Journal of Clinical Neuroscience最新文献

{"title":"Differential diagnosis between recurrent disc herniation and granulation tissue after lumbar disc herniation Surgery: Qualitative analysis on MRI scans","authors":"Ziya Asan ,&nbsp;Halime Tozak Yildiz","doi":"10.1016/j.jocn.2024.110870","DOIUrl":"10.1016/j.jocn.2024.110870","url":null,"abstract":"<div><h3>Background</h3><div>Recurrence of disc herniation is a prevalent late-term complication among patients surgically treated for lumbar disc herniation. Differential diagnosis between recurrent disc herniation and granulation tissue can be achieved through signal intensity measurements on T2-weighted MRI examinations. This study aims to examine cases operated on for recurrence of lumbar disc herniation, assessing those presenting with either disc recurrence or granulation tissue. The objective is to demonstrate that differential diagnosis can be facilitated through signal intensity value measurements and radiological findings in MRI examinations of patients with disc herniation recurrence and granulation tissue.</div></div><div><h3>Methods</h3><div>Analysis involved reviewing lumbar MRI T2 sequences of patients operated on with a presumptive diagnosis of lumbar disc herniation recurrence. Mean T2 signal intensity values in preoperative MRI images of cases with disc herniation recurrence and granulation tissue were examined and recorded on the Picture Archiving and Communication System. Mean T2 signal intensity values of recurrent disc herniation and granulation tissue were then compared.</div></div><div><h3>Results</h3><div>Among the patients who underwent surgery, disc herniation recurrence was observed in 135 cases, while granulation tissue was found in 12 patients (8.89 %). The preopreative mean T2 signal intensity value for disc herniation was recorded as 54.82 ± 2.42, whereas the mean T2 signal intensity value for granulation tissue was 205.96 ± 5.62.</div></div><div><h3>Conclusions</h3><div>T2 sequences in MRI examinations offer the clearest evaluation of disc herniations. Mean T2 signal intensity value measurements conducted on the PACS system can aid in differentiating between recurrent disc herniation and granulation tissue. These findings serve to inform surgical protocols during the preoperative phase.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"129 ","pages":"Article 110870"},"PeriodicalIF":1.9,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142442004","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":"Daytime versus out-of-hours surgery for Chronic Subdural Hematoma","authors":"Conor S. Gillespie ,&nbsp;Christopher Quelch ,&nbsp;Kisanet Medhanie ,&nbsp;Sruthi Ranganathan ,&nbsp;Rajeevlochan Ravi ,&nbsp;Munashe Veremu ,&nbsp;William H. Cook ,&nbsp;Prabhjot S. Malhotra ,&nbsp;Oliver D. Mowforth ,&nbsp;Daniel P. Brown","doi":"10.1016/j.jocn.2024.110863","DOIUrl":"10.1016/j.jocn.2024.110863","url":null,"abstract":"<div><div>Chronic Subdural Hematoma (CSDH) is one of the most common neurosurgical pathologies. Due to an elderly demographic with increasing co-morbidities, surgery is often deferred out of hours. This may reduce complication risk, but increases length of stay and may compromise patient care due to delayed surgery. We performed a retrospective service evaluation of CSDH patients undergoing primary surgery (September 2021–September 2023) at a tertiary neurosciences centre. Out of hours (OOH) was defined as an operation start time outside 8 am–8 pm. Primary outcome was recurrence requiring repeat surgery. Secondary outcomes included complications, thromboembolic events (DVT/PE), length of stay, and in hospital mortality. Differences were assessed using Chi-Squared tests and Student’s t-tests. A total of 263 patients were included (200 (76.0 %) male, mean age 75.0 ± 11.3 yrs). Median time from admission to surgery was 37 h (IQR 14–71.5 h). In total, 49.8 % (131/263) of operations took place OOH. There were no significant differences in baseline characteristics between the two groups. At a median follow-up of 9.2 months (IQR 4.8–13.2 months) there was no difference in recurrence rates between OOH and in hours groups (14.5 % vs. 17.7 %, <em>p</em> = 0.483). There was no difference in complication rates (13.7 % vs 16.2 %, <em>p</em> = 0.585), thromboembolic events (3.8 % vs 3.1 %, <em>p</em> = 0.743), length of stay (mean 15.9 vs 15.2 days, <em>p</em> = 0.787), or in-hospital mortality (2.3 % vs 3.1 %, <em>p</em> = 0.483). OOH surgery for CSDH surgery is safe, does not appear to affect complications, recurrence, or mortality, and should be considered in appropriately selected cases.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"129 ","pages":"Article 110863"},"PeriodicalIF":1.9,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142437844","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":"Dorsal arachnoid web: A neurological condition with significant gaps in clinical and translational evidence.","authors":"Johana Patricia Galván-Barrios, Jessica Manosalva-Sandoval","doi":"10.1016/j.jocn.2024.110860","DOIUrl":"https://doi.org/10.1016/j.jocn.2024.110860","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":" ","pages":"110860"},"PeriodicalIF":1.9,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380958","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":"Enhancing exposure in endoscopic endonasal resection of Craniopharyngioma: Sellar floor dural incision technique","authors":"Raywat Noiphithak ,&nbsp;Juan C. Yanez-Siller","doi":"10.1016/j.jocn.2024.110855","DOIUrl":"10.1016/j.jocn.2024.110855","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"129 ","pages":"Article 110855"},"PeriodicalIF":1.9,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380960","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":"Letter to the editor: Comment on \"Global neurotrauma: A systematic review and summary of the current state of registries around the world\".","authors":"Rizky Andana Pohan, M Ramli, Adi Atmoko, Sa'dun Akbar, Erfan Ramadhani, Rikas Saputra, Ririn Dwi Astuti","doi":"10.1016/j.jocn.2024.110856","DOIUrl":"https://doi.org/10.1016/j.jocn.2024.110856","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":" ","pages":"110856"},"PeriodicalIF":1.9,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380959","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":"Comment on: \"Decreased timing to vasospasm prophylaxis improves outcomes among patients with aneurysmal subarachnoid hemorrhage (aSAH) on prehospital CCBs, ARBs, or ACE-inhibitors\".","authors":"Gurdeep Gambhir","doi":"10.1016/j.jocn.2024.110859","DOIUrl":"10.1016/j.jocn.2024.110859","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":" ","pages":"110859"},"PeriodicalIF":1.9,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375511","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":"Worm-like necrotic inflammatory substance in Jackson-Pratt drain after spinal fusion","authors":"Meagan Paige Aladin ,&nbsp;Jose Mantilla Arango ,&nbsp;Eddie Louie ,&nbsp;Themistocles Protopsaltis ,&nbsp;Ariane Lewis","doi":"10.1016/j.jocn.2024.110861","DOIUrl":"10.1016/j.jocn.2024.110861","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"129 ","pages":"Article 110861"},"PeriodicalIF":1.9,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142377879","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 reconstruction to primary empty sella: “7 E” technique","authors":"Juan F. Villalonga,&nbsp;Ernesto Ardisana,&nbsp;Agustín Martínez-Font,&nbsp;José I. Pailler,&nbsp;Álvaro Campero","doi":"10.1016/j.jocn.2024.110854","DOIUrl":"10.1016/j.jocn.2024.110854","url":null,"abstract":"<div><div>We present the seven “E” technique step by step for the reconstruction of the empty sella with an illustrative case.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"129 ","pages":"Article 110854"},"PeriodicalIF":1.9,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142377878","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":"Clinical profile and outcomes in Tolosa-Hunt Syndrome; a systematic review","authors":"H. Shafeeq Ahmed ,&nbsp;Deepak B. Shivananda ,&nbsp;Sneha Reddy Pulkurthi ,&nbsp;Akhil Fravis Dias ,&nbsp;Prachi Parinita Sahoo","doi":"10.1016/j.jocn.2024.110858","DOIUrl":"10.1016/j.jocn.2024.110858","url":null,"abstract":"<div><h3>Introduction</h3><div>Tolosa-Hunt Syndrome (THS) stands as a rare headache disorder distinguished by painful ophthalmoplegia, accompanied by headaches and cranial nerve palsies. The syndrome was initially identified by Eduardo Tolosa in Spain in 1954. He observed granulomatous inflammation surrounding a carotid siphon in a patient with an intracavernous carotid aneurysm. The objective of this systematic review is to consolidate and summarize existing studies on THS, providing a comprehensive evaluation of its clinical findings and outcomes.</div></div><div><h3>Methods</h3><div>This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) checklist. Systematic searches were conducted on PubMed and Scopus databases to identify literature examining the sociodemographics, clinical findings, cranial nerve palsies, laboratory and radiological data, treatment, and outcomes of THS. The study followed a pre-established protocol registered on the PROSPERO database (ID: CRD42023494249).</div></div><div><h3>Results</h3><div>Out of 1115 studies screened, 11 met the predefined inclusion and exclusion criteria. The studies predominantly focused on Asian populations, emphasizing unilateral orbital headaches as a common clinical feature. Ophthalmological findings, including restriction of eye movements, diplopia, ptosis, and vision loss, were prevalent. Studies also highlighted some cases presenting atypically without ophthalmoplegia but with acute vision changes. Oculomotor nerve palsy, followed by abducens and trochlear nerve palsies, were the most frequently reported. Laboratory investigations across the studies often showed normal cerebrospinal fluid findings and varying levels of inflammatory markers like ESR and CRP. Inflammation of the cavernous sinus and orbital apex was noted most frequently. Treatment strategies were consistent across the studies, with steroids (both IV and oral) being the mainstay treatment for managing THS. Despite the use of steroids, the studies reported varied outcomes in terms of pain relief and recovery from cranial nerve deficits, with some cases showing rapid improvement while others had prolonged or incomplete recovery. Other immunosuppressants and steroid sparing agents are used with varying levels of success. Recurrence rates ranged from 9% to 71% across studies.</div></div><div><h3>Conclusion</h3><div>This review discusses the varied constellation of symptoms associated with THS, with headaches and cranial nerve findings being consistently observed. High and low doses, as well as both intravenous and oral steroids, have proven to be effective in managing THS. Overall, the prognosis appears favorable, with a limited number of cases showing recurrence.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"129 ","pages":"Article 110858"},"PeriodicalIF":1.9,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375512","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":"Long-term course of gastrostomy nutritional management in patients with Duchenne muscular dystrophy: A retrospective cohort study","authors":"Yuki Takanarita ,&nbsp;Yuichi Okata ,&nbsp;Hiroyuki Awano ,&nbsp;Ryosuke Bo ,&nbsp;Yuko Bitoh","doi":"10.1016/j.jocn.2024.110857","DOIUrl":"10.1016/j.jocn.2024.110857","url":null,"abstract":"<div><div>Duchenne muscular dystrophy (DMD) is a progressive neuromuscular disease that commonly requires gastrostomy due to dysphagia. This study aimed to investigate the proportion of patients with DMD requiring gastrostomy and to assess the timing and outcomes of gastrostomy in patients with DMD to optimize perioperative care and improve long-term management. We conducted a retrospective cohort study by reviewing the medical records of patients with DMD treated between March 1991 and November 2023 at Kobe University Hospital. To identify risk factors for gastrostomy, Fisher’s two-tailed test and logistic analysis were used to compare the gastrostomy (group G) and comparison group without gastrostomy (group C) groups. We identified patients &gt;18 years with DMD. We excluded those without medical records from the last decade and those on nasogastric tube feeding. Among the 135 eligible patients, five (median age, 23 years) underwent percutaneous endoscopic gastrostomy (PEG; uptake rate, 3.7 %), and their data were analyzed for perioperative outcomes. Complications included ventilatory disturbances, aspiration pneumonia, and hemorrhagic shock. Two patients experienced significant postoperative complications, underscoring the high-risk nature of PEG in this population. Participants’ postoperative weight changes varied significantly. The presence or absence of ventilatory management, cardiomyopathy treatment, scoliosis, and steroid treatment were examined as risk factors between groups G and C, but no significant differences were observed. This study highlights low gastrostomy usage among patients with DMD, with varying outcomes. Meticulous planning and early consideration of gastrostomy are crucial to enhance the quality of life and nutritional outcomes in these patients.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"129 ","pages":"Article 110857"},"PeriodicalIF":1.9,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371975","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}