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Roxadustat protects oxidative stress and tissue injury in the brain induced by ischemic stroke via the HIF-1α/NRF2 axis. 罗沙司他通过HIF-1α/NRF2轴保护缺血性中风引起的脑氧化应激和组织损伤。
IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2024-10-28 DOI: 10.23736/S0390-5616.24.06329-X
Keping Jiao, Huiqin Zhang, Bin Li, Yanyan Wang, Jian Liu
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引用次数: 0
Follow-up neuroimaging after non-perimesencephalic, angiogram-negative subarachnoid hemorrhage. 非脑周血管造影阴性蛛网膜下腔出血后的后续神经影像学检查。
IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2024-10-01 Epub Date: 2023-01-31 DOI: 10.23736/S0390-5616.22.05686-7
Jean-Philippe Dufour, Menno R Germans, Emanuela Keller, Zsolt Kulcsàr, Luca Regli, Giuseppe Esposito

Background: In approximately 15% of spontaneous subarachnoid hemorrhage (SAH) patients, no bleeding source is found in the initial imaging. These patients can be categorized as either perimesencephalic (PM-SAH) or non-perimesencephalic (NP-SAH) subarachnoid hemorrhage patients. Follow-up imaging is routinely performed after NP-SAH to detect treatable etiologies; however, the optimal follow-up imaging protocol remains unclear. This study examines the optimal time interval to re-imaging and the performance of magnetic resonance imaging and angiography (MRI/A) in this setting.

Methods: In this retrospective study, the records of NP-SAH patients treated at the University Hospital of Zurich (Switzerland) from 2005 to 2018 were analyzed. Clinical and radiological data were collected. Re-imaging data was grouped according to imaging modality and divided into three time-categories after bleeding: short-term (<2 weeks), medium-term (2-8 weeks) and long-term (>8 weeks) re-imaging.

Results: Eighty-one NP-SAH patients were included. In 8 patients an aneurysm was diagnosed during re-imaging via digital subtraction angiography (9.9% diagnostic yield). Five aneurysms were detected at short-term in 81 patients (6.2% short-term yield) and three at medium-term re-imaging in 27 patients (11.1% medium-term yield). No aneurysms were found after 8 weeks in 56 patients. Five of these 8 patients also received MRI/A re-imaging, which was able to show the aneurysm in all 5 cases.

Conclusions: Our study emphasizes the importance of re-imaging in NP-SAH patients, which should be done both at short-term and at medium-term follow-up after the hemorrhage. Long-term re-imaging after 8 weeks might not be of diagnostic benefit. MRI/A might be considered as a possible noninvasive re-imaging modality in this setting.

背景:大约 15%的自发性蛛网膜下腔出血(SAH)患者在最初的造影检查中没有发现出血源。这些患者可分为脑膜周围性(PM-SAH)或非脑膜周围性(NP-SAH)蛛网膜下腔出血患者。NP-SAH 后常规进行随访成像以检测可治疗的病因,但最佳随访成像方案仍不明确。本研究探讨了在这种情况下再次成像的最佳时间间隔以及磁共振成像和血管造影(MRI/A)的性能:在这项回顾性研究中,分析了 2005 年至 2018 年在苏黎世大学医院(瑞士)接受治疗的 NP-SAH 患者的病历。收集了临床和放射学数据。根据成像方式对再成像数据进行分组,并将出血后再成像分为三个时间类别:短期(8 周)再成像:结果:共纳入81例NP-SAH患者。结果:共纳入 81 例 NP-SAH 患者,其中 8 例患者在再次成像时通过数字减影血管造影术诊断出动脉瘤(诊断率为 9.9%)。81 名患者在短期检查中发现了 5 个动脉瘤(短期诊断率为 6.2%),27 名患者在中期再造影检查中发现了 3 个动脉瘤(中期诊断率为 11.1%)。56 名患者在 8 周后未发现动脉瘤。在这8名患者中,有5名患者还接受了核磁共振/A再成像检查,5例患者均显示出动脉瘤:我们的研究强调了对 NP-SAH 患者进行再次成像的重要性,在出血后的短期和中期随访中都应进行再次成像。8 周后的长期再成像可能对诊断无益。在这种情况下,MRI/A 可被视为一种可能的无创再成像方式。
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引用次数: 0
Granulocyte-colony stimulating factor, a potential candidate for the treatment of Parkinson's disease. 治疗帕金森病的潜在候选药物--粒细胞集落刺激因子。
IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2024-10-01 Epub Date: 2021-05-03 DOI: 10.23736/S0390-5616.21.05314-5
Jiawen Yuan, Li-Xia Xue, Jin-Peng Ren

Background: Granulocyte colony-stimulating factor (G-CSF) activates the PI3K/Akt pathway to exert neuroprotective effects. The current study aimed to determine if G-CSF reverses behavioral deficits, even after motor malfunction occurs in Paraquat (PQ)-treated mice.

Methods: Male C57BL/6 mice (8 weeks old) were divided into 3 groups: PQ + G-CSF-treated group (N.=8); PQ + saline-treated group (N.=8); and saline-treated control group (N.=8). Spontaneous locomotor activity was evaluated together with the pole test. The DA, 3, 4-dihydroxyphenyl acetic acid (DOPAC), and homovanillic acid (HVA) levels in the bilateral striatum were determined by HPLC. The number of substantia nigra pars compacta tyrosine hydroxylase (TH)-immunoreactive neurons was calculated using an unbiased cell counting stereology method, the activities of total GSH-PX and SOD, and the malondialdehyde (MDA) content were assessed.

Results: After G-CSF treatment, spontaneous motor activity and the Tturn and TLA times in the CSF group were significantly lower than the control group, and the striatal dopamine level in the striatum and the number of TH-positive neurons in the substantia nigra (SN) were significantly increased compared to the control group (5478±654 vs. 3647±488 DA neurons, P<0.05). Compared to the control group, the GSH-PX and SOD activities were increased, while the MDA level was significantly decreased in the SN (P<0.05).

Conclusions: The data strongly suggest that G-CSF reverses behavioral deficits in PQ-treated mice with movement disorders. Thus, G-CSF may be utilized as a prospective drug candidate for the treatment of Parkinson's disease.

背景:粒细胞集落刺激因子(G-CSF粒细胞集落刺激因子(G-CSF)可激活 PI3K/Akt 通路,从而发挥神经保护作用。本研究旨在确定即使在百草枯(PQ)处理的小鼠出现运动功能障碍后,G-CSF是否仍能逆转其行为障碍:雄性 C57BL/6 小鼠(8 周大)分为 3 组:方法:雄性C57BL/6小鼠(8周龄)分为3组:百草枯+G-CSF处理组(n=8);百草枯+生理盐水处理组(n=8);生理盐水处理对照组(n=8)。自发运动活动与极点试验一起评估。双侧纹状体中的DA、3, 4-二羟基苯乙酸(DOPAC)和高香草酸(HVA)水平由高效液相色谱法测定。采用无偏差细胞计数立体法计算黑质酪氨酸羟化酶(TH)免疫反应神经元的数量,评估总 GSH-PX 和 SOD 的活性以及丙二醛(MDA)的含量:G-CSF治疗后,CSF组的自发运动活动、Tturn和TLA时间明显低于对照组,纹状体中多巴胺水平和黑质(SN)中TH阳性神经元数量明显高于对照组(5478±654 vs. 3647±488 DA神经元,P<0.05)。与对照组相比,SN 中 GSH-PX 和 SOD 活性增加,而 MDA 水平明显下降(PConclusions:这些数据有力地表明,G-CSF 可逆转 PQ 治疗的运动障碍小鼠的行为缺陷。因此,G-CSF 可作为治疗帕金森病的候选药物。
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引用次数: 0
Safety and efficacy of dual antiplatelet therapy combining aspirin and ticagrelor in patients with undergoing intracranial stenting procedures. 在接受颅内支架手术的患者中联合使用阿司匹林和替卡格雷的双重抗血小板疗法的安全性和有效性。
IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2024-10-01 Epub Date: 2022-09-16 DOI: 10.23736/S0390-5616.22.05745-9
Yihui Ma, Xiangyu Zhang, Tingbao Zhang, Yu Feng, Wenyuan Zhao, Xinjun Chen

Background: Thromboembolic complications are one of the major periprocedural complications following neuroendovascular procedures. Dual antiplatelet therapy (DAPT) with aspirin and clopidogrel remain the principal agents for prevention of thromboembolic complications. However, clopidogrel resistance is associated with higher risk of thromboembolic complications. This study investigated the safety and efficacy of DAPT with ticagrelor and aspirin in patients undergoing intracranial stenting procedures.

Methods: This retrospective study was based on patients with intracranial aneurysms who undergoing intracranial stenting procedures at our institution between August 2017 and July 2020. These patients received DAPT with ticagrelor and aspirin were included. DAPT with 90 mg ticagrelor twice daily and aspirin 100 mg daily was continued for 3 months after the intracranial stenting procedure and aspirin continued for 1 year.

Results: In this study, 151 patients were identified. The most common aneurysm location was the internal carotid artery with 127 (71.8%) patients. Of the 151 cases with 160 treated aneurysms, 30 (18.8%) patients were treated by flow diverters (FDs), and 130 (81.2%) by stent-assisted coiling. Five (3.3%) patients had thromboembolic complications. Intraprocedural aneurysmal rupture was observed in one patient because of coil extrusion during coil insertion. None of the patients showed a newly DAPT-related intracerebral hemorrhage. Two patients developed dyspnea, and the symptom resolved without intervention. Furthermore, ecchymoma and gastrointestinal bleeding occurred in one patient respectively. DAPT-related thromboembolic and hemorrhagic complications were not significantly different between the FD group and stent-assisted coiling group.

Conclusions: In our study, DAPT combining ticagrelor and aspirin seems to be a safe and efficient treatment for preventing thromboembolic complications in patients with intracranial aneurysms, without any increase in hemorrhagic complications. Ticagrelor may be an effective alternative for patients undergoing neurointervention.

背景:血栓栓塞并发症是神经内血管手术后的主要围手术期并发症之一。阿司匹林和氯吡格雷双重抗血小板疗法(DAPT)仍是预防血栓栓塞并发症的主要药物。然而,氯吡格雷耐药与血栓栓塞并发症的风险较高有关。本研究探讨了在接受颅内支架手术的患者中使用替卡格雷和阿司匹林进行DAPT的安全性和有效性:这项回顾性研究的对象是2017年8月至2020年7月期间在我院接受颅内支架手术的颅内动脉瘤患者。这些患者接受了使用替卡格雷和阿司匹林的DAPT治疗。在颅内支架手术后,每天两次使用90毫克替卡格雷和每天100毫克阿司匹林的DAPT持续3个月,阿司匹林持续1年:本研究共确定了 151 例患者。最常见的动脉瘤位置是颈内动脉,有 127 例(71.8%)患者。在151例共160个接受治疗的动脉瘤中,30例(18.8%)患者接受了血流分流术(FD)治疗,130例(81.2%)患者接受了支架辅助卷曲术治疗。5例(3.3%)患者出现血栓栓塞并发症。一名患者在插入盘管时因盘管挤出而导致术中动脉瘤破裂。没有一名患者新近出现与 DAPT 相关的脑出血。两名患者出现呼吸困难,症状在未进行干预的情况下得到缓解。此外,一名患者分别出现了瘀斑和消化道出血。与DAPT相关的血栓栓塞和出血并发症在FD组和支架辅助卷曲组之间没有明显差异:在我们的研究中,联合替卡格雷和阿司匹林的DAPT似乎是预防颅内动脉瘤患者血栓栓塞并发症的一种安全有效的治疗方法,而出血并发症并没有增加。对于接受神经介入治疗的患者来说,替卡格雷可能是一种有效的替代疗法。
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引用次数: 0
Predictive value of neutrophil-to-lymphocyte ratio and neutrophil-to-monocyte ratio in severe traumatic brain injury: a retrospective cohort. 中性粒细胞与淋巴细胞比率和中性粒细胞与单核细胞比率在严重脑外伤中的预测价值:回顾性队列。
IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2024-10-01 Epub Date: 2023-03-08 DOI: 10.23736/S0390-5616.23.05877-0
Luiz F Matias, Murilo D Pimentel, Mateus F Medeiros, Franciani R Rocha, Marcelo V Gambetta, Samantha C Lopes

Background: The neutrophil-lymphocyte ratio (NLR), the platelet-lymphocyte ratio (PLR), the lymphocyte-monocyte ratio (LMR), the neutrophil-monocyte ratio (NMR) and the systemic immune inflammation index (SII) are associated with clinical outcomes in oncological diseases, cardiovascular diseases, infectious / inflammatory diseases, endocrinological, pulmonary and brain injuries. Here, we investigate its association with hospital mortality in patients with severe traumatic brain injury.

Methods: We retrospectively reviewed clinical data from patients with severe traumatic brain injury (sTBI) who were treated in our department between January 2015 and December 2020. NLR, PLR, NMR, LMR and SII data were collected between admission and day 3, as well as other indicators related. The relationship between hematological ratios and in-hospital mortality were analyzed.

Results: A total of 96 patients were included in study, hospital mortality was 40.6% (N.=39). The levels of NLR on admission (D0), NLR day 1 (D1), NLR day 2 (D2), NLR day 3 (D3), NMR day 1 (D1) and NMR day (2) remained significantly higher in patients with death intra-hospital (P=0.030; P=0.038; P=0.016; P=0.048; P=0.046 and P=0.001, respectively). Multivariate logistic analysis showed that higher NLR values at admission and day 2 NMR were associated with in-hospital mortality (OR=1.120, P=0.037; and OR=1.307, P=0.004, respectively). Analysis of the recipient operating characteristic (ROC) curve showed that the NLR on admission had a sensitivity of 59.0% and a specificity of 66.7% (area under the curve 0.630, P=0.031, Youden's Index 0.26) and the NMR of day 2 had a sensitivity of 67.7% and a specificity of 70.4% (area under the curve 0.719, P=0.001, Youden's index 0.38) to predict mortality intra-hospital based on the best threshold.

Conclusions: Our analysis indicates that higher NLR levels on admission and day 2 NMR are independent predictors of in-hospital mortality in patients with sTBI.

背景:中性粒细胞-淋巴细胞比值(NLR)、血小板-淋巴细胞比值(PLR)、淋巴细胞-单核细胞比值(LMR)、中性粒细胞-单核细胞比值(NMR)和全身免疫炎症指数(SII)与肿瘤疾病、心血管疾病、感染性/炎症性疾病、内分泌疾病、肺部疾病和脑损伤的临床结果相关。在此,我们研究了其与严重脑外伤患者住院死亡率的关系:我们回顾性分析了 2015 年 1 月至 2020 年 12 月期间在我科接受治疗的严重创伤性脑损伤(sTBI)患者的临床数据。收集了入院至第 3 天的 NLR、PLR、NMR、LMR 和 SII 数据以及其他相关指标。分析了血液学比率与院内死亡率之间的关系:研究共纳入96名患者,住院死亡率为40.6%(N=39)。入院时(D0)、NLR 第 1 天(D1)、NLR 第 2 天(D2)、NLR 第 3 天(D3)、NMR 第 1 天(D1)和 NMR 第 2 天(D2)的水平在院内死亡患者中仍显著较高(分别为 P=0.030; P=0.038; P=0.016; P=0.048; P=0.046 和 P=0.001)。多变量逻辑分析显示,入院时较高的NLR值和第2天的NMR值与院内死亡率相关(OR=1.120,P=0.037;OR=1.307,P=0.004)。受试者操作特征曲线(ROC)分析显示,根据最佳阈值,入院时的NLR预测院内死亡率的灵敏度为59.0%,特异度为66.7%(曲线下面积为0.630,P=0.031,Youden指数为0.26),第2天的NMR预测院内死亡率的灵敏度为67.7%,特异度为70.4%(曲线下面积为0.719,P=0.001,Youden指数为0.38):我们的分析表明,入院时较高的 NLR 水平和第 2 天的 NMR 是 sTBI 患者院内死亡率的独立预测因素。
{"title":"Predictive value of neutrophil-to-lymphocyte ratio and neutrophil-to-monocyte ratio in severe traumatic brain injury: a retrospective cohort.","authors":"Luiz F Matias, Murilo D Pimentel, Mateus F Medeiros, Franciani R Rocha, Marcelo V Gambetta, Samantha C Lopes","doi":"10.23736/S0390-5616.23.05877-0","DOIUrl":"10.23736/S0390-5616.23.05877-0","url":null,"abstract":"<p><strong>Background: </strong>The neutrophil-lymphocyte ratio (NLR), the platelet-lymphocyte ratio (PLR), the lymphocyte-monocyte ratio (LMR), the neutrophil-monocyte ratio (NMR) and the systemic immune inflammation index (SII) are associated with clinical outcomes in oncological diseases, cardiovascular diseases, infectious / inflammatory diseases, endocrinological, pulmonary and brain injuries. Here, we investigate its association with hospital mortality in patients with severe traumatic brain injury.</p><p><strong>Methods: </strong>We retrospectively reviewed clinical data from patients with severe traumatic brain injury (sTBI) who were treated in our department between January 2015 and December 2020. NLR, PLR, NMR, LMR and SII data were collected between admission and day 3, as well as other indicators related. The relationship between hematological ratios and in-hospital mortality were analyzed.</p><p><strong>Results: </strong>A total of 96 patients were included in study, hospital mortality was 40.6% (N.=39). The levels of NLR on admission (D0), NLR day 1 (D1), NLR day 2 (D2), NLR day 3 (D3), NMR day 1 (D1) and NMR day (2) remained significantly higher in patients with death intra-hospital (P=0.030; P=0.038; P=0.016; P=0.048; P=0.046 and P=0.001, respectively). Multivariate logistic analysis showed that higher NLR values at admission and day 2 NMR were associated with in-hospital mortality (OR=1.120, P=0.037; and OR=1.307, P=0.004, respectively). Analysis of the recipient operating characteristic (ROC) curve showed that the NLR on admission had a sensitivity of 59.0% and a specificity of 66.7% (area under the curve 0.630, P=0.031, Youden's Index 0.26) and the NMR of day 2 had a sensitivity of 67.7% and a specificity of 70.4% (area under the curve 0.719, P=0.001, Youden's index 0.38) to predict mortality intra-hospital based on the best threshold.</p><p><strong>Conclusions: </strong>Our analysis indicates that higher NLR levels on admission and day 2 NMR are independent predictors of in-hospital mortality in patients with sTBI.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10867134","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}
引用次数: 0
Continuous subcortical monitoring of motor pathways during glioma surgery with ultrasonic surgical aspirator: technical description in a single institute experience. 使用超声手术吸引器对胶质瘤手术过程中的运动通路进行皮层下连续监测:一家研究所的技术描述。
IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2024-10-01 Epub Date: 2022-06-28 DOI: 10.23736/S0390-5616.22.05819-2
Alessandro D'Elia, Laura Lavalle, Antonella Bua, Mario Schiano DI Cola, Marco Ciavarro, Vincenzo Esposito

Background: Actual challenge in surgical treatment of intra-axial gliomas involving eloquent areas is maximal safe resection. Mapping and monitoring of cortical and subcortical motor functions are important tools to avoid postoperative deficits. In the present study, we present our experience with a continuous dynamic motor mapping technique pairing a traditional monopolar stimulator with a Cavitron ultrasonic surgical aspirator (CUSA) to perform a continuous stimulation of the white matter avoiding removal interruption.

Methods: We describe a single center retrospective analysis of 1-year consecutive patients with intraxial tumors located adjacent to corticospinal tract and treated with surgical resection adopting "continuous dynamic mapping technique." With the support of a reconstruction software (3D Slicer), we classified the extent of resection (EOR) as gross total resection (GTR) (>98%), sub-total resection (STR) (from 90% to 97%), and partial resection (<90%). Medical Research Council (MRC) grading was adopted to evaluate neurological outcomes (from 0 to 5), assessed on first postoperative day, at 1 week, 1 month and 3 months.

Results: From July 2017 to July 2018, 29 patients underwent to surgical removal of intraxial tumor adjacent to motor areas, using continuous dynamic subcortical mapping. Median age was 54 years old (range 12-75 years). At preoperative MRI tractography reconstruction, mean distance between tumor and corticospinal tract was 4.4 mm (range At 1 week postoperative assessment, motor deficits were still present in 12 patients (41%). At 1 month, 10 patients (35%) had persisting deficits, which required admission to rehabilitation department. At 3 months, 4 patients (14%) had persistent motor impairment and overall 28 patients (98%) were able to walk by themselves.

Conclusions: Our early experience showed that a combination of dynamic subcortical mapping with transcranial and cortical strip MEP (motor evoked potentials) monitoring is useful in tumors close to motor eloquent areas to extend surgical resection avoiding permanent consequences. However, we need for further experience to consolidate and improve this technique.

背景:轴内胶质瘤的手术治疗面临的实际挑战是最大程度的安全切除。皮层和皮层下运动功能的映射和监测是避免术后功能障碍的重要工具。在本研究中,我们介绍了一种将传统单极刺激器与 Cavitron 超声手术吸入器(CUSA)配对使用的连续动态运动绘图技术,该技术可对白质进行连续刺激,避免切除中断:我们描述了一项单中心回顾性分析,研究对象是连续 1 年采用 "连续动态绘图技术 "进行手术切除治疗的轴内肿瘤患者,这些肿瘤位于皮质脊髓束附近。在重建软件(3D Slicer)的支持下,我们将切除范围(EOR)分为全切(GTR)(>98%)、次全切(STR)(90%~97%)和部分切除(Results:2017年7月至2018年7月,29名患者接受了手术切除邻近运动区的轴内肿瘤,采用的是连续动态皮层下映射。中位年龄为 54 岁(范围为 12-75 岁)。术前核磁共振成像束成像重建时,肿瘤与皮质脊髓束之间的平均距离为 4.4 毫米(范围 在术后 1 周的评估中,12 名患者(41%)仍存在运动障碍。术后 1 个月,10 名患者(35%)的运动障碍依然存在,需要入住康复科。3个月后,4名患者(14%)出现持续性运动障碍,而28名患者(98%)总体上可以自己行走:我们的早期经验表明,动态皮层下映射与经颅和皮层条状 MEP(运动诱发电位)监测相结合,对于靠近运动功能区的肿瘤非常有用,可以延长手术切除时间,避免永久性后果。然而,我们还需要更多的经验来巩固和改进这项技术。
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引用次数: 0
Women in neurosurgery: review of the literature combined with a gender-based analysis of the development over the past 20 years in Austria. 神经外科中的女性:文献综述,结合对奥地利过去 20 年发展的性别分析。
IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2024-10-01 Epub Date: 2022-06-28 DOI: 10.23736/S0390-5616.22.05766-6
Veronika Sperl, Barbara Kiesel, Marlies Bauer, Lisa I Wadiura

Background: The number of female neurosurgeons has grown over the last decades, however, a gender gap still exists in most western countries. The reasons for this gender gap remain mostly unclear. The aim of the present study was to analyze the development of the numbers of female neurosurgeons in Austria over the last 20 years in comparison to other surgical disciplines. Additionally, a literature review was performed summarizing articles reporting on women in neurosurgery.

Methods: Data including male and female residents as well as board certified surgeons over the last 20 years retrieved from the Austrian Medical Association were collected. An additional PubMed query was performed focusing on literature reporting on working conditions, work-life-balance as well as data of female leading positions.

Results: In 2021, 5237 surgeons were registered at the Austrian Medical Association including 258 (5%) neurosurgeons. In total, 1081 of 5237 (21%) surgeons and 61 of 253 (24%) of all Austrian neurosurgeons were female. In comparison to the percentage of women in all surgical disciplines, the number of female neurosurgeons is represented slightly above the average of 21%. According to data representing the trend of the last 20 years, the percentage of female neurosurgeons in Austria has doubled over the last 20 years. Comparably, this trend can be observed in all surgical disciplines.

Conclusions: The percentage of female neurosurgeons in Austria are constantly increasing over the last 20 years, however a gender gap still exists. Consequently, studies are warranted to analyse the causes to improve the reported gender gap in Neurosurgery.

背景:过去几十年来,女性神经外科医生的人数不断增加,但在大多数西方国家,性别差距依然存在。造成这种性别差距的原因大多仍不清楚。本研究旨在分析奥地利女性神经外科医生人数在过去 20 年中的发展情况,并与其他外科学科进行比较。此外,还对有关神经外科女医生的文章进行了文献综述:方法:从奥地利医学协会收集了过去 20 年中包括男性和女性住院医师以及获得认证的外科医生的数据。此外,还在PubMed上查询了有关工作条件、工作与生活平衡的文献以及女性领导职位的数据:2021 年,共有 5237 名外科医生在奥地利医学协会注册,其中包括 258 名神经外科医生(占 5%)。5237 名外科医生中有 1081 名(21%)为女性,253 名奥地利神经外科医生中有 61 名(24%)为女性。与女性在所有外科学科中所占的比例相比,女性神经外科医生的人数略高于 21% 的平均比例。根据过去 20 年的趋势数据,奥地利女性神经外科医生的比例在过去 20 年中翻了一番。这一趋势在所有外科学科中都可以看到:结论:在过去 20 年中,奥地利女性神经外科医生的比例不断上升,但性别差距依然存在。因此,有必要进行研究,分析原因,以改善神经外科中的性别差距。
{"title":"Women in neurosurgery: review of the literature combined with a gender-based analysis of the development over the past 20 years in Austria.","authors":"Veronika Sperl, Barbara Kiesel, Marlies Bauer, Lisa I Wadiura","doi":"10.23736/S0390-5616.22.05766-6","DOIUrl":"10.23736/S0390-5616.22.05766-6","url":null,"abstract":"<p><strong>Background: </strong>The number of female neurosurgeons has grown over the last decades, however, a gender gap still exists in most western countries. The reasons for this gender gap remain mostly unclear. The aim of the present study was to analyze the development of the numbers of female neurosurgeons in Austria over the last 20 years in comparison to other surgical disciplines. Additionally, a literature review was performed summarizing articles reporting on women in neurosurgery.</p><p><strong>Methods: </strong>Data including male and female residents as well as board certified surgeons over the last 20 years retrieved from the Austrian Medical Association were collected. An additional PubMed query was performed focusing on literature reporting on working conditions, work-life-balance as well as data of female leading positions.</p><p><strong>Results: </strong>In 2021, 5237 surgeons were registered at the Austrian Medical Association including 258 (5%) neurosurgeons. In total, 1081 of 5237 (21%) surgeons and 61 of 253 (24%) of all Austrian neurosurgeons were female. In comparison to the percentage of women in all surgical disciplines, the number of female neurosurgeons is represented slightly above the average of 21%. According to data representing the trend of the last 20 years, the percentage of female neurosurgeons in Austria has doubled over the last 20 years. Comparably, this trend can be observed in all surgical disciplines.</p><p><strong>Conclusions: </strong>The percentage of female neurosurgeons in Austria are constantly increasing over the last 20 years, however a gender gap still exists. Consequently, studies are warranted to analyse the causes to improve the reported gender gap in Neurosurgery.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40408782","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}
引用次数: 0
Clinico-pathologic predictors of dismal course in atypical meningiomas: a retrospective single-centre analysis. 非典型脑膜瘤不良病程的临床病理学预测因素:单中心回顾性分析。
IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2024-10-01 Epub Date: 2022-06-28 DOI: 10.23736/S0390-5616.22.05741-1
Alice Ryba, Matthias Millesi, Thomas Roetzer, Wolfgang Marik, Stefan Wolfsberger

Background: Despite continuous refinement of the WHO Classification for meningiomas, the biological behavior of atypical meningiomas remains difficult to predict on the basis of this grading system alone. The aim of this study was to investigate the prognostic significance of clinical and radiological parameters in a series of atypical meningioma with long follow-up of minimum 5 years.

Methods: Of 1675 meningiomas treated at the Medical University Vienna (Austria) between 1993 and 2015, 179 were atypical meningioma. Of those, 93 patients were identified with follow-up of ≥5 years. Patients were grouped by recurrence and evaluated for overall and progression free survival as well as potential prognostic parameters such as age, gender, tumor size and location, edema, irregular surface, contrast enhancement, bone invasion and hyperostosis, necrosis, EOR and MIB-1.

Results: From 42 (45%) patients in group recurrent and 51 (55%) patients in group non-recurrent, seven independent factors were associated with decreased progression-free survival in univariate analysis: size ≥5 cm, age ≥60 years, male gender, subtotal resection, irregular surface, and necrosis on magnetic resonance imaging, and MIB-1≥6%. In multivariable analysis, only larger size, older age, necrosis and higher MIB-1 remained independent prognostic risk factors for recurrence of atypical meningioma.

Conclusions: We identified larger size, older age, presence of necrosis on magnetic resonance imaging, and higher MIB-1, as detrimental parameters for recurrence of atypical meningioma. Until molecular profiling of atypical meningioma becomes routinely available, these parameters may aid the clinician in decision making about surveillance intervals and adjuvant radiation treatment.

背景:尽管世界卫生组织对脑膜瘤的分类不断完善,但仅凭这一分级系统仍难以预测非典型脑膜瘤的生物学行为。本研究的目的是调查一系列至少随访 5 年的非典型脑膜瘤的临床和放射学参数对预后的意义:1993年至2015年间,维也纳医科大学治疗了1675例脑膜瘤,其中179例为非典型脑膜瘤。其中,93名患者的随访时间≥5年。根据复发情况对患者进行分组,评估总生存期和无进展生存期以及潜在的预后参数,如年龄、性别、肿瘤大小和位置、水肿、不规则表面、对比度增强、骨侵犯和骨质增生、坏死、EOR和MIB-1:在单变量分析中,复发组的42例(45%)患者和非复发组的51例(55%)患者中,有7个独立因素与无进展生存率下降有关:肿瘤大小≥5厘米、年龄≥60岁、男性、次全切除、表面不规则、磁共振成像显示坏死和MIB-1≥6%。在多变量分析中,只有体积较大、年龄较大、坏死和较高的MIB-1仍是非典型脑膜瘤复发的独立预后风险因素:我们发现,体积较大、年龄较大、磁共振成像中出现坏死和较高的MIB-1是非典型脑膜瘤复发的不利参数。在非典型脑膜瘤的分子图谱分析成为常规方法之前,这些参数可能有助于临床医生做出监测间隔和辅助放射治疗的决策。
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引用次数: 0
Nerve high-resolution ultrasound in a 2-year follow-up of radial nerve palsy related to humeral shaft fractures. 神经高分辨率超声在与肱骨轴骨折相关的桡神经麻痹两年随访中的应用。
IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2024-10-01 Epub Date: 2022-06-28 DOI: 10.23736/S0390-5616.22.05781-2
Luca Leonardi, Simona Loreti, Antonella DI Pasquale, Laura Fionda, Fiammetta Vanoli, Stefania Morino, Matteo Garibaldi, Girolamo Alfieri, Antonio Lauletta, Marco Salvetti, Giovanni Antonini

Background: High-resolution nerve ultrasonography (HRUS) could have an emerging importance in diagnosis and follow-up of axonopathic radial palsy associated with humeral shaft fractures due to closed trauma. The aim of our study was to establish the role of HURS in this context through a longitudinal multimodal analysis.

Methods: Clinical, electrodiagnostic (EDX) and HRUS evaluations were prospectively performed at month 1, 3, 6, 12 and 24 from injury, in a continuous series of 19 patients collected in a 5-year study. Clinical severity was scored on MRC of involved muscles, EDX on presence/absence of functional continuity; anatomical continuity and nerve cross sectional area (NCSA) of radial (RN) and posterior interosseus (PIN) nerves were evaluated through HRUS.

Results: All patients showed clinical improvement during follow-up; EDX functional continuity was reached by all patients within 12 months; HRUS revealed RN anatomical continuity in all patients and PIN involvement in 74%. RN NCSA progressively reduced during FU, but it was still significantly higher than contralateral at month 24; PIN NCSA became normal within 24 months.

Conclusions: When anatomical RN continuity is confirmed by HRUS, good functional outcome is reached even in patients with EDX loss of functional continuity. Together with clinical and EDX evaluations, HRUS may provide useful data in the follow-up of radial palsy due to humeral shaft fractures.

背景:高分辨率神经超声检查(HRUS)在诊断和随访闭合性创伤导致的肱骨轴骨折相关的轴索病性桡神经麻痹方面具有新的重要性。我们的研究旨在通过纵向多模态分析确定神经超声在这方面的作用:方法:在一项为期 5 年的研究中收集了 19 例连续系列患者,分别在受伤后第 1、3、6、12 和 24 个月进行了临床、电诊断(EDX)和 HRUS 评估。临床严重程度根据受累肌肉的MRC评分,EDX根据功能连续性的有无评分;桡神经(RN)和后骨间神经(PIN)的解剖连续性和神经横截面积(NCSA)通过HRUS进行评估:所有患者的临床症状在随访期间均有所改善;所有患者均在 12 个月内达到 EDX 功能连续性;所有患者的 HRUS 均显示 RN 解剖连续性,74% 的患者 PIN 受累。在随访期间,RN的NCSA逐渐降低,但在第24个月时仍明显高于对侧;PIN的NCSA在24个月内变得正常:结论:当 HRUS 证实解剖学上的 RN 连续性时,即使 EDX 显示功能连续性丧失的患者也能获得良好的功能预后。HRUS与临床和EDX评估相结合,可为肱骨轴骨折所致桡骨瘫的随访提供有用数据。
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引用次数: 0
Specifies of the fetal median callosal artery. 明确胎儿胼胝体中动脉的位置。
IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2024-10-01 Epub Date: 2022-09-09 DOI: 10.23736/S0390-5616.22.05820-9
Ljiljana Vasović, Ana Mrkaić, Milena M Trandafilović, Martina Drevenšek

Background: A variable artery in the anterior cerebral circulation, named median callosal artery (MdCA) belongs to one of the three groups of anteromedial central branches of the anterior communicating artery (ACoA). The lack of information on MdCA in human fetuses inspired the authors to explore and present its morphological features.

Methods: The arteries of the brain base were analyzed and measured on 193 specimens of human fetuses, whose values are preserved from the time of preparation of PhD thesis.

Results: The median callosal artery was observed in 45% (87/193) of fetuses from 12.5 to 25 weeks of gestation. The MdCA originating from the single ACoA was found in 4.66% cases. MdCAs originating from the so-called anterior communicating rete (16.58%), as well from the partially duplicated (5.69%) and total duplicated ACoA (10.88%) were also found. A statistically significant difference of the artery OD between male and female fetuses was not found. There was a non-significant positive correlation between fetal age presented in gestational weeks and the artery OD (r=0.214). The OD of the MdCA did not correlate with the diameters of the anterior cerebral artery (ACA). An unusual convergent union of initial ACA medial vessels and partial duplication at MdCA beginning and its trunk fenestrations were shown, along with bilateral distribution of MdCA branches.

Conclusions: The wide range of variability of the median callosal artery in human fetuses, presented in this paper, contributes to anatomical knowledge on the anterior part of cerebral circulation.

背景:大脑前循环中有一条可变动脉,被命名为胼胝体中动脉(median callosal artery,MdCA),属于前交通动脉(anterior communicating artery,ACoA)的三组前内侧中央分支之一。由于缺乏有关人类胎儿胼胝体正中动脉的信息,作者萌生了探索并展示其形态特征的想法:方法:对 193 个人类胎儿标本的脑底动脉进行了分析和测量,这些标本的数值保存在博士论文撰写期间:结果:在妊娠 12.5 至 25 周的胎儿中,45%(87/193)观察到胼胝体中动脉。在 4.66% 的病例中发现了源自单一 ACoA 的 MdCA。此外,还发现有 16.58%的 MdCA 起源于所谓的前交通嵴(anterior communicating rete),以及部分重复(5.69%)和完全重复的 ACoA(10.88%)。男女胎儿的动脉外径差异无统计学意义。以孕周为单位的胎龄与动脉外径呈非显著正相关(r = 0.214)。MdCA的外径与大脑前动脉(ACA)的直径没有相关性。结果显示,ACA最初的内侧血管和MdCA起始处的部分重复及其主干瘘管异常汇合,MdCA分支呈双侧分布:本文所展示的人类胎儿胼胝体中动脉的广泛变异有助于人们对脑循环前部的解剖学认识。
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引用次数: 0
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Journal of neurosurgical sciences
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