Journal of Clinical Neuroscience最新文献

{"title":"Spontaneous perforation of septum pellucidum – A rare marker of chronic hydrocephalus","authors":"Ram Kishan Nekkanti, Gowtham Matham, Krishnakumar Kesavapisharady, H.V. Easwer","doi":"10.1016/j.jocn.2024.110885","DOIUrl":"10.1016/j.jocn.2024.110885","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"130 ","pages":"Article 110885"},"PeriodicalIF":1.9,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142531366","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":"Pseudocapsular dissection in a large plurihormonal Pit-1 positive PitNET","authors":"Nicholas G. Candy , Stephen Santoreneos , Peter-John Wormald","doi":"10.1016/j.jocn.2024.110887","DOIUrl":"10.1016/j.jocn.2024.110887","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"130 ","pages":"Article 110887"},"PeriodicalIF":1.9,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522050","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":"The safety and efficacy of NeVa mechanical thrombectomy device in acute ischemic stroke: A systematic review and meta-analysis","authors":"Mohammad Amin Habibi ,&nbsp;Mohammad Sina Mirjnani ,&nbsp;Saeed Kargar-Soleimanabad ,&nbsp;Mohammad Taha Akbari Javar ,&nbsp;Maryam Diyanati ,&nbsp;Muhammad Hussain Ahmadvand ,&nbsp;Inka K. Berglar ,&nbsp;Adam A. Dmytriw","doi":"10.1016/j.jocn.2024.110892","DOIUrl":"10.1016/j.jocn.2024.110892","url":null,"abstract":"<div><h3>Background</h3><div>Recent favorable cohort studies on endovascular therapy for ischemic stroke have predominantly utilized NeVa thrombectomy (NeVa^TM) stent retrievers. We carried out a systematic review and <em>meta</em>-analysis to investigate the efficacy and safety of this second-generation stent retriever in acute ischemic stroke patients.</div></div><div><h3>Method</h3><div>We conducted the study according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The electronic databases of PubMed, Embase, and Scopus were searched until 26 November 2023 and was updated on August 1, 2024.</div></div><div><h3>Results</h3><div>This <em>meta</em>-analysis systematically investigated 11 studies with a total of 805 patients suffering from ischemic stroke. The mean age of participants across the studies ranged from 65 to 77 years with a male preponderance of 50.16 %. While ten studies reported on the etiology of strokes, some studies reported the risk factors such as hypertension, dyslipidemia, diabetes, history of coronary artery disease, and previous stroke. The results of our study indicate that the all-hemorrhagic complications rate was 0.32 (95 %CI: 0.18–0.45), while the complete arterial recanalization rate was 0.76 [95 %CI: 0.49–1.04]. The overall recanalization rate was found to be 0.97 [95 %CI: 0.94–1.00]. Moreover, the postoperative hemorrhage rate was 0.28 [95 %CI: 0.14–0.41], while the repeated re-thrombosis rate was 0.01 [95 %CI: −0.01–0.03]. Lastly, the vasospasm rate was calculated to be 0.09 [95 %CI: −0.03–0.21].</div></div><div><h3>Conclusion</h3><div>NeVa™ is a safe option capable of achieving a high rate of recanalization and functional independence.</div><div>Abbreviations: PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses; PROSPERO, International Prospective Register of Systematic Reviews; NeVa™, NeVa Thrombectomy; ICH, Intracranial Hemorrhage; mTICI, modified Thrombolysis in Cerebral Infarction; mRS, modified Rankin Scale; ACA, Anterior Cerebral Artery; MCA, Middle Cerebral Artery; PCA, Posterior Cerebral Artery; ICA, Internal Carotid Artery; NIHSS, National Institutes of Health Stroke Scale.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"130 ","pages":"Article 110892"},"PeriodicalIF":1.9,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522051","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":"Does gender diversity affect the number and impact of publications among major academic institutes in India? Barriers and opportunities","authors":"Harsh Deora ,&nbsp;Vishnu Jayan ,&nbsp;Sandeep Mishra ,&nbsp;Shweta Kedia ,&nbsp;Vivek Tandon ,&nbsp;Kanwaljeet Garg ,&nbsp;P.S. Chandra ,&nbsp;Shashank Sharad Kale","doi":"10.1016/j.jocn.2024.110888","DOIUrl":"10.1016/j.jocn.2024.110888","url":null,"abstract":"<div><h3>Background</h3><div>A glaring gender inequality persists in global neurosurgery, influenced by various factors, including the notion that female neurosurgeons have lower academic output. This study aims to compare the research output of female and male neurosurgeons at the leading academic institutions in India.</div></div><div><h3>Methods</h3><div>The pertinent details regarding female neurosurgeons were collected from the Neurological Society of India (NSI) and Women In Neurosurgery (India) database. The institutes with at least five neurosurgery faculty recognised by the Medical Council of India (MCI) were included in the study. Various bibliometric parameters of male and female faculty at these academic centres were collected and compared using PubMed and Web of Science databases.</div></div><div><h3>Results</h3><div>Among the 2643 neurosurgeons in NSI, 113 were females (4.27%). Out of 156 faculty members across eighteen academic institutions, only seven (4.7%) were female, with eleven institutions lacking female faculty. Female academic neurosurgeons had slightly higher h-index (9.57 vs. 9.56), citation per publication (8.82 vs. 8.54), and original article percentage (47.5 vs. 46.5) compared to males. They also had more citations per year (34.01 vs. 33.17), while males had more total publications (51.19 vs. 46.71) and citations (565.22 vs. 533.57), but these differences weren’t statistically significant. Only 4.1% (327/7955) of neurosurgery research was contributed by females. Female neurosurgeons authored articles received 3735 citations (4.2%) out of 87,953 total citations.</div></div><div><h3>Conclusion</h3><div>Female academic neurosurgeons in India exhibit comparable or superior academic output compared to their male counterparts, suggesting gender equality or even superiority in certain aspects of academic performance.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"130 ","pages":"Article 110888"},"PeriodicalIF":1.9,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142531367","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":"Same-day discharge following lumbar spine neural decompression","authors":"Halil Bulut ,&nbsp;Maria Maestre ,&nbsp;Daniel Tomey","doi":"10.1016/j.jocn.2024.110875","DOIUrl":"10.1016/j.jocn.2024.110875","url":null,"abstract":"<div><h3>Introduction</h3><div>The concept of same-day discharge following lumbar spine surgery for neural elements decompression, introduced in the 1980 s, represents a significant paradigm shift in postoperative care, offering potential benefits in terms of efficiency, convenience, and cost-effectiveness. However, concerns regarding patient safety and complications have persisted. This study aims to assess same-day discharge rates following lumbar spine decompression surgery, identify preoperative predictors, and compare outcomes between same-day discharge and hospitalization.</div></div><div><h3>Methods</h3><div>A retrospective comparative analysis was conducted using data from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Participant Use File spanning 2016 to 2021. A total of 58,430 patients undergoing lumbar spine decompression procedures were included. Statistical analysis was performed using SPSS software, with significance determined at p &lt; 0.05.</div></div><div><h3>Results</h3><div>Significant differences were observed in preoperative factors, operative variables, and postoperative outcomes between patients discharged on the same day and those hospitalized. Preoperative comorbidities, operative time, length of stay, utilization of minimally invasive approaches, and 30-day mortality rates differed significantly between the two groups. Notably, same-day discharge demonstrated superior outcomes, with lower rates of unplanned intubation, readmission, and reoperation compared to hospitalization.</div></div><div><h3>Conclusion</h3><div>In conclusion, same-day discharge following lumbar spine decompression procedures holds promise as a safe and effective practice, offering advantages in terms of patient outcomes and healthcare resource utilization. Further research and implementation of standardized protocols are warranted to maximize the benefits of same-day discharge while ensuring patient safety and satisfaction.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"130 ","pages":"Article 110875"},"PeriodicalIF":1.9,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142501287","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 transpterygoid trans lacero-cavernous resection of Knosp 4 functioning pituitary macroadenoma","authors":"Jaskaran Singh Gosal ,&nbsp;Pavan Gabra ,&nbsp;Simran Bhalla ,&nbsp;Raghavendra Kumar Sharma ,&nbsp;Vikas Janu ,&nbsp;Sarbesh Tiwari ,&nbsp;Nikhil Agrawal ,&nbsp;Ravindra Kumar Shukla ,&nbsp;Mahesh Gadhvi ,&nbsp;Daniel Prevedello ,&nbsp;Deepak Kumar Jha","doi":"10.1016/j.jocn.2024.110886","DOIUrl":"10.1016/j.jocn.2024.110886","url":null,"abstract":"<div><div>In this video, we demonstrate the technique of endoscopic transpterygoid trans lacerum trans cavernous approach for the excision of Knosp 4 functioning pituitary macroadenomas. We highlight the anatomy and key steps of the approach using cadaveric dissection and present two clinical cases. A 42-year-old female with a growth hormone-secreting tumor and Knosp 4 macroadenoma underwent an extended endoscopic endonasal approach and near-total excision of the tumor. Postoperatively she was neurologically intact. Postoperative MR showed a small residue in the lateral compartment of the cavernous sinus and along the right optic tract superiorly. Due to the proximity of the residual tumor near the optic apparatus, she was offered a pterional approach, and the tumor around the optic apparatus was excised. She was given stereotactic radiosurgery for the small residual tumor in the cavernous sinus and is currently doing well, under remission. The second case was a 23-year young male with acromegaly and bilateral Knosp 4 macroadenoma. He underwent endoscopic transpterygoid trans lacerum trans cavernous approach and gross total excision of the tumor was done. He had transient bilateral ophthalmoplegia in the immediate postoperative period which recovered fully within 6 weeks. He is currently in remission without any need for radiotherapy. To conclude, an in-depth knowledge of the anatomy helps in improving surgical outcomes in extended endoscopic endonasal surgeries.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"129 ","pages":"Article 110886"},"PeriodicalIF":1.9,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142501281","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":"Uninostril endonasal trans-sphenoidal approach for pituitary macroadenoma–Operative nuances step by step","authors":"A. Mittal,&nbsp;R. Mishra,&nbsp;I. Jain,&nbsp;H. Patel,&nbsp;A. Shrivastava","doi":"10.1016/j.jocn.2024.110867","DOIUrl":"10.1016/j.jocn.2024.110867","url":null,"abstract":"<div><div>The Uninostril Endonasal Transsphenoidal approach stands out for its ability to preserve nasal anatomy, ensuring normal postoperative breathing while reducing postoperative nasal complications. The Uninostril approach offers a simplified access, expedites both the nasal phase and closure, all while leaving the contralateral nostril untouched, allowing for a potential rescue flap if needed. This method is particularly suited for primary cases of sellar suprasellar Knosp 0/1 pituitary adenomas located medial to the carotid arteries and with T2 iso to hyperintense signals on the MRI. The objective of this article is to elucidate the operative step by step nuances of the uninostril endonasal <em>trans</em>-sphenoidal surgery.</div><div>The patient positioning is key with a neutral head alignment positioned above the heart level and slightly tilted to the opposite side. This position is ergonomically better, reduces the venous bleeding, and enhances gravity-assisted tumor removal. Despite its advantages—such as improved postoperative nasal quality and a comparable rate of gross total tumor resection to the Bi-nostril approach—the Uninostril technique is not without limitations. Challenges include a restricted field of view, limited instrument maneuverability, and the potential need to convert to a Bi-nostril approach in cases of excessive bleeding or visualization difficulties. Overall, this approach provides a viable alternative for pituitary adenoma resection in selected subset of the patients, effectively balancing the oncologic resection and patient’s related outcomes.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"130 ","pages":"Article 110867"},"PeriodicalIF":1.9,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142501289","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":"Volume-staged versus dose-staged stereotactic radiosurgery, with or without embolization, in the treatment of large brain arteriovenous malformations: A systematic review and meta-analysis","authors":"Collin J. Larkin ,&nbsp;Zachary A. Abecassis ,&nbsp;Ketan Yerneni ,&nbsp;Dominic A. Nistal ,&nbsp;Constantine L. Karras ,&nbsp;Pedram Golnari ,&nbsp;Matthew B. Potts ,&nbsp;Babak S. Jahromi","doi":"10.1016/j.jocn.2024.110883","DOIUrl":"10.1016/j.jocn.2024.110883","url":null,"abstract":"<div><h3>Background and objective</h3><div>While safe and effective modalities exist to treat small arteriovenous malformations (AVMs), large (&gt;10 cm³) AVMs remain difficult to cure via surgical or endovascular means. Staged stereotactic radiosurgery (SRS), either volume-staged (VS) or dose-staged (DS), has been proposed for large AVMs. The relative efficacy of these two strategies, with or without endovascular embolization, is unclear. Accordingly, the goal of this study is to review existing literature on VS-SRS and DS-SRS for large brain AVMs to compare obliteration rates and complications, and determine the utility of neoadjuvant embolization.</div></div><div><h3>Methods</h3><div>MEDLINE, Scopus, and the Cochrane registry were searched for studies with at least five adult patients and an AVM volume of ≥10 cm³ prior to treatment. Meta-analyses of proportions were conducted and compared using a Wald-type test and the impact of prior embolization was investigated using weighted linear regression analysis.</div></div><div><h3>Results</h3><div>Eighteen studies (VS-SRS n = 235, DS-SRS n = 157) fit inclusion criteria, all of which were retrospective and none of which directly compared both treatment strategies. The average rate of complete AVM obliteration was significantly higher with VS-SRS (46.6 %; 39.7 % – 53.6 %) than DS-SRS (17.8 %; 7.0 % – 38.2 %, p = 0.027). Complication rates were comparable between VS-SRS (18.0 %; 9.2 % – 32.1 %) and DS-SRS (23.6 %; 12.2 % – 40.8 %, p = 0.544). Regression analysis demonstrated no significant relationship between prior embolization and complete obliteration for either VS-SRS (r = −0.36, <em>p</em> = 0.34) or DS-SRS (r = 0.58, <em>p</em> = 0.29).</div></div><div><h3>Conclusion</h3><div>VS-SRS, without neoadjuvant embolization, appears to be the optimal approach when treating large AVMs with radiosurgery. Further prospective studies are warranted.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"129 ","pages":"Article 110883"},"PeriodicalIF":1.9,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142501282","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":"Predictors of time to achieve clinically significant improvements following lateral lumbar interbody fusion","authors":"Fatima N. Anwar ,&nbsp;Andrea M. Roca ,&nbsp;Vishrudh Vasudevan ,&nbsp;Yousaf Ilyas ,&nbsp;Alexandra C. Loya ,&nbsp;Srinath S. Medakkar ,&nbsp;Vincent P. Federico ,&nbsp;Kern Singh","doi":"10.1016/j.jocn.2024.110889","DOIUrl":"10.1016/j.jocn.2024.110889","url":null,"abstract":"<div><h3>Background</h3><div>As lateral lumbar interbody fusions (LLIF) are increasingly performed, our understanding of postoperative clinical trajectories is important in informing preoperative patient expectations. While minimum clinically important difference (MCID) rates are widely utilized in spine surgery literature, there is less published on how long it takes for patients to achieve MCID following LLIF.</div></div><div><h3>Objective</h3><div>To evaluate the length of time it takes for patients to report MCID achievement for back pain, leg pain, disability, and physical function and evaluate predictors of time to achieve MCID.</div></div><div><h3>Methods</h3><div>Patients undergoing elective LLIF by the senior author with baseline and postoperative patient-reported outcomes (PROs) recorded were retrospectively identified. Data on potential predictors of time to MCID achievement were gathered including demographics, comorbidities, diagnostic information, and baseline PROs. MCID achievement rates for Oswestry Disability Index (ODI), Visual Analog Scale-Back (VAS-Back), VAS-Leg, and Patient-Reported Outcome Measurement Information System-Physical Function (PROMIS-PF) were calculated at six-, twelve, 6 month- 1 year- and 2-year postoperative timepoints. A Kaplan-Meier survival analysis was conducted to determine the proportion of patients achieving MCID at each time point. A multivariate Cox regression determined predictors of time to MCID achievement.</div></div><div><h3>Results</h3><div>One hundred-five patients were included in the analysis. The mean time to achieve MCID for PROMIS-PF was 44.7 weeks, for VAS-Back was 38.5 weeks, for VAS-Leg was 36.7 weeks, and for ODI was 38.3 weeks. Worse baseline VAS-Back significantly predicted earlier MCID achievement for VAS-Back (HR: 1.55), while diabetes was predictive of later MCID achievement (HR: 0.21). Higher body mass index and worse preoperative ODI predicted earlier MCID achievement for ODI (HR: 1.04–1.08), and higher VAS-Leg score and two-level fusion were predictive of later MCID achievement for ODI, (HR:0.26–0.81). Worse preoperative VAS-Leg, isthmic spondylolisthesis, and three-level fusion were predictors of earlier achievement of MCID for VAS-Leg (HR: 1.27–6.47). Herniated nucleus pulposus and foraminal stenosis were early predictors (HR: 2.92–3.23) and workers’ compensation was a late predictor of MCID attainment for PROMIS-PF (HR: 0.13).</div></div><div><h3>Conclusion</h3><div>Select demographic variables, comorbidities, spinal pathology, and preoperative PROs influenced the time it took for patients to report clinically significant improvements in pain, disability, and physical function scores. These findings can be used to prognosticate outcomes for patients undergoing LLIF and inform patient expectations of postoperative recovery.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"130 ","pages":"Article 110889"},"PeriodicalIF":1.9,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142501286","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 traumatic brain injury treatment guided by continuous monitoring of intracranial pressure and brain tissue oxygen partial pressure: A single-center pilot study","authors":"Zhong Wang ,&nbsp;Ruijian Zhang,&nbsp;Zhitong Han,&nbsp;Junqing Wang,&nbsp;Rile Wu,&nbsp;Weiping Zhao,&nbsp;Xiaojun Zhang,&nbsp;Jingang Bao,&nbsp;Weiran Yang,&nbsp;Zhilong Zhang","doi":"10.1016/j.jocn.2024.110884","DOIUrl":"10.1016/j.jocn.2024.110884","url":null,"abstract":"<div><div>Severe traumatic brain injury (TBI) is a leading cause of death and disability. Monitoring intracranial pressure (ICP) is recommended, but the data on the outcomes are conflicting. Adding continuous brain tissue oxygen partial pressure (PbtO2) monitoring may have some benefit but the OXY-TC suggested it did not improve 6-month neurological outcomes. This single-center pilot randomized controlled study aimed to evaluate whether adding PbtO2 monitoring was feasible and could improve the prognosis of severe TBI. The participants were randomized into either an ICP alone or an ICP + PbtO2 group for 7 days, with treatment protocols based on existing guidelines. Clinical parameters were collected hourly. The primary outcome was the feasibility of using PbtO2 monitoring. The secondary outcomes were 6-month survival, analyzed by the log-rank test, the 3- and 6-month Glasgow Outcome Scale (GOS) scores, compared between groups by chi-squared test. Seventy patients were included (36 ICP, 34 ICP + PbtO2). The ICP + PbtO2 group had lower mean daily ICP (13.4 vs. 18.2 mmHg, P = 0.0024) and higher mean daily cerebral perfusion pressure (82.1 vs. 74.5 mmHg, P = 0.0055). The ICP + PbtO2 group had higher 6-month survival (79.4 % vs. 55.6 %, P = 0.0337) and more favorable outcomes at 3 months (67.6 % vs. 38.9 %, P = 0.0160) and 6 months (70.6 % vs. 41.7 %, P = 0.0149). Adding PbtO2 monitoring to ICP monitoring is feasible in patients with severe TBI and could maybe improve the intermediate-term outcomes. The results will serve to design larger trials.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"130 ","pages":"Article 110884"},"PeriodicalIF":1.9,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142501285","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}