Migraine care has become scientifically precise while many patient pathways remain operationally imprecise. Diagnostic criteria, global burden data, migraine-specific preventive therapies, and emerging digital tools are available, yet many patients still experience delayed diagnosis, underestimated disability, escalating acute medication use, and late access to prevention. This perspective argues that delayed access should be understood not merely as an administrative barrier, but as a modifiable risk factor that may contribute to migraine progression, medication overuse, and avoidable disability. It proposes precision triage as a practical implementation framework for connecting headache classification, burden assessment, medication-overuse risk, rational preventive treatment selection, timely referral, and accountable use of digital health tools. The central claim is that modern migraine care must shift from disconnected visits to a pathway-based model that asks what each patient needs next and how soon. Such a shift may help translate existing headache knowledge into faster, fairer, and more clinically responsive care.

Introduction Medication-overuse headache (MOH) is a common but often underdiagnosed secondary headache disorder that develops in individuals with pre-existing headache disorders as a result of excessive use of acute headache medications. This study aims to assess the estimated prevalence and awareness of MOH among the general population in the Western region of Saudi Arabia and to explore factors associated with headache frequency and medication use. Methods An observational cross-sectional study was conducted from December 2024 to January 2025 among adults aged 19-60 years residing in Western Saudi Arabia. Data were collected using an online self-administered questionnaire distributed via social media platforms. The tool collected data on sociodemographic factors, headache patterns, medication use, and MOH awareness. A total of 518 responses were included in the final analysis. Results A total of 518 participants completed the questionnaire; 362 (69.9%) were female, with a mean age of 31.2 ± 12.9 years. Overall, 490 participants (94.6%) reported a history of headaches. The estimated prevalence of MOH was 2.4%, while awareness among participants was 20.8% (n = 109). A significant association was observed between age and headache prevalence (p = 0.004), with the highest prevalence of 97.1% (n = 165) among participants aged 20-29 years. In addition, a significant association was found between age and medication use (p = 0.049), with a progressive increase observed: medication use increased from 71.4% (n = 85) in participants under 20 years to 85.5% (n = 59) in those aged 40-49 years. These findings reflect the direction and practical impact of age-related differences. Conclusion The study found a lower estimated prevalence of MOH compared to previous national studies, while awareness remained low in Western Saudi Arabia. These findings highlight the importance of educational initiatives and improved headache management strategies to address the risks of medication overuse.

Glioblastoma is the most common and aggressive primary malignant brain tumor in adults, associated with poor prognosis despite standard multimodal treatment. Long-term survival beyond five years is rare, particularly in IDH-wild-type disease. We report the cases of two female patients with IDH-wild-type, CNS WHO grade 4 glioblastoma who achieved survival exceeding five years following standard therapy. The first case was a 51-year-old woman presenting with seizures and a left temporoparietal glioblastoma. She underwent gross total resection followed by radiotherapy (60 Gy) with concurrent and 12 cycles of adjuvant temozolomide (200 mg/m²). Due to high PD-L1 expression, nivolumab was added during adjuvant treatment. Molecular analysis revealed PTEN, TP53, and TERT promoter mutations. She remains disease-free at five years. The second case involved a 27-year-old woman presenting with headache and a left frontal glioblastoma. She underwent gross total resection followed by standard chemoradiotherapy and 12 cycles of adjuvant temozolomide (200 mg/m²). Next-generation sequencing (NGS) identified multiple alterations in DNA damage response and tumor suppressor pathways. She also remains in complete remission at five years. These cases highlight that long-term survival in IDH-wild-type glioblastoma is possible, although rare. Favorable clinical factors such as young age, good performance status, and gross total resection, together with distinct molecular profiles, may contribute to prolonged survival. These observations underscore the importance of integrating clinical and molecular features to refine prognostic assessment in glioblastoma.

Eclampsia occurring beyond 48 hours postpartum is termed "late postpartum eclampsia" (LPPE), which is a clinically challenging condition. It has an occurrence of approximately 15% of all eclampsia cases and often presents in women with no documented antenatal hypertension. We report a case of LPPE manifesting on postoperative day (POD) 7 following elective lower-segment cesarean section (LSCS) in a primigravida with pre-existing hypothyroidism in the complete absence of hypertensive recordings prior to and during the antenatal or immediate postoperative period. This case adds to the limited literature by highlighting potential risk factors and the need for a high index of suspicion. A 21-year-old primigravida woman (P1L1), POD 7 after elective LSCS for cephalopelvic disproportion, presented to the emergency department with a six-hour prodrome of severe occipital headache, blurring of vision, and two witnessed generalized tonic-clonic seizures. She had a background history of hypothyroidism managed with levothyroxine 25 µg once daily with no recorded hypertension prior to or during antenatal visits or during her initial postoperative hospital stay. Vital parameters recorded during the post-ictal phase were BP 140/92 mmHg, pulse 90 per minute, saturation 98% on room air, and random blood sugar level 92 mg/dl. She was administered intravenous levetiracetam and shifted for a CT brain, which showed no abnormality. Investigations revealed a spot urine protein-to-creatinine ratio of 308 mg/g with normal hepatic and renal parameters. She was diagnosed with LPPE based on new-onset hypertension, significant proteinuria, and neurological involvement. She was later managed with intravenous magnesium sulfate (MgSO₄) and antihypertensive therapy. After clinical stabilization, she was discharged on POD 13. This case underscores that LPPE can occur as late as POD 7 in the absence of documented hypertension, which makes anticipatory management difficult. It also highlights the need for structured postpartum surveillance protocols and explicit patient and family education regarding warning symptoms.

Injury rehabilitation is a complex process shaped by interacting biological, psychological, and social factors. This study aimed to explore the biopsychosocial experiences of Chinese university dancers during injury rehabilitation. A qualitative study was conducted using semi-structured in-depth interviews with seven Chinese university dancers who had experienced injury rehabilitation. The data were analyzed using thematic analysis to identify key themes across biopsychosocial domains. The findings revealed that injury rehabilitation experiences were multidimensional. At the biological level, participants reported physical symptoms such as pain, joint instability, and reduced flexibility, along with somatic responses including headaches and sleep disturbances. Some dancers also described physical growth following rehabilitation, including improved strength and flexibility. At the psychological level, negative emotions such as anxiety, frustration, anger, and guilt were prominent, while resilience grounded in a positive mindset also emerged. At the social level, emotional and practical support from parents, teachers, and peers functioned as protective factors, whereas pressure to return, indifference, and criticism acted as risk factors. Notably, participants' experiences were situated within a broader cultural context, which influenced their perceptions of injury, responses to rehabilitation, and interactions with their social environment. These findings suggest that dancers' injury rehabilitation should be understood within an expanded biopsychosocial framework that incorporates cultural context. The study highlights the need for integrated and culturally sensitive rehabilitation interventions for injured dancers. Future research should adopt cross-cultural and longitudinal approaches to further elucidate these experiences.

Artificial intelligence (AI) has stimulated extensive research in clinical neurology, but relatively few AI systems have meaningfully changed bedside decision-making. This translational gap is not explained solely by inadequate algorithms. More often, AI models in neurology remain outside routine practice because they are trained on unstable labels, validated in narrow or single-center datasets, evaluated primarily by discrimination metrics, disconnected from clinical workflow, and deployed without prospective monitoring, reimbursement frameworks, or accountability. In this review, we propose the NEURAL framework for practice-changing neurological AI: Novel clinical insight, External and prospective validation, Utility over accuracy, Real-time workflow integration, Algorithmic transparency, and Long-term outcome linkage. Using this framework, we examine evidence across acute stroke, epilepsy and electroencephalography (EEG), sleep medicine, neurodegenerative disease, movement disorders, headache, vestibular disorders, neuroimmunology, rehabilitation, and neurocritical care. The most clinically advanced examples come from acute stroke, where imaging-based selection, large-vessel occlusion detection, and automated notification are linked to urgent, pathway-defined interventions. Automated EEG triage, focal cortical dysplasia detection, selected sleep-analysis tools, quantitative biomarker pipelines, and AI-assisted longitudinal monitoring may also become clinically meaningful if tested prospectively in real-world workflows. Many high-performing models for dementia progression, prodromal Parkinson disease, outpatient treatment response, and long-horizon risk prediction remain pre-implementation tools because they do not yet define a validated clinical action. Future neurological AI should therefore be judged less by whether it recognizes complex patterns and more by whether it improves the right decision for the right patient at the right time. A clinically useful AI system must demonstrate not only accuracy, but also actionability, workflow fit, equity, safety, sustainability, and measurable benefit for patients and health systems.