Surgical neurology international最新文献

{"title":"Targeted chopstick mononostril approach for a lower clivus chordoma.","authors":"Tancredo Alcântara, Jerold Justo, Tingting Jiang, Rosaria Abbritti, Thibault Passeri, Sébastien Froelich","doi":"10.25259/SNI_1117_2024","DOIUrl":"https://doi.org/10.25259/SNI_1117_2024","url":null,"abstract":"<p><strong>Background: </strong>Chordomas are rare, aggressive tumors often located at the craniovertebral junction. Endoscopic approaches are increasingly used for their treatment.</p><p><strong>Case description: </strong>We present a case of a patient with a chordoma at the craniovertebral junction treated through a mononostril endoscopic approach, enabling total resection with minimal nasal morbidity. The technique minimized nasal structure manipulation and avoided complications such as cerebrospinal fluid leaks. The nasopharyngeal mucosa was carefully sutured at the end of the procedure, further reducing postoperative nasal morbidity.</p><p><strong>Conclusion: </strong>The endoscopic \"chopstick\" approach, with mucosal suturing, offers reduced nasal morbidity and favorable recovery in craniovertebral junction chordomas.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"108"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048869","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":"Scrotal migration of the peritoneal catheter of a ventriculoperitoneal shunt: A case series in a single center.","authors":"Ahmad Siddiq Muhajir, Wihasto Suryaningtyas, Muhammad Arifin Parenrengi","doi":"10.25259/SNI_919_2024","DOIUrl":"https://doi.org/10.25259/SNI_919_2024","url":null,"abstract":"<p><strong>Background: </strong>Distal migration of ventriculoperitoneal (VP) shunt catheters to the scrotum is a rare yet significant complication in pediatric neurosurgery. It presents a unique challenge due to the anatomical predisposition observed in children.</p><p><strong>Case description: </strong>This case series elucidates three pediatric cases in which distal VP shunt migration to the scrotum manifested with varied presentations, including scrotal swelling, vomiting, and seizures. Each patient's medical history included prior VP shunt insertion for the management of hydrocephalus, with migration occurring within months of placement. Imaging studies confirmed scrotal positioning of the distal catheter tips, necessitating distinct management strategies: shunt repositioning, conversion to a ventriculoatrial (VA) shunt, and high ligation of a patent processus vaginalis (PPV) in cases associated with scrotal herniation. Factors such as rapid pediatric growth, high activity levels, and anatomical features, including a PPV, may facilitate catheter migration from the abdomen to the scrotum. These cases reflect diverse management approaches tailored to individual presentations and anatomical considerations, with repositioning and catheter shortening serving as viable strategies for recent, less severe cases, while VA shunt conversion and processus vaginalis ligation address more complex scenarios.</p><p><strong>Conclusion: </strong>Recognizing scrotal VP shunt migration as a potential complication is essential for early diagnosis and effective intervention. Timely and individualized management strategies are critical to preventing recurrence and ensuring optimal outcomes in the pediatric treatment of hydrocephalus with VP shunts.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"106"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046827","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":"Long-term follow-up of radiosurgery alone for basal ganglia germinoma manifesting as diabetes insipidus - A case report.","authors":"Walter Fagundes, Débora Nunes De Angeli, Thiago Lyrio Teixeira, Ana Luyza Oliveira Santos, Amanda Silva Guimarães","doi":"10.25259/SNI_660_2022","DOIUrl":"https://doi.org/10.25259/SNI_660_2022","url":null,"abstract":"<p><strong>Background: </strong>Intracranial germinoma (GEM) originates from primordial germ cells, more frequently in the pineal and suprasellar regions. Basal ganglia (BG) presentations are rare, especially associated with diabetes insipidus (DI) and without a neurohypophysis lesion or an \"occult germinoma.\" The management of GEM is controversial, although conventional wide-field irradiation with or without chemotherapy is the usual treatment. The potential role of radiosurgery in the management of these lesions remains unclear.</p><p><strong>Case description: </strong>A 15-year-old boy was admitted to the hospital, presenting with DI and right-hand dystonia. Magnetic resonance imaging (MRI) showed a paraventricular BG tumor near the left caudate nucleus. A stereotactic biopsy was performed, confirming the GEM diagnosis. The patient was treated by stereotactic radiosurgery (13 Gy), with remission of all symptoms. Eleven years after the onset of symptoms, the patient remained stable on a regular desmopressin regimen, maintaining normal water intake and urinary volume with improvement in the hand's dystonia. The brain MRI performed annually during the past 10 years after radiosurgery revealed no tumor recurrence or other abnormalities at the neurohypophysis and pituitary stalk.</p><p><strong>Conclusion: </strong>BG GEM is rare and it may manifest with DI, a possible consequence of peritumoral edema surrounding the hypothalamus. Radiosurgery alone may be an effective treatment option. The occult GEM of the neurohypophysis could also cause DI preceding the radiological onset of GEM. Hence, it is mandatory to follow-up on patients with BG GEM presenting with central DI closely for a long time with periodic clinical and neuroimaging evaluations.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"105"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995768","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":"Anatomical insights and clinical implications of the persistent trigeminal artery: A cadaveric study utilizing latex injection techniques.","authors":"Gervith Reyes Sotos, Julio Cesar Pérez Cruz, Carlos Castillo Rangel, Luis Delgado Reyes, Bernardo Cacho Diaz, Daniel Alejandro Vega Moreno, Tshiunza Mpoyi Chérubin, Vladimir Nikolenko, Eduardo Javier Valladares-Pérez, Francisco Castañeda Aguayo, Andreina Rosario Rosario, Manuel De Jesus Encarnacion Ramirez","doi":"10.25259/SNI_1084_2024","DOIUrl":"https://doi.org/10.25259/SNI_1084_2024","url":null,"abstract":"<p><strong>Background: </strong>The persistent trigeminal artery (PTA) is a rare embryonic connection between the internal carotid and basilar arteries. While typically regressing during development, it remains in some individuals, potentially leading to clinical concerns such as cerebrovascular complications or cranial nerve compression. A clear understanding of PTA anatomy is essential for neurosurgical planning and intervention, as its presence can affect blood flow dynamics and influence surgical strategies.</p><p><strong>Methods: </strong>This study involved a cadaveric analysis using a latex injection technique on a single male specimen. The brain was carefully removed, and a detailed seven-step injection process was employed to map the PTA. Microsurgical dissection was performed to document the artery's origin, path, branching patterns, and relationships with nearby structures. Measurements were taken using digital calipers, and high-resolution images were captured for further analysis.</p><p><strong>Results: </strong>The PTA was traced back to its origin at the posterior curve of the cavernous segment of the internal carotid artery. It traveled posterolaterally into the posterior cranial fossa, dividing into medial and lateral branches. Variations observed included slight twisting near its origin. The medial branch contributed to the posterior circulation, while the lateral branch supplied the superior cerebellar artery. These findings provide valuable insights into the PTA's anatomy and its clinical implications.</p><p><strong>Conclusion: </strong>This study expands the understanding of PTA anatomy, emphasizing its importance in neurosurgical planning and procedures. Larger sample studies are needed to validate and broaden these findings.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"103"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001963","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":"Cognitive impairment associated with suprasellar cavernous malformation: A case report and review of the literature.","authors":"Supapitch Subenja, Putch Phairintr, Raywat Noiphithak","doi":"10.25259/SNI_1004_2024","DOIUrl":"https://doi.org/10.25259/SNI_1004_2024","url":null,"abstract":"<p><strong>Background: </strong>Cavernous malformations (CMs) are benign vascular anomalies that most commonly occur in intra-axial locations but rarely develop in the suprasellar region. Suprasellar CMs pose unique diagnostic and therapeutic challenges due to their proximity to critical neurovascular structures, such as the optic chiasm, pituitary stalk, and hypothalamus. Although visual disturbances and headaches are typical symptoms of suprasellar CMs, cognitive impairment, especially memory loss, has rarely been reported.</p><p><strong>Case description: </strong>We present the case of a 58-year-old woman who developed progressive memory impairment for over 1 year. Magnetic resonance imaging revealed a 2.5 cm heterogeneous, lobulated lesion in the suprasellar region, exerting a mass effect on the optic chiasm and hypothalamus. The patient underwent endoscopic endonasal transsphenoidal resection with pituitary hemitransposition to achieve complete removal of the lesion. Pathological examination confirmed the diagnosis of CM. At the 6-month follow-up, the patient demonstrated modest improvement in memory function, which remained stable through the extended follow-up period of 31 months.</p><p><strong>Conclusion: </strong>This case highlights the rare presentation of memory impairment in suprasellar CM and underscores the importance of considering CMs in the differential diagnosis of suprasellar lesions. The endoscopic endonasal approach with pituitary hemitransposition provides an effective surgical pathway that allows complete resection. Early diagnosis and tailored surgical intervention may improve outcomes of patients with a suprasellar CMs. Further research is necessary to understand the relationship between suprasellar CMs and cognitive dysfunction.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"111"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034128","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":"Colorectal cancer metastasis to the brainstem: A single case report.","authors":"Asmaa Ibrahim Kebbe, Luna Elias Geagea, Houssein Ali Darwish","doi":"10.25259/SNI_873_2024","DOIUrl":"https://doi.org/10.25259/SNI_873_2024","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) is among the most widely prevalent malignancies afflicting increasingly high numbers of the population worldwide. Metastases majorly involve the liver and lungs but are not unheard of in the brain. Only one case has so far been reported to occur in the brainstem, excluding this one.</p><p><strong>Case description: </strong>We report a second case of an 85-year-old male who presented with headaches and difficulty swallowing and was found to have a right anterior pontine lesion extending into the midbrain on magnetic resonance imaging of the brain and cecal adenocarcinoma on subsequent colonoscopy. The pontine lesion was biopsied and confirmed to be a metastatic lesion. He underwent a course of radiotherapy and tolerated it well, with improvement of his presenting symptoms.</p><p><strong>Conclusion: </strong>CRC-related morbidity and mortality are on the rise, as is expected with the incidence of metastases to the brain, including the brainstem, which is an extremely rare site for such metastases. This case illustrates such an encounter and the possibility of early detection of these metastases through brain imaging of patients with known or suspected CRC and symptoms of neurologic dysfunction. The current preferred management is surgical resection when possible, with or without radiotherapy. However, due to the rarity of the case, more data might be required to make more accurate decisions in these cases.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"101"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015642","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 obliteration of a greater sphenoid wing dural arteriovenous fistula involving the diploic venous system.","authors":"Prasert Iampreechakul, Korrapakc Wangtanaphat, Wuttipong Tirakotai, Yodkhwan Wattanasen, Punjama Lertbutsayanukul, Sunisa Hangsapruek, Somkiet Siriwimonmas","doi":"10.25259/SNI_1113_2024","DOIUrl":"https://doi.org/10.25259/SNI_1113_2024","url":null,"abstract":"<p><strong>Background: </strong>Sphenoid wing dural arteriovenous fistulas (DAVFs) are rare vascular anomalies caused by abnormal arteriovenous shunting near the sphenoid bone. They are associated with significant risks, including cortical venous reflux and intracranial hemorrhage, especially when involving high-risk drainage pathways. Spontaneous regression of high-flow sphenoid wing DAVFs is exceedingly rare and has not been previously documented.</p><p><strong>Case description: </strong>We report a 59-year-old woman with a history of head trauma who presented with progressive right eye proptosis, redness, blurred vision, and tinnitus over 5 months. Imaging revealed a high-flow sphenoid wing DAVF with drainage into the diploic venous system, superficial middle cerebral vein, and basal vein of Rosenthal. Angiography demonstrated venous outlet stenosis and preexisting thrombosis in the superior ophthalmic vein. While the patient was being prepared for endovascular treatment, follow-up imaging 6 months later confirmed spontaneous obliteration of the fistula, accompanied by complete resolution of symptoms.</p><p><strong>Conclusion: </strong>This case highlights the unique occurrence of spontaneous regression in a high-flow sphenoid wing DAVF. The obliteration was likely facilitated by venous outlet stenosis, preexisting thrombosis, and the hemodynamic effects of contrast media during angiography. These findings emphasize the importance of careful monitoring and follow-up in the management of DAVFs, as spontaneous resolution, although rare, may occur.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"99"},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059396","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":"Operative considerations for resection of pituitary adenoma in patients with sickle cell disease: A retrospective analysis of 19,653 patients.","authors":"Nolan J Brown, Saarang Patel, Taylor Kenton Reardon, James L Rogers, Julian Lassiter Gendreau","doi":"10.25259/SNI_112_2025","DOIUrl":"https://doi.org/10.25259/SNI_112_2025","url":null,"abstract":"<p><strong>Background: </strong>Sickle cell disease (SCD) is a hemoglobinopathy that affects over 30 million individuals worldwide. When significant \"sickling\" occurs, blood flow to specific organs can be impaired, resulting in ischemia or infarction. This can be problematic during intracranial surgery, in which low systemic circulatory volume due to significant blood loss can lead to intracranial hypotension. Using a multivariable modeling approach, we gathered a large patient dataset through a nationally representative database to inform future neurosurgical management of patients with concurrent SCD and pituitary adenoma.</p><p><strong>Methods: </strong>We queried the Healthcare Cost and Utilization Project Nationwide Readmissions Database and implemented discharge weighting to identify a cohort of SCD patients who had undergone surgical resection of pituitary adenoma between 2015 and 2016. Variables investigated included patient age, sex, length of stay, postoperative complications and outcomes, payment methods, and median income, among several others.</p><p><strong>Results: </strong>Retrospective analysis identified 19,612 non-sickle cell patients (NSCP) and 41 SCD patients. Complication profiles for the SCD cohort demonstrated significantly higher rates of postoperative pulmonary embolism (<i>P</i> = 0.042) and pneumonia (<i>P</i> = 0.005) compared to those of the NSCP cohort. In addition, the SCD cohort trended toward higher rates of readmission (15.25% vs. 9.76%) and deep vein thrombosis, although neither achieved statistical significance (<i>P</i> = 0.45 and 0.07, respectively).</p><p><strong>Conclusion: </strong>SCD is a severe disorder that affects many individuals worldwide and represents a significant risk factor for complications and adverse outcomes in pituitary adenoma surgery. Further research is needed to explore SCD as a risk factor in pituitary surgery and the role it may play in perioperative complications.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"100"},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029245","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":"Spinal subdural empyema: A two-dimensional illustrative operative video.","authors":"Seung Jin Lee, Loizos Michaelides, Saarang Patel, Julian Lassiter Gendreau, Nolan J Brown, William Clifton, Mark A Edgar, Sukhwinder Sandhu, Selby Chen","doi":"10.25259/SNI_141_2025","DOIUrl":"https://doi.org/10.25259/SNI_141_2025","url":null,"abstract":"<p><strong>Background: </strong>Spinal subdural empyema rarely involves the spinal cord and may result in devastating neurological deficits. These lesions typically require prompt diagnosis, surgical evacuation, and antibiotic therapy. Here, we present the clinical course, imaging, and narrated operative video of a thoracic spinal subdural empyema initially diagnosed as an intramedullary neoplasm.</p><p><strong>Case description: </strong>A 73-year-old female presented with a 6-month history of worsening thoracic myelopathy; over the last few weeks, she rapidly developed paraplegia. She was initially diagnosed with an enlarging thoracic intramedullary mass. A spinal biopsy was performed for the presumptive diagnosis of primary intramedullary central nervous system lymphoma. However, at surgery, the thoracic lesion proved to be a chronic subdural empyema (i.e., surrounded by arachnoid granulations and soft-purulent tissue). Interestingly, the operative specimen failed to grow any specific organism.</p><p><strong>Conclusion: </strong>Spinal subdural empyema should be one of the differential diagnoses considered for patients presenting with intradural spinal cord lesions.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"95"},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050880","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":"Juha Hernesniemi: A message from overseas aspirants.","authors":"Rashid Nawaf Alhoti, Ozair Nissar Sheikh, Bandar Mohammed Alhadeethi, Wamedh Esam Matti, Ahmed Muthana, Samer S Hoz","doi":"10.25259/SNI_116_2025","DOIUrl":"https://doi.org/10.25259/SNI_116_2025","url":null,"abstract":"<p><strong>Background: </strong>Juha Hernesniemi has played a pivotal role in advancing microneurosurgery, particularly in resource-limited settings where structured training opportunities are scarce. His philosophy of simplicity, efficiency, and anatomical preservation has influenced neurosurgeons worldwide, providing them with a framework to refine their skills despite technical and educational constraints.</p><p><strong>Methods: </strong>This paper examines Hernesniemi's contributions to neurosurgical education through his extensive publications, surgical techniques, and mentorship philosophy. It highlights how his work has provided neurosurgical trainees with a structured pathway to mastering complex procedures, particularly in vascular and microneurosurgery.</p><p><strong>Results: </strong>Hernesniemi's influence extends beyond direct mentorship, fostering a self-sustaining cycle of learning, where trainees who benefit from his work continue to pass on knowledge to future generations. His surgical videos, research papers, and simplified techniques have empowered neurosurgeons, especially those in resource-constrained environments, to perform complex procedures safely and effectively.</p><p><strong>Conclusion: </strong>Juha Hernesniemi's contributions to microneurosurgery and neurosurgical education have left a lasting impact on the global community. His philosophy continues to shape future generations of neurosurgeons, reinforcing the power of knowledge dissemination in overcoming training barriers.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"96"},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036356","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}