Mignot Memorial Hospital is the principal hospital in Alderney, Channel Islands. It is located in the northern part of St. Anne, and operates as part of the States of Guernsey Health and Social Services Department. The hospital was established in 2008 and has 22 beds, serving Alderney's population of 2,300. 14 beds are used for continuing care; 8 of the beds are used for medical, post-operative, maternity or paediatric care.
The effectiveness of middle meningeal artery (MMA) embolization for chronic subdural hematoma is well established,1-3 and distal and multibranch penetration of embolic agents is recognized as a key factor for better outcomes.4 5 In recent years, several studies have described artificial intelligence (AI)-assisted neuroendovascular treatment.6-9 We recently reported that AI-assisted MMA embolization may enhance procedural safety through reflux detection and notification.10 This case (video 1) focuses on the overlay feature, highlighting its potential to improve procedural efficacy by enabling greater distal and multibranch penetration, resulting in a larger embolization volume. The overlay feature provided by the AI system enhanced visualization and notifications, enabling not only improved safety but also more effective multibranch penetration. As MMA embolization becomes more widespread, especially among younger operators, AI support that combines safety with efficacy holds promise for both clinical practice and training. Larger studies are needed to validate these findings further. neurintsurg;18/3/894/V1F1V1Video 1Artificial intelligence-assisted middle meningeal artery embolization with overlay visualization promoting distal and multibranch penetration.
BACKGROUND:Patients with spinocerebellar degeneration (SCD) and multiple system atrophy (MSA) encounter various challenges in daily life due to ataxia and other symptoms. A comprehensive understanding of their diverse needs can improve the effectiveness of rehabilitation interventions. OBJECTIVE:This study aims to identify the daily challenges faced by patients with SCD and MSA in Japan, focusing on differences between ambulatory and non-ambulatory patients. METHODS:A postal survey was conducted from March to May 2023, targeting members of the Japanese Society of Ataxia Patients diagnosed with SCD and MSA. The questionnaire assessed respondent demographics and symptoms impacting daily life. RESULTS:From the 283 responses received, 152 were deemed valid for analysis. Non-ambulatory patients reported significantly more difficulties across multiple items in the activities domain. Furthermore, subjective unsteadiness, difficulty speaking, and increased fall risk were identified as having the most significant impact on daily life, regardless of walking ability. CONCLUSION:These findings highlight the need to adapt rehabilitation approaches for patients with SCD and MSA as their disease progresses, emphasizing comprehensive assessment methods and multidisciplinary care to enhance their quality of life.
Developmental anomalies of the hearing organ, the cochlea, are diagnosed in approximately one-fourth of individuals with congenital. The majority of patients with cochlear malformations remain etiologically undiagnosed due to insufficient knowledge about underlying genes or the inability to make conclusive interpretations of identified genetic variants. We used exome sequencing for the genetic evaluation of hearing loss associated with cochlear malformations in three probands from unrelated families deafness. We subsequently generated monoclonal induced pluripotent stem cell (iPSC) lines, bearing patient-specific knockins and knockouts using CRISPR/Cas9 to assess pathogenicity of candidate variants. We detected FGF3 (p.Arg165Gly) and GREB1L (p.Cys186Arg), variants of uncertain significance in two recognized genes for deafness, and PBXIP1(p.Trp574*) in a candidate gene. Upon differentiation of iPSCs towards inner ear organoids, we observed developmental aberrations in knockout lines compared to their isogenic controls. Patient-specific single nucleotide variants (SNVs) showed similar abnormalities as the knockout lines, functionally supporting their causality in the observed phenotype. Therefore, we present human inner ear organoids as a potential tool to validate the pathogenicity of DNA variants associated with cochlear malformations.
Aim: Thoracic outlet syndrome (TOS) is a complex clinical condition caused by the compression of neurovascular structures in the thoracic outlet. Over the past few decades, research on TOS has expanded significantly. This study aims to analyze the literature on TOS using bibliometric methods to identify critical trends, influential authors, prominent themes, and emerging topics in the field. Material and Method: A comprehensive literature search was conducted using the Web of Science (WoS) database for articles on TOS published between 1980 and 2023, employing the keyword 'thoracic outlet syndrome.' The collected data were analyzed using bibliometric methods. VOSviewer software was utilized to visualize bibliometric networks and map critical findings. Citation analysis was performed to identify influential journals and significant articles in the field. Additionally, keyword clustering and trend analyses were conducted to explore the thematic landscape of TOS research. Results: In a literature search on TOS, 2248 publications were found, with 1509 journal articles (67.13%) included in the bibliometric summary. The most common research area was surgery (633 articles, 41.94%), and the United States had the highest publication productivity (684 articles, 45.32%). The University of California System had the highest number of publications among institutions (62 articles, 4.1%). These 1509 articles received 7831 citations (6596 excluding self-citations), averaging 13.1 citations per article and with an h-index of 57. 'Annals of Vascular Surgery' published the most articles (71, 4.7%), while 'Journal of Vascular Surgery' had the highest number of cited articles (65, 4.3%), accumulating 2563 citations. Conclusion: This bibliometric analysis provides valuable insights into the evolution and trends of research on TOS. The keyword analysis offers a roadmap for researchers to design new studies. Additionally, the study highlights the influence of economic size and development levels on academic productivity in TOS, underscoring the importance of promoting multidisciplinary studies, especially in less developed countries.
The transradial approach is increasingly used in neurointervention due to its minimally invasive nature and lower risk of severe access-related complications. However, radial artery steno-occlusion, although generally asymptomatic, may limit future vascular access. This study aimed to evaluate the incidence, predictors, and recanalization of puncture artery steno-occlusion following trans-wrist neurointervention. A retrospective institutional review was conducted on transradial and transulnar neurointerventions performed between February 2022 and May 2024. Postprocedural ultrasound was performed on the following day to assess puncture artery stenosis or occlusion. Risk factors were evaluated using univariate and multivariate logistic regression analyses. Follow-up ultrasound was conducted when available to assess recanalization. Among 96 therapeutic trans-wrist procedures, puncture artery steno-occlusion was observed in 21 cases (22
