Publicaciones

Minimally invasive evacuation for spontaneous supratentorial haemorrhage: scoping for candidates and hypothetical logistic burdens in a pragmatic scenario

Mosteiro A, Coronel-Coronel M, Pedrosa L et al. Neurosurg Rev. 2025 Sep 27;48(1):669. doi: 10.1007/s10143-025-03823-4.

https://pubmed.ncbi.nlm.nih.gov/41014383/

Abstract: Minimally invasive surgery (MIS) is being evaluated as a promising treatment for spontaneous intracerebral haemorrhage (ICH). Transitioning to early clot removal requires accurate estimation of eligible candidates in practical scenarios. We conducted a prospective population-based observational study of ICH across all public stroke centres in Catalonia-Spain, between 2020 and 2022. Patient characteristics, need for conventional surgery and clinical outcomes were recorded. Inclusion and exclusion criteria from major trials assessing MIS for ICH were retrospectively applied to obtain the number of potential candidates. Sensitivity analyses examined the impact of withdrawal of care (WoC) decisions and variations in
selection criteria on eligibility estimates. Among 2,197 reported ICH cases, 1,571 met the selection criteria and had complete follow-up to be analysed. Annually, 113 (14.4%) patients met the criteria for catheter plus thrombolysis evacuation
(MISTIE-III criteria), and 45 (5.7%) for parafascicular evacuation (ENRICH criteria). Eligibility rates varied considerably depending on age and haematoma volume thresholds, and with changes in WoC, which affected 20–29% of potential candidates.
Conventional evacuation was performed as a life-saving measure in 40 (5%) patients annually according to local protocols. If implemented, MIS protocols could increase the number of clot evacuation procedures in a range of 1.1–1.8 times. In a hypothetical scenario of MIS implementation for early ICH evacuation protocol in Catalonia, 5.7–14.4% of patients could potentially qualify for surgery. Consequently, the annual number of emergent clot evacuation procedures might increase 1.1-fold to 1.8-fold, highlighting substantial impact on healthcare infrastructure and resource planning.

Funding: The HIC-CAT registry was supported by the Instituto de Salud Carlos III (ISCIII) through the RICORS-ICTUS network (RD24/0009/0010). The study was also founded by the European Union program FEDER, and the European Regional Development Fund (ERDF) (PI22/0105).

 

Status of neurosonology in Spain. A study from the Spanish Society of Neurosonology (SONES)

Rodríguez-Pardo J, Carneado-Ruiz J, Martínez-Martínez M et al. Neurologia (Engl Ed). 2025 Jul-Aug;40(6):548-557. doi: 10.1016/j.nrleng.2025.06.003. Epub 2025 Jun 21. PMID: 40550309

https://pubmed.ncbi.nlm.nih.gov/40550309/

Abstract: Stroke patients have shown low reward sensitivity, which is a transdiagnostic dimension that defines the extent to which a person actively pursues rewarding stimuli. Low reward sensitivity has been related to depression and dysregulation of the frontostriatal network. To date, studies have addressed this dimension in heterogenic stroke lesions and the underlying mechanisms of frontostriatal stroke patients are still unknown. This study included 54 participants (32 chronic frontostriatal stroke patients and 22 healthy controls). Reward sensitivity was assessed using the probabilistic reversal learning task. Depressive symptoms were measured with the Adult Self-Report, and resting-state functional connectivity (rsFC) was examined using functional near-infrared spectroscopy (fNIRS) in prefrontal, motor, and parietal cortices. Group differences and predictors of reward sensitivity were analyzed using Bayesian ANCOVA and multiple regression models. Stroke patients displayed lower reward sensitivity, higher depressive problems, and lower resting-state functional connectivity between the right orbitrofrontal cortex and the left dorsolateral prefrontal cortex, the right orbitrofrontal cortex and the right dorsolateral prefrontal, and the right dorsolateral prefrontal cortex and right premotor cortex and supplementary motor area. In stroke patients, lower reward sensitivity was predicted by higher depressive problems and lower resting-state functional connectivity between the right dorsolateral prefrontal cortex and the right premotor cortex and the right supplementary motor area. This work showed the relevance of reward sensitivity in frontostriatal post-stroke patients and its relationship with depression, and supports

Funding: Funding for open access publishing: Universidad de Almería/ CBUA. This work was supported by the Ministry of Science, Innovation and Universities (grant numbers PID2019-108423RB-100 and PID2023-147063 NB-I00), the Carlos III Institute of Health (grant number RICORS-ICTUS; RD21/0006/0010) and PPIT-UAL, Junta de Andalucía-ERDF 2021–2027. Objective RSO1.1. Programme: 54.A.