Temple University Hospital

The goal of this systematic review is to establish the prevalence of sexual dysfunction among women with migraines. Secondarily, this review explores factors contributing to the relationship between sexual dysfunction and migraine in women. A thorough search of PubMed from inception to June 17, 2024 was completed. Search terms included migraine related terms and sexual dysfunction outcome related terms. Two independent reviewers assessed articles for relevance and extracted information from selected articles. In this review, a thorough search of the MEDLINE and CINAHL databases yielded 16 studies with 1,715 participants.The results demonstrated prevalence rates of sexual dysfunction in female migraine patients between 22.6% and 90%. There was a pooled prevalence of 69% (95% CI 61-77%) with substantial between-study heterogeneity (I2 = 78.73%). Prevalence rates of sexual dysfunction were higher in women with migraine than in healthy controls. Migraine characteristics, such as duration, frequency, and pain are associated with sexual dysfunction. A bi-directional correlation exists between psychological factors, such as anxiety and depression, and sexual dysfunction in patients with migraine. Migraines are associated with profound impacts on health-related quality of life. Sexual dysfunction is commonly associated with migraine in female patients, indicating that clinicians should routinely screen for sexual dysfunction in this population. Anxiety and depression may play a significant role in female sexual dysfunction in migraine.

Meningioma, one of the most common neoplasms of the central nervous system in adults, is most likely derived from the meningothelial cells of the arachnoid matter. Although most meningiomas have a benign clinical course and a relatively good prognosis, some can demonstrate more aggressive biological features, including local invasion and distant metastases. Extracranial meningioma metastases are rare, occurring in less than 1% of cases. We present a case of atypical meningioma status post resection with intracranial recurrence followed by multiple radiation therapies who developed extracranial metastases 14 years after primary tumor resection.

ABSTRACTPulmonary Langerhans cell histiocytosis (PLCH) frequently complicated by pulmonary hypertension (PH), which markedly worsens prognosis. We retrospectively reviewed three institutional PLCH‐PH cases treated with off‐label Sotatercept added to background triple therapy and performed a systematic review of published PLCH‐PH reports (PubMed/Embase through May 2025). Our three patients (ages 69, 62, 49; all female) had progressive vascular disease despite optimized vasodilator therapy. Following Sotatercept, all experienced ≥ 3‐fold increases in 6‐min walk distance and improved functional class. Hemodynamics improved substantially: right‐atrial pressure −78.6%, pulmonary vascular resistance −75.5%, pulmonary artery systolic pressure −58.5%, mean PAP − 56.0%, PA diastolic pressure −51.0%, PAWP − 47.1%; cardiac output and index rose +75.9% and +73.8%, respectively. BNP/NT‐proBNP normalized. Systematic review identified 34 published cases (2010–2025): mean age 37.2 ± 13.7 years, 44.1% female, 45.7% current/former smokers. Reported management strategies included targeted vasodilators, cytotoxic PLCH therapies (e.g., cladribine), smoking cessation, and selective surgery/transplant. In this small series, Sotatercept added to background therapy produced marked clinical and hemodynamic gains in refractory PLCH‐PH. These effects of Sotatercept in Group 5 PH—are encouraging but limited by sample size and retrospective design. Prospective, collaborative studies are needed to define safety, efficacy, and optimal patient selection.