Journal of Clinical Neuroscience最新文献

{"title":"Predictors of withdrawal of life-sustaining therapies in older adults with TBI and a modified frailty index score","authors":"John J. Francis ,&nbsp;Ahmed I. Kashkoush ,&nbsp;Vanessa P. Ho ,&nbsp;Mary J. Roach ,&nbsp;Michael L. Kelly","doi":"10.1016/j.jocn.2025.111191","DOIUrl":"10.1016/j.jocn.2025.111191","url":null,"abstract":"<div><h3>Background</h3><div>Withdrawal-of-life-sustaining-therapies (WLST) in patients with traumatic brain injury (TBI) is a complex decision-making process. The clinical factors related to WLST in older adults with TBI are currently poorly understood. The present study aims to determine the clinical predictors of WLST in older patients with TBI.</div></div><div><h3>Methods</h3><div>All patients ≥ 65 years old with TBI (Head Abbreviated Injury Scale Score ≥ 3) were identified from the Geriatric TBI Database, a prospective registry of patients admitted to 45 trauma centers nationwide with TBI between 2017–2019. We collected factors related to past medical history, baseline demographic data, clinical presentation, TBI sub-type, neurosurgical interventions, and do-not-attempt-resuscitation (DNAR) orders. The primary outcome measure was WLST. Binary logistic regression was subsequently performed to determine factors independently associated with WLST.</div></div><div><h3>Results</h3><div>A total of 1600 patients were identified. The median age was 80 years old and 48.6 % of patients were male. In this cohort, 120 patients (7.5 %) underwent WLST. A logistic regression model revealed that Glasgow Coma Scale (GCS) (OR 0.82; 95 %-CI 0.77––0.87), cerebral edema (3.2; 1.5–7.0), craniotomy/craniectomy (2.5; 1.4–4.4), and DNAR (8.8; 5.5–14.3) were all independently associated with WLST. This model demonstrated excellent discrimination ability with a concordance statistic of 0.935.</div></div><div><h3>Conclusions</h3><div>This study demonstrates that patients ≥ 65 years old with poor initial GCS, cerebral edema, craniotomy/craniectomy, and DNAR were all independently associated with WLST. Pre-injury frailty was not associated with WLST. Further studies are needed to evaluate the prognostic value of frailty indices in the management of patients with TBI.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111191"},"PeriodicalIF":1.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143642800","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":"Intracranial meningioma with intratumoral hemorrhage: A systematic review of associated features and outcomes","authors":"Dillon H. Putzler ,&nbsp;Mohammad Faizan Khan ,&nbsp;Frishan O. Paulo ,&nbsp;Lauren A. Nguyen ,&nbsp;Christine Galang ,&nbsp;Erin Rauber ,&nbsp;Ryan Gensler ,&nbsp;Julian Gendreau ,&nbsp;Gina Watanabe ,&nbsp;Paolo Palmisciano","doi":"10.1016/j.jocn.2025.111188","DOIUrl":"10.1016/j.jocn.2025.111188","url":null,"abstract":"<div><div>Intratumoral hemorrhage (ITH) is a rare clinical entity associated with gliomas and rarely with meningiomas. The hemorrhage risk of ITH in meningiomas remains poorly described. Literature suggests that patient age, tumor location, and histology may play some role. In this study, we aim to address ITH risk factors by evaluating patient and tumor characteristics, symptoms, and outcomes of ITH associated with meningioma. PubMed, Web of Science, Ovid EMBASE, and Scopus databases were searched from database inception to December 2024 for cases of meningioma with ITH based on PRISMA guidelines. Patient demographics, presenting symptoms, tumor characteristics, treatments, and survival outcomes were extracted and analyzed. 107 cases from 68 studies were collected. Patients were mostly female (61 %), with an average age of 56 years. The most common comorbidity was hypertension (19 %). Patients often presented awake (47 %) with headache (22 %) or weakness (20 %), 21 % were comatose on admission. Most tumors were WHO grade 1 (85 %), located on the convexity (56 %) with meningothelial histotype (34 %). Single-stage resection with hematoma evacuation was the most common treatment modality (91 %). Embolization (2 %) was rarely performed. 59 % of patients had complete resolution of symptoms, and 88 % survived to last follow-up. Current management favors single-stage resective surgery and hematoma evacuation; pre-operative embolization has a limited role. Postoperatively, the role of anticoagulation for VTE prophylaxis is unclear. Most patients survive with complete resolution of symptoms after operative intervention.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111188"},"PeriodicalIF":1.9,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143628172","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":"Survey on the impact of WHO 2021 classification of brain tumors on adult glioma management in Africo-Asian region","authors":"Sarvesh Goyal ,&nbsp;Shweta Kedia ,&nbsp;Sonal Jain ,&nbsp;Hemlata Jangir ,&nbsp;Nenkimun Dirting Bakwa ,&nbsp;Bipin Chaurasia ,&nbsp;Claire Karekezi ,&nbsp;James A Balogun ,&nbsp;Lynne Lourdes N. Lucena ,&nbsp;Mahnaaz Sultana Azeem ,&nbsp;Mabel Banson ,&nbsp;Santanu Kumar Bora ,&nbsp;Selfy Oswari ,&nbsp;Vaishali Suri ,&nbsp;Vasundhara Rangan","doi":"10.1016/j.jocn.2025.111174","DOIUrl":"10.1016/j.jocn.2025.111174","url":null,"abstract":"<div><div>The 2021 WHO classification of central nervous system (CNS) tumors introduced significant changes based on molecular and biological tumor characteristics, aiming to improve prognostication and enable more precise treatment approaches. This study investigated the awareness, adoption, and impact of the new classification on adult glioma management among healthcare professionals in Africo-Asian region. Through a structured survey questionnaire distributed across these regions, assessment of the level of awareness, diagnostic changes, challenges faced, and future perspectives among respondents was done. The survey received responses from 56 participants. Findings revealed that while 67.85% of respondents from Asia and 32.15% from Africa reported awareness of the new classification, both groups faced significant challenges in accessing molecular diagnostics, with financial constraints limiting widespread implementation. This paper provides insights into the current state of brain glioma management in resource-limited settings and discusses the potential need for further refinements in the WHO classification of CNS tumors and adult glioma management guidelines to address these disparities.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111174"},"PeriodicalIF":1.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143621178","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":"Validation of data capture in the Australasian shunt registry with a prospectively maintained institutional database","authors":"Michael J. Stuart ,&nbsp;Alison Wray ,&nbsp;Mark Dexter ,&nbsp;Robert AJ. Campbell","doi":"10.1016/j.jocn.2025.111179","DOIUrl":"10.1016/j.jocn.2025.111179","url":null,"abstract":"<div><h3>Background</h3><div>The Australasian Shunt Registry was established in 2016 with the aim of providing safety and quality data in addition to enhancing capacity for research to improve health outcomes for patients with cerebrospinal fluid shunts. The Queensland Children’s Hospital is the largest single contributor of paediatric patient data to the Registry and maintains an independent institutional shunt database. The aim of this study was to validate the demographic data and outcomes captured by the Registry against that institutional database.</div></div><div><h3>Methods</h3><div>Data from the institutional database and a sample of data from the same institution held by the Australasian Shunt Registry were acquired from the period of 1 January 2017 to 1 October 2024. Patients ≤ 18 years of age undergoing placement of a new ventriculoperitoneal shunt system were included. Revision and mortality data were acquired from the Australasian Shunt Registry and Queensland statewide electronic medical records independently. Comparison was made between demographic and mortality data captured by each database. The primary outcome of time to shunt revision (shunt survival) in each sample was assessed through the generation of Kaplan-Meier curves and analysis by both Wilcoxon and log-rank tests.</div></div><div><h3>Results</h3><div>Over the study period the shunt registry reported a full or partial opt-out rate of 9.5 %. 344 patients were identified and included from the institutional database, and 294 patients were included from the Registry. The identified patient samples were demographically similar with a mean age of 5 years, and 44 % female in both groups. The most common aetiologies of hydrocephalus in both cohorts were congenital (28 % vs 28 %, p = 0.49), tumour (33 % vs 27 %, p = 0.08) and haemorrhage (25 % vs 18 %, p = 0.02). Mortality during followup was consistent across both samples (13 % vs 11 %, p = 0.27). Similarly, binary revision status during the followup period was similar (34 % vs 32 %, p = 0.3). Kaplan-Meier analysis of time to revision (shunt survival) estimated shunt survival to be 4.82 years (95 % CI 4.42––5.22 years) in the institutional database and 5.25 (95 % CI 4.81–5.69 years) in the Registry with no significant differences between the samples on Wilcoxon, p = 0.3 or late Log-Rank, p = 0.36 tests.</div></div><div><h3>Conclusions</h3><div>The Australasian Shunt Registry appears to capture a valid sample which is representative of the demographics and clinical outcomes of patients treated at one large contributing institution. Ongoing efforts to ensure comprehensive data capture at all participating sites are justified to ensure that future findings derived from Registry data are representative of the studied population.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111179"},"PeriodicalIF":1.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143621177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic endonasal pituitary transposition trans-tuber-cinereum for resection of the third ventricle craniopharyngioma","authors":"Xie Tao ,&nbsp;Yang Zijiang ,&nbsp;Yang Liangliang ,&nbsp;Li Zeyang ,&nbsp;Liu Tengfei ,&nbsp;Zhang Xiaobiao","doi":"10.1016/j.jocn.2025.111176","DOIUrl":"10.1016/j.jocn.2025.111176","url":null,"abstract":"<div><div>Endoscopic endonasal approach (EEA) to craniopharyngioma has been widely used in the last decade. However, intrinsic third ventricle craniopharyngioma is still a difficult type for EEA. Endoscopic endonasal suprachiasmatic <em>trans</em>-lamina terminalis approach is an alternative solution. In consideration of the origin of intra-third ventricle craniopharyngioma is tuberoinfundibular area in the floor of the third ventricle, the suprachiasmatic <em>trans</em>-lamina terminalis approach is limited in exposing this area from anterior-superior direction. In this technical note, we describe our surgical technique for resection of the third ventricle craniopharyngioma by using endoscopic endonasal pituitary transposition <em>trans</em>-tuber-cinereum approach. The surgical technique includes posterior clinoidectomy, pituitary transposition, and opening the tuber cinereum. This described approach was performed in two patients with intrinsic third ventricle craniopharyngiomas, both of them achieved gross total resection. Transient pituitary deficiency was replaced with hormones. No other complications were occurred. Endoscopic endonasal pituitary transposition <em>trans</em>-tuber-cinereum approach is a safe and effective for this special type of craniopharyngioma.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111176"},"PeriodicalIF":1.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143621180","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":"Integrating adaptive digital health and family education: A new approach to assessing psychomotor development in malnourished children.","authors":"Monica Widyaswari, Ali Fakhrudin","doi":"10.1016/j.jocn.2025.111186","DOIUrl":"https://doi.org/10.1016/j.jocn.2025.111186","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":" ","pages":"111186"},"PeriodicalIF":1.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633645","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":"Swahili translation and cultural adaptation of the National Institutes of Health Stroke Scale","authors":"Peter Kuria Waweru ,&nbsp;Samwel Maina Gatimu ,&nbsp;Elijah Yulu ,&nbsp;Stella Kibet ,&nbsp;Dalphine Ndiema ,&nbsp;Adam Mang’ombe ,&nbsp;Sarah Shali Matuja ,&nbsp;Innocent Kitandu Paul ,&nbsp;Matilda K Basinda ,&nbsp;Sospeter Berling ,&nbsp;Gladness Xavier ,&nbsp;Nassiuma Manakhe ,&nbsp;Christine Tunkl ,&nbsp;Patrick Lyden","doi":"10.1016/j.jocn.2025.111182","DOIUrl":"10.1016/j.jocn.2025.111182","url":null,"abstract":"<div><h3>Background</h3><div>The severity of early neurologic deficits after stroke is the single most important predictor of post-stroke outcomes. Of all stroke severity scales, the National Institutes of Health Stroke Scale (NIHSS) is the most widely used. Despite being freely accessible, however, this tool remains underutilized in sub-Saharan Africa (SSA) likely due to absence of culturally adapted translations. For this reason, we translated the NIHSS to Swahili in a bid to promote its local use as an initial measure in the standardization of stroke care in the East African region. Swahili remains among the 10 most commonly spoken languages in the world, with over 200 million speakers, mostly centred in East Africa.</div></div><div><h3>Methods</h3><div>The NIHSS was translated into Swahili by a team of native Swahili speakers composed of two stroke physicians, two speech therapists and one nurse, and three independent translators in collaboration with the tool’s developer. Two Swahili translators performed forward translations of the original document from English to Swahili while a third independent translator performed backward translations to English, which was followed by clinician and cognitive reviews. Afterwards, reviewers from Kenya and Tanzania reviewed the tool for cross-cultural adaptation and international harmonisation. We further reconciled and generated a draft tool that was validated in Kenya and Tanzania.</div></div><div><h3>Results</h3><div>The NIHSS was translated into Swahili, a process that involved broad modifications of the tool including alterations of images, words and phrases to more locally familiar scenes and items. The results of validation of the Swahili version of the NIHSS in Kenya and Tanzania showed no significant differences with the original tool; with good interrater reliability in most domains.</div></div><div><h3>Conclusions</h3><div>The result of this process is a Swahili translation of the NIHSS that reflects the original tool. We expect the tool to help advance stroke care in Swahili-speaking regions.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111182"},"PeriodicalIF":1.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143628173","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":"Machine Learning-Based localization of the epileptogenic zone using High-Frequency oscillations from SEEG: A Real-World approach","authors":"Aswin Raghu ,&nbsp;C.P. Nidhin ,&nbsp;V.S. Sivabharathi ,&nbsp;Pranav Rakesh Menon ,&nbsp;Priyalakshmi Sheela ,&nbsp;Remya Ajai ,&nbsp;T.R. Krishnaprasad ,&nbsp;Anand Kumar ,&nbsp;Arjun Ramakrishnan ,&nbsp;Siby Gopinath ,&nbsp;Harilal Parasuram","doi":"10.1016/j.jocn.2025.111177","DOIUrl":"10.1016/j.jocn.2025.111177","url":null,"abstract":"<div><h3>Introduction</h3><div>Localizing the epileptogenic zone (EZ) using Stereo EEG (SEEG) is often challenging through manual analysis. Even methods based on signal analysis have limitations in identifying the EZ, particularly in patients with neocortical epilepsy.</div></div><div><h3>Methods</h3><div>We developed machine learning (ML) methods that utilize HFO from SEEG recordings to train models to localize the EZ. We used data from 52 epilepsy patients (37 seizure free and 15 non-seizure free) who had epilepsy surgeries at our centre and were followed up for an average of 27.4 months. A total of 27 features encompassing statistical, linear, and nonlinear parameters were computed for HFOs from EZ and non-EZ brain areas. Performances of different classification algorithms were compared.</div></div><div><h3>Results</h3><div>In cases of mesial temporal lobe epilepsy, we achieved a cross-validation accuracy of 85.4% with the Extra-Trees classifier, 85.3% with the Random-Forest, and 82.1% with the Voting-classifier, using training data from ripples and fast ripples. For neocortical epilepsy patients, the extra trees classifier yielded an accuracy of 84.2%, while the random forest and voting classifiers attained accuracies of 84% and 80%, respectively.</div></div><div><h3>Conclusion</h3><div>In our approach, we employed a more realistic strategy by training the ML models at the SEEG contact level. This ensured that HFO data from a specific contact used for training the model was excluded from testing, thereby minimizing bias. This approach provides a more practical and applicable method for real-world use. Our findings indicate that the ML model-based localization of the EZ could function as an independent approach, potentially reducing the bias associated with visual analysis of SEEG.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111177"},"PeriodicalIF":1.9,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143621314","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":"Diagnostic accuracy of MRI without gadolinium for follow-up of pilocytic astrocytoma in the paediatric population","authors":"Macfarlane Adam Ian ,&nbsp;Soares Jewel Hannah ,&nbsp;Maharaj Monish","doi":"10.1016/j.jocn.2025.111173","DOIUrl":"10.1016/j.jocn.2025.111173","url":null,"abstract":"<div><h3>Purpose</h3><div>Pilocytic astrocytoma is the most common glial tumour in the paediatric population with a long-term life expectancy after surgery. Long-term radiological follow-up with magnetic resonance imaging (MRI) is necessary to detect recurrence of tumour or growth of residual tumour. Established MRI protocols typically dictate post-gadolinium sequences despite concerns around the side-effect and safety concerns of gadolinium-based contrast agents. This study aims to investigate whether omission of gadolinium-enhanced sequences for the long term follow-up MRI for paediatric patients with pilocytic astrocytoma, maintains diagnostic accuracy assessing potential recurrence or growth of residual tumour.</div></div><div><h3>Methods</h3><div>A retrospective review of follow-up MRI for 47 patients with histopathologically proven pilocytic astrocytoma was performed. Patients with optic pathway or suprasellar glioma were excluded from this study. All patients underwent surgery and had a minimum of 2 years of postoperative imaging for review. MRIs were chosen from most recent report of stability or at a time when growth/progression had been diagnosed. Two neuroradiologists and two paediatric neurosurgeons were randomly allocated a series of MRIs with gadolinium enhanced sequences removed, reviewers were blinded to the original report and subsequent treatment decisions. In addition, 30 paired MRI studies were randomly allocated to second review to test interobserver reliability. The reviewer responses were recorded and compared with the original report and analysed with respect to preserved diagnostic accuracy.</div></div><div><h3>Results</h3><div>170 MRI scans were subject to review across 66 episodes of care for 47 patients. 22.7 % of patients experienced growth of residual tumour during the period of follow-up. The sensitivity of non-enhanced MRI for detection of growth was 82 % (95 %CI 64.40–92.12) with a specificity of 97.10 % (95 % CI 90.03–99.20). Accuracy was similar for both neuroradiologists and neurosurgeons (91.49 % vs. 94 %). Interobserver reliability was calculated using Cohen’s Kappa co-efficient with a result of 0.792 showing substantial agreement. We also confirmed a statistically significant difference between gross total resection and sub-total resection and correlation with future growth (41 % vs. 0 %, n = 64, p = 0.001).</div></div><div><h3>Conclusion</h3><div>In paediatric patients who have undergone surgery for pilocytic astrocytoma, long term MRI follow-up without gadolinium-enhanced sequences maintains diagnostic accuracy compared with enhanced sequences. Omission of gadolinium-enhanced sequences may lead to decreased costs, duration of scans and anxiety around follow-up procedures.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111173"},"PeriodicalIF":1.9,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143621313","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 Excision of Giant Pituitary Neuroendocrine Tumor with Subarachnoid extension","authors":"Mohamed Amjad Jamaluddin ,&nbsp;Sanal Mohan ,&nbsp;Hiran Ramanan ,&nbsp;R. Vijaynath ,&nbsp;Mohammed Iqbal Jaser ,&nbsp;Winston Markose ,&nbsp;Palukuru Nikshith Kumar Reddy","doi":"10.1016/j.jocn.2025.111175","DOIUrl":"10.1016/j.jocn.2025.111175","url":null,"abstract":"<div><div>Giant Pituitary Neuroendocrine Tumor, though challenging,<!--> <!-->if planned well can be removed endoscopically<!--> <!-->with help of significant bony drilling, angled scopes and<!--> <!-->suckers, and proper reconstruction.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111175"},"PeriodicalIF":1.9,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143621179","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}