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Latest digest preview
May 3, 2026
This week's digest highlights: In acute ischemic stroke management, glenzocimab shows promise when added to thrombolysis, but further validation is needed before altering current protocols. For patients with NF2-related schwannomatosis, salvage microsurgery after bevacizumab failure demonstrates potential, though results warrant confirmation through full-text analysis. In degenerative cervical myelopathy cases, posterior decompression may be compared to ACDF, but the current evidence remains preliminary and requires further investigation. For treating Meige syndrome, both pallidus internus and subthalamic nucleus deep brain stimulation are effective, with STN-DBS potentially offering benefits in energy efficiency. Bone flap preservation strategies post-decompressive craniectomy are validated, with subcutaneous methods showing a slight edge based on recent RCT findings.
Research • Endovascular / Vascular • Stroke • 2026-03-16
Preliminary evidence; confirm full-text methods and endpoints before changing practice.
OGlenzocimab should not be added to standard thrombolysis for acute ischemic stroke due to a lack of significant benefit and a concerning trend toward increased mortality, highlighting the need for caution with new antiplatelet agents.
Design
Randomized, double-blind, placebo-controlled, phase 2/3 trial
Population
Adults ≥18 with acute ischemic stroke, NIHSS ≥6, treated with IV thrombolysis within 4.5 hours
Intervention
Glenzocimab fixed dose IV infusion over 6 hours
Comparator
Placebo
Primary outcome
Poor outcome defined as mRS 4-6 vs 0-3 at day 90
Why it matters
Before this study, the efficacy of adding glenzocimab to thrombolysis with or without thrombectomy was uncertain. This RCT found no significant benefit on the primary outcome of poor functional outcome (mRS 4-6) at 90 days, with a trend toward increased mortality. Clinicians should not add glenzocimab to standard thrombolysis for acute ischemic stroke.
Confirms current practice: glenzocimab should not be used in acute ischemic stroke.
See source article for primary outcome data.
Glenzocimab is a glycoprotein VI inhibitor that blocks platelet aggregation. Prior phase data suggested potential benefit in stroke patients undergoing thrombectomy.
Sample size adjusted from 1000 to 400 during the trial, reducing power.Protocol amendments changed primary endpoint, increasing risk of bias.
Multiple protocol amendments and sample size changes raise concerns about design stability.
When evaluating antiplatelet agents in acute stroke, always check for increased bleeding and mortality signals even if efficacy is neutral.
Not stated
Research • Tumor / Skull Base • Neurosurgery • 2025-09-16
Preliminary evidence; confirm full-text methods and endpoints before changing practice.
OIn NF2 patients treated with bevacizumab, a perioperative window of 6 weeks to 6 months is advisable to mitigate intraoperative bleeding risks, particularly for those with high cumulative doses, although further validation of these findings is necessary.
Design
Multicenter retrospective study
Population
NF2-related schwannomatosis patients with vestibular schwannoma who had prior bevacizumab treatment
Intervention
Salvage microsurgery after bevacizumab
Comparator
None
Primary outcome
Perioperative bleeding risk and postoperative outcomes
Why it matters
Before this study, the perioperative bleeding risk in NF2 patients undergoing VS surgery after bevacizumab was poorly defined. This multicenter retrospective study found that higher cumulative bevacizumab dose and longer discontinuation-to-surgery interval were associated with increased intraoperative bleeding. Surgeons should aim for a bevacizumab-free window of 6 weeks to 6 months before surgery, especially in patients with high cumulative exposure.
May support a bevacizumab-free window of 6 weeks to 6 months before VS surgery, particularly in patients with high cumulative exposure.
See source article for primary outcome data.
Bevacizumab is used for NF-related schwannomatosis to reduce tumor growth. Surgery after bevacizumab carries concerns about bleeding and wound healing.
Retrospective design with small sample size (n=21).Subjective assessment of intraoperative bleeding by surgeons.
Small sample and subjective bleeding assessment limit generalizability.
In NF2 patients on bevacizumab, plan surgery at least 6 weeks after last dose; consider longer washout for high cumulative doses (>600 mg/kg).
Not stated