Journal of Neurosurgery: Case Lessons最新文献

{"title":"Brain metastasis and intracranial leptomeningeal metastasis from malignant peripheral nerve sheath tumors: illustrative cases.","authors":"Masasuke Ohno,&nbsp;Shoichi Haimoto,&nbsp;Satoshi Tsukushi,&nbsp;Waki Hosoda,&nbsp;Fumiharu Ohka,&nbsp;Ryuta Saito","doi":"10.3171/CASE23148","DOIUrl":"10.3171/CASE23148","url":null,"abstract":"<p><strong>Background: </strong>Malignant peripheral nerve sheath tumors (MPNSTs) are rare soft-tissue tumors. Intracranial metastasis from MPNSTs is quite rare.</p><p><strong>Observations: </strong>The authors report on a 73-year-old male whose MPNST metastasized to the brain and a 32-year-old male with leptomeningeal metastasis from MPNST and review 41 cases of MPNST that developed intracranial metastasis, as reported in the literature.</p><p><strong>Lessons: </strong>Brain metastasis and leptomeningeal metastasis of MPNSTs show different clinical courses and require pathology-specific treatment.</p>","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"6 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/33/99/CASE23148.PMC10555573.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9865711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-dimensional fusion images from digital subtraction angiography for the treatment of direct carotid-cavernous fistulas: illustrative case.","authors":"Fumiaki Maruyama,&nbsp;Toshihiro Ishibashi,&nbsp;Yukiko Abe,&nbsp;Yuichi Murayama","doi":"10.3171/CASE23214","DOIUrl":"10.3171/CASE23214","url":null,"abstract":"<p><strong>Background: </strong>Direct carotid-cavernous fistulas (dCCFs) are often treated endovascularly. However, because the dCCF is usually a high-flow shunt, it is often difficult to obtain an accurate vascular structure using conventional digital subtraction angiography (DSA). Here, the authors report a case of successfully treated dCCF using three-dimensional (3D) fused DSA images.</p><p><strong>Observations: </strong>The patient presented with tinnitus, followed by oculomotor palsy, prompting magnetic resonance imaging that indicated a dural arteriovenous fistula of the cavernous sinus. DSA was performed before treatment, and a diagnosis of dCCF due to a ruptured aneurysm was made. In this case, the 3D fused simulation images enabled the authors to obtain an accurate vascular structure, resulting in successful coil embolization.</p><p><strong>Lessons: </strong>Three-dimensional fusion images from DSA provide detailed anatomical information and are useful for treating high-flow dCCFs.</p>","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"6 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b4/62/CASE23214.PMC10555568.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9865713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous improvement in syringomyelia in a patient with Chiari 1 malformation: illustrative case.","authors":"Oyku Ozturk,&nbsp;Emetullah Cındıl,&nbsp;Hakan Emmez,&nbsp;Pelin Kuzucu,&nbsp;Emrah Celtıkcı","doi":"10.3171/CASE23210","DOIUrl":"10.3171/CASE23210","url":null,"abstract":"<p><strong>Background: </strong>\"Chiari malformation\" refers to a spectrum of hindbrain abnormalities characterized by impaired cerebrospinal fluid circulation through the foramen magnum. Syringomyelia is frequently found in patients with Chiari malformation type 1. Although many theories have suggested how cerebrospinal fluid enters and makes the cystic cavity in the spinal cord, the pathogenesis of syringomyelia remains controversial. This report documents a case with spontaneous resolution of syringomyelia followed up by 3-year serial magnetic resonance imaging (MRI). These kinds of cases support a more conservative approach.</p><p><strong>Observations: </strong>A 59-year-old female presented to the authors' clinic in June 2019 with a history of Chiari malformation type 1. This symptomatic patient has been followed up with serial MRI. When the last MRI was performed in August 2022, compared with previous imaging, resolution of the syringomyelia was recognized.</p><p><strong>Lessons: </strong>Because the natural evolution of mildly symptomatic/asymptomatic patients with syringes is unclear, these patients pose a treatment dilemma. Although surgical intervention is a widely accepted therapeutic method, a more conservative approach can be considered in cases with spontaneous resolution. Especially for patients without progressive symptoms, the surgical approach should not be considered as the first step. In view of relapses, follow-up with periodic neurological examinations and radiological imaging is preferrable.</p>","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"6 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3e/d0/CASE23210.PMC10555572.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9865710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traumatic bilateral lumbosacral facet dislocation without fracture: illustrative case.","authors":"Jose Castillo,&nbsp;Khadija Soufi,&nbsp;Freddie Rodriguez,&nbsp;Julius O Ebinu","doi":"10.3171/CASE23261","DOIUrl":"10.3171/CASE23261","url":null,"abstract":"<p><strong>Background: </strong>Traumatic bilateral lumbosacral facet dislocations without fractures are extremely rare. Only 7 cases have been documented since the first description by Watson-Jones in 1974. Although various treatment strategies have been reported, no consensus has been reached regarding the best surgical approach.</p><p><strong>Observations: </strong>A 35-year-old female presented for medical attention following a high-speed motor vehicle collision. She sustained multiple injuries, including an abdominal aortic injury requiring emergent thoracic endovascular aortic repair. She was found to have bilateral lumbosacral dislocation without fracture (L5-S1) and was noted to be neurologically intact. Once medically stabilized, the patient was taken to the operating room for minimally invasive reduction and stabilization of her lumbosacral spine. Postoperatively, the patient was neurologically intact and remained stable with no deficits and appropriate lumbosacral alignment throughout her 2-year follow-up.</p><p><strong>Lessons: </strong>The authors report a minimally invasive approach to the management of bilateral lumbosacral facet dislocation without fracture. Although conventional open approaches have been described previously, consideration should be given to minimally invasive strategies in select patients to facilitate their rehabilitative postoperative course.</p>","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"6 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7c/73/CASE23261.PMC10555645.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9824168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-assisted screw fixation in a cadaver utilizing magnetic resonance imaging-based synthetic computed tomography: toward radiation-free spine surgery. Illustrative case.","authors":"A Daniel Davidar,&nbsp;Brendan F Judy,&nbsp;Andrew M Hersh,&nbsp;Carly Weber-Levine,&nbsp;Safwan Alomari,&nbsp;Arjun K Menta,&nbsp;Kelly Jiang,&nbsp;Meghana Bhimreddy,&nbsp;Mir Hussain,&nbsp;Neil R Crawford,&nbsp;Majid Khan,&nbsp;Gary Gong,&nbsp;Nicholas Theodore","doi":"10.3171/CASE23120","DOIUrl":"10.3171/CASE23120","url":null,"abstract":"<p><strong>Background: </strong>Synthetic computed tomography (sCT) can be created from magnetic resonance imaging (MRI) utilizing newer software. sCT is yet to be explored as a possible alternative to routine CT (rCT). In this study, rCT scans and MRI-derived sCT scans were obtained on a cadaver. Morphometric analysis was performed comparing the 2 scans. The ExcelsiusGPS robot was used to place lumbosacral screws with both rCT and sCT images.</p><p><strong>Observations: </strong>In total, 14 screws were placed. All screws were grade A on the Gertzbein-Robbins scale. The mean surface distance difference between rCT and sCT on a reconstructed software model was -0.02 ± 0.05 mm, the mean absolute surface distance was 0.24 ± 0.05 mm, and the mean absolute error of radiodensity was 92.88 ± 10.53 HU. The overall mean tip distance for the sCT versus rCT was 1.74 ± 1.1 versus 2.36 ± 1.6 mm (p = 0.24); mean tail distance for the sCT versus rCT was 1.93 ± 0.88 versus 2.81 ± 1.03 mm (p = 0.07); and mean angular deviation for the sCT versus rCT was 3.2° ± 2.05° versus 4.04°± 2.71° (p = 0.53).</p><p><strong>Lessons: </strong>MRI-based sCT yielded results comparable to those of rCT in both morphometric analysis and robot-assisted lumbosacral screw placement in a cadaver study.</p>","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"6 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/49/c3/CASE23120.PMC10555644.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9829524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rubrospinal activation during asleep subthalamic nucleus deep brain stimulation: a false localizing sign. Illustrative case.","authors":"Devon L Mitchell,&nbsp;John Pearce,&nbsp;Patrick King,&nbsp;Sepehr Sani","doi":"10.3171/CASE23100","DOIUrl":"10.3171/CASE23100","url":null,"abstract":"<p><strong>Background: </strong>Deep brain stimulation (DBS) can be a life-changing intervention for patients with Parkinson's disease (PD), but its success is largely dependent on precise lead placement. The subthalamic nucleus (STN) is one of the most common surgical targets of DBS, but the close anatomical and physiological resemblance of the STN to the mediocaudal red nucleus renders these landmarks difficult to distinguish.</p><p><strong>Observations: </strong>We present an atypical case in which targeted localization of the STN resulted in symptoms pathognomonic of rubrospinal tract (RST) stimulation. A 79-year-old female with a 12-year history of right-hand resting tremor due to medically refractory PD presented for asleep bilateral STN-DBS surgery. Right STN intraoperative testing revealed left hand and elbow flexion contractures, initially suggestive of corticospinal tract activation, despite imaging studies demonstrating reasonable lead placement in the central dorsolateral STN. The lead was moved anteromedially near the medial border of the STN, but stimulation at this location revealed similar but more robust flexor hand and arm contractures, without any extraocular muscle involvement. Thus, activation of the RST was suspected.</p><p><strong>Lessons: </strong>Isolated activation of the RST is possible during STN-DBS surgery. Its identification can help avoid false localization and suboptimal lead placement.</p>","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"6 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9c/3f/CASE23100.PMC10555643.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9824172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep brain stimulation in an adolescent with hypomyelination with atrophy of the basal ganglia and cerebellum due to a TUBB4A mutation: illustrative case.","authors":"Jennifer A MacLean,&nbsp;Jaya Nataraj,&nbsp;Joffre Olaya,&nbsp;Mark A Liker,&nbsp;Terence D Sanger","doi":"10.3171/CASE23158","DOIUrl":"10.3171/CASE23158","url":null,"abstract":"<p><strong>Background: </strong>Hypomyelination with atrophy of the basal ganglia and cerebellum (H-ABC) is a rare genetic disease due to a TUBB4A mutation, with motor features including dystonia. Deep brain stimulation (DBS) can be used to treat dystonia in pediatric populations, although the response is highly variable and preferential toward specific etiologies.</p><p><strong>Observations: </strong>A single pediatric subject with H-ABC received DBS using a staged procedure involving temporary depth electrode placement, identification of optimal stimulation targets, and permanent electrode implantation. After surgery, the patient significantly improved on both the Burke-Fahn-Marsden Dystonia Rating Scale and the Barry-Albright Dystonia Scale. The patient's response suggests that DBS can have potential benefit in H-ABC.</p><p><strong>Lessons: </strong>TUBB4A mutations are associated with a variety of clinical phenotypes, and there is a lack of clearly identified targets for DBS, with this case being the second reported instance of DBS in this condition. The staged procedure with temporary depth electrode testing is recommended to identify optimal stimulation targets. The response seen in this patient implies that such a staged procedure may provide benefit in other conditions where DBS targets are currently unknown, including rare genetic or metabolic conditions associated with movement disorders.</p>","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"6 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f3/b3/CASE23158.PMC10555642.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9826957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assigning developmental venous anomaly thrombosis to SARS-CoV-2 only when the causal connection has been proven.","authors":"Josef Finsterer","doi":"10.3171/CASE23131","DOIUrl":"10.3171/CASE23131","url":null,"abstract":"TO THE EDITOR: I read with interest the article by Ironside et al. on a 28-year-old male with right-sided parieto-occipital intracerebral bleeding due to thrombosis of a right occipital developmental venous anomaly (DVA) (Ironside N, Petrosian D, Abbas S, et al. Developmental venous anomaly thrombosis in a patient with coronavirus disease 2019-associated hypercoagulability: illustrative case. J Neurosurg Case Lessons. 2023;5[6]:CASE22487). The patient underwent emergent decompressive hemicraniectomy with external ventricular drain placement and received intravenous heparin. His modified Rankin scale score at the 2-month follow-up was 2. The study is excellent but has limitations that are cause for concern and should be discussed. The assumed causal relationship between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and DVA thrombosis with secondary lobar bleeding has not been proven. The index patient had a mild respiratory infection 4 weeks before the cerebral hemorrhage and tested positive for SARS-CoV-2 using a home antigen test. In a study of 316 paired samples, only 33 samples were positive for antigen testing and reverse transcriptase–polymerase chain reaction (RT-PCR) by both methods. The sensitivity of the antigen test was calculated to be only 84.6%. A second argument against a possible causal relationship is the long latency period of 4 weeks between the mild respiratory infection and presentation because of the cerebral bleeding. A caveat in this regard is that there is no mention of whether the patient was tested for SARS-CoV-2 on admission or whether the RT-PCR result was not reported. Moreover, tests for hypercoagulability were noninformative. Therefore, other pathophysiological mechanisms should be considered to explain DVA thrombosis. Because the patient also had arterial hypertension, we should know if his blood pressure was elevated at presentation. We should also know if he had regularly consumed nonalcoholic liquids and if he had a leisurely or active lifestyle. Surprisingly, the workup for hypercoagulability was noninformative. Because venous thrombosis is usually accompanied by increased D-dimer, we should know if this parameter was actually normal or if it was not determined before craniotomy. It would also be interesting to know whether the patient was tested for any infectious or immunological parameters, particularly C-reactive protein, leukocyte count, lymphocyte typing, cytokines, and chemokines. Was his platelet function checked, and was it normal? Overall, the interesting study has limitations that call the results and their interpretation into question. Addressing these issues would strengthen the conclusions and could improve the status of the study. As long as the causal connection between SARS-CoV-2 and thrombosis of a DVA has not been clearly proven, a causal connection cannot be established.","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/71/17/CASE23131.PMC10555633.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9795115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intratumoral abscess complicating a postradiation-induced World Health Organization grade II meningioma: illustrative case.","authors":"Katherine Callahan,&nbsp;Isidora Beach,&nbsp;Sadie Casale,&nbsp;John DeWitt,&nbsp;Bruce Tranmer","doi":"10.3171/CASE23146","DOIUrl":"10.3171/CASE23146","url":null,"abstract":"<p><strong>Background: </strong>Cerebral meningiomas and brain abscesses are common independently, but intrameningioma abscesses rarely occur, with only 15 cases in the literature. These abscesses most frequently develop in patients with a known source of bacteremia; only one case of intrameningioma abscess without a known source of infection has been reported previously.</p><p><strong>Observations: </strong>This is the second reported case of an intrameningioma abscess without a clear source of infection, occurring in a 70-year-old female with a history of transsphenoidal craniopharyngioma resection and radiation many years prior. She presented with severe fatigue and altered mental status initially ascribed to adrenal insufficiency, and magnetic resonance imaging showed a new heterogeneously enhancing left temporal mass with surrounding edema. After urgent tumor resection, pathology demonstrated a World Health Organization grade II meningioma (radiation induced). After a course of steroids and intravenous nafcillin, the patient recovered without neurological deficits.</p><p><strong>Lessons: </strong>The natural history of intrameningioma abscesses is not fully understood. These uncommon lesions can form secondary to hematogenous spread facilitated by meningiomas' robust vascularization, typically in patients with bacteremia. Even when no significant source of infection is identified, the differential diagnosis of intrameningioma abscess should be considered because this pathology can be rapidly progressive, even fatal, but is treatable if recognized promptly.</p>","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/53/ea/CASE23146.PMC10555632.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9795119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resection of a ventral intramedullary spinal cord ependymoma through an anterior cervical approach: illustrative case.","authors":"Hani Chanbour,&nbsp;Patrick D Kelly,&nbsp;Michael C Topf,&nbsp;Michael C Dewan,&nbsp;Peter J Morone,&nbsp;Scott L Zuckerman","doi":"10.3171/CASE23243","DOIUrl":"10.3171/CASE23243","url":null,"abstract":"<p><strong>Background: </strong>Although posterior myelotomy leaves patients with dorsal column deficits, few reports have explored the anterior cervical approach for cervical intramedullary tumors. The authors describe the resection of a cervical intramedullary ependymoma through an anterior approach with a two-level corpectomy and fusion.</p><p><strong>Observations: </strong>A 49-year-old male presented with a C3-5 ventral intramedullary mass with polar cysts. Because of the ventral location of the tumor and the added benefit of avoiding a posterior myelotomy and dorsal column deficits, an anterior C4-5 corpectomy offered a direct route and excellent visualization of the ventrally located tumor. After a C4-5 corpectomy, microsurgical resection, and C3-6 anterior fusion with a fibular allograft filled with autograft, the patient remained neurologically intact. Magnetic resonance imaging (MRI) on postoperative day (POD) 1 confirmed gross-total resection. The patient was extubated on POD 2 and was discharged home on POD 4 with a stable examination. At 9 months, the patient developed mechanical neck pain refractory to conservative treatment and underwent a posterior fusion to address pseudarthrosis. MRI at 15 months showed no evidence of tumor recurrence with the resolution of neck pain.</p><p><strong>Lessons: </strong>An anterior cervical corpectomy provides a safe corridor to access ventral cervical intramedullary tumors and avoids posterior myelotomy. Although the patient required a three-level fusion, we believe the tradeoff of decreased motion compared to dorsal column deficits is preferred.</p>","PeriodicalId":16554,"journal":{"name":"Journal of Neurosurgery: Case Lessons","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cf/0d/CASE23243.PMC10555634.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9795124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}