Acta Neurochirurgica最新文献

{"title":"MR-guided Laser Interstitial Thermal Therapy mesencephalotomy for medically intractable malignant pain","authors":"Mickael Aubignat,&nbsp;Jean-Marc Constans,&nbsp;Martial Ouendo,&nbsp;Jean-Philippe Arnault,&nbsp;Claire Josse,&nbsp;Christine Desenclos,&nbsp;Michel Lefranc","doi":"10.1007/s00701-025-06544-1","DOIUrl":"10.1007/s00701-025-06544-1","url":null,"abstract":"<div><p>Stereotactic mesencephalotomy is a neurosurgical technique designed to sever spinothalamic pain transmission pathways for medically intractable pain. This report presents the first case of Magnetic Resonance-guided Laser Interstitial Thermal Therapy (MRgLITT) mesencephalotomy for severe malignant pain due to metastatic melanoma. The procedure significantly reduced the patient’s pain, with a postoperative visual analog scale (VAS) score decreasing from &gt; 7 to &lt; 3. No adverse effects were observed. The case underscores the potential of MRgLITT mesencephalotomy as a precise, minimally invasive option for pain management in palliative care settings.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06544-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor regarding “Is Knosp enough? A novel classification for Acromegaly: a retrospective analysis of cure rates and outcome predictors in a large tertiary centre”","authors":"Victor E. Staartjes,&nbsp;Luca Regli,&nbsp;Carlo Serra","doi":"10.1007/s00701-025-06511-w","DOIUrl":"10.1007/s00701-025-06511-w","url":null,"abstract":"","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06511-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143892705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of primary referral patterns and return to work in patients with incident back pain due to lumbar disc herniation","authors":"Mikkel Kjeldgaard,&nbsp;Berit Schiøttz-Christensen,&nbsp;Janus Nikolaj Laust Thomsen,&nbsp;Christian Volmar Skovsgaard,&nbsp;Carsten Reidies Bjarkam","doi":"10.1007/s00701-025-06546-z","DOIUrl":"10.1007/s00701-025-06546-z","url":null,"abstract":"<div><h3>Objective</h3><p>To examine primary referral patterns and return to work in patients with incident back pain due to Lumbar Disc Herniation (LDH).</p><h3>Methods</h3><p>Nationwide register-based cohort study including all Danish residents aged 18–65 who were referred from primary to specialized healthcare in 2017 with incident back pain and subsequently received a diagnosis of lumbar disc herniation (LDH), defined by ICD-10 codes DM51X.X. Patients were identified using the Danish National Patient Registry (DNPR), including both those directly diagnosed with LDH and those who initially received a diagnosis of nonspecific low back pain (ICD-10: DM54) that progressed to LDH within one year. Demographic data were obtained from the Danish Civil Registration System (CRS), and work capacity outcomes were assessed over a two-year follow-up using the Danish Register for Evaluation of Marginalization (DREAM).</p><h3>Results</h3><p>A total of 30,082 persons, corresponding to 0.8% of the Danish population aged 18–65, were referred from primary health care to specialized health care with incident back pain and a final diagnosis of LDH. Of these, 5356 (17.8%) were referred to an emergency department, 14,628 (48.6%) to a medical department, and 10,098 (33.6%) to a surgical department. However, the admission rate and the initial department referred to varied widely between regions. Overall, 1915 (6.4%) underwent surgery. Surgical departments operated more frequently on patients with previous high (11%) or intermediate (14%) work capacity than on those with low work capacity (4%), although the latter were more often referred for surgical evaluation. Over 80% of patients with high or intermediate work capacity maintained or returned to work within a year.</p><h3>Conclusion</h3><p>In Denmark, referral from primary to specialized health care of patients with incident back pain due to LDH varies considerable between regions highlighting the need for more standardized referral pathways. Specifically, ensuring a better balance between emergency, medical, and surgical referrals could reduce unnecessary emergency admissions and improve the precision of surgical referrals optimizing the use of surgical capacity and healthcare resources in general.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06546-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143892741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of ultrasound and MRI in the diagnosis of common peroneal nerve injuries","authors":"Lauren E. Tagliero,&nbsp;Courtney R. Carlson Strother,&nbsp;Robert J. Spinner,&nbsp;Allen T. Bishop,&nbsp;Alexander Y. Shin","doi":"10.1007/s00701-025-06542-3","DOIUrl":"10.1007/s00701-025-06542-3","url":null,"abstract":"<div><h3>Background</h3><p>This study aimed to determine the accuracy of ultrasound (US) and MRI compared to intraoperative findings in patients who underwent surgery for their common peroneal nerve (CPN) injury.</p><h3>Methods</h3><p>Patients who underwent surgical management of a CPN injury with preoperative US were reviewed. The status of the CPN as interpreted by the radiologist in the preoperative US and MRI were recorded. The intraoperative findings of the CPN were compared to the imaging findings. The CPN was classified as intact, partial injury, or complete transection. The location of the injury, and presence of a neuroma-in-continuity or stump neuroma were recorded. The sensitivity and specificity of US for diagnosis of a complete transection and an intact CPN were calculated.</p><h3>Results</h3><p>Thirteen patients were included in this study. Preoperative US accurately diagnosed a complete transection in 3 out of 4 patients and an intact CPN in 4 out of 5 patients. MRI did not accurately identify the status of the CPN in any patients. US had 75% sensitivity and 78% specificity for detecting complete transection, and 80% sensitivity and 63% specificity for detecting an intact CPN. The level of injury was correctly identified in 7 out of 13 cases by US and 1 out of 8 cases by MRI. A neuroma was correctly identified in 7 of 11 cases by US and 1 out of 8 cases by MRI.</p><h3>Conclusion</h3><p>US has a high sensitivity and specificity when diagnosing CPN lesions and was more accurate than MRI.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06542-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143892709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting Härtel’s technique for percutaneous transoval glycerol injection","authors":"Haldor Slettebø,&nbsp;Tomas Sakinis","doi":"10.1007/s00701-025-06526-3","DOIUrl":"10.1007/s00701-025-06526-3","url":null,"abstract":"<div><h3>Purpose</h3><p>Percutaneous transoval glycerol injection (GI) has been widely used since 1981 in the treatment of patients with trigeminal neuralgia. However, outcomes have been more variable than with other percutaneous treatments. Although most authors state that they use Härtel’s technique, the variations are numerous—which may explain procedural problems and most of the poor results. The aim of the present imaging-based study, therefore, was to revisit Härtel’s technique and identify optimal landmarks for guiding the needle from the cheek to Meckel’s cave.</p><h3>Methods</h3><p>Eleven patients referred for trigeminal neuralgia were studied. We used CT- and MRI-based simulations to determine the optimal entry points in the cheek and trajectories through foramen ovale (FO) to reach Meckel’s cave – and compared our findings with the results from Härtel’s original study.</p><h3>Results</h3><p>The optimal entry point was located at 2 mm below the horizontal plane through the angle of the mouth and just in front of the anterior edge of the mandibular ramus. From this entry point—situated around 10 mm below Härtel’s preferred entry point—Meckel’s cave was easily accessible through the medial part of FO in 17 of 22 sides.</p><h3>Conclusion</h3><p>The findings from this study suggest that the technical results of transoval glycerol injection can be improved if we 1. Select the optimal entry point, 2. Guide the needle under fluoroscopy through the medial part of the foramen ovale, and 3. Minimize movement of the soft tissues in the cheek.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06526-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143888710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repeated stereotactic radiosurgery for residual intracranial dural arteriovenous fistulas","authors":"Tzu-Chiang Peng,&nbsp;Chun-Fu Lin,&nbsp;Ai Seon Kuan,&nbsp;Hsiu-Mei Wu,&nbsp;Cheng-Chia Lee,&nbsp;Chung-Jung Lin,&nbsp;Huai-Che Yang","doi":"10.1007/s00701-025-06536-1","DOIUrl":"10.1007/s00701-025-06536-1","url":null,"abstract":"<div><h3>Objective</h3><p>Stereotactic radiosurgery (SRS) is widely used for the treatment of intracranial dural arteriovenous fistulas (DAVFs); however, the outcomes of repeated SRS to deal with residual DAVFs are unclear. This study assessed the benefits and potential negative consequences of repeated SRS in patients with residual DAVFs.</p><h3>Methods</h3><p>This retrospective study examined all patients who underwent two SRS procedures for DAVFs in a single academic medical center between January 1998 and December 2022. Information related to patient demography, DAVFs characteristics, and clinical outcomes were obtained from medical records. The objective in this study was to obtain a preliminary overview of the results of repeated SRS for DAVFs.</p><h3>Results</h3><p>The study cohort of 19 patients included 14 patients with non-cavernous sinus (NCS) DAVFs and 5 patients with cavernous sinus (CS) DAVFs. The NCS group included 8 patients who were categorized as low-grade (Borden grade 1) and 6 as high-grade (Borden grade 2 or 3). The median follow up duration after the second session of SRS was 37 months. Symptomatic improvement was noted in 16 patients (84.2%) and total obliteration was identified in 11 patients (57.9%). No patient suffered from intracranial hemorrhage after the repeated SRS. One patient (5.3%) experienced symptomatic radiation-induced change mandating temporary course of medical treatment.</p><h3>Conclusions</h3><p>Repeated SRS appears to be a safe and effective approach to deal with residual DAVFs, resulting in symptomatic improvement and complete radiologic obliteration.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06536-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143883739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical experiences and accuracy of stereoelectroencephalography using the robotic arm Cirq","authors":"Kohei Kanaya,&nbsp;Asuka Nakamura,&nbsp;Daishiro Abe,&nbsp;Yutaro Sato,&nbsp;Mana Wakabayashi,&nbsp;Tomoya Shigehara,&nbsp;Daichi Watanabe,&nbsp;Yuki Yoshizawa,&nbsp;Tetsuhiro Fukuyama,&nbsp;Tetsuyoshi Horiuchi","doi":"10.1007/s00701-025-06541-4","DOIUrl":"10.1007/s00701-025-06541-4","url":null,"abstract":"<div><h3>Background</h3><p>Robot-assisted stereoelectroencephalography (SEEG) has become increasingly popular worldwide. Robotic arm Cirq (BrainLab, Munich, Germany) is an optional instrument for SEEG. This study aimed to evaluate the accuracy of electrode implantation using Cirq.</p><h3>Methods</h3><p>Data were retrospectively collected from 10 consecutive SEEG cases from July 2022 to August 2024 at our institute. Two cases of simultaneous SEEG and grid implantation via craniotomy were excluded. Eight SEEG cases (37 depth electrodes) were included in this study. We evaluated the accuracy of the electrode placement. The distances between the planned and actual site of entry and the target were measured in the anterior-posterior (Xe, Xt) and cranial-caudal (Ye, Yt) directions. The distance between the planned and the actual target site was measured at the surface depth (Zt). The two-dimensional differences of the entry (De₂) and target (Dt₂) and the three-dimensional differences, including the depth parameter of the target (Dt), were measured. The two-dimensional and three-dimensional Euclidean distances (ED₂, ED) were also calculated.</p><h3>Results</h3><p>The differences between the planned entry and the actual entry in Xe and Ye were 2.5 ± 1.6 mm and -0.6 ± 1.8 mm, respectively. De₂ was 3.2 ± 1.4 mm. The differences between the planned target and the actual target in Xt, Yt, and Zt were 2.1 ± 1.5 mm, 0.5 ± 1.5 mm, and 1.4 ± 2.9 mm, respectively. Dt₂ and Dt were 2.7 ± 1.4 mm and 4.1 ± 1.7 mm, respectively. ED₂ and ED were 1.8 ± 1.1 mm and 3.4 ± 1.8 mm, respectively.</p><h3>Conclusions</h3><p>We reported our initial experience with a high accuracy and features of the Cirq robotic arm for SEEG procedures using the standard surface matching method.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06541-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143883737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brainshift correction using navigated intraoperative ultrasound informs intraoperative decision-making during glioma surgery","authors":"Ashwin Rai,&nbsp;Vikas Singh,&nbsp;Prakash Shetty,&nbsp;Aliasgar V Moiyadi","doi":"10.1007/s00701-025-06457-z","DOIUrl":"10.1007/s00701-025-06457-z","url":null,"abstract":"<div><h3>Background</h3><p>Brainshift can hamper the accuracy of neuronavigation systems in intra-axial tumor surgery. Correction of brainshift becomes imperative to avoid loss of accuracy and erroneous assessment of residual tumor as well as its relationship to critical eloquent substrates.</p><h3>Method</h3><p>This paper describes a case of a frontal tumor close to motor cortex. Workflow for rigid image fusion (RIF) based iUS-MR correction of brainshift is demonstrated highlighting its accuracy and clinical value in assessing tumor margins as well as functional boundaries.</p><h3>Conclusion</h3><p>iUS-MR fusion provides a cost-effective, accurate and practical solution for observation and correction of brainshift. </p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06457-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143883738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical indications and patient outcomes of intracranial venous sinus stenting beyond overt idiopathic intracranial hypertension: a scoping review","authors":"Shiva A. Nischal,&nbsp;Rocío Fernández-Méndez,&nbsp;Vasu Gautam,&nbsp;Shaan Patel,&nbsp;Catherine J. McMahon,&nbsp;Peter J. Hutchinson,&nbsp;John D. Pickard,&nbsp;J. Nicholas P. Higgins,&nbsp;Alexis J. Joannides","doi":"10.1007/s00701-025-06514-7","DOIUrl":"10.1007/s00701-025-06514-7","url":null,"abstract":"<div><h3>Background</h3><p>Intracranial venous sinus stenting (VSS) was initially developed as an alternative approach to addressing venous outflow obstruction in the context of idiopathic intracranial hypertension (IIH). In recent years, the technique has been increasingly used for other conditions involving venous compromise beyond overt IIH. The aim of this study was to describe the nature and volume of literature considering clinical applications and efficacy of VSS.</p><h3>Methods</h3><p>A scoping review was conducted using MEDLINE, EMBASE, Scopus, The Cochrane Library, and various grey literature sources. Articles published since the introduction of VSS in 2002 were included. Independent screening of articles occurred in two stages: title-and-abstract and full-text screening. Relevant data was extracted and evidence mapping with narrative synthesis followed.</p><h3>Results</h3><p>The search strategy yielded 1814 articles, of which 165 were included in this review. A total of 27 additional clinical indications of VSS beyond overt IIH were identified, spanning a diverse range of neurological pathology. Most evidence came from case reports, with the United States being the commonest study origin. Focal stenotic lesions and stenting locations were distributed throughout the dural sinus anatomy. An outline of patient outcomes reported by VSS providers is presented, with pulsatile tinnitus and visual impairment showing the greatest likelihood of clinical resolution.</p><h3>Conclusion</h3><p>This scoping review demonstrates the wider clinical utility and therapeutic potential of VSS beyond overt IIH. We also highlight the need for further studies to assess efficacy for each respective indication and clinical standardisation of VSS practice.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06514-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143871383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gamma Knife radiosurgery for brain arteriovenous malformations – a single-center experience","authors":"Mirea Hancevic,&nbsp;Jakob Nemir,&nbsp;Sergej Marasanov,&nbsp;Hrvoje Hrsak,&nbsp;Luka Luketin,&nbsp;Ivan Peric,&nbsp;David Ozretic,&nbsp;Ivan Jovanovic,&nbsp;Marko Rados,&nbsp;Ervina Bilic,&nbsp;Goran Mrak,&nbsp;Zdravko Heinrich","doi":"10.1007/s00701-025-06523-6","DOIUrl":"10.1007/s00701-025-06523-6","url":null,"abstract":"<div><h3>Background</h3><p>Gamma Knife stereotactic radiosurgery (SRS) has emerged as a non-invasive and effective treatment for brain arteriovenous malformations (AVM), particularly in cases where surgical resection is not feasible. The factors influencing AVM obliteration following Gamma Knife radiosurgery remain incompletely understood and differing results across studies indicate the need for further research. This study reviews a single center’s 20-year experience with Gamma Knife radiosurgery for AVMs, evaluating factors associated with successful treatment outcomes.</p><h3>Methods</h3><p>A retrospective analysis was conducted on 241 patients treated with Gamma Knife SRS for intracranial AVMs at University Hospital Center Zagreb between 2004 and 2021. Patient demographics, AVM characteristics, prior treatments, radiosurgical parameters, and clinical outcomes were analyzed. AVM obliteration was assessed using MR angiography and digital subtraction angiography. Binary logistic regression and Cox regression analysis were performed to identify factors associated with treatment success and shorter time to obliteration.</p><h3>Results</h3><p>AVM obliteration was achieved in 171 patients (71%), with a mean time to complete obliteration of 3 years. Higher prescription doses correlated with increased obliteration rates (<i>p</i> &lt; 0.05), as did hemispheric AVM location (<i>p</i> &lt; 0.05) while smaller nidus volumes were associated with faster obliteration times (<i>p</i> &lt; 0.05). 75.5% of previously embolized AVMs achieved obliteration vs 68.2% of non-embolized AVMs, however the difference was not statistically significant. The introduction of cone beam CT angiography in treatment planning improved obliteration rates (69.1% to 75.8%), though statistical significance was not reached. The overall complication rate was 15.4%, with 5.8% experiencing post-SRS hemorrhage.</p><h3>Conclusion</h3><p>Higher prescription doses correlated with improved obliteration rates, and smaller AVMs achieved faster obliteration. The use of additional imaging modalities in treatment planning possibly contributed to non-inferior obliteration rates in previously embolized AVMs.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06523-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143865456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}