NeuroSci最新文献

{"title":"Retrospective Cohort Study of 221 Cases of Epidural Per-Cutaneous Peri-Neural Release (Adhesiolysis).","authors":"Yasin Said Almakadma, Jouhara Jouhar, Abdulaziz Farooq, Tahani Albatarni","doi":"10.3390/neurosci7020033","DOIUrl":"10.3390/neurosci7020033","url":null,"abstract":"<p><strong>Background: </strong>Lower limb (LL) and low back Radicular Syndromes (RSs) may result from discopathy of the lumbo-sacral spine. Consistent benefits are reported from Epidural Adhesiolysis (EA).</p><p><strong>Aim: </strong>To evaluate clinical and European Quality of Life items (EQ-5D) of Peri-Neural Release interventions (PNR, a modified approach and terminology for EA) among patients diagnosed with lumbo-sacral discopathy associated radicular syndromes.</p><p><strong>Methods: </strong>A retrospective study was conducted by retrieving records of patients e treated by PNR for low back and lower limbs pain between January 2018 and December 2024. Eligible patients were adults who were diagnosed with lumbo-sacral discopathy, stenosis, or Post Lumbar Surgery Syndrome (PLSS). Data on Patient-Reported Outcome Measures (PROMs) adopting the European Quality of Life five items (Euro-QoL 5D) that includes self-ratings of mobility, active daily living, self-care, pain and discomfort, anxiety and depression) was collected before the procedure and on subsequent follow-up visits. Other clinical outcomes included numerical pain rating scales (NRSs), sleep quality, time to pain during activity, and self-reported health scores.</p><p><strong>Results: </strong>A total of 221 patients were included in this analysis. Of these, 56.6% were female, with a mean age of 45.1 ± 14.7 years. In total, 50.2% of patients underwent PNR alone, followed by 28.1% who underwent PNR balloon decompression neuroplasty. Of the remaining patients, 7.2% underwent epiduroscopic PNR, 6.3% PNR combined with annuloplasty (biacuplasty) and 8.1% underwent PNR combined with nucleoplasty. Significant improvements were observed across all EQ-5D and NRS (<i>p</i> < 0.001) at follow-up assessments without major complications. The interventions were associated with a decrease in NRS from 7.9 to 3.1, and an increase in the duration of pain-free activity (walking, standing, sitting) (<i>p</i> < 0.001). Self-reported overall health scores improved from 53.9 ± 18.4 to 81.1 ± 15.1. In terms of complications, two patients reported post-operative headache. The remaining side effects included coccydynia at the site of intervention, resolving with application of non-steroid anti-inflammatory topicals and self-resolving lower limb numbness in five cases.</p><p><strong>Conclusions: </strong>The presented data suggest that PNR-whether performed alone or in combination with adjunctive intradiscal procedures-is a safe intervention, and is associated, in the majority of patients, with substantial pain relief and improvement in EQ-5D both in the short- and long-term follow-up.</p>","PeriodicalId":74294,"journal":{"name":"NeuroSci","volume":"7 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505776","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":"Differentiating Atypical BPPV from Central Positional Vertigo: A Narrative Review.","authors":"Giorgos Sideris, George Korres, Ilias Lazarou, Eleni Vasileiou, Amanda Male, Diego Kaski","doi":"10.3390/neurosci7020032","DOIUrl":"10.3390/neurosci7020032","url":null,"abstract":"<p><p>While typical benign paroxysmal positional vertigo (BPPV) presents with reproducible patterns of nystagmus and vertigo during positional testing, atypical variants often deviate from typical patterns, making diagnosis more complex. Recognizing atypical BPPV is crucial to avoid misdiagnosis and inappropriate management. This study aims to describe the clinical spectrum of atypical BPPV, differentiate it from central positional vertigo, and provide practical diagnostic guidance for clinicians. A narrative review was conducted to explore the clinical spectrum of atypical BPPV. Findings indicate that it may present with vertigo without nystagmus, conflicting torsional components in bilateral cases, or persistent symptoms despite repositioning maneuvers. Canal switch and pseudo-spontaneous nystagmus have also been described. Although these variants may mimic central etiologies, the absence of consistent neurological signs supports a peripheral mechanism. Diagnosis relies on detailed assessment of nystagmus characteristics-such as latency, /duration, and direction-as well as the exclusion of red flags, like direction-changing nystagmus without head movement, vomiting, or non-positional ocular motor abnormalities. Atypical BPPV remains a diagnostic challenge and requires careful bedside assessment and clinical testing. Understanding these variants is essential for timely and appropriate treatment. When doubt persists and resolution with treatment does not occur, neuroimaging should be considered to exclude central pathology.</p>","PeriodicalId":74294,"journal":{"name":"NeuroSci","volume":"7 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505746","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":"Beyond Hyperexcitability: A Review of Neural Mechanisms in Charles Bonnet Syndrome.","authors":"Eric Altieri, Luca Battaglini","doi":"10.3390/neurosci7020031","DOIUrl":"10.3390/neurosci7020031","url":null,"abstract":"<p><p>Charles Bonnet syndrome (CBS) is characterized by complex visual hallucinations in visually impaired individuals who maintain intact cognitive function. Despite significant progress in understanding this condition, the precise neural mechanisms underlying CBS remain incompletely understood. This review synthesizes current evidence regarding the pathophysiology of CBS, with particular emphasis on emerging neurobiological models that extend beyond simple cortical hyperexcitability. Recent neuroimaging, neurophysiological, and computational modeling studies suggest that CBS hallucinations may arise from complex interactions among deafferentation-induced neural plasticity, neurotransmitter imbalances, and altered functional connectivity within visual processing hierarchies. The evidence increasingly points toward a model involving desynchronization between bottom-up and top-down visual processing pathways, rather than mere hyperexcitability of deafferented visual cortex. This integrated perspective has important implications for both the theoretical understanding of visual perception and the development of targeted therapeutic interventions.</p>","PeriodicalId":74294,"journal":{"name":"NeuroSci","volume":"7 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505753","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":"Impulsivity in NrCAM KO Mice Is Reduced by NMDAR Antagonist MK-801 but Not by AMPAR Antagonist CNQX.","authors":"Mona Buhusi, Catalin V Buhusi","doi":"10.3390/neurosci7020029","DOIUrl":"10.3390/neurosci7020029","url":null,"abstract":"<p><p>The neuronal cell adhesion molecule NrCAM is widely expressed in the nervous system across the lifespan and has important physiological functions in the development of neuronal circuits through axonal growth and guidance and formation and maintenance of synapses in the cortex. NrCAM gene polymorphisms are associated with vulnerability to neuropsychiatric disorders such as schizophrenia, as well as vulnerability to substance use disorders. We investigated the effects of acute and chronic stress and the effects of systemic administration of AMPAR antagonist CNQX and NMDAR antagonist MK-801 on delay discounting in male NrCAM knockout (KO) mice and their wild-type littermate controls (WT). Under the no-stress condition, no discounting differences were found. Acute stress increased discounting and impulsivity in WTs but not in NrCAM KO mice. Chronic stress increased discounting and impulsivity in both genotypes. CNQX increased impulsive choice in WT controls but not in NrCAM KOs; impulsive choice decreased in both genotypes after MK-801 administration. Relative to WTs, NrCAM KOs had more neuronal activation in the prelimbic and orbitofrontal cortices. In NrCAM KO mice, a low dose of MK-801 decreased neuronal activation in the ventral orbitofrontal cortex and increased activation in the accumbens shell and core. These results indicate differential effects of genotype, stress, and response to glutamatergic drugs and support a role for NrCAM in stress-induced behavioral alterations relevant to addiction and psychiatric disorders.</p>","PeriodicalId":74294,"journal":{"name":"NeuroSci","volume":"7 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505778","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":"Spontaneous Resorption of Lumbar Disc Herniation: A Narrative Review of Pathophysiology, Predictive Factors, and Clinical Decision-Making.","authors":"Jagoš Golubović, Bojan Jelača, Dušan Rodić, Slobodan Torbica, Srđan Stošić, Đula Đilvesi","doi":"10.3390/neurosci7020030","DOIUrl":"10.3390/neurosci7020030","url":null,"abstract":"<p><p>Lumbar intervertebral disc herniation is a common cause of low back and radicular leg pain, traditionally managed with a combination of conservative therapies and, when indicated, surgical discectomy. An intriguing phenomenon observed in many patients is the spontaneous resorption of herniated disc material over time, often correlating with significant symptom improvement. This article is presented as a narrative review synthesizing experimental, imaging, and clinical literature relevant to spontaneous disc resorption and its implications for clinical decision-making. This paper provides a comprehensive overview of spontaneous disc herniation resorption, exploring the underlying pathophysiological mechanisms and the factors that predict which herniations are likely to regress without surgery. Key mechanisms include inflammatory-mediated degradation of disc fragments, neovascularization with macrophage infiltration and phagocytosis of extruded nucleus pulposus tissue, and biological processes such as enzymatic matrix breakdown and cellular apoptosis that collectively lead to shrinkage of the herniated mass. Patient and disc characteristics that favour spontaneous resorption are identified, such as younger age, extruded or sequestered fragment type, larger initial herniation size, and robust inflammatory response on imaging, whereas certain chronic degenerative changes may reduce this likelihood. We also review current clinical guidelines and expert recommendations on when surgical intervention is warranted versus when conservative management and observation are appropriate. Understanding the probability of natural disc fragment resolution is critical in guiding treatment decisions. In the absence of severe neurological deficits or intractable pain, a period of non-operative management can often be pursued safely, given that the majority of patients experience substantial relief within a few months as discs regress. Conversely, timely surgery is advised for those with neurological compromise or refractory symptoms. By synthesizing the latest evidence on spontaneous disc herniation resorption and its predictors, this review aims to assist neurosurgeons and spine specialists in optimizing patient selection for conservative care and identifying the proper timing for surgical intervention to achieve the best clinical outcomes. Given the narrative design, conclusions are based on synthesis of heterogeneous evidence rather than formal comparative analysis.</p>","PeriodicalId":74294,"journal":{"name":"NeuroSci","volume":"7 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147504931","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":"TLR4-Mediated Immune Dysfunction Links MASLD and Parkinson's Disease: Insights from an Omics-Based Network Analysis.","authors":"Christina Flourou, Nikolaos Dietis, Sotirios Tsiordas, Georgios Hadjigeorgiou, George D Vavougios","doi":"10.3390/neurosci7020028","DOIUrl":"10.3390/neurosci7020028","url":null,"abstract":"<p><p><b>Background and aim</b>: Alterations in immune signaling have emerged as a key factor contributing to Parkinson's disease pathophysiology. Increasing evidence also suggests that MASLD and Parkinson's disease may share common immunological mechanisms. Among these, TLR4 has been linked to immune surveillance processes and inflammatory responses in both the central nervous system and the liver. The aim of our study was to delineate TLR4-mediated immune networks underpinning the molecular overlap between MASLD and Parkinson's disease. <b>Methods</b>: Disease-disease and gene-disease associations were systematically retrieved from the DisGeNet database to map TLR4-related molecular networks across both conditions. Functional enrichment analyses were subsequently applied to identify biological pathways significantly associated with TLR4, including potential gene-drug interactions. Guided by these results, a scoping review of the literature was undertaken to summarize existing evidence addressing TLR4-dependent mechanisms in MASLD and Parkinson's disease. <b>Results</b>: DisGeNet analysis indicated 978 shared genes and 39 SNPs shared between both diseases. TLRs, including TLR4-associated coreceptors such as CD14, are among these shared genes. Among these, TLR4 and its missense SNP rs4986791 emerged as key shared immunometabolic nodes linking both diseases. Among the shared SNPs identified in both diseases, we focused on TLR4, where the common variant was rs4986791. Gene set enrichment analysis revealed multiple biological processes associated with cytokine signaling, inflammation, and fibrogenesis. Gene-drug enrichment analysis identified statins and fibrates among the compounds enriched in TLR4-containing networks. <b>Conclusions</b>: These findings support a role for TLR4-associated pathways in linking immunometabolic processes across MASLD and Parkinson's disease. Disruption of these pathways is associated with aberrant inflammatory regulation, with tissue-specific effects further contributing to the distinct molecular pathology observed in each condition. Consequently, modulation of TLR4 signaling represents a plausible strategy for the development or repositioning of disease-modifying interventions applicable to both conditions.</p>","PeriodicalId":74294,"journal":{"name":"NeuroSci","volume":"7 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505283","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":"Moyamoya Vasculopathy and Atypical Moyamoya-like Patterns: Insights into Diagnosis and Therapeutic Implications.","authors":"Rosalinda Calandrelli, Carlo Augusto Mallio, Caterina Bernetti, Luca Massimi, Fabio Pilato","doi":"10.3390/neurosci7010027","DOIUrl":"10.3390/neurosci7010027","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this narrative review is to update current knowledge on Moyamoya vasculopathy (MMV) by addressing key diagnostic debates-including laterality; genetic subtypes; regional epidemiology; and features distinguishing Moyamoya Disease (MMD), Moyamoya Syndrome (MMS) and their mimics.</p><p><strong>Methods: </strong>Key and representative studies were identified through PubMed/MEDLINE and Scopus, focusing on publications from 2014-2025 while also considering earlier seminal works.</p><p><strong>Results: </strong>MMD typically presents with bilateral steno-occlusion of the terminal internal carotid arteries (ICAs) and proximal middle and anterior cerebral arteries (MCAs/ACAs) due to concentric vascular thickening, accompanied by characteristic 'puff-of-smoke' collaterals, whereas MMS shows a similar but more often unilateral pattern with fewer collaterals, influenced by the underlying condition. However, this distinction often fails to reflect the full clinical and radiological variability of the Moyamoya spectrum. Atypical moyamoya-like patterns, often confined to M1 or A1 segments, further complicate diagnosis. Clinical manifestations ranged from asymptomatic cases to ischemic or hemorrhagic strokes, and occasionally seizures. Diagnosis relied on multimodal imaging (DSA, MRA, CTA), but genetic mutations, contributing to radiological variability, often complicate differentiation between MMD, MMS, and mimics. Management is pattern-specific: MMS and atypical forms are generally managed conservatively, whereas MMD frequently requires surgical revascularization, particularly in children and symptomatic adults. Nevertheless, variability within diagnostic categories limits the applicability of rigid treatment protocols.</p><p><strong>Conclusions: </strong>Current diagnostic algorithms remain limited. Integrating advanced imaging findings with clinical, genetic, and epidemiological data is essential to define the full disease spectrum, improve diagnostic accuracy, and inform patient management and outcome assessment.</p>","PeriodicalId":74294,"journal":{"name":"NeuroSci","volume":"7 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12922065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146260381","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":"Myelin Basic Protein Post-Translational Modifications Orchestrate Astrocyte Regulatory Networks.","authors":"Jeremy Ramsden, Marika Chikviladze, Nino Mamulashvili, Lali Shanshiashvili, David Mikeladze","doi":"10.3390/neurosci7010026","DOIUrl":"10.3390/neurosci7010026","url":null,"abstract":"<p><p>Multiple sclerosis (MS) pathogenesis involves not only immune-mediated myelin injury but also glial responses. We examined how three charge isomers of myelin basic protein (MBP)-native (C1), phosphorylated (C4), and citrullinated (C8)-modulate rat astrocytes. Cytokines were quantified and grouped (pro/anti-inflammatory, chemotactic, neurotrophic, angiogenic, tissue remodeling), and regulatory markers assessed. C1 strongly upregulated the lipid-sensing receptor LXR, and reduced global DNA methylation; C4 moderately enhanced LXR; C8 failed to activate LXR or alter methylation. Functionally, C1 attenuated IL-1β, IL-6 and GM-CSF while increasing IL-10 and certain chemokines. C4 elicited an intermediate pattern, inducing CX3CL1 (fractalkine), CCL20, VEGF-A and TIMP-1 with minor effects on classical cytokines. In contrast, C8 triggered a robust pro-inflammatory phenotype, increasing IL-1α/β, TNF-α and GM-CSF, with higher IL-10, fractalkine, CCL20, VEGF-A and TIMP-1. All isomers suppressed IFN-γ, IL-4 and CNTF. These data indicate that MBP post-translational modifications drive distinct astrocyte phenotypes through integrated cytokine, metabolic and epigenetic pathways: C1 favors immune regulation and repair, C4 blends inflammatory and reparative cues, and C8 amplifies neuroinflammation. Understanding how modified MBP shapes astrocyte behavior provides mechanistic insight into lesion evolution in MS and suggests astrocyte-directed strategies to modulate neuroinflammation and promote remyelination.</p>","PeriodicalId":74294,"journal":{"name":"NeuroSci","volume":"7 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12921786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146260444","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":"Operationalizing the Mind-Body Connection: Interoception via the Autonomic Nervous System.","authors":"Brittany Nackley, Bruce H Friedman","doi":"10.3390/neurosci7010025","DOIUrl":"10.3390/neurosci7010025","url":null,"abstract":"<p><p>Traditional interoception research investigates cardioception, respiroception, or gastroception as a proxy for the sense of the body as a whole. These single-organ tasks sacrifice construct and ecological validity for a content validity that has been elusive. We propose that interoception is better captured by one's sense of their own autonomic nervous system, or <i>ANSception</i>. The ANS integrates multimodal signals via lesser-myelinated neurons, making it an integral part of the interoceptive nervous system. Thirty-four participants moved a slider to reflect their perceived sympathetic activation (ANSception) while their physiology was monitored. Most participants reported integrating information from two or more organ systems during ANSception. The relationship between ANSception and physiology showed unique but often robust responses by condition and physiological measure. For example, one participant had a negative-to-positive-to-negative pattern for ANSception-EDA correlations from baseline to stimulus to recovery (r = -0.677; 0.657; -0.507, <i>p</i> < 0.001). Another participant had a strong positive correlation between their ANSception and blood pressure (r = 0.601, <i>p</i> < 0.001) during a five-minute reportedly meditative state. We propose that the role of interoception is to scan, integrate and manage information across organ systems, and we conclude that ANSception better captures this role than traditional single-organ tasks.</p>","PeriodicalId":74294,"journal":{"name":"NeuroSci","volume":"7 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12922123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146260449","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":"Safety and Efficacy of Stroke Thrombolysis for Patients with Cerebral Cavernous Malformations: Literature Review and Nationwide Cohort Study.","authors":"Huanwen Chen, Rachel K Laursen, Matthew K McIntyre, Monika Jain, Hamza A Salim, Dhairya A Lakhani, Ajay Malhotra, Dheeraj Gandhi, Marco Colasurdo","doi":"10.3390/neurosci7010024","DOIUrl":"10.3390/neurosci7010024","url":null,"abstract":"<p><strong>Background: </strong>Intravenous thrombolysis (IVT) is relatively contraindicated in acute ischemic stroke (AIS) patients with intracranial vascular malformations per current guidelines. Thus, the presence of cerebral cavernous malformations (CCMs) may complicate treatment decision-making.</p><p><strong>Methods: </strong>We performed a literature review of the PubMed, Embase, Scopus, and Web of Science databases through July 2025, identifying reported cases of IVT administration in AIS patients with CCMs. Additionally, we conducted a retrospective cohort study using the Nationwide Readmissions Database (2016-2022) of AIS patients with CCM, and assessed outcomes with IVT versus no IVT treatment. The primary outcome was functional independence at discharge; secondary outcomes included mortality and intracranial hemorrhage (ICH).</p><p><strong>Results: </strong>Only 34 CCM patients across 7 studies were identified in the literature, with symptomatic ICH occurring in 2 cases (5.9%). In the nationwide cohort, 846 AIS patients with CCMs were included, of whom 240 (28.4%) received IVT. Compared to no IVT treatment, IVT was associated with significantly higher rates of functional independence (46.4% vs. 24.6%, adjusted OR [aOR] 3.04 [95% CI 1.98-4.68], <i>p</i> < 0.001), without significant differences in mortality (8.5% vs. 8.3%, aOR 1.40 [95% CI 0.52-3.76], <i>p</i> = 0.50) or ICH (20.3% vs. 16.1%, adjusted OR 1.01 [95% CI 0.53-1.93], <i>p</i> = 0.97).</p><p><strong>Conclusions: </strong>The current literature on the safety and efficacy of IVT in AIS patients with CCMs is limited. Our nationwide study suggests that IVT was associated with higher rates of early functional independence without increased risks of hemorrhage or death among patients with CCM.</p>","PeriodicalId":74294,"journal":{"name":"NeuroSci","volume":"7 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12921825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146259579","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}