Neurosurgery最新文献

{"title":"Primary or Salvage Stereotactic Radiosurgery for Meningiomas Invading the Superior Sagittal Sinus.","authors":"Chris Z Wei, Hansen Deng, Ujwal Yeole, Jack K Donohue, Shalini Jose, Mishika Mehta, Luigi Albano, Suchet Taori, Constantinos G Hadjipanayis, Ajay Niranjan, L Dade Lunsford","doi":"10.1227/neu.0000000000003619","DOIUrl":"https://doi.org/10.1227/neu.0000000000003619","url":null,"abstract":"<p><strong>Background and objectives: </strong>Meningiomas invading the superior sagittal sinus (SSS) present significant challenges for surgical management. Stereotactic radiosurgery (SRS) is increasingly used as a primary or salvage management in these difficult cases. The aims of this study were to evaluate the rate of long-term tumor control and the long-term neurological outcomes.</p><p><strong>Methods: </strong>The authors retrospectively reviewed outcomes in 248 patients (152 females, 67.3%; median age, 61 years) with SSS invasive meningiomas who underwent primary or salvage SRS during a 22-year interval. The clinical presentation, radiographic characteristics, and neurological function of each patient were recorded. A total of 140 patients underwent resection before SRS for their SSS meningiomas. Overall, 56% of the patient had tumors involve the posterior one-third of the SSS; 51.6% of patients presented with peritumoral edema before SRS.</p><p><strong>Results: </strong>The 1-, 2-, 5-, and 10-year local tumor control (LTC) rates were 97.7%, 94.1%, 85.7%, and 78.3%, respectively. Upfront SRS for SSS-invading meningiomas provided LTC comparable with that observed with salvage SRS for histologically confirmed WHO Grade I meningiomas (hazard ratio 0.86, CI 95% 0.33-2.24, P = .76). Tumor volumes <5.2 cc predicted better LTC (hazard ratio 5.1, CI 95% 1.9-19.3, P = .03). The median overall survival after SRS was 14.6 years. Ten patients (4%) died related to documented local intracranial tumor progression. A total of 12 patients (4.8%) developed symptomatic adverse radiation effects at median duration post-SRS of 14 months (range 2-182 months). Motor function improved in 20% patients who presented with motor weakness, after SRS.</p><p><strong>Conclusion: </strong>SRS is safe and effective in managing small to medium sized SSS invading meningiomas, especially when the tumors involve the posterior one-third of the SSS. For larger SSS meningioma with symptomatic mass effect, adjuvant SRS for residual or recurrent tumors provides long-term tumor control.</p>","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144541600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intracranial Dural Arteriovenous Fistulas With and Without Pial Artery Supply: Analysis of Treatment Outcomes.","authors":"Xin Su, Yongjie Ma, Zihao Song, Huiwei Liu, Chao Zhang, Huishen Pang, Yiguang Chen, Mingyue Huang, Jiaxing Yu, Liyong Sun, Guilin Li, Tao Hong, Ming Ye, Peng Hu, Peng Zhang, Hongqi Zhang","doi":"10.1227/neu.0000000000003604","DOIUrl":"https://doi.org/10.1227/neu.0000000000003604","url":null,"abstract":"<p><strong>Background and objectives: </strong>The prevalence of pial arterial supply (PAS) to intracranial dural arteriovenous fistulas (DAVFs) and its implications for the management of these fistulas have been limited to relatively small cohort studies and remain somewhat controversial. We conducted a retrospective study to characterize PAS in DAVFs and explore its implications for treatment.</p><p><strong>Methods: </strong>Consecutive patients evaluated over a 21-year period were retrospectively reviewed. Angiograms were examined to characterize the angioarchitecture of DAVFs and identify the presence of PAS. PAS was classified into 2 types: dilated preexisting dural branches and pure pial supply. Baseline characteristics, treatment approaches, and treatment and follow-up outcomes were compared between the DAVF cohorts with and without PAS. To minimize patient selection bias, the 2 cohorts were matched in a 1:1 ratio using propensity score matching.</p><p><strong>Results: </strong>In this cohort, 259 out of 1101 patients (23.5%) exhibited an additional PAS. Multivariate analysis identified 7 independent predictors of PAS: younger age (P < .001), longer disease duration (P = .021), multiple DAVFs (P < .001), tentorial DAVFs (P < .001), transverse-sigmoid sinus DAVFs (P < .001), and the presence of venous ectasia (P = .019) and congestion (P < .001). Complication rates were higher in the PAS group, particularly for postoperative hemorrhage (P < .001) and ischemia-related complications (P < .001), which remained significant even after propensity score matching (P = .013 and P = .001).</p><p><strong>Conclusion: </strong>The findings suggest that embolization of PAS before DAVF closure may significantly increase the risk of both intracranial hemorrhagic and ischemic complications. Therefore, routine embolization of PAS before DAVF closure is not supported by these results, particularly given the exceptionally low incidence of presumed hemorrhagic complications arising from an unobliterated \"pure\" pial supply before DAVF obliteration.</p>","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144541599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External Ventricular Drain Versus Intraparenchymal Pressure Monitor in Severe Traumatic Brain Injury: A TRACK-TBI Study.","authors":"Madeline E Greil, Jason K Barber, Nancy R Temkin, Robert H Bonow, Geoffrey T Manley, Brandon Foreman, Randall M Chesnut","doi":"10.1227/neu.0000000000003594","DOIUrl":"https://doi.org/10.1227/neu.0000000000003594","url":null,"abstract":"<p><strong>Background and objectives: </strong>The 2 most common intracranial pressure (ICP)-monitoring devices in traumatic brain injury (TBI) are external ventricular drains (EVDs) and intraparenchymal monitors (IPMs). EVDs and IPMs differ in functionality and debate remains as to whether device selection affects patient outcomes. We aimed to determine whether the use of EVDs or IPMs for ICP monitoring was associated with better outcomes using data from severe TBI patients prospectively enrolled in the 18-center US Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) study.</p><p><strong>Methods: </strong>We included patients aged 17 years or older with severe (Glasgow Coma Scale 3-8), nonpenetrating TBI who underwent placement of an EVD or IPM within 24 hours of arrival to a TRACK-TBI study center. Groups were compared using the Fisher exact or Mann-Whitney tests, before and after propensity weighting to attempt to better balance the groups. The primary outcome was 6-month Glasgow Outcome Scale-Extended for TBI (GOSE-TBI). Secondary outcomes include hospital length of stay, survival on discharge, and 6-month neuropsychological outcomes.</p><p><strong>Results: </strong>We analyzed 189 patients, 115 monitored with an EVD and 74 with an IPM. There was no significant difference in median 6-month GOSE-TBI between the EVD and IPM groups, 3 (2-5) and 3 (1-5), respectively (P = .201). A greater proportion of EVD patients were alive at hospital discharge (83% vs 69%), but this was no longer significant after propensity weighting (P = .091). Hospital length of stay for survivors was similar (28.0 ± 18.7 days for EVD vs 30.1 ± 24.7 days for IPM, P = .986). There were no significant differences in neuropsychological outcomes.</p><p><strong>Conclusion: </strong>Our study of a multicenter severe TBI cohort did not find a significant difference in 6-month GOSE-TBI between patients monitored with an EVD and those monitored with an IPM. When correcting for other patient characteristics, the selection of ICP monitor type may not affect acute hospital or 6-month functional outcomes.</p>","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Artificial Intelligence Tool for the Diagnosis of Facial Pain.","authors":"Kim J Burchiel, Suzanne Bergman, Michael McGehee, James Obayashi","doi":"10.1227/neu.0000000000003610","DOIUrl":"https://doi.org/10.1227/neu.0000000000003610","url":null,"abstract":"<p><strong>Background and objectives: </strong>Differentiation between temporomandibular disorders (TMDs) and trigeminal neuralgia (TN) as causes of orofacial pain is very important because the nature of these disorders and their treatments are vastly different. TMDs are usually treated with a rehabilitative approach, although dental correction or even surgery may be necessary in rare cases where the origin of the pain appears to be related to oral or temporomandibular joint pathology. By contrast, TN is largely treated with anticonvulsant medications, trigeminal nerve surgery, or trigeminal ablative procedures. TMDs are several orders of magnitude more common than TN, which may result in misdiagnosis and mistreatment if the proper diagnosis is not made initially.</p><p><strong>Methods: </strong>We completed a study of 101 patients with either TMD or TN using supervised machine learning. A predictive model was developed using the 2 inputs of a questionnaire and directed physical examination.</p><p><strong>Results: </strong>The network was trained to achieve the corresponding correct output, which was based on orofacial physical examination and expert diagnosis of each subject.</p><p><strong>Conclusion: </strong>The analysis of this network indicated that TMDs and TN can be reliably differentiated using a standardized questionnaire and physical examination with approximately 90% accuracy.</p>","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Nidus Occlusion After Radiosurgery in Brain Arteriovenous Malformations-A Prospective Study Using Arterial Spin Labeling.","authors":"Dorian Hirschmann, Wolfgang Marik, Anna Cho, Philippe Dodier, Wei-Te Wang, Arthur Hosmann, Brigitte Gatterbauer, Christian Dorfer, Wolfgang Serles, Lukas Haider, Gregor Kasprian, Josa Maria Frischer","doi":"10.1227/neu.0000000000003590","DOIUrl":"https://doi.org/10.1227/neu.0000000000003590","url":null,"abstract":"<p><strong>Background and objectives: </strong>The gold standard for the evaluation of brain arteriovenous malformation (AVM) nidus occlusion after stereotactic radiosurgery is digital subtraction angiography (DSA), which is an invasive technique. We evaluated the role of MRI, especially arterial spin labeling (ASL) in the assessment of nidus occlusion after radiosurgery. DSA was used as the gold standard for comparison.</p><p><strong>Methods: </strong>Fifty radiosurgically treated brain AVMs were included in this prospective single-center study. All patients underwent a standardized MRI protocol including following sequences: 2-dimensional T2w (TSE) in 3 planes, T1-weighted Magnetization Prepared Rapid Gradient Echo (MPRAGE), axial resolve diffusion-weighted imaging, ASL, time of flight, and time-resolved angiography with interleaved stochastic trajectories. Nidus obliteration according to the standardized MRI protocol was evaluated by an experienced neuroradiologist within 3 days after image acquisition and before DSA was subsequently performed as the reference standard. A second observer retrospectively rated MRI images of all 50 cases blinded to clinical and DSA data after the prospective study was concluded.</p><p><strong>Results: </strong>All cases rated as obliterated by the MRI protocol were confirmed by DSA. However, 26 and 28 AVMs were rated as patent by the observers, which was verified in 22 (85/79%) cases by DSA. ASL had the highest sensitivity among all MRI sequences. In 3 patients, ASL was the only sequence that correctly revealed a residual nidus according to 1 observer. Overall, the sensitivity and specificity of the standardized MRI protocol for detection of a residual nidus were 100/100% and 86/79%, respectively. The interobserver agreement was excellent (κ = 0.92, 0.81-1.00). At last follow-up of this prospective study, 70% of AVMs were completely obliterated.</p><p><strong>Conclusion: </strong>MRI evaluation of nidus occlusion including ASL is highly sensitive for residual nidus detection and has a high potential to replace invasive DSA examinations for patients who underwent radiosurgery of brain AVMs.</p>","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Return-to-Sport Recommendations for Athletes With Congenital Cervical Spine Pathology: A Modified Delphi Consensus Survey of Expert Opinion.","authors":"Scott L Zuckerman, Jacob Jo, Grant H Rigney, Julian E Bailes, Christopher M Bonfield, Robert C Cantu, Patrick C H Chan, Andrew M Cordover, Domagoj Coric, Hank Feuer, Raymond J Gardocki, Andrew C Hecht, Wellington K Hsu, Jacob R Joseph, Ronald A Lehman, Allan D Levi, Susan M Liew, Philip K Louie, Steven C Ludwig, Joseph Maroon, Vincent J Miele, Jeff Mullin, Venu M Nemani, Frank M Phillips, Sheeraz Qureshi, K Daniel Riew, Myron A Rogers, Rick C Sasso, Gabriel A Smith, Jay D Turner, Alexander R Vaccaro, Robert G Watkins, Nicholas Theodore, David O Okonkwo, Allen K Sills, Gavin A Davis","doi":"10.1227/neu.0000000000003576","DOIUrl":"https://doi.org/10.1227/neu.0000000000003576","url":null,"abstract":"<p><strong>Background and objectives: </strong>Recommendations guiding participation in sports for athletes with congenital cervical spine pathology are lacking, and management of these athletes remains challenging. Thus, the objective was to perform a modified Delphi consensus survey of expert opinion on return-to-sport (RTS) decisions in athletes with congenital cervical spine pathologies.</p><p><strong>Methods: </strong>A cross-sectional, modified Delphi consensus survey investigating RTS decisions in athletes with various types of congenital cervical spine pathology was undertaken. An international panel of neurosurgery/orthopedic spine surgeons with sport expertise was identified. The cervical spine pathologies studied were craniocervical anomalies, Klippel-Feil syndrome, os odontoideum, Chiari malformation, and congenital cervical stenosis. A 2 × 2 scheme was used to classify sport risk based on impact forces and frequency: low impact/low frequency, low impact/high frequency, high impact/low frequency, and high impact/high frequency. Consensus was a-priori defined at ≥70%. Descriptive statistics were performed.</p><p><strong>Results: </strong>Of the 34 sports spine surgeons invited (56% neurosurgeons and 44% orthopedic surgeons), survey completion was 100%. The following scenarios achieved ≥70% consensus to recommend athletes to return-to-play high impact/high frequency sports: C1 ring anomaly and no prior neurapraxic event, occipitalized C1, Klippel-Feil of 1 motion segment with/without kyphosis, and asymptomatic Chiari malformation without syrinx. Consensus was also achieved that an athlete with congenital stenosis who has experienced at least 2 neurapraxic events should be advised not to RTS. Although consensus was not achieved in other areas, notable findings are discussed.</p><p><strong>Conclusion: </strong>The following scenarios reached ≥70% consensus recommending athletes to return to high impact/high frequency sports: C1 ring anomaly without a prior neurapraxic event, occipitalized C1, Klippel-Feil syndrome involving 1 motion segment, and asymptomatic Chiari malformation without a syrinx. In addition, consensus was reached advising athletes with congenital stenosis with 2 or more neurapraxic events not to RTS. Although consensus was not obtained in other areas, notable findings are discussed.</p>","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter: A Reflection on Nursing in Neurosurgery.","authors":"Erin Conahan, Katherine Archer, Kimberly Meyer","doi":"10.1227/neu.0000000000003600","DOIUrl":"https://doi.org/10.1227/neu.0000000000003600","url":null,"abstract":"","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Return-to-Sport Recommendations for Athletes With Cervical Spine Trauma: A Modified Delphi Consensus Survey of Expert Opinion.","authors":"Scott L Zuckerman, Jacob Jo, Grant H Rigney, Julian E Bailes, Christopher M Bonfield, Robert C Cantu, Patrick C H Chan, Andrew M Cordover, Domagoj Coric, Hank Feuer, Raymond J Gardocki, Andrew C Hecht, Wellington K Hsu, Jacob R Joseph, Ronald A Lehman, Allan D Levi, Susan M Liew, Philip K Louie, Steven C Ludwig, Joseph Maroon, Vincent J Miele, Jeff Mullin, Venu M Nemani, Frank M Phillips, Sheeraz Qureshi, K Daniel Riew, Myron A Rogers, Rick C Sasso, Gabriel A Smith, Jay D Turner, Alexander R Vaccaro, Robert G Watkins, Nicholas Theodore, David O Okonkwo, Allen K Sills, Gavin A Davis","doi":"10.1227/neu.0000000000003564","DOIUrl":"https://doi.org/10.1227/neu.0000000000003564","url":null,"abstract":"<p><strong>Background and objectives: </strong>Recommendations regarding return to sport (RTS) for athletes who have experienced cervical spine trauma are lacking, and management of these athletes remains challenging. The objective of this article was to perform a modified Delphi consensus survey of expert opinion on RTS in athletes who have suffered a traumatic injury to the cervical spine.</p><p><strong>Methods: </strong>A cross-sectional, modified Delphi consensus survey examining RTS decisions in athletes with a history of a traumatic injury to the cervical spine was undertaken. A panel of international neurosurgery and orthopedic spine surgeons with expertise in sport was identified. Sport risk was classified through a 2 × 2 scheme based on impact forces and frequency: 1 = low impact/low frequency; 2 = low impact/high frequency; 3 = high impact/low frequency; and 4 = high impact/high frequency. Consensus was set a priori at ≥70%. Descriptive statistics were performed.</p><p><strong>Results: </strong>Survey completion was 100% among the 34 sports spine surgeons invited (56% neurosurgeons and 44% orthopedic surgeons). The following scenarios achieved ≥70% consensus to recommend advising athletes to return to play high impact /high frequency forces sport: healed fractures of C1, C2; subaxial facet/laminar/body fractures; fibrous union of a prior laminar fracture; and cervical disk abutting cord without compression. Notable findings, including areas that did not reach consensus, are discussed.</p><p><strong>Conclusion: </strong>Following a modified Delphi survey on RTS in athletes with spine pathology, the following scenarios reached consensus to RTS to high impact/high frequency forces sports: healed fractures of C1, C2; fractures of the subaxial facet/lamina/body; fibrous union of a prior laminar fracture; and cervical disk abutting the cord without compression. However, many scenarios of unhealed cervical spine fractures with fibrous union did not reach consensus.</p>","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter: Resting State Functional Networks in Gliomas: Validation With Direct Electric Stimulation Using a New Tool for Planning Brain Resections.","authors":"Antonia Cadavid-Cobo, Juliana Arteaga, Alexandra Ramos-Márquez, Edgar G Ordóñez-Rubiano","doi":"10.1227/neu.0000000000003601","DOIUrl":"https://doi.org/10.1227/neu.0000000000003601","url":null,"abstract":"","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Reply: Resting State Functional Networks in Gliomas: Validation With Direct Electric Stimulation Using a New Tool for Planning Brain Resections.","authors":"Manuela Moretto, Beatrice Federica Luciani, Luca Zigiotto, Francesca Saviola, Stefano Tambalo, Donna Gift Cabalo, Luciano Annicchiarico, Martina Venturini, Jorge Jovicich, Silvio Sarubbo","doi":"10.1227/neu.0000000000003602","DOIUrl":"https://doi.org/10.1227/neu.0000000000003602","url":null,"abstract":"","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}