BMC Neurology最新文献

Background: Transient ischaemic attack (TIA) is a strong predictor of stroke, has a high risk of recurrence, and may lead to a variety of sequelae. The purpose of this study was to understand the epidemiological characteristics and trends of TIA through a systematic review and meta-analysis, to identify high-risk populations, and to provide a basis for prevention and intervention measures.

Methods: Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 guidelines, we searched Chinese-language (CNKI, Wanfang, VIP, and CBM) and English-language databases (PubMed, Cochrane, Embase, and Web of Science) from inception to October 25, 2024. Cross-sectional or cohort studies reporting the prevalence or incidence of TIA were included. Quality assessment was performed using the AHRQ and NOS scales. Data synthesis was performed with Stata 17.0, employing a random-effects model for high heterogeneity (I² > 50%). Subgroup analyses were conducted on the basis of region, publication year, gender, age and diagnostic criteria.

Results: From 20,114 screened records, 47 studies were included, contributing a total of 50 datasets for analysis (23 for prevalence and 27 for incidence). The global pooled prevalence of TIA was 1.95% (95% CI: 1.27-2.77%), and the prevalence was elevated in Asia (2.19%) and among older adults (> 65 years, 5.13%). The annual incidence was 54 per 100,000 person-years, with the highest incidence occurring in the Americas (81 per 100,000). No significant gender differences were found in terms of prevalence or incidence. The incidence decreased over time but increased with age. The use of imaging-based criteria is associated with a lower and likely more accurate estimation of TIA prevalence.

Conclusion: This study provides updated global estimates of TIA epidemiology, revealing significant variations influenced by diagnostic criteria, age, and region. The substantial heterogeneity and potential underreporting highlight the need for standardized, imaging-based diagnostic protocols in future research. The development of precise risk stratification tools and region-specific prevention strategies is imperative for mitigating the global burden of TIA.

Background: Rosai-Dorfman disease (RDD), also known as sinus histiocytosis with massive lymphadenopathy (SHML), is an extremely rare non-Langerhans cell histiocytosis. The diagnostic histiocytes in RDD are characterized by the immunophenotypic markers S100 (+), CD68 (+), and CD1a (-) (Abla O, Blood 131: 2877, 2018),(Emile JF, Blood 127: 2672, 2016) , and exhibit phagocytosis with varying frequency. To our knowledge, this is the first reported case of isolated Intracranial Rosai-Dorfman Disease Mimicking Sellar Pituitary Adenoma, with peripheral facial paralysis as the initial presentation. By integrating imaging findings, histopathological features, and treatment response, we explore the diagnostic challenges and management strategies, aiming to enhance clinicians' awareness of RDD involving the pituitary.

Case presentation: We report the case of a 50-year-old Han Chinese female who presented with left-side peripheral facial paralysis and tender enlargement of the left cervical lymph nodes. Pituitary MRI revealed an intrasellar mass with homogeneous enhancement, initially diagnosed as a pituitary adenoma. The patient underwent transnasal transsphenoidal endoscopic resection of the pituitary adenoma. But histopathology and immunohistochemistry (S100+, CD68+, CD1a-) confirmed the diagnosis of RDD. Postoperatively, the facial paralysis improved, Unfortunately, 6 months follow-up MRI showed tumor recurrence.

Conclusion: The clinical manifestations of intrasellar RDD are insidious and lack specificity, making it easy to confuse with common pituitary space-occupying lesions. Currently, surgical resection remains the gold standard for definitive diagnosis and is the primary therapeutic intervention, long-term follow-up is crucial for monitoring recurrence.