Journal of Clinical Neuroscience最新文献

{"title":"Effect of blood pressure variability on the outcomes of acute ischemic stroke patients undergoing intravenous thrombolysis","authors":"Mingwei Ma ,&nbsp;Tingting Huang ,&nbsp;Ning Ru ,&nbsp;Xi Pan ,&nbsp;Dapeng Wang","doi":"10.1016/j.jocn.2024.110935","DOIUrl":"10.1016/j.jocn.2024.110935","url":null,"abstract":"<div><h3>Background</h3><div>There is limited research on the relationship between blood pressure variability (BPV) and outcomes among patients receiving intravenous thrombolysis (IVT) for acute ischemic stroke (AIS). This study aimed to investigate the effect of 24-h BPV on the outcome of patients with AIS treated with IVT.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on clinical data of patients with AIS who had undergone IVT treatment. During the initial 24 h after IVT, various BPV parameters for systolic and diastolic blood pressure were calculated, including the maximum BP, minimum BP, mean BP, standard deviation, coefficient of variation, and average real variability (ARV). Follow-up was conducted at 90 days post-onset, with outcomes classified as “good” or “poor” based on a modified Rankin Scale score of ≤2 or &gt;2, respectively.</div></div><div><h3>Results</h3><div>A total of 216 patients were included in the study and divided into two groups based on their outcomes: a good-outcome group (<em>n</em> = 151, 69.9 %) and a poor-outcome group (<em>n</em> = 65, 30.1 %). A comparison of the poor-outcome group with the other group revealed significant differences in age, baseline National Institutes of Health Stroke Scale, Trial of Org 10172 in Acute Stroke Treatment classification, diabetes mellitus, and atrial fibrillation (<em>P</em> &lt; 0.05). The maximum systolic blood pressure (163.58 ± 19.76 vs. 173.91 ± 18.51 mmHg) and average rate of ventricular response (10.35 vs. 12.09) in the good-outcome group were lower than those in the poor-outcome group (all <em>P</em> &lt; 0.05). After adjusting for confounding factors in the binary logistic regression analysis, the maximum systolic blood pressure (odds ratio = 1.023, 95 % confidence interval = 1.004–1.043, <em>P</em> = 0.019] and ARV (odds ratio = 1.103, 95 % confidence interval = 1.007–1.208, <em>P</em> = 0.035) were significantly associated with adverse outcomes.</div></div><div><h3>Conclusion</h3><div>The maximum systolic blood pressure and mean true variation rate were negatively correlated with outcomes.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"131 ","pages":"Article 110935"},"PeriodicalIF":1.9,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142702585","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 trends of Laser interstitial thermal therapy (LITT) and Vagus Nerve stimulation (VNS) for refractory epilepsy in adult patients: A Nationwide Inpatient Sample based propensity score matched analysis","authors":"Mayur Sharma ,&nbsp;Victoria Scott ,&nbsp;Beatrice Ugiliweneza ,&nbsp;Dengzhi Wang ,&nbsp;Maxwell Boakye ,&nbsp;Joseph Neimat ,&nbsp;Sanjeev Sreenivasan","doi":"10.1016/j.jocn.2024.110932","DOIUrl":"10.1016/j.jocn.2024.110932","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of our study was to report the national trends of Vagus nerve stimulation (VNS) and Laser interstitial thermal therapy (LITT) and compare their outcomes in patients with medically refractory epilepsy (RE).</div></div><div><h3>Methods</h3><div>Nationwide Inpatient Sample database (NIS, 1998–2018) was used to extract the data using the ICD-9/10 codes. Adult patients (&gt;18 years) with a primary diagnosis of RE who underwent either VNS or LITT were included. Patient demographics, complications, length of hospital stay (LOS), discharge disposition and index-hospitalization costs were analyzed.</div></div><div><h3>Results</h3><div>A cohort of 226,248 patients with RE were included, of which only 0.66 % underwent VNS (n = 1500) and 0.34 % (n = 770) underwent LITT. VNS accounted for 66 % of the surgical procedures. The use of LITT gradually increased from 2012 (0.69/1000 RE cases) to 2018 (4.43/1000 RE cases) compared to VNS (2012: 9.85/1000 RE to 2018: 5.31/1000 RE cases). Median age was similar across the cohorts (LITT: 38 years; VNS: 36 years, p = 0.33). Index hospitalization median charges were significantly lower following LITT compared to VNS (LITT: $ 115,838; VNS: $ 131,984, p &lt; 0.0033). No differences in terms of median LOS, discharge to home, complications and median index hospitalization charges were noted between the procedures (LITT vs. VNS).</div></div><div><h3>Conclusion</h3><div>LITT is increasingly being performed for RE with decreasing trends for VNS. The complications profile was similar among both the procedures. Both LITT and VNS are minimally invasive and safe treatment modalities in carefully selected patients with RE.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"131 ","pages":"Article 110932"},"PeriodicalIF":1.9,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142702583","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":"Optical coherence tomography as an adjunct tool to assess response to treatment in cerebral venous thrombosis: A prospective longitudinal study","authors":"Guduru Sravanthi ,&nbsp;Rajani Battu ,&nbsp;Mohammed Shereef Pallimalil ,&nbsp;Neerupaka Venkatachalam ,&nbsp;Kuldeep Kumar Sharma ,&nbsp;K.N. Gopalakrishna ,&nbsp;Girish Baburao Kulkarni ,&nbsp;P.R. Srijithesh ,&nbsp;Pooja Mailankody","doi":"10.1016/j.jocn.2024.110937","DOIUrl":"10.1016/j.jocn.2024.110937","url":null,"abstract":"<div><h3>Introduction</h3><div>Papilledema, due to raised intracranial pressure (ICP) is commonly seen in cerebral venous thrombosis (CVT) and can have serious complications. This study reports the quantitative assessment of papilledema through the measurement of the Peripapillary choroidal thickness (ChT) and Peripapillary retinal nerve fiber layer thickness (RNFLT) using optical coherence tomography (OCT).</div></div><div><h3>Methods</h3><div>We conducted a prospective longitudinal study of 30 subjects with CVT. Age and gender-matched healthy individuals were included as controls. In addition to history, RNFLT and ChT measurements were obtained at presentation, discharge, and follow-up two months after discharge.</div></div><div><h3>Results</h3><div>The mean age of the patients was 32.8 ± 9.9 years. Papilledema was seen in 14 (46.66 %) patients. The peripapillary RNFLT and ChT were significantly greater in patients with CVT [RNFLT 121.5 μm (105,169) in the right eye (RE), 120 μm (103,148) in the left eye (LE); ChT 159 μm (143,171) in the RE, 155.5 μm (140,166) in the LE] as compared to controls [RNFLT 106.5 μm (102,111) in RE, 103.5 μm (98,107) in LE; ChT 130 μm (119,134) in RE, 124 μm (119,136) in LE]. There was a significant decrease in the peripapillary RNFLT and ChT in patients with papilledema at follow-up after two months in all segments in both eyes.</div></div><div><h3>Conclusion</h3><div>In patients with CVT, RNFLT, and ChT reduced significantly with treatment. OCT is potentially useful to objectively assess response to treatment in patients with CVT.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"131 ","pages":"Article 110937"},"PeriodicalIF":1.9,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142702584","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":"Expanded endoscopic endonasal approach to a retrochiasmatic craniopharyngioma with significant retroclival cystic extension","authors":"Michael Wei ,&nbsp;Neda Haghighi ,&nbsp;Yi Chen Zhao ,&nbsp;James King","doi":"10.1016/j.jocn.2024.110930","DOIUrl":"10.1016/j.jocn.2024.110930","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"131 ","pages":"Article 110930"},"PeriodicalIF":1.9,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142702581","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":"Endoscopic strategies for giant V2 schwannoma: A step-by-step guide to the combined endonasal and pre lacrimal approaches","authors":"Ravi Sankar Manogaran ,&nbsp;Kalyan Chidambaram ,&nbsp;Prerna Angrish ,&nbsp;ch Sajid Rashid ,&nbsp;Reshma Raj ,&nbsp;Ramandeep Singh Virk ,&nbsp;Mohit Sinha","doi":"10.1016/j.jocn.2024.110931","DOIUrl":"10.1016/j.jocn.2024.110931","url":null,"abstract":"<div><div>This video article aims to describe the surgical technique and effectiveness of a combined endoscopic transnasal and pre-lacrimal recess approach for paramedian V2 schwannoma.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"131 ","pages":"Article 110931"},"PeriodicalIF":1.9,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142702582","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":"Corrigendum to \"Impact of anesthesia type on surgical outcomes and medical complications in chronic subdural hematoma surgery\" [J. Clin. Neurosci. 129 (2024) 110876].","authors":"Stephen Ahn, Jae Sung Park, Chul Bum Cho, Seung Ho Yang, Young Il Kim","doi":"10.1016/j.jocn.2024.110923","DOIUrl":"https://doi.org/10.1016/j.jocn.2024.110923","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":" ","pages":"110923"},"PeriodicalIF":1.9,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710119","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":"Endoscopic endonasal odontoidectomy with C1 anterior arch preservation for spinal-cord compression in the elderly","authors":"Raffaele De Marco ,&nbsp;Federica Penner ,&nbsp;Maria Chiara Canitano ,&nbsp;Giuseppe Riva ,&nbsp;Diego Garbossa ,&nbsp;Francesco Zenga","doi":"10.1016/j.jocn.2024.110933","DOIUrl":"10.1016/j.jocn.2024.110933","url":null,"abstract":"<div><div>The endoscopic endonasal corridor for odontoidectomy (EEO) is a valuable route in expert’s hand to manage craniovertebral junction (CVJ) pathologies of the midline. The possibility to preserve part of the C1 anterior arch along to an adequate preoperative planning, makes this option a viable choice especially in elderly patients with multiple comorbidities who cannot sustain a second procedure closed in time. Indeed, the current case shows the results of EEO in the presence of ventral compression due to degenerative non-rheumatoid <em>retro</em>-odontoid pannus in an 80-year-old male. Due to the absence of instability preoperatively and the C1 anterior arch preservation, no posterior instrumentation was planned nor was necessary at follow-up.</div><div>A step-by-step description of the technique is showed.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"131 ","pages":"Article 110933"},"PeriodicalIF":1.9,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695555","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":"Baseline American Society of Anesthesiologists classification predicts worse anxiety and pain interference following Lumbar Interbody Fusion","authors":"John F. Sencaj ,&nbsp;Malik A. Siddique ,&nbsp;Gregory A. Snigur ,&nbsp;Sloane O. Ward ,&nbsp;Shriya N. Patel ,&nbsp;Kern Singh","doi":"10.1016/j.jocn.2024.110929","DOIUrl":"10.1016/j.jocn.2024.110929","url":null,"abstract":"<div><h3>Background</h3><div>The American Society of Anesthesiologists (ASA) classifications allow physicians to briefly assess a patient’s risk for general anesthesia and surgical intervention. Although simple to calculate, a patient’s ASA score may correlate with differences in outcomes following spinal operations. The purpose of this study is to establish the effect of ASA score on Patient-Reported Outcomes Measurement Information System (PROMIS) outcomes following Lateral Lumbar Interbody Fusion (LLIF).</div></div><div><h3>Methods</h3><div>All patient data was collected from a single spinal surgeon database. Patients were separated into cohorts of “Lower ASA” (ASA &lt; 3) and “Higher ASA” (ASA ≥ 3). Demographics, perioperative characteristics, preoperative Patient-Reported Outcomes (PROs), and postoperative PROs at 6 weeks and final postoperative time points were compared statistically. These included Visual Analog Scales for back and leg pain (VAS-B, VAS-L), the Oswestry Disability Index (ODI), the 9-item Patient Health Questionnaire (PHQ-9), and PROMIS measures for Physical Function (PROMIS-PF), Sleep Disturbance (PROMIS-SD), Anxiety (PROMIS-A), and Pain Interference (PROMIS-PI). PRO improvements between preoperative and postoperative time points and Minimum Clinically Important Difference (MCID) were also compared.</div></div><div><h3>Results</h3><div>In total, 154 patients were included (111 and 43 in the Lower and Higher ASA cohorts, respectively). Patient age, body mass index (BMI), presence of diabetes, and Charlson Comorbidity Index (CCI) score were significantly different between the two cohorts (<span><span>Table 1</span></span>, p &lt; 0.004 for all). Primary vs. non-primary surgery, number of spinal levels fused, postoperative length of stay, and rates of isthmic spondylolisthesis and foraminal stenosis also significantly differed (<span><span>Table 2</span></span>, p &lt; 0.05 for all). Patients with a higher ASA score were found to have higher PROMIS-A preoperatively <strong>(</strong><span><span>Table 3</span></span>, p = 0.029). These patients also had higher PROMIS-A and PROMIS-PI at final postoperative evaluation (p values of 0.007 and 0.047, respectively). Score changes over time and MCID achievement did not seem to be impacted by baseline ASA score.</div></div><div><h3>Conclusions</h3><div>Patients with a higher preoperative ASA score were found to have worse anxiety pre-operatively and worse anxiety and pain interference at the final postoperative evaluation. Clinical improvement over time was not significantly affected by the ASA score.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"131 ","pages":"Article 110929"},"PeriodicalIF":1.9,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695551","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":"Global neurotrauma registries: Challenges and opportunities for low- and middle-income countries.","authors":"Sean O'Leary, Sahil Chilukuri, Peace Odiase, Umaru Barrie","doi":"10.1016/j.jocn.2024.110928","DOIUrl":"https://doi.org/10.1016/j.jocn.2024.110928","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":" ","pages":"110928"},"PeriodicalIF":1.9,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687214","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":"Assessment of subcutaneous fat tissue thickness as a biomarker for cervical intervertebral disc degeneration","authors":"Sevde Nur Emir ,&nbsp;Servet Emir","doi":"10.1016/j.jocn.2024.110921","DOIUrl":"10.1016/j.jocn.2024.110921","url":null,"abstract":"<div><div>Cervical intervertebral disc degeneration (IVDD) is a chronic musculoskeletal disorder contributing to neck pain, often associated with mechanical instability of the disc. Obesity and increased subcutaneous fat tissue thickness (SFTT) have been identified as key risk factors for the development of IVDD. This study retrospectively analyzed 245 Turkish female patients aged 40–50 years, who presented with neck pain and underwent cervical MRI between 2022 and 2024. Patients with malignancy, prior spinal surgery, congenital anomalies, or artifacts on MRI were excluded. The severity of IVDD at the C6-C7 level was graded using the Pfirrmann system, and SFTT measurements were performed on axial T2-weighted images at the C3, C5, and C7 levels. Statistical analyses included the Mann-Whitney <em>U</em> test, Kruskal-Wallis test, and Spearman correlation. IVDD was absent in 29.39 % of participants, while the remaining showed varying grades of degeneration, with Grade 2 being the most common (24.08 %). Patients with disc degeneration had significantly higher SFTT at all measured levels (p &lt; 0.001). ROC analysis identified an optimal cutoff value for SFTT at the C7 level as 22.57 mm, with 79.19 % sensitivity and 63.89 % specificity. These results indicate a positive correlation between increased SFTT and both the presence and severity of IVDD, suggesting that SFTT, particularly at the C7 level, may serve as a non-invasive biomarker for IVDD. Further multicenter research is recommended to confirm these findings.</div><div>Abbreviations: AUC, Area Under the Curve; BMI, Body Mass Index; C, Cervical; IL, Interleukin; IVDD, Intervertebral Disc Degeneration; MRI, Magnetic Resonance Imaging; ROC, Receiver Operating Characteristic; SFTT, Subcutaneous Fat Tissue Thickness; T2WI, T2-Weighted Image; TNF, Tumor Necrosis Factor.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"130 ","pages":"Article 110921"},"PeriodicalIF":1.9,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687216","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}