Background: The independent prognostic value of cerebrospinal fluid analysis in multiple sclerosis is not established.
Objective: To determine the prognostic value of intrathecal synthesis in a cohort of patients with relapsing-onset MS taking into consideration demographic and imaging parameters.
Methods: In this prospective cohort study conducted from 1993 to 2013, we analyzed the time to confirmed disability (persistent above 6 months) and irreversible disability (persistent for the entire disease course) of two disability milestones, Expanded Disability Status Scale score ≥ 4 or 6, and the time to secondary progressive onset in 579 patients with relapsing-onset multiple sclerosis. Demographic parameters (age at onset, gender) and imaging parameters (periventricular lesions) were included in the Cox models.
Results: 447 patients (77.2%) had intrathecal synthesis (oligoclonal bands and/or increased immunoglobulin G index value). No statistically significant relation was found between intrathecal synthesis and the time to reach each disability milestone or secondary progressive onset. An age older than 40 years and more than 3 periventricular lesions predicted a worse prognosis.
Conclusions: Cerebrospinal fluid analysis did not predict the time to disability milestones in relapsing-onset multiple sclerosis independently of age and imaging data.
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http://dx.doi.org/10.1016/j.jns.2015.04.044 | DOI Listing |
J Am Anim Hosp Assoc
January 2025
From Veterinary Neurological Center "La Fenice," Selargius, Italy (I.T., F.T., A.G.).
An 8 yr old, male, mixed-breed dog was presented with a 2 mo history of progressive weakness, worsened in the last 2 days before examination. Neurological examination revealed ambulatory tetraparesis, ataxia, and proprioceptive deficits in all four limbs. Menace response was reduced in the right eye and discomfort was detected on neck manipulation.
View Article and Find Full Text PDFJ Neurosurg Case Lessons
January 2025
Division of Neurosurgery, Tohoku Medical and Pharmaceutical University, Sendai, Japan.
Background: The authors report the first case of thoracic interdural spinal cysts presenting as radiculopathy attributed to overdrainage-related cervical venous plexus enlargement. This case emphasizes the importance of considering interdural spinal cysts and cerebrospinal fluid overdrainage in the differential diagnosis of radiculopathy.
Observations: A 37-year-old male patient with a history of orthostatic headache presented with bilateral deltoid muscle atrophy consistent with C5 radiculopathy.
J Neurosurg Case Lessons
January 2025
Department of Neurosurgery, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
Background: The diagnosis of intracranial extraosseous Ewing's sarcoma (EES) poses challenges due to the absence of specific clinical and imaging features prior to surgery. It is crucial to differentiate the tumor from other small round cell malignancies postoperatively.
Observations: A 7-year-old patient was admitted to the authors' hospital due to the in situ recurrence of a posterior fossa tumor more than 1 month after the initial surgery for headache.
J Neurosurg Case Lessons
January 2025
Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina.
Background: Myelomeningocele and sagittal craniosynostosis are 2 neurosurgical pathologies with complications such as increased intracranial pressure (ICP) and hydrocephalus. While the 2 defects commonly occur independently, their simultaneous occurrence is exceptionally rare.
Observations: The authors report the case of a newborn male diagnosed with a simultaneous myelomeningocele and sagittal craniosynostosis.
J Neurotrauma
January 2025
International Collaboration on Repair Discoveries (ICORD), University of British Columbia (UBC), Vancouver, Canada.
Recent studies have reported that monitoring spinal cord perfusion pressure (SCPP) using a pressure probe to measure "intraspinal pressure" (ISP) within the subdural space at the injury site may improve the hemodynamic management of acute spinal cord injury (SCI) patients. This study aimed to investigate, within a pig model of SCI, the relationship between the ISP measured within the subdural space and the "spinal cord pressure" (SCP) measured within the spinal cord itself. Specifically, we sought to characterize the changes to ISP and SCP over time, both rostral and caudal to the injury epicenter, and in relation to native spinal cord morphometry.
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