Journal of Clinical Neuroscience最新文献

{"title":"Low Middle Income Countries and Academic Productivity of Neurosurgery: A Quantitative Analysis From Pakistan","authors":"Kaleem Ullah Ranjha ,&nbsp;Syeda Fatima Abid ,&nbsp;Muhammad Hammad Khan ,&nbsp;Muhammad Shayan Waheed ,&nbsp;Laiba Sarfraz ,&nbsp;Muhammad Kashif ,&nbsp;Ahmed Muthana ,&nbsp;Samer S. Hoz ,&nbsp;Minaam Farooq","doi":"10.1016/j.jocn.2024.110992","DOIUrl":"10.1016/j.jocn.2024.110992","url":null,"abstract":"<div><div>Neurosurgical training and practice rely heavily on research, which is a pivotal marker of academic productivity. This study investigates the current landscape of neurosurgery publications originating from Pakistan, encompassing overall research output, prevalent topics, and disparities across institutions and regions. Electronic databases, including PubMed, Scopus, Web of Science, and ScienceDirect, were systematically searched up to November 1, 2023, using specified keywords. Data pertaining to authors, publication years, affiliations, article types, citations, journals, impact factors, and topics were extracted from eligible articles. From inception till Nov 1, 2023, a total of 825 articles relating to Neurosurgery were published from Pakistan. A significant upsurge in publications occurred from 2017 onwards, reaching its peak in 2021 with 115 studies published. A total of 12 articles had 100 or more citations. The majority of publications were original articles (n = 592, 71.7 %) followed by reviews (n = 144, 17.5 %), predominantly focusing on brain-related topics (n = 203, 24.6 %), neuro-oncology (n = 164, 19.8 %), spine (n = 145, 17.5 %), and trauma (n = 143. 17.3 %). Vascular neurosurgery contributed 88 studies, general neurosurgery 40, neuroradiology 28, functional neurosurgery 14, and pediatric neurosurgery 17. Shamim MS was the top author with the most number of publications (n = 89), followed by Enam SA (n = 51). JPMA (n = 93) and Surgical Neurology International (n = 71) emerged as the top publishing journals. Aga Khan University and Hospital emerged as the most prolific contributor with 236 original studies conducted. There exists notable regional disparities and a lack of experimental studies. While there has been a substantial increase in neurosurgical publications from Pakistan in recent years, significant regional disparities and challenges persist. Addressing these issues is crucial to fostering a more robust research environment in neurosurgery within the country.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"132 ","pages":"Article 110992"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854320","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":"Biomechanical study between two varieties of axial screw fixation techniques: Analysed by finite elements","authors":"Zhao Li ,&nbsp;Fanchao Meng ,&nbsp;Yushi Fang ,&nbsp;Ruiyu Qin ,&nbsp;Xun Zhang ,&nbsp;Wei Zhao","doi":"10.1016/j.jocn.2024.110978","DOIUrl":"10.1016/j.jocn.2024.110978","url":null,"abstract":"<div><h3>Background</h3><div>The atlantoaxial vertebral model was established in order to compare the biomechanical properties of C2 pedicle and translaminar screws from the perspective of the screws themselves.</div></div><div><h3>Methods</h3><div>A finite element model of the screw-vertebrae was developed. The screw load–displacement ratios were analysed under up/down and left/right load conditions; the vertebral load–displacement ratios under flexion/posterior extension (FLX/EXT), left/right lateral bending (LLB/RLB), and left/right rotation (LAR/RAR) load conditions; the bone-screw interface stress values and screw load–displacement ratios under physiological load conditions; and the structural stress values of the screw-rod structure under front/back and left/right load conditions.</div></div><div><h3>Results</h3><div>The C2 pedicle screw group (C2PG) exhibited significantly greater load–displacement ratios than did the C2 translaminar screw group (C2TG). The vertebral load–displacement ratios were significantly greater in the C2PG than in the C2TG. Under physiological loading, the maximum stress of the cortical bone in the C2TG exceeded the threshold significantly, and the anteriormost part of the vertebrae exhibited much greater displacement in the C2TG than in the C2PG. In screw-rod stability studies, C2TG exhibited greater peak stress in the screw-rod structure under anterior-posterior loading.</div></div><div><h3>Conclusions</h3><div>This study is the first to analyse the biomechanical properties of two types of axial screws from the perspective of the screws themselves. In this study, C2 pedicle screws exhibited greater biomechanical stability from the perspective of the two screws themselves. From the perspective of a single screw-vertebrae model, this may account for the higher postoperative revision rate of axial translaminar screws than pedicle screws in atlantoaxial internal fixation.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"132 ","pages":"Article 110978"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872257","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":"Circulating plasma protein identified as a therapeutic target for intracranial aneurysm through Mendelian Randomization analysis","authors":"Songquan Wang ,&nbsp;Jiali Mu ,&nbsp;Quansheng Wu ,&nbsp;Laizhao Chen ,&nbsp;Xiaofeng Yin","doi":"10.1016/j.jocn.2024.110998","DOIUrl":"10.1016/j.jocn.2024.110998","url":null,"abstract":"<div><h3>Background</h3><div>Intracranial aneurysms are the main cause of subarachnoid hemorrhage (SAH), a severe stroke with devastating effects. However, there are no existing medications for intracranial aneurysms (IAs) and novel therapeutic targets are required. Methods: We performed a summary data-based Mendelian Randomization (MR) analysis to explore the causal association between circulating plasma proteins and the risk of IAs and SAH. Colocalization analysis was conducted to identify shared causal variants between circulating plasma proteins and IAs, as well as SAH. Finally, mediation MR analyses were conducted to clarify the role of potential plasma proteins in aneurysm formation. Results: Proteome-wide MR analysis showed that FGF5 (fibroblast growth factor 5) had a causal effect on IA and SAH risk (Pfdr &lt; 0.05). Moreover, genetic variants affecting FGF5 expression levels showed strong evidence of colocalization with IA risk (PPH4 = 0.993) and SAH risk (PPH = 0.988), suggesting that this protein represents a potential direct target for IA intervention. Mediation analysis using two-step MR showed that systolic blood pressure and diastolic blood pressure mediate the effects of FGF5 on IA and SAH. Conclusion: Our investigation identified a causal connection between FGF5 and IAs.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"132 ","pages":"Article 110998"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894694","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":"The role of injection timing in interferon beta-induced flu-like syndrome in multiple sclerosis: Potential confounders and future directions","authors":"Hung Youl Seok,&nbsp;Mi-Yeon Eun","doi":"10.1016/j.jocn.2025.111046","DOIUrl":"10.1016/j.jocn.2025.111046","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"132 ","pages":"Article 111046"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970132","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":"Is naso-axial line a better predictor in endoscopic endonasal resection of the odontoid and pannus removal? Technical nuances of maximizing corridor and maintaining occipital cervical joint stability","authors":"Adnan Hussain Shahid ,&nbsp;Mehdi Khaleghi ,&nbsp;Sudhir Suggala ,&nbsp;Danner Butler ,&nbsp;Ursula Hummel ,&nbsp;Mark Gacek ,&nbsp;Richard Menger ,&nbsp;Jai Deep Thakur","doi":"10.1016/j.jocn.2024.110995","DOIUrl":"10.1016/j.jocn.2024.110995","url":null,"abstract":"<div><h3>Background</h3><div>The transoral transpharyngeal odontoidectomy, followed by occipitocervical fixation, have traditionally been a recognized method for ameliorating ventral compression at the craniovertebral junction (CVJ), despite its associated comorbidities. As an alternative, the endoscopic endonasal odontoid resection is a viable approach for various CVJ abnromalities that preserve the oropharynx and leads to fewer procedure-related complications(1–4). We present our case to detail the technical nuances of the procedure and its advantages over other techniques.</div></div><div><h3>Case description</h3><div>In this video, we describe our experience of a novel modified endoscopic endonasal odontoidectomy (EEO) for the removal of a large <em>retro</em>-odontoid pannus, compressing the spinal cord at the level of CVJ. The patient is a 73-year-old male presenting with progressive bilateral myelopathic symptoms. There was significant clinical improvement postoperatively, and C1-C3 fixation was performed. An MRI at two months later showed an adequate ventral decompression and normal spinal cord shape at the level of CVJ.</div></div><div><h3>Conclusion</h3><div>The endoscopic endonasal approach to the odontoid process offers a less invasive alternative to other methods, which may reduce patient discomfort during and after surgery. By avoiding disruption of the oropharynx, this method can significantly lower the risk of complications such as surgical site infection and poor healing associated with the surgical approach. This technique is advisable for carefully selected patients with favorable sinonasal anatomy. The nasal axial line can more accurately predict the inferior border of the odontoid resection during preoperative planning and intraoperative neuronavigation. It guides the lower extent of odontoidectomy that is affordable by endoscopic endonasal approach.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"132 ","pages":"Article 110995"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909751","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":"Achondroplasia Status and Adverse Short-Term Postoperative Outcomes in Elective Spinal Decompression Surgery: A Propensity Score-Matched Case-Control Study","authors":"Renuka Chintapalli,&nbsp;Atman Desai","doi":"10.1016/j.jocn.2025.111064","DOIUrl":"10.1016/j.jocn.2025.111064","url":null,"abstract":"<div><h3>Introduction</h3><div>Achondroplasia is the most common form of skeletal dysplasia, affecting approximately 1 in 25,000 individuals in the US. Previous research suggests that achondroplasia patients undergoing spine surgery have worse postoperative outcomes. Most of these findings are based on small, single-center retrospective studies and describe the impact of achondroplasia status on only one or two outcomes. We sought to assess the association between achondroplasia and a comprehensive battery of postoperative care outcomes in a national cohort.</div></div><div><h3>Methods</h3><div>The Merative™ Marketscan® Commercial Database and the accompanying Medicare Supplement were queried for adult patients diagnosed with achondroplasia who underwent elective thoracic/thoracolumbar or lumbar decompression +/- fusion surgery between 2006 and 2023. Propensity score matching was used to identify an equal number of age and sex-matched controls without achondroplasia. Outcomes of interest were length of hospital stay, non-home discharge disposition, 90-day readmission and postoperative medical or surgical complications. Bivariate analyses were conducted to examine the distribution of baseline characteristics based on achondroplasia status. Multivariate regression was employed to assess the association between achondroplasia status and short-term postoperative outcomes.</div></div><div><h3>Results</h3><div>Overall, 111 achondroplasia cases and an equal number of age- and sex-matched controls were included. Compared to controls, those with achondroplasia were more likely to have a longer length of hospital stay (B-coefficient = 3.34, 95 % confidence interval [95 % CI] = 1.00–4.70), non-home discharge (odds ratio [OR] = 20.51, [5.78–72.73]) and a higher complication rate (OR = 3.63, [1.49–8.87]). The association between achondroplasia status and 90-day readmission did not reach statistical significance (p = 0.48).</div></div><div><h3>Conclusions</h3><div>Patients with achondroplasia undergoing spinal surgery experience worse overall short-term postoperative outcomes compared to their age- and sex-matched counterparts. Patient-specific factors may contribute to the higher complication rates observed. While the presence of achondroplasia is unchangeable, surgeons should be prepared for increased risks in their management plans. These findings highlight the need for tailored preoperative assessments and enhanced postoperative strategies to improve outcomes in this vulnerable population.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"134 ","pages":"Article 111064"},"PeriodicalIF":1.9,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074209","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":"Evaluating the brain injury guidelines (BIG) in an Australian trauma centre: A retrospective cohort analysis","authors":"William Chelepy,&nbsp;Timothy Williamson,&nbsp;Rumal Jayalath","doi":"10.1016/j.jocn.2025.111092","DOIUrl":"10.1016/j.jocn.2025.111092","url":null,"abstract":"<div><h3>Background</h3><div>The Brain Injury Guidelines (BIG) were developed to improve resource utilisation for patients with traumatic brain injury (TBI). The original BIG have never been validated outside the USA. The unique challenges facing Australian healthcare warrant validation of the BIG in this setting. This study aimed to evaluate the current standard of TBI management, safety of the BIG, and hypothetical resource savings resulting from their implementation.</div></div><div><h3>Methods</h3><div>A single institution, retrospective cohort study. Patients were identified by searching the database of radiology reports for computerised tomography (CT) studies, for patients presenting to the Princess Alexandra Hospital emergency department (ED) from 1 January 2018 to 1 January 2023. Chart review of the medical record was performed and patients were classified into BIG1, BIG2 or BIG3 based on neurological examination, intoxication, antiplatelet/anticoagulant use, and CT findings. The primary outcome was the need for neurosurgical intervention. Secondary outcomes were worsening neurological examination within 24 h of admission, progression on repeat head CT (RHCT) and post-discharge ED visits and 30-day readmissions. The guidelines were considered to fail if any BIG1 or BIG2 patient required neurosurgical intervention or ICU admission.</div></div><div><h3>Results</h3><div>878 patients were included, of which 106 (12.1 %) were BIG1, 113 (12.9 %) BIG2, and 659 (75.1 %) BIG3. Subdural and subarachnoid haemorrhage were the most common intracranial haemorrhage (ICH) in all groups. No BIG1 or BIG2 patient showed neurological deterioration or required intervention. Radiological progression was seen in 7 % and 3.4 % of RHCT for BIG1 and BIG 2 patients respectively; in no case did this change management. There was 1 (0.9 %) post-discharge ED visit in the BIG1 group. There were no 30-day readmissions in the BIG1 or BIG2 group. All patients needing intervention or readmission were BIG3. Current practice is not in line with the BIG, with excessive intervention performed in 97.2 % of BIG1 patients and 96.5 % of BIG2 patients. Agreement between the assigned and verified therapeutic plan was perfect (k = 1.00), meaning no patient failed the BIG. Adoption of the BIG could have saved 101 RHCT, 208 neurosurgical consultations and 189 inpatient days.</div></div><div><h3>Conclusion</h3><div>The BIG are safe in Australia and would significantly improve healthcare resource utilisation. Current practice regularly deviates from the BIG, suggesting significant resource saving to be realised. Future studies should prospectively validate the BIG so widespread adoption can be supported and implemented. Integration with allied health, long-term outcomes and potential modifications to the BIG remain to be explored.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"134 ","pages":"Article 111092"},"PeriodicalIF":1.9,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074342","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":"Prospective evaluation of modified Cincinnati Prehospital Stroke Severity Scale for identifying large vessel occlusion","authors":"Lingwen Zhang ,&nbsp;Xiaoqing Bu ,&nbsp;Juan Liao ,&nbsp;Yonghong Yang ,&nbsp;Zhao Yang ,&nbsp;Ting Liu ,&nbsp;Shudong Liu ,&nbsp;Libo Zhao ,&nbsp;Li Liu ,&nbsp;Deyu Yang","doi":"10.1016/j.jocn.2025.111077","DOIUrl":"10.1016/j.jocn.2025.111077","url":null,"abstract":"<div><h3>Objective</h3><div>To develop a novel, straightforward diagnostic scale for predicting large vessel occlusion (LVO) and anterior circulation LVO (ALVO) in the emergency setting, evaluating its validity against existing scales.</div></div><div><h3>Methods</h3><div>We prospectively enrolled patients with suspected stroke presenting consecutively at the National Comprehensive Stroke Centre’s emergency department between February 20, 2022, and November 11, 2022. Emergency physicians assessed each patient using the modified Cincinnati Prehospital Stroke Severity Scale (mCPSSS) and the National Institutes of Health Stroke Scale (NIHSS). The study analyzed the mCPSSS and other prevalent stroke scales to evaluate their efficacy in detecting LVO and ALVO, employing receiver operating characteristic curve (ROC) analysis and area under the curve (AUC) statistics to assess the scales’ sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy.</div></div><div><h3>Results</h3><div>A total of 383 patients with suspected stroke were included in this study. The performance in identifying LVO in the emergency setting was greatest for mCPSSS ≥ 2 with a sensitivity of 0.802 and specificity of 0.770, PPV of 0.644, NPV of 0.882, and accuracy of 0.781. mCPSSS ≥ 2 was 0.766 sensitive, 0.733 specific, PPV of 0.564, NPV of 0.886, and accuracy of 0.749 in predicting ALVO. The mCPSSS identified LVO and ALVO with an optimal cut-off value of 2, exhibiting AUC superior to those of other widely used stroke scales, with AUC values of 0.824 for LVO and 0.790 for ALVO.</div></div><div><h3>Conclusion</h3><div>The mCPSSS could serve as an effective and straightforward scale for identifying LVOs in emergency settings.</div><div>Clinical Trial Registration information: <span><span>https://www.chictr.org.cn/</span><svg><path></path></svg></span> (ChiCTR2200056776).</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"134 ","pages":"Article 111077"},"PeriodicalIF":1.9,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074345","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":"2-Hydroxyglutarate magnetic resonance spectroscopy for preoperative IDH molecular profiling – A review of the literature and real-world clinical translation in a busy neurosurgical neuro-oncology unit","authors":"Frances Anne McHugh ,&nbsp;James Jiang ,&nbsp;Heidi Luton ,&nbsp;Jonathan Parkinson ,&nbsp;Raymond Cook ,&nbsp;Allison Newey ,&nbsp;Chungo Choi ,&nbsp;Marina Kastelan ,&nbsp;Patrick Horsley ,&nbsp;Michael Back ,&nbsp;James Drummond","doi":"10.1016/j.jocn.2025.111062","DOIUrl":"10.1016/j.jocn.2025.111062","url":null,"abstract":"<div><div>2-hydroxyglutarate (2HG), a metabolic by-product that accumulates in IDH-mutated (IDHmut) glioma cells, can be quantified through magnetic resonance spectroscopy (MRS) offering a non-invasive method to determine molecular subtype. Incorporation of 2HG MRS into standard pre-operative MR protocol offers an adjunct to surgical decision making but limitations in post-processing and barriers exist to its integration into routine clinical practice. Our study explored the real-world translation of 2HG MRS into a busy neuro-oncology surgical unit at the Royal North Shore Hospital campus.</div><div>69 Spectra were acquired and reported prospectively between March 2018 and March 2024 in patients with suspected glioma using a 3 T Siemens Vida MRI, in addition to standard clinical magnetic resonance imaging and assessment. SV PRESS MRS was acquired with optimised parameters and the spectroscopic waveform analysed externally by a single center. The MRS voxel was localised on 3D FLAIR sequencing. Immunohistochemistry and genomic analysis were available for 30 patients to validate 2HG outcomes against standard ex vivo methods.</div><div>Utilising 1.2 mM as threshold calculated sensitivity was 80.9 %, specificity 77.8 %. Positive predictive value was 89.5 % and negative predictive value was 63.6 %.<!--> <!-->Utilising 3 mM as threshold calculated specificity 100 % given the absence of false negatives but sensitivity was significantly reduced &lt;10 %.</div><div>2HG/Cr ratio with a cutoff of 0.085 for positivity yielded sensitivity 94.7%, specificity 66.67% and accuracy 85.7%</div><div>Our experience re-demonstrates the potential of 2HG MRS in preoperative imaging in suspected IDHmut gliomas in a busy neuro-oncology unit but highlights the limitations of real-world clinical translation, technical complexities and difficulty in standardization.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"133 ","pages":"Article 111062"},"PeriodicalIF":1.9,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143135919","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 outcomes of adults with intracranial grade 1 and 2 ganglioglioma","authors":"Dana L. Hutton ,&nbsp;Janhavi Kulkarni ,&nbsp;Khaja Syed ,&nbsp;Ian Scott ,&nbsp;Michael D. Cearns ,&nbsp;Samantha J. Mills ,&nbsp;Michael D. Jenkinson","doi":"10.1016/j.jocn.2025.111088","DOIUrl":"10.1016/j.jocn.2025.111088","url":null,"abstract":"<div><div>Ganglioglioma is a rare primary brain tumour that most frequently occurs in children and young adults. They are generally low-grade and have a favourable prognosis, but there is limited literature to guide the optimal management. The aim of this study was to investigate the clinical outcomes of adults with intracranial ganglioglioma, and to determine the frequency and duration of radiological follow-up. Thirteen adult patients with CNS WHO grade 1 and 2 ganglioglioma were identified retrospectively from case records at a tertiary neurosurgical centre between 2010 and 2022. Patient characteristics, magnetic resonance imaging (MRI) features, and clinical outcomes were obtained. Surgery was classified as gross total (GTR) or subtotal (STR) resection. 84.6 % (n = 11) of patients had temporal lobe tumours, with most (69.2 %) presenting with seizures, at a median age of 29.0 years. GTR and STR were achieved in nine and five patients, respectively. No patients received adjuvant radiotherapy. During the median follow-up period of 8.9 years there was no radiological recurrence after GTR, and only one recurrence after STR at 65 months that did not require treatment. There was no patient mortality. Two patients continued to have seizures at last clinical follow-up. Low grade adult intracranial ganglioglioma has an excellent prognosis, with a recurrence rate below 10 % in this series. Long-term surveillance is not necessarily required if GTR has been achieved and patients can be considered for discharge after annual MRI for 5 years. In patients where only STR is achieved, annual MRI is required although the progression/recurrence rate remains low and asymptomatic.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"134 ","pages":"Article 111088"},"PeriodicalIF":1.9,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065650","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}