Brain & spine最新文献

{"title":"Lumbar disc space height in relation to neural foraminal dimensions and patient characteristics: A morphometric analysis from L1-S1 using computed tomography","authors":"David Shin ,&nbsp;Ethan Vyhmeister ,&nbsp;Daniel Im ,&nbsp;Andrew Fay ,&nbsp;Owen Faehner ,&nbsp;Andrew Cabrera ,&nbsp;Alexander Bouterse ,&nbsp;Lauren Seo ,&nbsp;Derran Bedward ,&nbsp;Mei Carter ,&nbsp;Davis Carter ,&nbsp;Jacob Razzouk ,&nbsp;Omar Ramos ,&nbsp;Nathaniel Wycliffe ,&nbsp;Wayne Cheng ,&nbsp;Olumide Danisa","doi":"10.1016/j.bas.2024.104162","DOIUrl":"10.1016/j.bas.2024.104162","url":null,"abstract":"<div><h3>Introduction</h3><div>The normative relationship between lumbar intervertebral disc space height (DSH) and neuroforaminal dimensions (NFD) has yet to be defined.</div></div><div><h3>Research question</h3><div>The purpose of this study was to investigate the relationship between lumbar DSH and NFD using computed tomography (CT), accounting for influences of patient demographic and anthropometric characteristics.</div></div><div><h3>Materials and methods</h3><div>We analyzed CT imaging of 350 female and 350 male patients. Anterior, middle, and posterior DSH were measured. NFD were defined as sagittal anterior-to-posterior (AP) width, axial AP width, foraminal height, and area. Statistical analyses were performed to assess associations among DSH, NFD, and patient height, weight, body mass index, sex, and ethnicity.</div></div><div><h3>Results</h3><div>Irrespective of disc level, mean anterior, middle, and posterior DSH were 7.98 mm (n = 3500), 8.16 mm (n = 3500), and 4.09 mm (n = 3500). DSH measurements demonstrated increasing, linear trends moving caudally from L1-L2 to L5-S1, while NFD demonstrated a unimodal distribution pattern with largest NFD at L3-L4 and smallest NFD at L1-2 and L5-S1. Male patients demonstrated larger DSH compared to female patients from L1-S1. Asian patients demonstrated taller DSH across all levels L1-S1.</div></div><div><h3>Discussion and conclusion</h3><div>This study describes 38,500 CT-based L1-S1 DSH and NFD in young patients without spinal pathology. DSH follows an increasing trend moving caudally from L1-S1, while NFD demonstrate a unimodal distribution clustered at L3-L4. NFD are not moderately or strongly associated with DSH. DSH is influenced by sex and ethnicity but is not moderately or strongly influenced by patient height, weight, and BMI.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104162"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11700277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decompressive craniectomy following subarachnoid hemorrhage: A prospective Swedish multicenter study","authors":"Bryndís Baldvinsdóttir ,&nbsp;Erik Kronvall ,&nbsp;Elisabeth Ronne-Engström ,&nbsp;Per Enblad ,&nbsp;Paula Klurfan ,&nbsp;Johanna Eneling ,&nbsp;Peter Lindvall ,&nbsp;Helena Aineskog ,&nbsp;Steen Friðriksson ,&nbsp;Mikael Svensson ,&nbsp;Peter Alpkvist ,&nbsp;Jan Hillman ,&nbsp;Ola G. Nilsson","doi":"10.1016/j.bas.2025.104218","DOIUrl":"10.1016/j.bas.2025.104218","url":null,"abstract":"<div><h3>Introduction</h3><div>Decompressive craniectomy (DC) in patients with severe aneurysmal subarachnoid hemorrhage (aSAH) can be a life-saving procedure. The aim of this nationwide prospective study was to investigate the use of DC in aSAH patients in Sweden.</div></div><div><h3>Research question</h3><div>To explore the risk factors and functional outcome associated with DC in patients with aSAH.</div></div><div><h3>Material and methods</h3><div>Patients treated for aSAH at all neurosurgical centers in Sweden during a 3.5-year period (2014–2018) were prospectively registered. Clinical, radiological and treatment-related factors with regard to DC were analyzed using Chi-Square and logistic regression analysis. Functional outcome was assessed by the extended Glasgow outcome scale one year after the bleeding.</div></div><div><h3>Results</h3><div>During the study period, 1037 patients were treated for aSAH. Thirty-five patients (3.4%) underwent DC. At one year follow-up, 25 of these (71%) had unfavorable functional outcome. Multivariate logistic regression analysis revealed that poor clinical grade before aneurysm treatment, middle cerebral artery (MCA) aneurysm, edema on the initial computed tomography (CT), and adverse events during aneurysm occlusion were independent and significant risk factors for performing DC.</div></div><div><h3>Discussion and conclusion</h3><div>DC is relatively uncommon in aSAH patients and is related to increased risk of unfavorable outcome. However, favorable functional outcome was seen in 29% of patients with DC. Adverse events during aneurysm occlusion were significant risk factors for DC.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104218"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143487943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of government-issued lockdowns during the COVID-19 pandemic on traumatic brain injuries in Tyrol, Austria","authors":"Victoria Schön ,&nbsp;Alina Farbmacher ,&nbsp;Lukas Grassner ,&nbsp;Barbara Klein ,&nbsp;Claudius Thomé ,&nbsp;Daniel Pinggera","doi":"10.1016/j.bas.2024.104159","DOIUrl":"10.1016/j.bas.2024.104159","url":null,"abstract":"<div><h3>Introduction</h3><div>In February 2020, COVID-19 infections started to spread in Austria. This was followed by governmental actions and constraints such as lockdowns, quarantine protocols, and a ban on outdoor sports. The goal of this study was to investigate the influence of these measures on the number of traumatic brain injuries (TBI) in the state of Tyrol.</div></div><div><h3>Methods</h3><div>The incidence of TBI during lockdowns and restrictions of outdoor activities in 2020 and 2021 were compared with corresponding periods in previous years. The data was retrospectively collected and analyzed.</div></div><div><h3>Results</h3><div>During the first lockdown in the winter of 2020/2021, there was a notably lower incidence of moderate and severe TBIs compared to the corresponding period in 2019/2020 (p = 0.016). Similarly, there was a reduction in TBIs from sports accidents during this period (p = 0.010). However, when comparing other lockdown periods to the previous years, no differences were observed.</div></div><div><h3>Conclusion</h3><div>The various governmental measures restricting mobility aimed to contain the COVID-19 pandemic but showed little influence on the number of TBI cases. Only a lockdown in the accident-prone winter months has influenced the incidence of TBIs.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104159"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and natural development of thoracolumbar kyphosis in achondroplasia: A systematic review and meta-analysis","authors":"Chady Omara ,&nbsp;Rania A. Mekary ,&nbsp;Carmen L.A. Vleggeert-Lankamp","doi":"10.1016/j.bas.2024.104177","DOIUrl":"10.1016/j.bas.2024.104177","url":null,"abstract":"<div><h3>Introduction</h3><div>Thoracolumbar kyphosis (TLK) is a frequently reported spinal deformity in achondroplasia, which in combination with the characteristic narrow spinal canal in achondroplasia predisposes for symptomatic spinal stenosis. There is however no consensus on the optimal treatment, due to limited data on diagnostic criteria, the natural development and the prevalence of TLK.</div></div><div><h3>Research question</h3><div>This study aims to assess the prevalence, natural development, and diagnostic criteria for pathological TLK in individuals with achondroplasia.</div></div><div><h3>Material and methods</h3><div>A systematic review and meta-analysis were conducted. Studies involving achondroplasia patients, which reported TLK measurement methods were included. The primary outcome was the pooled prevalence of TLK, stratified by age.</div></div><div><h3>Results</h3><div>Eight studies, encompassing 852 patients, met the inclusion criteria. Pathological TLK was most frequently defined as a Cobb angle of 20° or greater, between T10 and L2. TLK was present in 87% (95% CI 80%–91%) of patients under two years old, decreasing to 33% (24%–43%) at age three, 26% (19%–35%) between five and ten years, and 23% (16%–31%) in patients aged 10–20 years.</div></div><div><h3>Discussion and conclusion</h3><div>Pathological TLK in achondroplasia, defined as a Cobb angle of 20° or greater, appears primarily in early childhood and often resolves by walking age. However, approximately one-fourth of cases persist into adulthood, with factors such as developmental motor delay and vertebral wedging contributing to this persistence. Routine clinical and radiological evaluations during childhood, along with conservative management, are recommended to mitigate the need for surgery during adulthood.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104177"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of the spatiotemporal dynamics of vascular injury and regeneration following experimental Spinal Cord Injury","authors":"Christian J. Entenmann ,&nbsp;Emily J. von Bronewski ,&nbsp;Lilly Waldmann ,&nbsp;Lea Meyer ,&nbsp;Katharina Kersting ,&nbsp;Laurens T. Roolfs ,&nbsp;Lasse M. Schleker ,&nbsp;Melina Nieminen-Kelhä ,&nbsp;Irina Kremenetskaia ,&nbsp;Frank L. Heppner ,&nbsp;Michael G. Fehlings ,&nbsp;Peter Vajkoczy ,&nbsp;Vanessa Hubertus","doi":"10.1016/j.bas.2025.104191","DOIUrl":"10.1016/j.bas.2025.104191","url":null,"abstract":"<div><h3>Introduction</h3><div>The loss of vasculature in Spinal Cord Injury (SCI) contributes to secondary injury, expanding the injury to unharmed spinal cord (SC) regions. Understanding these mechanisms is crucial for developing therapeutic interventions.</div></div><div><h3>Research question</h3><div>Comprehensive analysis of the temporospatial dynamics of vascular injury and regeneration following SCI.</div></div><div><h3>Materials and methods</h3><div>Adult C57BL/6J mice were subjected to clip-compression SCI (Th 6/7, 5g, 60s, n = 20) or sham injury (laminectomy, n = 4), and sacrificed at 1, 3, 7, 14, and 28 days (d) post-injury following intracardial fluorescein isothiocyanate (FITC)-Lectin perfusion. Histological analysis (CD31, FITC-Lectin, Ki-67, IgG, TER-119) assessed vascular changes, permeability, and proliferation within the injury epicenter (region 0 (R0), ± 0,5 mm) and two adjacent SC regions (R1: ± 1 mm, R2: ± 2.5 mm).</div></div><div><h3>Results</h3><div>Perfusion loss (FITC-Lectin+/CD31+), was most severe in R0 and R1 at d3 (p &lt; 0.01). Significant vascular loss in R2 started at d3 (p = 0.043). Perfusion was restored at d28 in R0 and R1, and at d7 in R2. Vessel density (CD31⁺) returned to baseline quicker (R0: d3, R1 and R2: d14). Vascular proliferation (CD31+/Ki-67+) manifested across all regions at d3 (p &lt; 0.01), and most notably in R2 (p &lt; 0.01). Vascular permeability for IgG remained disrupted until d3 in R0 and R1 and until d14 in R2.</div></div><div><h3>Discussion and conclusion</h3><div>Vascular injury is most severe initially and spreads to the surrounding SC regions. Gradual vascular regeneration occurs early and up to a considerable distance from the injury epicenter, highlighting the potential of early therapeutic interventions targeted at vascular repair and regeneration.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104191"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143102239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stereotactic aspiration alone or Ommaya placement and aspiration followed by stereotactic radiosurgery for cystic brain metastasis: A systematic review and meta-analysis","authors":"David R. Peters ,&nbsp;Alfredo Conti ,&nbsp;Marc Levivier ,&nbsp;Luis Schiappacasse ,&nbsp;Mohamed Faouzi ,&nbsp;Mioara Florentina Trandafirescu ,&nbsp;Constantin Tuleasca","doi":"10.1016/j.bas.2025.104184","DOIUrl":"10.1016/j.bas.2025.104184","url":null,"abstract":"<div><h3>Introduction</h3><div>Cystic brain metastases (BMs) are often more challenging to treat than solid BMs. Stereotactic cyst aspiration for volume reduction followed by stereotactic radiosurgery (SRS) is an alternative treatment modality that may benefit patients with large cystic BMs not favorable for SRS alone nor microsurgical resection.</div></div><div><h3>Research question</h3><div>Here, we perform a systematic review and meta-analysis of stereotactic aspiration alone or reservoir (Ommaya) placement plus aspiration followed by SRS for cystic BMs.</div></div><div><h3>Material and methods</h3><div>Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we reviewed articles published between 1968 and December 31^−th, 2022. We retained 10 studies reporting 280 patients.</div></div><div><h3>Results</h3><div>Overall rate of tumor control for combined treatment of Ommaya placement plus aspiration plus SRS was 81.2% (62.5–99.9%, p &lt; 0.001) and for stereotactic aspiration plus SRS was 64.7% (46.1–83.3%, p &lt; 0.001). Overall rate of further intervention for combined treatment of Ommaya placement plus aspiration plus SRS was 15.8% (p = 0.08) and for stereotactic aspiration plus SRS was 14.8% (5.3–24.4%, p = 0.002). Overall complication rate for combined treatment of Ommaya placement plus aspiration plus SRS was 12.8% (2.3–23.3%, p = 0.01) and for stereotactic aspiration plus SRS was 1.5% (p = 0.12).</div></div><div><h3>Discussion and conclusion</h3><div>Combined treatment of Ommaya placement plus cyst aspiration plus SRS in cystic BMs yields better local control as compared to stereotactic aspiration plus SRS, with similar rate of further intervention between procedures. Aspiration of the cyst plus SRS should be considered for patients with cystic metastases not able to undergo open surgery or upfront SRS.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104184"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143102303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors influencing the adoption of innovation in spine surgery: An international survey of AO spine network","authors":"Arun Kumar Viswanadha ,&nbsp;Luca Ambrosio ,&nbsp;Pieter-Paul A. Vergroesen ,&nbsp;Zorica Buser ,&nbsp;Hans Joerg Meisel ,&nbsp;Nancy Santesso ,&nbsp;Jason P.Y. Cheung ,&nbsp;Yabin Wu ,&nbsp;Hai V. Le ,&nbsp;Gianluca Vadalà ,&nbsp;Amit Jain ,&nbsp;Andreas K. Demetriades ,&nbsp;Sam K. Cho ,&nbsp;Patrick C. Hsieh ,&nbsp;Ashish Diwan ,&nbsp;Tim Yoon ,&nbsp;Sathish Muthu ,&nbsp;AO Spine Knowledge Forum Degenerative","doi":"10.1016/j.bas.2025.104206","DOIUrl":"10.1016/j.bas.2025.104206","url":null,"abstract":"<div><h3>Introduction</h3><div>Knowledge translation from research to clinical practice can often be challenging, and practice modification patterns among surgeons may stem from a variety of sources, including personal experience, peer influence, ongoing education, and evolving research findings.</div></div><div><h3>Research question</h3><div>This study aimed to investigate the adoption patterns amongst surgeons for newer innovations and to analyse the factors affecting the implementation of the same in clinical practice. We used the adoption of osteobiologics as a case example.</div></div><div><h3>Methods</h3><div>An international expert survey was conducted among AO Spine users and members. The survey, comprising 30 items, explored surgeons' demographics, risk aversion, and factors influencing practice change. We categorized the innovation-adoptive nature of the surgeons and scored their risk-adoptive behaviour.</div></div><div><h3>Results</h3><div>A total of 458 responses were received from surgeons across 81 countries including 433 male (95%), orthopaedic surgeons (n = 263; 57%) from university-affiliated hospitals (n = 185; 40%). Most were in the early majority phase of the innovation-adoption cycle (n = 174; 38%) with a majority in the ‘high-moderate’ risk-adoption category (n = 396; 86%). This risk adoption behaviour had a significant correlation with their appetite for innovation (r = 0.182,p=&lt;0.001). About 67.9% of respondents preferred scientific literature and conference presentations showcasing solid clinical evidence to be the most influential factor in driving change in their clinical practice. Material logistics (55%) is considered an important barrier to practice modification followed by familiarity (50%) and financial reimbursements (25%).</div></div><div><h3>Discussion &amp; conclusion</h3><div>A complex interplay exists between risk-adoptive behaviour amongst surgeons and the factors influencing a change in their clinical practice. Although most surgeons were in the early adoptive phase in accepting the innovations into their clinical practice, they were also equally noted to be risk tolerant. Hence, a successful adoption of practice-changing innovation hinges on addressing not only logistical and financial challenges but also on providing robust scientific evidence to drive the necessary change in clinical practice.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104206"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143422354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The diagnostic and prognostic capability of artificial intelligence in spinal cord injury: A systematic review","authors":"Saran Singh Gill ,&nbsp;Hariharan Subbiah Ponniah ,&nbsp;Sho Giersztein ,&nbsp;Rishi Miriyala Anantharaj ,&nbsp;Srikar Reddy Namireddy ,&nbsp;Joshua Killilea ,&nbsp;DanieleS.C. Ramsay ,&nbsp;Ahmed Salih ,&nbsp;Ahkash Thavarajasingam ,&nbsp;Daniel Scurtu ,&nbsp;Dragan Jankovic ,&nbsp;Salvatore Russo ,&nbsp;Andreas Kramer ,&nbsp;Santhosh G. Thavarajasingam","doi":"10.1016/j.bas.2025.104208","DOIUrl":"10.1016/j.bas.2025.104208","url":null,"abstract":"<div><h3>Background</h3><div>Artificial intelligence (AI) models have shown potential for diagnosing and prognosticating traumatic spinal cord injury (tSCI), but their clinical utility remains uncertain.</div></div><div><h3>Method</h3><div>ology: The primary aim was to evaluate the performance of AI algorithms in diagnosing and prognosticating tSCI. Subsequent systematic searching of seven databases identified studies evaluating AI models. PROBAST and TRIPOD tools were used to assess the quality and reporting of included studies (PROSPERO: CRD42023464722). Fourteen studies, comprising 20 models and 280,817 pooled imaging datasets, were included. Analysis was conducted in line with the SWiM guidelines.</div></div><div><h3>Results</h3><div>For prognostication, 11 studies predicted outcomes including AIS improvement (30%), mortality and ambulatory ability (20% each), and discharge or length of stay (10%). The mean AUC was 0.770 (range: 0.682–0.902), indicating moderate predictive performance. Diagnostic models utilising DTI, CT, and T2-weighted MRI with CNN-based segmentation achieved a weighted mean accuracy of 0.898 (range: 0.813–0.938), outperforming prognostic models.</div></div><div><h3>Conclusion</h3><div>AI demonstrates strong diagnostic accuracy (mean accuracy: 0.898) and moderate prognostic capability (mean AUC: 0.770) for tSCI. However, the lack of standardised frameworks and external validation limits clinical applicability. Future models should integrate multimodal data, including imaging, patient characteristics, and clinician judgment, to improve utility and alignment with clinical practice.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104208"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143422355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subject: Letter to the Editor on \"Diagnostic and prognostic performance of urine ubiquitin carboxy-terminal hydrolase L1 across multiple acute brain injury types – A longitudinal prospective cohort study\"","authors":"Muhammad Ibrahim","doi":"10.1016/j.bas.2025.104209","DOIUrl":"10.1016/j.bas.2025.104209","url":null,"abstract":"","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104209"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143422405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis of subarachnoid haemorrhage: Systematic evaluation of CT head diagnostic accuracy and comparison with the 2022 NICE guidelines","authors":"Conor S. Gillespie ,&nbsp;John Gerrard Hanrahan ,&nbsp;Roxana Mahdiyar ,&nbsp;Keng Siang Lee ,&nbsp;Mohammad Ashraf ,&nbsp;Ali M. Alam ,&nbsp;Justyna O. Ekert ,&nbsp;Orla Mantle ,&nbsp;Simon C. Williams ,&nbsp;Jonathan P. Funnell ,&nbsp;Nihal Gurusinghe ,&nbsp;Raghu Vindlacheruvu ,&nbsp;Peter C. Whitfield (Prof) ,&nbsp;Rikin A. Trivedi ,&nbsp;Adel Helmy ,&nbsp;Peter J. Hutchinson (Prof)","doi":"10.1016/j.bas.2025.104200","DOIUrl":"10.1016/j.bas.2025.104200","url":null,"abstract":"<div><h3>Introduction</h3><div>Aneurysmal subarachnoid haemorrhage has a high incidence, and morbidity. It has been suggested that a negative non-contrast CT head can rule out SAH if performed within 6 h of symptom onset.</div></div><div><h3>Research question</h3><div>What is the sensitivity of CT head at ruling out SAH stratified by time-point, and what is the potential impact of omitting Lumbar Puncture (LP) from the diagnostic pathway?</div></div><div><h3>Material and methods</h3><div>Systematic review and meta-analysis (PROSPEROID CRD42022379929). Three databases were searched, and articles published between January 2000–May 2022 included (Search date 27^th November 2022). Primary objective was diagnostic accuracy of CT scans for detecting SAH at &lt;6 h from symptom onset, including reported sensitivity, and specificity values.</div></div><div><h3>Results</h3><div>63 articles were included (38,237 patients, 7673 with SAH). Pooled CT head sensitivity was 0.94 for excluding SAH (22 studies, 95% Confidence Interval [CI] 0.90–0.97). At &lt;6 h, CT head sensitivity was 0.995 (6 studies, 95% CI 0.941–1.000). Most studies (57.1%, n = 36/63) were classified as high risk of bias. If LP was removed from the diagnostic pathway in the UK, assuming an incidence of 4800 SAH per-year, 336 SAH would be missed per-year, 24 per-year if LP was removed for negative CT &lt; 6 h (95% CI 0–278) and 58 per-year if mean sensitivity is used (95% CI 0–240).</div></div><div><h3>Discussion and conclusion</h3><div>CT head appears to be highly sensitive at excluding SAH &lt;6 h from symptom onset. High quality, prospective data is required to further established the utility of early (&lt;6 h) negative CT head. We recommend that if there is strong clinical suspicion of SAH, yet CT head is reported negative &lt;6 h of symptom onset, that a LP be performed.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104200"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143395701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}