Surgical neurology international最新文献

{"title":"Management of isolated neurosarcoidosis mimicking cerebral meningiomatosis with multiple cranial neuropathies: An uncommon clinical scenario.","authors":"Ashish Mishra, Ved Prakash Maurya, Nandita Chaudhary, Arun Kumar Srivastava","doi":"10.25259/SNI_579_2025","DOIUrl":"10.25259/SNI_579_2025","url":null,"abstract":"<p><strong>Background: </strong>Sarcoidosis is an immune-mediated disorder characterized by granulomatous inflammation of the affected organ. Isolated neurosarcoidosis presents as aseptic granulomatous meningitis or focal mass lesions due to granulomas. This case is notable for its radiological resemblance to meningiomatosis, which has a substantial disease burden.</p><p><strong>Case description: </strong>A 47-year-old man presented with symptoms of vertigo and right-sided hearing impairment for the past year. After 6 months, he experienced progressive visual impairment in the right eye and a headache associated with dural stretching on the right side. Neurological evaluation revealed significant visual impairment in the right eye, limited to finger counting at 1 m. The right-sided primary optic atrophy was due to mass effect from the sarcoid granuloma on the optic nerve. Pure-tone audiometry indicated mild sensorineural hearing loss on the right side. Radiological investigations showed multiple intracranial lesions, with the largest lesion located at the right anterior clinoid, exhibiting pial breach, and perilesional edema. The institutional tumor board diagnosed cerebral meningiomatosis. Due to rapidly progressive visual deterioration caused by the right clinoidal lesion, a right pterional craniotomy with gross total excision of the lesion was performed. The histopathology evaluation report revealed neurosarcoidosis. The patient was started on glucocorticoids and immunosuppressant medication by clinical immunology. Follow-up magnetic resonance imaging of the brain after 1 year showed stable disease without any recurrence.</p><p><strong>Conclusion: </strong>Surgical removal of lesions causing mass effect should be regarded as the primary therapy. Insufficient response to medical treatment may result in permanent deficits. When dealing with multiple intracranial lesions, the aim should be to achieve optimal results through surgical intervention.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"345"},"PeriodicalIF":0.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208834","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":"Suboccipital approach for fourth ventricle choroid plexus papilloma: 3-dimensional operative video.","authors":"Ricardo Lourenço Caramanti, Raysa Moreira Aprígio, Carlos Eduardo Rocha, Daniel Gregório Gonsalves, Dionei Freitas de Morais, Paulo Henrique Pires de Aguiar, Feres Chaddad-Neto","doi":"10.25259/SNI_312_2025","DOIUrl":"10.25259/SNI_312_2025","url":null,"abstract":"<p><strong>Background: </strong>Choroid plexus papilloma (CPP) is a rare tumor of the central nervous system. The most common CPP surgery complication is intraoperative bleeding, mainly in cases of posterior inferior cerebellar artery (PICA) branch encasement. In these cases, early identification of the PICA and tumor feeding vessels is necessary, with their proximal control, and progressive coagulation of the choroid plexus, aiming to reduce the blood supply to the tumor. This video explains step-by-step the surgical technique CPP with intraoperative PICA breach bleeding.</p><p><strong>Case description: </strong>We present a 48-year-old female with a year of progressive occipital headache and 2 weeks of ataxia and dizziness. In neurological examination, she presented with gait ataxia. The imaging investigation with magnetic resonance showed a fourth ventricle mass of 2,8 centimeter, with cerebellar compression and left PICA encasement. The treatment was a surgical resection by a suboccipital approach. There was a rupture of a PICA branch during tumor resection, which was controlled with compression and bipolar coagulation. A near-total resection was performed with a small tumor remnant remaining in the PICA. The patient evolved with improvement of pre-operative symptoms. Tumor biopsy confirms the CPP diagnosis.</p><p><strong>Conclusion: </strong>CPP of the fourth ventricle is a rare benign tumor, which should be included in the differential diagnosis of intraventricular tumors. The IV ventricle location presents additional surgical challenges, such as arterial encasement and brainstem adhesions. This surgical video highlights the main techniques to perform an IV ventricle CPP resection.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"341"},"PeriodicalIF":0.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208670","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":"Nodular fasciitis of the sphenoid sinus presenting with a visual field defect: A case report.","authors":"Go Matsuoka, Naoko Inoshita, Miku Maeda, Noriaki Tanabe, Hiroaki Kanda, Atsushi Ishida, Haruko Yoshimoto, Hideki Shiramizu, Shozo Yamada","doi":"10.25259/SNI_619_2025","DOIUrl":"10.25259/SNI_619_2025","url":null,"abstract":"<p><strong>Background: </strong>Nodular fasciitis (NF) is a self-limiting mesenchymal neoplasm. Although it can occur in various parts of the body, its presence within the sphenoid sinus is extremely rare in adults. To the best of our knowledge, only one other case has been reported in the English literature. Because of its rapid growth and potential to mimic malignant tumors, accurate diagnosis and timely treatment are essential.</p><p><strong>Case description: </strong>We report a case of a 58-year-old man who presented with visual disturbance in the right eye. Computed tomography and magnetic resonance imaging revealed a mass lesion in the sphenoid sinus, with erosion of the bony wall of the right optic nerve canal. The mass was completely removed through an endoscopic transnasal transsphenoidal approach, both for histopathological diagnosis and optic nerve decompression. Pathological examination confirmed the diagnosis of NF. Postoperatively, the patient's visual field improved significantly.</p><p><strong>Conclusion: </strong>This case highlights NF as a rare but important differential diagnosis in patients presenting with visual impairment due to a mass in the paranasal sinus. In symptomatic cases, early surgical intervention should be considered to prevent symptom progression and ensure an accurate diagnosis.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"336"},"PeriodicalIF":0.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208783","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":"Impact of omega-3 supplementation on inflammatory markers and clinical outcomes in patients with moderate-to-severe head injuries: An experimental trial.","authors":"I Wayan Niryana, I Gusti Ketut Agung Surya Kencana, Joshua Sutikno, Tjokorda Gde Bagus Mahadewa","doi":"10.25259/SNI_444_2025","DOIUrl":"10.25259/SNI_444_2025","url":null,"abstract":"<p><strong>Background: </strong>Head injuries are a major cause of morbidity and mortality, with traumatic brain injuries affecting young individuals and elderly populations. The inflammatory response, oxidative stress, and neuroinflammation following head trauma contribute significantly to poor clinical outcomes. Omega-3 fatty acids, known for their anti-inflammatory and antioxidant properties, have emerged as a potential adjunct therapy to mitigate these effects.</p><p><strong>Methods: </strong>An experimental trial was conducted from January to July 2024 at our institution, involving 46 patients with moderate-to-severe head injuries. Participants were randomly assigned to receive either standard therapy (control group) or standard therapy plus omega-3 supplementation (treatment group). Each omega-3 capsule contained 1000 mg of fish oil, with 180 mg of eicosapentaenoic acid and 120 mg of docosahexaenoic acid (DHA), with patients in the treatment group receiving one capsule daily. C-reactive protein (CRP), neutrophilto-lymphocyte ratio (NLR), and malondialdehyde (MDA) levels were measured on Day 1 and Day 7, while Glasgow outcome scale-extended (GOS-E) scores were assessed after 3 months. Data were analyzed using the Mann-Whitney U-test.</p><p><strong>Results: </strong>Omega-3 supplementation significantly reduced CRP, NLR, and MDA levels in the treatment group compared to the control group (<i>P</i> < 0.05 for all). However, there was no significant difference in GOS-E scores between the groups (<i>P</i> = 0.717).</p><p><strong>Conclusion: </strong>Omega-3 supplementation significantly reduced inflammatory markers and oxidative stress in patients with moderate-to-severe head injuries. However, it did not improve long-term clinical outcomes as measured by GOS-E scores, indicating the need for further studies to explore optimal dosing, composition (particularly high-DHA formulations), magnesium status, and long-term effects of omega-3 therapy in head injury recovery.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"338"},"PeriodicalIF":0.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208837","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":"Extreme lateral infrajugular transtubercular exposure for resection of a glomus jugulare: Microsurgical operative video.","authors":"Ehsan Dowlati, Ryan Gensler, Danielle Golub, Justin Turpin, Timothy G White, Athos Patsalides, Peter M Costantino, Amir R Dehdashti","doi":"10.25259/SNI_191_2025","DOIUrl":"10.25259/SNI_191_2025","url":null,"abstract":"<p><strong>Background: </strong>Glomus jugular tumors (GJTs), a subset of paragangliomas, are highly vascularized neoplasms arising in the jugular foramen, typically affecting middle-aged women. Although benign, GJTs often present with critical cranial neuropathies such as hearing loss, swallowing disturbances, and facial weakness and can cause venous outflow obstruction from jugular vein compression. In symptomatic cases, early intervention is warranted and involves surgical resection. Approaches include transmastoid approach, juxtacondylar approach, infratemporal approaches, transotic approach, extreme lateral infrajugular transtubercular exposure (ELITE), or a combination thereof. Due to the highly vascularized nature of these tumors and the relative fragility of nearby cranial nerves, significant bleeding and neurological deficits can occur as a consequence of resection. Intraoperative bleeding, however, can be reduced with preoperative embolization.</p><p><strong>Case description: </strong>We present the case of a 57-year-old woman with a right-sided GJT extending into the jugular foramen and compressing the facial nerve. Given her progressive symptoms, we felt that radiosurgery was not an ideal treatment. The goals of the procedure were to decompress the facial nerve and achieve maximal safe tumor resection. We utilized the ELITE approach with tailored mastoidectomy, allowing anterolateral access to the tumor. The mastoidectomy allows skeletonization of the sigmoid sinus and jugular bulb as well as the fallopian canal housing the facial nerve. To minimize postoperative cranial nerve palsies, neuromonitoring was used to limit facial nerve manipulation, and an intrabulbar dissection approach was employed to avoid iatrogenic injury to other neurovascular structures. The patient consented to the procedure and the publication of her images.</p><p><strong>Conclusion: </strong>This case highlights a surgical approach that prioritizes both tumor resection and cranial nerve protection and offers insights into strategies for optimizing outcomes in GJT management. Furthermore, this case underscores the importance of tailored, precise techniques to minimize surgical morbidity for patients with these challenging lesions.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"347"},"PeriodicalIF":0.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208806","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":"Editorial: Why don't physicians just pick up the phone? Better communication between doctors helps provide the \"best medicine\".","authors":"Nancy E Epstein","doi":"10.25259/SNI_786_2025","DOIUrl":"https://doi.org/10.25259/SNI_786_2025","url":null,"abstract":"","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"348"},"PeriodicalIF":0.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208730","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":"Subarachnoid hemorrhage secondary to ruptured posterior inferior cerebellar artery aneurysm in a patient with type 3 osteogenesis imperfecta: A case report and topic review.","authors":"Segev Gabay, Ariel Agur, Oz Haim","doi":"10.25259/SNI_611_2025","DOIUrl":"10.25259/SNI_611_2025","url":null,"abstract":"<p><strong>Background: </strong>Osteogenesis imperfecta (OI) is a rare genetic disorder characterized by collagen Type I deficiency, leading to bone fragility, skeletal deformities, and, less commonly, vascular abnormalities. Cerebrovascular complications in OI are rare. There are few reports of subarachnoid hemorrhage (SAH) secondary to ruptured aneurysms in OI patients, particularly involving the posterior circulation.</p><p><strong>Case description: </strong>We present a unique scenario of a long-term survivor, a female patient, with Type III OI who experienced a spontaneous SAH due to a ruptured posterior inferior cerebellar artery aneurysm.</p><p><strong>Conclusion: </strong>Given the patient's underlying OI, special neurosurgical and endovascular techniques were employed to ensure safe aneurysm coiling and cerebrospinal fluid diversion. We outline these challenges faced in the management of such a patient and provide a literature review to contextualize our findings.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"342"},"PeriodicalIF":0.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208527","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":"Atypical presentation of acute cerebellar infarct as Lhermitte-Duclos disease.","authors":"Krishna Kumar G, Mangalkumar Rachatte, Soumya Pahari, Anupam Sharma, Aayushi Sharma","doi":"10.25259/SNI_347_2025","DOIUrl":"10.25259/SNI_347_2025","url":null,"abstract":"<p><strong>Background: </strong>Cerebellar infarct resembling Lhermitte-Duclos disease (LDD) is a rare case scenario. LDD being a rare, slowly growing cerebellar tumor is generally characterized by headaches, ataxia, cranial nerve palsies, and impaired cerebellar symptoms. Primarily diagnosed with a magnetic resonance imaging, the lesion has several differential diagnoses, including vascular malformation with cerebellar venous congestion, rhombencephalosynapsis, cerebellar dysplasia, and medulloblastoma. In unusual instances, a cerebellar stroke may mimic LDD, potentially leading to a delay in management.</p><p><strong>Case description: </strong>We present a case of a 49-year-old female with complaints of headache and vomiting for 5 days with no previous similar history. Based on the initial impression and classical imaging findings, LDD was diagnosed, and she was managed conservatively. Even though the majority of patients with LDD develop the disease over a course of time, some cases have been reported to show acute presentation. However, on worsening of symptoms, with extension of lesion on repeat imaging, an emergency craniotomy was performed, and biopsy revealed an acute infarct with hemorrhagic transformation.</p><p><strong>Conclusion: </strong>Various neurological conditions can imitate LDD and vice versa. We recommend that a cerebellar stroke should be ruled out when encountering with a radiological diagnosis of LDD, to avoid critical delays in the management of stroke.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"340"},"PeriodicalIF":0.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208755","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":"Possibility of calcification of type I collagen matrix in growth hormone-secreting pituitary neuroendocrine tumor.","authors":"Shinichiro Teramoto, Takuma Kodama, Akihide Kondo","doi":"10.25259/SNI_462_2025","DOIUrl":"10.25259/SNI_462_2025","url":null,"abstract":"<p><strong>Background: </strong>In acromegaly caused by growth hormone (GH)-secreting pituitary neuroendocrine tumor (PitNET), excessive secretion of GH and insulin-like growth factor 1 (IGF-1) enhances bone anabolic effects while inducing the production of type I collagen, leading to increased bone mass and bone mineral density. We investigated the possibility of calcification of type I collagen matrix used in endoscopic transsphenoidal surgery (ETSS) for GH-secreting PitNET.</p><p><strong>Methods: </strong>Twelve patients with GH-secreting PitNET who underwent ETSS and were followed up for more than 1 year after surgery were divided into two groups: The \"DuraGen group,\" in which DuraGen, a type I collagen matrix, was used as the overlay graft to cover the closed sella turcica for sellar floor reconstruction after tumor resection and the \"fat group,\" in which fat was used. Clinical characteristics associated with surgery for GH-secreting PitNET were compared between the groups.</p><p><strong>Results: </strong>Seven patients were assigned to the DuraGen group and five to the fat group. One year after surgery, the reconstructed sellar floor was thickly calcified in all cases in the DuraGen group, but not calcified in all cases in the fat group. Patient characteristics, tumor-related factors including image findings, tumor size, histopathology and extent of tumor resection, and the pre- and postoperative course of GH and IGF-1 demonstrated no significant differences between the groups.</p><p><strong>Conclusion: </strong>In ETSS for acromegaly due to GH-secreting PitNET, the possibility of calcification of type I collagen matrix used as the overlay graft for sellar floor reconstruction should be considered.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"346"},"PeriodicalIF":0.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208922","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":"Comparison of midline shift and ventricular size measured by transcranial ultrasound and non-contrast computed tomography in patients with acute subdural hemorrhage undergoing decompressive craniectomy: A prospective observational study.","authors":"Adethen Gunasekaran, Jerry Jame Joy, Rajasekar Ramadurai, VivekChandar Chinnarasan, Srinivasan Swaminathan, Gopikrishnan Rajasekar, Krishnan Nagarajan, Prasanna Udupi Bidkar","doi":"10.25259/SNI_544_2025","DOIUrl":"10.25259/SNI_544_2025","url":null,"abstract":"<p><strong>Background: </strong>Managing traumatic brain injury (TBI) involves complex monitoring, especially of elevated intracranial pressure. Transcranial ultrasound (TCUS) is emerging as a useful bedside tool for assessing optic nerve sheath diameter, cerebral blood flow velocities, midline shift, ventricle size, and complications. This study compares midline shift and ventricle size measurements obtained using TCUS and non-contrast computed tomography (NCCT) in patients with acute subdural hematoma (SDH) who underwent emergency decompressive craniectomy (DC).</p><p><strong>Methods: </strong>Sixty consecutive patients who underwent DC for acute SDH were enrolled. TCUS was performed before NCCT, which was done 12-24 h post-surgery. Midline shift and ventricular size (lateral and third ventricles) were assessed on both imaging modalities. Secondary parameters, including hematoma, contusion, parenchymal changes, and basal cistern patency, were also evaluated.</p><p><strong>Results: </strong>TCUS demonstrated a strong correlation with NCCT for midline shift (r = 0.984, <i>P</i> < 0.001). Ventricular measurements showed good correlation - lateral ventricle (r = 0.667) and third ventricle (r = 0.914, <i>P</i> < 0.001). Bland-Altman analysis confirmed strong agreement. Hematoma (kappa = 1) and contusion (kappa = 0.8) showed a strong correlation. Moderate agreement was noted for parenchymal changes and basal cistern patency. TCUS was comparable to NCCT in detecting hemorrhage and parenchymal abnormalities, but less sensitive for contusion and cistern evaluation.</p><p><strong>Conclusion: </strong>TCUS shows excellent correlation with NCCT in evaluating midline shift and good correlation for ventricular size post-DC. It is a reliable, non-invasive bedside modality for postoperative monitoring in TBI patients.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"328"},"PeriodicalIF":0.0,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202578","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}