Acta neurologica Belgica最新文献

Background: Arterial supply of intracranial meningiomas is a complex issues and it affects the treatment and surgical complications. On the other hand, some classic angiographic signs can be useful for the diagnosis and found using noninvasinve imaging too.

Methods: We reported a case of a 53 years old man with a huge olphactory groove meningioma studies using Magnetic Resonance Imaging (MRI) and Digital Subtraction Angiography (DSA). Both MRI and DSA were able to image two calssic angiographic signs of meningioma, i.e. mother-in-law sign and sunburst sign, with different time frames.

Conclusions: The identification of classic DSA signs of arterial supply in cranial meningiomas using noninvasive imaging techniques can support the diagnosis and help in the planning of treatment.

Objective: To compare clinical characteristics and outcomes associated with cilostazol versus aspirin in patients with ischemic stroke, with attention to carotid plaque progression, lipid metabolism, platelet aggregation, adverse events, and 12-month stroke recurrence.

Methods: This retrospective study included 250 patients with ischemic stroke treated between August 2019 and April 2023, of whom 100 received cilostazol and 150 received aspirin according to routine clinical practice. Cilostazol was more commonly prescribed to patients with aspirin intolerance or perceived bleeding risk. Outcomes included changes in carotid plaque area and stenosis, lipid parameters, platelet function, adverse reactions, and recurrent ischemic stroke within 12 months.

Results: At 12-month follow-up, patients receiving cilostazol showed greater reductions in carotid plaque area and stenosis rate compared with those receiving aspirin (P < 0.05). Differences were also observed in lipid profiles and platelet aggregation assays, with patterns consistent with the known pharmacological actions of cilostazol (P < 0.05). Adverse reactions, including bleeding events, pruritus, myalgia, and liver enzyme elevations, occurred less frequently in the cilostazol group (P < 0.05). Recurrent ischemic stroke was documented in 6.0% of cilostazol-treated patients and 20.0% of aspirin-treated patients (P < 0.05). These findings reflect associations observed in this real-world cohort and should be interpreted in light of underlying baseline differences and the non-randomized study design.

Conclusion: In this retrospective cohort, cilostazol use was associated with more favorable safety outcomes and lower recurrence rates compared with aspirin. Because treatment allocation was clinically driven and residual confounding cannot be excluded, the results indicate associations rather than causal effects. Prospective randomized studies are needed to determine whether these observed differences represent true treatment benefits.

Introduction: Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an immune-mediated neuropathy in which remission does not necessarily imply immunological silence. Persistent low-grade inflammation may continue despite clinical stability. This study aimed to evaluate macrophage-related cytokines and chemokines in CIDP patients during remission compared with healthy controls.

Methods: We conducted a cross-sectional, case-control study including 30 patients fulfilling the 2021 EAN/PNS diagnostic criteria for CIDP in remission and 30 age- and sex-matched healthy controls. All patients received maintenance intravenous immunoglobulin (IVIg). Clinical status was assessed by INCAT scores, and peripheral blood was collected at least one month after the last IVIg infusion. Serum levels of IL-1β, TNF-α, IL-6, MIP-1α, and MIP-1β were measured by ELISA.

Results: CIDP patients had significantly higher IL-1β (p < 0.001) and TNF-α (p = 0.002) levels than controls, whereas IL-6, MIP-1α, and MIP-1β did not differ significantly. IL-1β positively correlated with TNF-α and MIP-1α, suggesting a coordinated inflammatory response. ROC analysis demonstrated moderate diagnostic performance for IL-1β (AUC = 0.783) and TNF-α (AUC = 0.733). No association was observed between biomarker levels and electrophysiological parameters.

Conclusion: Our findings indicate that residual immune activation persists during CIDP remission, with IL-1β and TNF-α emerging as potential biomarkers of subclinical inflammation. Although MIP-1α and MIP-1β were not elevated in remission, their correlation with proinflammatory cytokines suggests that they may be more relevant in the active phase of disease. Longitudinal studies comparing relapse and remission are warranted to clarify their sensitivity as markers of disease activity and to validate their prognostic role.