functional system scores (FSS), and cognitive parameters.</p><p><strong>Methods: </strong>The study involved 57 right-dominant individuals with MS and 40 right dominant healthy subjects. Disability was assessed using the Neurostatus-Expanded Disability Status Scale (Neurostatus-EDSS). Participants' performance on mental rotation tasks was evaluated with the Recognise Hand App™, Recognise Foot App™, measuring reaction times (seconds) and accuracy (%) for hand and foot stimuli. Cognitive functioning was assessed using the Brief International Cognitive Assessment for MS (BICAMS).</p><p><strong>Results: </strong>MS patients exhibited lower performance in right hand mental rotation reaction time (p = 0.042), right hand accuracy percentage (p < 0.001), right foot accuracy percentage (p = 0.035). Positive correlations were found between disease duration, EDSS total score, cerebellar FSS, bladder-bowel FSS, and ambulation scores with reaction times, while negative correlations were observed with accuracy percentages (p < 0.05). Additionally, a positive correlation was identified between accuracy percentages and BICAMS (p < 0.05).</p><p><strong>Conclusions: </strong>The study revealed substantial impairments in right-hand and right-foot performance in right dominant individuals with MS. Mental rotation abilities were found to be related to disease duration, higher EDSS and FSS scores, as well as cognitive functioning. Identifying the cognitive domains and functional systems associated with egocentric mental rotation will contribute to better understanding this underexplored area and developing potential treatment strategies to enhance functionality.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144537732","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":"Insights into diagnostics and management of spinal neuroschistosomiasis: A scoping review of 230 cases of a neglected disease.","authors":"Hossam Tharwat Ali, Ayat Ahmad Elsherbiny, Zainab Salah Elmellah, Bahy El-Din M Saied, Sara Abdelhameed Khalil, Manar Mahmoud AbouElhagag Mohamed","doi":"10.1007/s13760-025-02833-9","DOIUrl":"https://doi.org/10.1007/s13760-025-02833-9","url":null,"abstract":"<p><strong>Background: </strong>Schistosomiasis is a neglected tropical disease caused by parasitic worms from the genus Schistosoma. Spinal neuroschistosomiasis (SN) is a rare but serious complication that can result in significant morbidity and mortality, with only a few hundred cases documented in the literature.</p><p><strong>Methods: </strong>Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA-ScR) statement, extension for scoping reviews, a systematic search of PubMed, Scopus, and Web of Science using relevant keywords, from inception until November 7th, 2024, was carried out followed by screening and extraction of only detailed cases.</p><p><strong>Results: </strong>Of 657 reports, 108 reports of 230 detailed cases were finally included. The included patients had a mean (standard deviation) age of 25.22 (14.65) years with most of them being males (79.6%). The majority of our patients (85.7%) got infected in endemic areas. As for clinical presentations, myelitis was the most common syndrome (48.3%) followed by myeloradicular syndrome (33.5%). The dorsal cord was the most frequently affected region, documented in 56.5% of cases. Imaging studies revealed pathological findings in 57.7% with magnetic resonance imaging (MRI) and 34.4% with computed tomography (CT). Cerebrospinal fluid (CSF) findings included elevated protein (47.4%), pleocytosis (26.5%), and eosinophilia (29.6%). Anti-parasitic use was reported in most cases (79.6%) while steroids were attempted in 70.5% of cases. A complete recovery was achieved in 18% of cases. Death was the outcome in 4% of the included patients.</p><p><strong>Conclusions: </strong>Due to delayed diagnosis and rarity, SN causes significant morbidity and mortality with diagnostic challenges and heterogeneity.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144525954","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":"Heart rate variability in people with multiple sclerosis: A systematic review and meta-analysis.","authors":"Omid Mirmosayyeb, Mohammad Yazdan Panah, Mohammadreza Alinejadfard, Soroush Oraee, Saeed Vaheb, Vahid Shaygannejad","doi":"10.1007/s13760-025-02829-5","DOIUrl":"https://doi.org/10.1007/s13760-025-02829-5","url":null,"abstract":"<p><strong>Background: </strong>Multiple sclerosis (MS) is a neurodegenerative disease with diverse symptoms, including autonomic nervous system impairment. While autonomic dysfunction is well-documented in MS, debate continues over its extent and whether it primarily affects the sympathetic or parasympathetic divisions. This review aimed to investigate heart rate variability (HRV) as an indicator of cardiac autonomic function in people with MS (PwMS).\"</p><p><strong>Methods: </strong>PubMed/MEDLINE, Web of Science, Embase, and Scopus were systematically searched up to August 2024 to identify observational studies that assessed HRV in PwMS and healthy controls (HCs). The standard mean difference (SMD) of HRV parameters, along with its 95% confidence interval (CI), between PwMS and HCs was estimated utilizing R version 4.4.0 within the random-effects model.</p><p><strong>Results: </strong>This study combined data from 43 studies on 1518 PwMS and 1062 HCs. The meta-analysis revealed significant autonomic dysfunction in PwMS compared to HCs. Specifically, the time-domain measures such as root mean square of successive differences (RMSSD) (SMD = -0.81, p  <  0.01) and pNN50 (SMD = -0.63, p  <  0.001) showed significant reductions in PwMS, compared to HCs. Furthermore, among frequency domains, high frequency (HF) power (SMD = -0.51, p  <  0.01) and low frequency (LF) power were significantly lower in PwMS (SMD = -0.44, p  <  0.05) than HCs.</p><p><strong>Conclusion: </strong>This review revealed that PwMS exhibited different HRV than healthy individuals. Additionally, HRV findings demonstrated greater sympathetic dominance in PwMS compared to healthy individuals. Future studies are needed to explore HRV in PwMS across varying severity levels, subtypes, and treatments to understand autonomic dysfunction in this population better.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144525953","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":"Steroid therapy for severe cerebral venous thrombosis with rare manifestations of parkinsonism: a case report and literature review.","authors":"Wensi Hao, Yaqin Gu, Xunming Ji, Yuping Wang, Jiangang Duan","doi":"10.1007/s13760-025-02832-w","DOIUrl":"https://doi.org/10.1007/s13760-025-02832-w","url":null,"abstract":"","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511400","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":"Comparative assessment of endoscopic and microsurgery resection for intracranial ventricular tumors: a meta-analysis of 3059 patients.","authors":"Sandra Thair Al-Aish, Abbas F Abdul Hussein, Ahmed Sermed Al Sakini, Mohamed Rifai, Mustafa L Alshareefi, Mohammad Al Diab Al Azzawi, Khalid Sarhan, Hazim Alkousheh, Zineddine Belabaci, Arwa Jader, Santiago Pastrana-Brandes, Sameh Elmorsy Hassan","doi":"10.1007/s13760-025-02835-7","DOIUrl":"10.1007/s13760-025-02835-7","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and aim: &lt;/strong&gt;Surgical resection of ventricular brain tumors is traditionally performed via microsurgery, which requires open craniotomy and can result in significant complications. Endoscopic approaches have emerged as minimally invasive alternatives. There is a lack of consensus regarding the preferred surgical strategy for ventricular tumor resection; the technique with the optimal rates of recurrence, mortality, and complications is debatable.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;This article aims to evaluate the efficacy of endoscopic resection in comparison to microsurgical resection, focusing on identifying the approach with superior clinical outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;To determine surgical outcomes, we performed a meta-analysis of the existing original studies across PubMed, SCOPUS, Cochrane, and Web of Science medical databases from inception to 20 February 2024, per PRISMA guidelines that discussed microsurgery and endoscopic resection in ventricular tumors. Eligible studies (n = 47) were included, which contained data describing clinical outcomes, postoperative complications, and mortality rates that were extracted and analyzed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 47 studies, encompassing 3,059 patients (1,121 microsurgery, 1,938 endoscopy), were included. The mean age was 37.4 years (range 6-64), with 66.62% male (1,701/3,059). Colloid cysts were present in 67% (1,629/3,059), predominantly located in the third ventricle (55%, 715/1,301). Headache (96.15%, 2,700/2,808) was the most common symptom, followed by nausea/vomiting (12.5%, 351/2,808) and visual field deficits (11.26%, 316/2,808). The pooled gross-total resection (GTR) rate was 81.5% (95% CI, 75-88.1%; I²=66.66%), with endoscopic and microsurgery subgroups yielding GTR rates of 80% and 84.4%, respectively. Recurrence occurred in 4.7% (95% CI, 2.8-6.6%; I²=72.74%), with endoscopic and microsurgery rates of 3.9% and 6.6%. The mortality rate was 1.7% (95% CI, 0.9-2.5%; I²=29.1%), lower in endoscopic (0.6%) than microsurgery (5.2%). Postoperative hydrocephalus was noted in 4.8% (95% CI, 1.5-8.1%; I²=49.7%), cognitive deficits in 4.9% (95% CI, 3-6.9%; I²=33.57%), and cerebrospinal fluid leakage in 4.7% (95% CI, 1.8-7.6%; I²=53.81%). Seizures occurred in 3.6% (95% CI, 2-5.2%; I²=5.08%), neurological deficits in 5.5% (95% CI, 3-8%; I²=72.64%), visual field defects in 4.3% (95% CI, 2.6-6%; I²=35%), and wound infections in 2.5% (95% CI, 1-4%; I²=0%). Subgroup analyses generally showed lower complication rates for endoscopic surgery compared to microsurgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Endoscopic resection offers favorable trends in the management of ventricular tumors. These include improved neurological outcomes, postoperative complications such as visual field defects and seizure rates, and lower mortality rates. Despite the need for further research to fully elucidate its benefits, Endoscopic resection stands out as a valuable tech","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144525952","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":"Poor neurological outcome after treatment with photobiomodulation in a patient recovering from sequelae of vertebral artery dissection.","authors":"W J van Rooij, M Sluzewski","doi":"10.1007/s13760-025-02830-y","DOIUrl":"https://doi.org/10.1007/s13760-025-02830-y","url":null,"abstract":"<p><strong>Background: </strong>PhotBioModulation Therapy (PBMT) is regarded as a safe therapy for various disorders. We report a patient with a vertebral artery dissection treated with PBMT resulting in a poor neurological outcome.</p><p><strong>Case presentation: </strong>A 69-year-old patient with a PICA infarction after a vertebral artery dissection was treated with PhotoBioModulation Therapy using a helmet. This therapy induces strong vasodilatation in the area of application. Shortly after this treatment, she fell asleep and did not wake up the next morning. Clinically she was comatose and an MRI showed bithalamic and mesencephalic infarction as a result of thrombosis of the basilar artery tip. A causative relation between the PhotoBioModulation Therapy and the poor outcome is likely based on the time course, the immediate complaints after treatment, and the usually excellent prognosis after vertebral artery dissection.</p><p><strong>Conclusion: </strong>We advise the manufacturers of PBMT devices to add (recent) stroke to the list of contraindications.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144493367","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}