BMC Neurology最新文献

{"title":"Low-dose vs. standard-dose alteplase for acute ischemic stroke: a retrospective cohort study of safety and efficacy in an Iranian population.","authors":"Fatemeh Rahimi, Ashraf Zarvani, Farzad Fayedeh, Athena Sharifi-Razavi","doi":"10.1186/s12883-025-04413-z","DOIUrl":"10.1186/s12883-025-04413-z","url":null,"abstract":"","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"395"},"PeriodicalIF":2.2,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When MOGAD mimics MS: diagnostic and therapeutic insights from a unique CNS demyelinating case.","authors":"Ya Lin Luo, Lin Yun Chen, Zu Cai Xu, Ping Xu, Ya Chen","doi":"10.1186/s12883-025-04442-8","DOIUrl":"10.1186/s12883-025-04442-8","url":null,"abstract":"<p><strong>Background: </strong>Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) lacks specificity in clinical and neuroimaging characterization. Expanding clinical and MRI findings is important for understanding MOGAD; however, the role of oligoclonal bands (OCBs) remains unclear.</p><p><strong>Case presentation: </strong>A previously healthy man presented with slowed responses, slurred speech, and an unsteady gait for one week. Brain MRI-enhanced scans revealed nodular, circular, perivascular Line-like, and pepper-like enhancements. Anti-MOG antibody titer was 1:100, and OCBs were present in both serum and cerebrospinal fluid (CSF), with higher number of bands in the CSF. The patient received intravenous methylprednisolone pulse therapy and showed remarkable clinical and radiological improvements. Oral prednisone tapering and mycophenolate mofetil were used to prevent relapse. MRI demonstrated MS-like lesion activity during the 2-year follow-up period, though no clinical relapse occurred.Anti-MOG antibody titer was 1:32 in both CSF and serum, and OCBs were present only in the CSF (≥ 2 discrete bands).We used the cell-based assay (CBA) to detect the antibody status of MOG and NMDAR-Abs in both serum and cerebrospinal fluid (CSF) samples. The detection of MOG-IgG antibodies in the case used the fixed Cell-Based Assay. The specific secondary antibody was the FITC-conjugated goat anti-human IgG antibody.</p><p><strong>Conclusions: </strong>This case reveals that varied MRI features in MOGAD underscore the complexity of the disease. Although OCB positivity is associated with a higher risk of relapse in MOGAD patients [1-3]continuous MRI remains the primary method for detecting subclinical disease activity. Due to its invasive nature and limited value in assessing disease progression, repeated CSF analysis for routine OCB monitoring is not recommended.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"398"},"PeriodicalIF":2.2,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary intracranial plasmablastic lymphoma with intradural extramedullary metastasis: a case report.","authors":"Zhuoru Jiang, Zhengyang Zhu, Zhennan Tao, Fengnan Niu, Xin Zhang, Bing Zhang","doi":"10.1186/s12883-025-04409-9","DOIUrl":"10.1186/s12883-025-04409-9","url":null,"abstract":"<p><strong>Background: </strong>Primary central nervous system plasmablastic lymphoma (PCNSPBL) represents an exceptionally rare and aggressive subtype of diffuse large B-cell lymphoma (DLBCL), characterized by its distinct immunophenotypic profile and predilection for immunocompromised individuals. Accurate preoperative diagnosis remains challenging due to the nonspecific radiological features observed on conventional magnetic resonance imaging (MRI), necessitating comprehensive histopathological evaluation for definitive diagnosis. While intracranial involvement of PBL has been documented in the literature, intraspinal metastasis of this malignancy has not been previously reported. This study presents a novel case of PCNSPBL with concurrent spinal cord metastasis in an elderly male patient, with a detailed analysis of advanced neuroimaging characteristics that may aid in the diagnostic evaluation of this rare entity.</p><p><strong>Case presentation: </strong>A 52-year-old male patient presented to our institution with left-sided limb weakness. Laboratory investigations revealed positive Epstein-Barr virus-encoded small RNA (EBER). Conventional MRI demonstrated a mass lesion with a clear anatomical relationship to the inferior horn of the right lateral ventricle, presenting as compression and stenosis of the right ventricle. Due to the mass effect, the patient underwent surgical resection of the right temporal lobe lesion, with histopathological examination confirming the diagnosis of plasmablastic lymphoma.</p><p><strong>Conclusions: </strong>This report represents the first documented case of PCNSPBL with intradural extramedullary metastasis, underscoring the diagnostic challenges associated with this rare malignancy. Advanced neuroimaging techniques, including functional MRI, serve as valuable complements to conventional MRI in the diagnostic workup. Early and accurate diagnosis of PBL is critical for timely intervention, and further studies are warranted to establish standardized imaging protocols for this rare entity.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"394"},"PeriodicalIF":2.2,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular therapy compared to best medical treatment in Non-ATTENTION patients: a multicenter registry study.","authors":"Yong Liang, Song Ouyang, Miao Li, Chenping Li, Kang Ou, Caiyu Ma, Ziling Wang, Wen Sun","doi":"10.1186/s12883-025-04427-7","DOIUrl":"10.1186/s12883-025-04427-7","url":null,"abstract":"","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"397"},"PeriodicalIF":2.2,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implications of coexisting neural antibodies with glial fibrillary acidic protein autoimmunity: a single center retrospective cohort study.","authors":"Xiumei Wei, Guanghui Liu, Dongmei Wang, Sanming Jie, Bingbing Li, Yongming Wu, Suyue Pan, Shengnan Wang","doi":"10.1186/s12883-025-04439-3","DOIUrl":"10.1186/s12883-025-04439-3","url":null,"abstract":"<p><strong>Background and purpose: </strong>This study aimed to elucidate the differences between patients with anti-glial fibrillary acidic protein (GFAP) antibodies who exhibited concurrent positivity for other neuro-antibodies and those who did not.</p><p><strong>Methods: </strong>Hospitalised patients demonstrating anti-GFAP antibody positivity in cerebrospinal fluid (CSF) were retrospectively collected and followed up from March 2019 to July 2022. Data including clinical features, laboratory results, imaging findings, therapy, and prognosis were extracted from the medical record system.</p><p><strong>Results: </strong>Thirty-seven patients with positive anti-GFAP antibody in CSF were included. Ten patients exhibited concomitant other neuro-antibodies and were categorised as the \"overlapping group\". Compared to the non-overlapping group, the incidence of seizures was significantly higher in the overlapping syndrome group (50% vs. 3.7%, p = 0.003), and a similar trend was observed for status epilepticus (30% vs. 3.7%, p = 0.052). Encephalitis was more prevalent in the overlapping group (60.0%) than in the non-overlapping group (11.1%) (P = 0.005). Serum white blood cell and neutrophil counts were significantly higher in the overlapping group compared to the non-overlapping group (P = 0.037, P = 0.042, respectively). The overlapping group demonstrated a higher percentage of immunosuppressant usage and a longer hospital stay compared to the non-overlapping group. During the follow-up, two patients in the overlapping group expired, while all the patients in the non-overlapping group survived.</p><p><strong>Conclusions: </strong>Patients with anti-GFAP antibodies and concurrent other neuro-antibodies exhibited different clinical features compared to non-overlapping cases. We suggest that in the presence of coexisting neuronal surface antibodies, these specific neuro-antibodies were predominant in clinical manifestations and prognosis, rather than the anti-GFAP antibody, especially when in a relatively high titer.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"401"},"PeriodicalIF":2.2,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lymphomatosis cerebri presenting with rapidly progressive parkinsonism and Holmes tremor: a case report.","authors":"Tsukika Iguchi, Tsuyoshi Furuya, Takahiro Koinuma, Asuka Nakajima, Atsuhito Fuse, Hiroto Eguchi, Yasunori Sugiyama, Yasushi Shimo","doi":"10.1186/s12883-025-04426-8","DOIUrl":"10.1186/s12883-025-04426-8","url":null,"abstract":"<p><strong>Background: </strong>Lymphomatosis cerebri (LC) is a rare subtype of primary central nervous system lymphoma (PCNSL) characterized by diffuse infiltration without mass formation. LC typically presents with cognitive decline and gait disturbances; however, extrapyramidal manifestations, including Parkinsonism and Holmes tremor, are exceedingly rare. This report describes a unique case highlighting the diagnostic challenges and atypical manifestations of LC.</p><p><strong>Case presentation: </strong>A 75-year-old man presented with rapidly progressive cognitive decline, Parkinsonism, and Holmes tremor. Brain magnetic resonance imaging (MRI) revealed diffuse T2 and FLAIR hyperintensities involving the deep white matter, basal ganglia, and midbrain, without contrast enhancement. Despite normal dopamine transporter imaging, biopsy confirmed diffuse large B-cell lymphoma, consistent with LC. The patient received whole-brain radiation therapy, resulting in mild improvement.</p><p><strong>Conclusions: </strong>This case illustrates that LC can manifest with atypical parkinsonian syndromes, such as parkinsonism and Holmes tremor. Clinicians should consider LC in the differential diagnosis of rapidly progressive movement disorders, especially when neuroimaging reveals diffuse non-enhancing white matter lesions such as leukodystrophy and demyelinating disease. Advanced imaging modalities such as ASL-MRI may facilitate early diagnosis and biopsy targeting.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"392"},"PeriodicalIF":2.2,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of internal carotid artery agenesis with intercavernous anastomosis (Lie's type D anastomosis) by simple balloon dilatation.","authors":"ZunLu Zhang, JinPing Zhang, Dingwen Yu, He Li","doi":"10.1186/s12883-025-04424-w","DOIUrl":"10.1186/s12883-025-04424-w","url":null,"abstract":"<p><p>This article reports a rare vascular anomaly: internal carotid artery agenesis with intercavernous anastomosis (Lie's type D anastomosis). According to Digital Subtraction Angiography (DSA), the left common carotid artery (LCCA) continues as the external carotid artery (ECA), and no lumen arteriosclerosis or the origin of the internal carotid artery (ICA) is observed on the angiogram. The patient's left internal carotid artery (LICA) originated from the C6 segment of the right internal carotid artery and was compensated by it. At the same time, both the left middle cerebral artery(LMCA) and the anterior cerebral artery(ACA) originates from the right internal carotid artery (RICA) system. Severe stenosis at the beginning of LICA resulted in TIA in patients. After simple balloon dilation treatment, the patient showed favorable angioplasty and no further ischemic events occurred during a 1-year follow-up. Previous such studies have less experience with previous involvement. This article suggests that simple balloon dilation may effectively improve the prognosis of patients with vascular anomaly accompanied by severe stenosis, with low risk. This has certain teaching and clinical guidance value.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"391"},"PeriodicalIF":2.2,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced family caregiving improves quality of life, resilience, and hope review in POST-SPINAL SURGERY patients: A Quasi-Experimental study.","authors":"Mohammad Reza Zamani, Aida Shahabi, Behzad Imani, Sajjad Abdolmaleki, Alireza Abdi, Shirdel Zandi","doi":"10.1186/s12883-025-04421-z","DOIUrl":"10.1186/s12883-025-04421-z","url":null,"abstract":"<p><strong>Background: </strong>Patients undergoing spinal surgery often experience chronic pain and functional limitations. These complications frequently lead to diminished quality of life, hope, and resilience. Inadequate family knowledge regarding home-based patient care exacerbates these challenges. This study investigates the effect of family support through education and follow-up after discharge on the quality of life, resilience, and hope in patients following spinal surgery.</p><p><strong>Methods: </strong>This quasi-experimental study was conducted on 50 spinal surgery patients in Hamadan from November 2023 to October 2024. Participants were selected through convenience sampling and randomly allocated to either intervention or control groups. The intervention group received two visual training sessions before discharge and one month of follow-up, while the control group received only routine care. Data were collected using SF-36 (Quality of Life), MHS (Hope), and CD-RISC (Resilience) questionnaires. Finally, the data were analyzed using Independent and Paired t-tests, Chi-square, and ANCOVA at the significance level of P < 0.05 in SPSS 24.</p><p><strong>Results: </strong>The groups showed no significant differences in baseline characteristics (P > 0.05). Post-intervention, the intervention group demonstrated significantly higher scores in quality of life (P = 0.013, Cohen's d = 0.73, 95% CI [0.21-1.25]) and resilience (P = 0.01, d = 0.76, 95% CI [0.25-1.27]) compared to controls, indicating medium-to-large effect sizes. No significant difference was found for hope (P = 0.543, d = 0.17, 95% CI [-0.18, 0.52]).</p><p><strong>Conclusion: </strong>Family education and post-discharge follow-up improved quality of life and resilience in spinal surgery patients, though no significant effect was observed on hope. These findings underscore the importance of structured family caregiving support and systematic follow-up in enhancing patient outcomes.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"396"},"PeriodicalIF":2.2,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between estimation of pulse wave velocity and all-cause mortality in critically ill patients with ischemic stroke: a retrospective cohort study and predictive model establishment based on machine learning.","authors":"Shuangmei Zhao, Chang Zhu, Yu Guo, Shiyin Ma, Chucheng Jiao, Liutao Sui, Rongyao Hou, Xiaoyan Zhu","doi":"10.1186/s12883-025-04385-0","DOIUrl":"10.1186/s12883-025-04385-0","url":null,"abstract":"<p><strong>Background: </strong>Estimated pulse wave velocity (ePWV) has been established as a simple yet effective tool for assessing arterial stiffness and predicting long-term cardiovascular and cerebrovascular mortality. However, the association between ePWV and poor prognosis in critically ill patients with ischemic stroke (IS) remains understudied. This study aimed to investigate the relationship between ePWV and adverse outcomes in critically ill IS patients.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using data from the Medical Information Mart for Intensive Care IV (MIMIC-IV, version 3.0), stratified by ePWV quartiles. Our primary objective was to examine mortality rates at pivotal timeframes: 30 days, 90 days, and 1-year post-observation. Kaplan-Meier (KM) curves complemented these analyses, along with a Cox proportional hazards model, restricted cubic spline curves (RCS), and subgroup analysis, to comprehensively evaluate the association between ePWV and all-cause mortality. To model the mortality risk, four machine learning algorithms were employed, namely Logistic Regression (LR), Random Forest (RF), XGBoost, and Naive Bayes (NB). Model interpretability was improved using Shapley Additive Interpretation (SHAP) analysis, with calibration validating predictive accuracy. We comprehensively compared four machine learning algorithms (LR, RF, XGBoost, NB) against five clinical risk scores.</p><p><strong>Results: </strong>Our analysis encompassed a cohort of 1,337 patients, with a male preponderance of 51.6%. The 30-day, 90-day, and 1-year mortality rates were 14.1%, 17.9%, and 23.4%, respectively. The RCS analysis revealed a dose-dependent increase in all-cause mortality risk with higher ePWV levels. Critically ill IS patients in the highest ePWV quartile had significantly higher mortality at all time points compared to lower quartiles. Boruta feature selection identified ePWV as a key predictor. The LR model demonstrated superior accuracy in predicting 30-day mortality, while XGBoost outperformed others for 90-day and 1-year mortality predictions.</p><p><strong>Conclusion: </strong>Elevated levels of the ePWV demonstrate strong prognostic value for both short- and long-term mortality in critically ill IS patients. Machine learning models incorporating ePWV outperformed traditional clinical scores, suggesting potential utility for risk stratification in acute stroke management.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"386"},"PeriodicalIF":2.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neutrophil degranulation is increased at seven days after human intracerebral hemorrhage, but not at 72 h, and correlates with decreased miR-3613 and miR-3690.","authors":"Kyle B Walsh, Miranda C Marion, Dengfeng Li, Hannah C Ainsworth, Amy Zinnia, Xiang Zhang, Stacie L Demel, Brady Williamson, David J Roh, Robert Campbell, Frederik Denorme, Daniel Woo, Carl D Langefeld","doi":"10.1186/s12883-025-04408-w","DOIUrl":"10.1186/s12883-025-04408-w","url":null,"abstract":"","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"388"},"PeriodicalIF":2.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}