Risk Factors Associated With Bell's Palsy: A Real-World Analysis of 281,600 Patients.

Introduction: Bell's palsy is the most common cause of peripheral facial paralysis, with an annual incidence of 5-50 per 100,000 cases worldwide. Its etiology remains largely unknown, though risk factors such as herpes simplex virus reactivation, diabetes, depression, and pregnancy-related complications have been suggested. Understanding these risk factors is critical for improving diagnosis, prevention, and treatment strategies.

Closing the diagnostic gap: A narrative review of recent advances in functional MRI diagnostics in spinal cord injury.

Introduction: Conventional MRI (T1 and T2-weighted sequences) is the standard for diagnosing spinal cord injuries but often lacks specificity, showing limited correlation with microstructural changes and function. This creates a diagnostic gap, especially in patients with mild or ambiguous symptoms, delaying early intervention.

Research Question: Can advanced MRI techniques-such as quantitative MRI (qMRI), functional MRI (fMRI), Magnetic Resonance Spectroscopy (MRS), and Transmagnetic Stimulation (TMS)-address the limitations of conventional MRI by providing enhanced diagnostic metrics and biomarkers of spinal cord integrity?

Material And Methods: This study reviews advanced MRI modalities and their potential to provide quantifiable insights into spinal cord microstructure and function.

The neuronal reserve in glioma surgery: functional reorganization of the motor network examined by navigated transcranial magnetic stimulation and diffusion tensor imaging tractography.

Objective: Patients suffering from rolandic gliomas are differently affected by motor deficits due to the lesion growth and edema as well as the surgical intervention. One reason for the different dynamics of disease progression and surgical outcome might be an individual potential for compensation and adaptation of the motor network. The aim of the present study was therefore to investigate the reorganization capacity of the motor cortex in patients with glioma by using navigated transcranial magnetic stimulation and diffusion tensor imaging tractography.

Navigated Transcranial Magnetic Stimulation and Diffusion Tensor Imaging Tractography in Insular Glioma Surgery.

Background And Objectives: The surgical resection of insular gliomas is associated with a high rate of postoperative morbidity as they grow close to descending motor fibers and lenticulostriate arteries. It is believed that intraoperative perforator infarctions are the determining factor for patients' postoperative outcome, while the majority of patients with intraoperative ischemic events do not develop postoperative motor deficits. This study aims to evaluate whether navigated transcranial magnetic stimulation (nTMS) and nTMS-based fiber tracking could be valuable for the preoperative assessment of patients with insular gliomas.

An Algorithm for the Microsurgical Resection of Cerebellar Cavernomas.

Background And Objectives: Cavernous malformations (CMs) account for 8% to 15% of all cerebrovascular anomalies and pose clinical significance due to their potential to cause symptomatic hemorrhage, seizures, and focal neurological deficits. While the majority of CMs are located supratentorial, the less common posterior fossa, particularly cerebellar CMs (cCMs), pose a unique treatment challenge. This study aims to contribute to the understanding and management of cerebellar CMs, thereby assisting in the decision-making process for clinical interventions in this patient population.

NTMS based tractography and segmental diffusion analysis in patients with brainstem gliomas: Risk stratification and clinical potential.

Introduction: Surgery on the brainstem level is associated with a high-risk of postoperative morbidity. Recently, we have introduced the combination of navigated transcranial magnetic stimulation (nTMS) and diffusion tensor imaging (DTI) tractography to define functionally relevant motor fibers tracts on the brainstem level to support operative planning and risk stratification in brainstem cavernomas.

Research Question: Evaluate this method and assess it's clinical impact for the surgery of brainstem gliomas.

Diagnosis and treatment of meralgia paresthetica between 2005 and 2018: a national cohort study.

The prevalence of meralgia paresthetica (MP), which is caused by compression of the lateral femoral cutaneous nerve (LFCN), has been increasing over recent decades. Since guidelines and large-scale studies are lacking, there are substantial regional differences in diagnostics and management in MP care. Our study aims to report on current diagnostic and therapeutic strategies as well as time trends in clinical MP management in Germany.

Reduction in wound healing complications and infection rate by lumbar CSF drainage after decompressive hemicraniectomy.

Objective: Wound healing disorders and surgical site infections are the most frequently encountered complications after decompressive hemicraniectomy (DHC). Subgaleal CSF accumulation causes additional tension of the scalp flap and increases the risk of wound dehiscence, CSF fistula, and infection. Lumbar CSF drainage might relieve subgaleal CSF accumulation and is often used when a CSF fistula through the surgical wound appears.

Thoracic Outlet Syndrome Part II: Consensus on the Management of Neurogenic Thoracic Outlet Syndrome by the European Association of Neurosurgical Societies' Section of Peripheral Nerve Surgery.

Background: In the first part of this report, the European Association of Neurosurgical Societies' section of peripheral nerve surgery presented a systematic literature review and consensus statements on anatomy, classification, and diagnosis of thoracic outlet syndrome (TOS) along with a subclassification system of neurogenic TOS (nTOS). Because of the lack of level 1 evidence, especially regarding the management of nTOS, we now add a consensus statement on nTOS treatment among experienced neurosurgeons.

Objective: To document consensus and controversy on nTOS management, with emphasis on timing and types of surgical and nonsurgical nTOS treatment, and to support patient counseling and clinical decision-making within the neurosurgical community.

Rationale and design of the peripheral nerve tumor registry: an observational cohort study.

Aim: Peripheral nerve tumors (PNT) are rare lesions. To date, no systematic multicenter studies on epidemiology, clinical symptoms, treatment strategies and outcomes, genetic and histopathologic features, as well as imaging characteristics of PNT were published. The main goal of our PNT Registry is the systematic multicenter investigation to improve our understanding of PNT and to assist future interventional studies in establishing hypotheses, determining potential endpoints, and assessing treatment efficacy.

Physiological variables in association with spreading depolarizations in the late phase of ischemic stroke.

Physiological effects of spreading depolarizations (SD) are only well studied in the first hours after experimental stroke. In patients with malignant hemispheric stroke (MHS), monitoring of SDs is restricted to the postoperative ICU stay, typically day 2-7 post-ictus. Therefore, we investigated the role of physiological variables (temperature, intracranial pressure, mean arterial pressure and cerebral perfusion pressure) in relationship to SD during the late phase after MHS in humans.

NTMS mapping of non-primary motor areas in brain tumour patients and healthy volunteers.

Objective: Navigated transcranial magnetic stimulation (nTMS) has been increasingly used for presurgical cortical mapping of the primary motor cortex (M1) but remains controversial for the evaluation of non-primary motor areas (NPMA). This study investigates clinical and neurophysiological parameters in brain tumour patients and healthy volunteers to decide whether single-pulse biphasic nTMS allows to reliably elicite MEP outside from M1 or not.

Materials And Methods: Twelve brain tumour patients and six healthy volunteers underwent M1 nTMS mapping.

The Corticospinal Reserve Capacity: Reorganization of Motor Area and Excitability As a Novel Pathophysiological Concept in Cervical Myelopathy.

Background: In degenerative cervical myelopathy (DCM), the dynamics of disease progression and the outcome after surgical decompression vary interindividually and do not necessarily correlate with radiological findings.

Objective: To improve diagnostic power in DCM by better characterization of the underlying pathophysiology using navigated transcranial magnetic stimulation (nTMS).

Methods: Eighteen patients with DCM due to cervical spinal canal stenosis were examined preoperatively with nTMS.

Standard-sampling microdialysis and spreading depolarizations in patients with malignant hemispheric stroke.

Spreading depolarizations (SD) occur in high frequency in patients with malignant hemispheric stroke (MHS). Experimentally, SDs cause marked increases in glutamate and lactate, whereas glucose decreases. Here, we studied extracellular brain glutamate, glucose, lactate, pyruvate and the lactate/pyruvate ratio in relationship to SDs after MHS.

Motor plasticity after extra-intracranial bypass surgery in occlusive cerebrovascular disease.

Objective: To explore plasticity in patients scheduled for extra-intracranial bypass surgery due to unilateral symptomatic occlusive cerebrovascular disease via navigated transcranial magnetic stimulation.

Methods: In this observational study, patients were allocated to different substudies and examined before and 3 months after operation. (1) Corticospinal excitability was determined via identification of the resting motor threshold.

Evaluation of urban environment pollution based on the accumulation of macro- and trace elements in epiphytic lichens.

Nitrogen, phosphorus, potassium, magnesium, zinc, nickel, copper, manganese, iron and lead accumulation properties of three epiphytic lichen species (Hypogymnia physodes (L.) Nyl., Parmelia sulcata Taylor and Xanthoria parietina (L.

Navigated transcranial magnetic stimulation improves the treatment outcome in patients with brain tumors in motor eloquent locations.

Background: Neurological and oncological outcomes of motor eloquent brain-tumor patients depend upon the ability to localize functional areas and the respective proposed therapy. We set out to determine whether the use of navigated transcranial magnetic stimulation (nTMS) had an impact on treatment and outcome in patients with brain tumors in motor eloquent locations.

Methods: We enrolled 250 consecutive patients and compared their functional and oncological outcomes to a matched pre-nTMS control group (n = 115).

The reliability of topographic measurements from navigated transcranial magnetic stimulation in healthy volunteers and tumor patients.

Background: Navigated transcranial magnetic stimulation (nTMS) is increasingly being used for preoperative mapping of the motor cortex. Any new technology should undergo rigorous validation before being widely adopted in routine clinical practice. The aim of this experimental study was to assess the intraexaminer and interexaminer reliability of topographic mapping with nTMS.

Assessing the functional status of the motor system in brain tumor patients using transcranial magnetic stimulation.

Background: Transcranial magnetic stimulation (TMS) is being used in the pre-operative diagnostics of patients with tumors in or near the motor cortex. Although the main purpose of TMS in such patients is to map the functional areas of the motor cortex in spatial relation to the tumor, TMS also provides some numerical neurophysiological measurements of the functional status of the patient's motor system. The aim of this paper is to provide reference values for these neurophysiological measurements from a large and varied clinical sample.