World neurosurgery最新文献_第5页

Letter to the Editor Regarding “Intersection of Care: Navigating Patient-Hospital Relationships in Neurosurgery”

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery

Pub Date : 2025-02-01 DOI: 10.1016/j.wneu.2025.123656

Saarang Patel , Nathan A. Shlobin

引用次数: 0

Infrastructural Barriers to Neurosurgical Care of Brain Tumors in Low- and Middle-Income Countries: A Systematic Review 低收入国家脑肿瘤神经外科治疗的基础设施障碍：系统回顾。

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery

Pub Date : 2025-02-01 DOI: 10.1016/j.wneu.2024.10.104

Muhammad Shakir , Aly Hamza Khowaja , Hammad Atif Irshad , Izza Tahir , Syeda Fatima Shariq , Ali I. Rae , Radzi Hamzah , Saksham Gupta , Kee B. Park , Syed Ather Enam

Background

Appropriate surgical infrastructure is important for improving patient outcomes. However, low- and middle-income countries (LMICs) often struggle to provide adequate brain tumor surgery due to fractured infrastructure. This study aims to identify and evaluate barriers to surgical care infrastructure for brain tumors in LMICs.

Methods

A comprehensive literature search was conducted from inception to October 20, 2022, using PubMed, Scopus, CINAHL, and Google Scholar. Inclusion criteria were studies that focused on surgical care of brain tumors in terms of infrastructure in low-resource settings. Studies were excluded if they did not focus on surgical care or were not conducted in LMIC. Data was extracted and analyzed qualitatively.

Results

A final analysis of 39 studies showed significant barriers: 66% had poor operating room infrastructure, 32% lacked specialized care centers and imaging facilities, 26% faced long-distance travel issues, 13% had poor public health infrastructure, and 11% had poor referral pathways and lacked advanced diagnostic facilities. Additionally, 3% had an uneven distribution of quality centers and inadequate ward capacity. Proposed strategies include cross-border collaboration (29%), optimizing existing resources (29%), improving referral pathways (7%), resource sharing within hospitals, and acquiring surgical devices through donations (7%).

Conclusions

The review highlights key barriers in infrastructure while providing effective neurosurgical care to brain tumors in LMICs. To overcome these challenges, targeted strategies need to be implemented by stakeholders, policymakers, and health ministries.

背景：适当的外科基础设施对改善患者预后非常重要。然而，由于基础设施不完善，中低收入国家（LMICs）往往难以提供适当的脑肿瘤手术。本研究旨在确定和评估中低收入国家脑肿瘤手术治疗基础设施的障碍：方法：使用 PubMed、Scopus、CINAHL 和 Google Scholar 对从开始到 2022 年 10 月 20 日的文献进行了全面检索。纳入标准是关注低资源环境下脑肿瘤手术治疗基础设施的研究。不关注手术治疗或不在低收入国家进行的研究将被排除在外。对数据进行提取和定性分析：对 39 项研究进行的最终分析表明存在重大障碍：66% 的研究显示手术室基础设施薄弱，32% 的研究显示缺乏专业护理中心和成像设施，26% 的研究显示面临长途旅行问题，13% 的研究显示公共卫生基础设施薄弱，11% 的研究显示转诊途径不畅并缺乏先进的诊断设施。此外，3%的优质中心分布不均，病房容量不足。建议采取的策略包括跨境合作（29%）、优化现有资源（29%）、改善转诊途径（7%）、医院内部资源共享以及通过捐赠获取手术设备（7%）：综述强调了在低收入和中等收入国家为脑肿瘤患者提供有效的神经外科治疗时，基础设施方面存在的主要障碍。为了克服这些挑战，利益相关者、政策制定者和卫生部门需要实施有针对性的战略。

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引用次数: 0

Impact of Antidepressant Use on Intraoperative Blood Loss and Transfusion Rates in Lumbar Fusion Surgery 使用抗抑郁药对腰椎融合手术术中失血量和输血率的影响

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery

Pub Date : 2025-02-01 DOI: 10.1016/j.wneu.2024.10.142

Michael McCurdy, Rajkishen Narayanan, Jonathan Dalton, Chloe K. Herczeg, Jeremy Heard, Yunsoo Lee, Alec Giakas, Emma Boyajieff, Abbey Glover, Saurav Sumughan, Grace Bowen, Yoni Dulitzki, Emmanuel Dean, Mark Kurd, Jose A. Canseco, Alan S. Hilibrand, Alexander R. Vaccaro, Christopher K. Kepler, Gregory D. Schroeder

Objective

A quarter of spine surgery patients take antidepressants. Basic science research has suggested serotonergic antidepressants impair platelet function. This has been supported by only a small number of works in the setting of spine surgery. The purpose of this study is to investigate the impact of antidepressants on intraoperative bleeding risk during lumbar fusion.

Methods

Patients who underwent elective 1–3 level lumbar fusion at a single, academic, tertiary center (2017–2021) were identified. Antidepressant use and class, demographic, and surgical data were evaluated. Bleeding risk was assessed by total intraoperative blood loss (mL), calculated using the formula by Gross et al., and by postoperative transfusion. Patients prescribed versus not prescribed an antidepressant were matched 1:1 by age, sex, body mass index, Elixhauser, smoking status, and levels fused. Appropriate statistical analysis was performed (alpha was set at 0.05).

Results

A total of 420 patients with and 420 patients without an antidepressant prescription at the time of lumbar fusion were identified. Patients without an antidepressant prescription had a higher Charlson Comorbidity Index (0.91 ± 1.09 vs. 0.76 ± 1.1; P = 0.048), but otherwise the groups were demographically similar, and underwent similar surgeries. Antidepressant use was not associated with increased intraoperative bleeding or postoperative transfusion rate, regardless of subanalysis by procedure type or antidepressant class.

Conclusions

Antidepressant use was not associated with increased intraoperative blood loss or increased postoperative transfusion requirement, regardless of subanalysis by fusion type or antidepressant class. The current findings do not support discontinuing antidepressants prior to lumbar fusion.

目标：四分之一的脊柱手术患者服用抗抑郁药。基础科学研究表明，血清素能抗抑郁药会损害血小板功能。在脊柱手术中，仅有少数研究证实了这一观点。本研究旨在探讨抗抑郁药对腰椎融合术术中出血风险的影响：确定了在一家学术性三级中心（2017-2021年）接受择期1-3级腰椎融合术的患者。评估了抗抑郁药的使用和等级、人口统计学和手术数据。出血风险通过术中总失血量（毫升）（采用格罗斯等人的公式计算）和术后输血量进行评估。根据年龄、性别、体重指数（BMI）、埃利克豪斯指数（Elixhauser）、吸烟状况和融合水平，将开具抗抑郁药与未开具抗抑郁药的患者进行1:1配对。进行了适当的统计分析（Alpha 设为 0.05）：结果：420 名患者在腰椎融合术时服用了抗抑郁药，420 名患者没有服用。无抗抑郁药处方的患者的夏尔森合并症指数较高（0.91 ± 1.09 vs. 0.76 ± 1.1; p = 0.048），除此之外，两组患者的人口统计学特征相似，接受的手术也相似。无论按手术类型或抗抑郁药类别进行何种子分析，使用抗抑郁药均与术中出血或术后输血率增加无关：无论按融合类型或抗抑郁药类别进行何种子分析，使用抗抑郁药均与术中失血量增加或术后输血需求增加无关。目前的研究结果不支持在腰椎融合术前停用抗抑郁药。

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引用次数: 0

Electromagnetic Navigation Improves Accuracy and Reduces Complications of Ventriculoperitoneal Shunts in Patients with Idiopathic Normal Pressure Hydrocephalus: A Single-Center Clinical Experience 电磁导航提高特发性正常压力脑积水患者脑室腹腔分流术的准确性并减少并发症：单中心临床经验。

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery

Pub Date : 2025-02-01 DOI: 10.1016/j.wneu.2024.11.011

Xudong Ma , Xuehai Fan , Wenqinyi Yang , Jiahe Guo , Ziwei Zhou , Dong Wang , Yimeng Wu , Ningnannan Zhang , Guozhi Song , Yan Xing , Xiuyun Liu , Kai Yu , Huijie Yu

Background

Ventriculoperitoneal (VP) shunt surgery is the primary treatment for patients with idiopathic normal pressure hydrocephalus (iNPH). This study compared the outcomes of VP shunt placement using electromagnetic (EM) navigation versus standard methods in patients with iNPH, focusing on catheter accuracy and postoperative complication rates.

Methods

This retrospective study included 31 patients with iNPH who underwent standard shunt placement using anatomical landmarks and 50 patients who underwent EM-guided shunt placement. Parameters assessed included shunt placement grade, catheter tip position, catheter angle, puncture attempts, operative duration, postoperative infection rates, intraparenchymal hemorrhage rates, and shunt malfunction rates. Patients had follow-ups at 3, 6, 12, and 24 months after surgery or until shunt failure.

Results

In the EM-guided group, a higher percentage of grade 1 shunt placements (92% vs. 71%, P = 0.03) and fewer grade 3 placements (2% vs. 13%, P = 0.068) were observed. The catheter tip position at the foramen of Monro was significantly more accurate (P < 0.001), with smaller lateral catheter deviation angles in both coronal (19.69° vs. 24.2°, P < 0.0001) and sagittal (21.75° vs. 39.3°, P < 0.01) sections. The EM-guided group had fewer puncture attempts, shorter operative durations, lower incidence of intraparenchymal hemorrhage (P < 0.01), and fewer shunt malfunctions over the 2-year follow-up period (2% vs. 26%, P = 0.0003).

Conclusions

The use of EM navigation in VP shunt placement for patients with iNPH improves catheter placement accuracy, reduces postoperative complications and shunt malfunction rates, and provides precise and individualized surgical treatment.

背景：脑室腹腔（VP）分流手术是特发性正常压力脑积水（iNPH）患者的主要治疗方法。本研究比较了在 iNPH 患者中使用电磁（EM）导航与标准方法进行 VP 分流置管的结果，重点关注导管的准确性和术后并发症发生率：这项回顾性研究包括 31 名使用解剖标志接受标准分流术的 iNPH 患者和 50 名接受电磁导引分流术的 iNPH 患者。评估参数包括分流管置入等级、导管尖端位置、导管角度、穿刺尝试次数、手术持续时间、术后感染率、实质内出血率和分流管故障率。术后3、6、12和24个月或分流失效前对患者进行随访：在EM引导组中，观察到1级分流置管率更高（92%对71%，P=0.03），3级置管率更低（2%对13%，P=0.068）。导管尖端在门罗孔的位置明显更准确（p < 0.001），冠状切面（19.69° vs. 24.2°，p < 0.0001）和矢状切面（21.75° vs. 39.3°，p < 0.01）的导管侧偏角都更小。在2年的随访期间，EM引导组的穿刺次数更少、手术时间更短、脑室内出血发生率更低（p < 0.01）、分流管故障更少（2% vs. 26%，p = 0.0003）：结论：在为 iNPH 患者进行 VP 分流时使用电磁导航可提高导管置入的准确性，减少术后并发症和分流故障率，并提供精确和个性化的手术治疗。

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引用次数: 0

Endoscopic Occipital Transtentorial Approach for Dorsal Midbrain Cavernous Malformation: Technical Notes With Illustrative Case 背侧中脑海绵状畸形的内窥镜枕骨经支架入路：技术说明与病例举例。

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery

Pub Date : 2025-02-01 DOI: 10.1016/j.wneu.2024.11.043

Shuang Liu, Chongjing Sun, Pin Chen, Hantao Yang, Tao Xie, Jinlong Huang, Qiang Xie, Fan Hu, Xiaobiao Zhang

Background

The dorsal midbrain, an anatomically intricate region, presents significant challenges for traditional surgical interventions due to the heightened risk of vascular and neurological injury, and the necessity of brain tissue retraction.

Methods

This study retrospectively reviewed the case of a 29-year-old male diagnosed with a cavernous malformation located in the dorsal aspect of the left midbrain. The patient underwent resection via the endoscopic occipital transtentorial approach (EOTA) in July 2024. Comprehensive records were analyzed, including preoperative magnetic resonance imaging and computed tomography imaging, detailed surgical notes, and postoperative outcomes.

Results

The patient initially presented with headaches and diplopia. Imaging revealed a 17 × 13 mm tumor in the dorsal aspect of the left midbrain, associated with obstructive hydrocephalus. The 2.5-hour EOTA surgery resulted in complete resection of the tumor, with the resolution of headache symptoms and improvement of diplopia. No new complications were reported postoperatively. The patient was discharged 7 days postsurgery without the need for intensive care unit admission. Pathological examination confirmed the diagnosis of a cavernous malformation. Additionally, the EOTA facilitated a concurrent endoscopic third ventriculostomy, and no evidence of hydrocephalus was observed during the 3-month follow-up period.

Conclusions

The EOTA constitutes a significant advancement in neurosurgical techniques for the resection of dorsal midbrain tumors, enhancing surgical precision and safety. This approach contributes to improved patient outcomes and a reduction in complication rates. Further studies are warranted to validate these findings and to establish standardized protocols for the application of EOTA in midbrain tumor resection.

背景：中脑背侧是一个解剖结构复杂的区域，由于血管和神经损伤的风险较高，且必须牵拉脑组织，这给传统手术干预带来了巨大挑战：本研究回顾性分析了一例被诊断为左侧中脑背侧海绵状畸形的 29 岁男性病例。患者于 2024 年 7 月通过内窥镜枕骨横隔入路（EOTA）接受了切除术。对患者的综合病历进行了分析，包括术前磁共振成像（MRI）和计算机断层扫描（CT）成像、详细的手术记录和术后结果：患者最初出现头痛和复视。影像学检查显示左侧中脑背侧有一个17x13毫米的肿瘤，并伴有梗阻性脑积水。经过 2.5 小时的 EOTA 手术，肿瘤被完全切除，头痛症状得到缓解，复视也有所改善。术后没有出现新的并发症。患者术后七天出院，无需入住重症监护室。病理检查证实了海绵畸形的诊断。此外，EOTA还有助于同时进行内镜下第三脑室造口术，并且在三个月的随访期间未发现脑积水迹象：结论：EOTA是神经外科技术在中脑背侧肿瘤切除术方面的重大进步，提高了手术的精确性和安全性。这种方法有助于改善患者预后，降低并发症发生率。为了验证这些研究结果，并为中脑肿瘤切除术中的EOTA应用制定标准化方案，我们有必要开展进一步的研究。

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引用次数: 0

Cerebrospinal Fluid Prognostic Index in Ventriculoperitoneal Shunt Infection 脑室腹腔分流术感染的 CSF 预后指数

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery

Pub Date : 2025-02-01 DOI: 10.1016/j.wneu.2024.11.088

Abdurrahman Arpa, Pinar Aydin Ozturk

Background

Considering the consequences of shunt infection, the importance of early diagnosis and effective treatment becomes clear. However, there is no clear parameter to predict the management of shunt infection. Since we thought that an index including cerebrospinal fluid (CSF) leukocyte, glucose, and protein levels may affect treatment guidance, we aimed to investigate its effect on prognosis using the index we defined as CSF prognostic index.

Methods

Ventriculoperitoneal shunt infection patients' age, gender, etiology of hydrocephalus, serum glucose, leukocytes, white blood cell, C-reactive protein, CSF leukocyte, glucose, and leukoglycemic index (LGI) at admission were included. A new index was defined to include leukocyte, glucose, and protein values in CSF and investigate their effect on prognosis. CSF prognostic index = CSF leukocyte × CSF protein/CSF glucose.

Results

The study included 46 patients aged less than 18 years with shunt infection. There was no correlation among serum glucose, C-reactive protein, leukocytes, monocytes, lymphocytes, platelets, serum LGI, CSF LGI, and treatment duration. A positive correlation was found between CSF prognostic index and treatment duration, which was statistically significant (P = 0.011).

Conclusions

The CSF prognostic index is an index that can be easily evaluated with CSF findings at the time of presentation and can predict both the duration of treatment and the need for intrathecal treatment. Considering the use of broader spectrum antibiotherapies initially in patients with a high CSF prognostic index will avoid possible complications, provide less psychosocial impact on the patient and his/her relatives, and reduce the cost of treatment.

目的：考虑到分流管感染的后果，早期诊断和有效治疗的重要性不言而喻。然而，目前还没有明确的参数来预测分流管感染的治疗。由于我们认为包括脑脊液（CSF）白细胞、葡萄糖和蛋白质水平在内的指标可能会影响治疗指导，因此我们将该指标定义为脑脊液预后指数，旨在研究其对预后的影响：方法：纳入脑室腹腔分流术感染患者入院时的年龄、性别、脑积水病因、血清葡萄糖、白细胞、白血球、CRP、CSF白细胞、葡萄糖和白糖指数（LGI）。新定义的指数包括 CSF 中的白细胞、葡萄糖和蛋白质值，并研究其对预后的影响。CSF 预后指数 = CSF 白细胞 x CSF 蛋白质 / CSF 葡萄糖：研究纳入了 46 名 18 岁以下的分流感染患者。血清葡萄糖、CRP、白细胞、单核细胞、淋巴细胞、血小板、血清 LGI、CSF LGI 与治疗时间无相关性。CSF预后指数与治疗时间呈正相关，有统计学意义（P = 0.011）：结论：脑脊液预后指数是一种可以根据患者发病时的脑脊液检查结果进行简便评估的指数，可以预测治疗持续时间和鞘内治疗的必要性。考虑对 CSF 预后指数较高的患者首先使用广谱抗生素治疗，可避免可能出现的并发症，减少对患者及其亲属的社会心理影响，并降低治疗费用。

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引用次数: 0

Navigated Osteosynthesis for Unstable Atlas Fractures: Technical Note and Case Series 不稳定寰椎骨折的导航植骨术：技术说明和病例系列。

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery

Pub Date : 2025-02-01 DOI: 10.1016/j.wneu.2024.11.107

John D. Arena , Yohannes Ghenbot , Samuel B. Tomlinson , Connor A. Wathen , Andrea L.C. Schneider , H. Isaac Chen , Zarina S. Ali , James M. Schuster , Dmitriy Petrov

Objective

Fractures of the atlas are typically considered stable or unstable based on the integrity of the transverse ligament. Whereas stable Jefferson burst fractures can be treated nonoperatively, unstable fractures with disruption of the transverse ligament often require surgical intervention. Atlas osteosynthesis has been proposed as a motion-preserving alternative to atlantoaxial fusion. Intraoperative navigation may facilitate safe placement of C1 instrumentation.

Methods

Cases of patients with unstable atlas fractures treated with navigated osteosynthesis at a single level I trauma center were identified and retrospectively reviewed. Clinical presentation, surgical management, and postoperative outcomes were assessed.

Results

Eight patients underwent navigated posterior atlas osteosynthesis for unstable C1 fractures between December 2015 and January 2024. All patients demonstrated injury to the transverse ligament (Dickman type I [n = 1] and type II [n = 7]). Patients were followed with serial radiographs showing preserved alignment, with no significant change in postoperative atlantodental interval at the most recent follow-up (+0.2 ± 0.87 mm [mean change ± standard deviation]; P = 0.53). Six patients obtained follow-up computed tomography, all of which demonstrated evidence of osseous union across fractures without hardware complication. No patients developed postoperative instability requiring fusion.

Conclusions

Atlas osteosynthesis is an attractive motion-preserving approach to the treatment of unstable atlas fractures, avoiding the morbidity of atlantoaxial fusion. Classically reserved for Jefferson fractures with Dickman type II transverse ligament injury, atlas osteosynthesis may also be a viable option for type I transverse ligament injuries. Intraoperative navigation can be particularly useful for screw placement in the setting of traumatically distorted anatomy with lateral mass displacement.

目的：基于横韧带的完整性，寰椎骨折通常被认为是“稳定”或“不稳定”。稳定型杰弗逊爆裂骨折可以非手术治疗，而不稳定型骨折伴横韧带断裂通常需要手术治疗。寰枢骨融合术已被提出作为一种保持运动的替代寰枢融合。术中导航可促进C1内固定的安全放置。方法：对在一级创伤中心行导航植骨术治疗不稳定寰椎骨折的病例进行回顾性分析。评估临床表现、手术处理和术后结果。结果：2015年12月至2024年1月，8例不稳定C1骨折患者行导航后路寰椎骨融合术。所有病例均表现为横韧带损伤（Dickman I型[n=1]和II型[n=7]）。对患者进行系列x线片随访，显示保持对齐，在最近的随访中，术后寰齿间距无明显变化（+0.2±0.87mm[平均变化±SD]， p=0.53）。6例患者随访CT，均显示骨折骨愈合，无硬体并发症。没有患者出现术后不稳定需要融合。结论：寰枢骨融合术是治疗不稳定寰枢骨折的一种有吸引力的保持运动的方法，避免了寰枢融合的发病率。传统上用于Jefferson骨折合并Dickman II型横韧带损伤，寰椎骨融合术也可能是治疗I型横韧带损伤的可行选择。术中导航对于外伤性解剖畸形伴侧块移位的螺钉置入尤其有用。

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引用次数: 0

Enhancing the Technical Pearls for L5–S1 Anterior Lumbar Interbody Fusion in Patients with Body Mass Index More Than 30: Clinical and Radiographic Outcomes at 1-Year Follow-Up 在体重指数大于30的患者中增强L5-S1前路腰椎体间融合的技术指标：1年随访的临床和影像学结果

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery

Pub Date : 2025-02-01 DOI: 10.1016/j.wneu.2024.11.119

Juan P. Giraldo, Gabriella P. Williams, Martin P. Zomaya, Winward Choy, Jay D. Turner, Laura A. Snyder, Juan S. Uribe

Background

Performing anterior lumbar interbody fusion (ALIF) in patients with a body mass index (BMI) >30 presents surgical challenges. To overcome those challenges, a modified procedure is described.

Methods

This study retrospectively reviewed patients with a BMI >30 who underwent the modified L5–S1 ALIF procedure from August 2017 to September 2023. Patient demographic and operative characteristics were collected. Clinical and radiographic outcomes were analyzed before surgery and at 1-year follow-up. An analysis was performed comparing patients with a BMI >30 who underwent the modified ALIF procedure versus the standard ALIF procedure.

Results

A total of 26 patients with BMI >30 were evaluated. Thirteen received treatment with the modified ALIF technique, and 13 received treatment with the standard ALIF technique. Operative time was significantly shorter in the modified ALIF technique cohort (P = 0.006). Preoperative and postoperative radiographic findings indicated significant differences in anterior disc height (P < 0.001), posterior disc height (P = 0.02), and L5–S1 segmental lordosis (P < 0.001) in patients undergoing the modified ALIF technique. There were no intraoperative complications. Postoperative visual analog scale for back pain, visual analog scale for leg pain, and Oswestry Disability Index scores significantly improved after surgery (P < 0.05) in both cohorts after 1 year. Complete interbody fusion was achieved according to computed tomography evaluation 1 year after surgery in more than 80% of cases.

Conclusions

ALIF surgery is a safe technique to address lumbar pathologies. This operative technique provides complimentary abdominal exposure data for access surgeons while performing ALIFs in patients with BMI >30. This technique could reduce operative time in such patients.

背景：在体重指数（BMI）为bbb30的患者中进行前路腰椎椎间融合术（ALIF）存在手术挑战。为了克服这些挑战，本文描述了一种改进的程序。方法：本研究回顾性分析了2017年8月至2023年9月期间接受改良L5-S1 ALIF手术的BMI为bbb30的患者。收集患者人口学和手术特征。分析术前和1年随访的临床和影像学结果。对BMI为bbb30的患者进行了比较分析，他们接受了改良的ALIF手术和标准的ALIF手术。结果：共对26例BMI为bbb30的患者进行了评估。13例采用改良ALIF技术治疗，13例采用标准ALIF技术治疗。改良ALIF技术组的手术时间明显缩短（p=0.006）。术前和术后x线检查显示前盘高度有显著差异(结论：ALIF手术是治疗腰椎病变的安全技术。该手术技术为进入外科医生在对BMI为bb30的患者进行ALIFs时提供了补充的腹部暴露数据。该技术可减少此类患者的手术时间。

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引用次数: 0

Letter to the Editor Regarding “Global Trends of Mechanical Thrombectomy in Acute Ischemic Stroke over the Past Decade: A Scientometric Analysis Based on WOSCC and GBD Database” 关于“近十年来急性缺血性卒中机械取栓的全球趋势：基于WOSCC和GBD数据库的科学计量学分析”的致编辑信。

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery

Pub Date : 2025-02-01 DOI: 10.1016/j.wneu.2024.123622

Saarang Patel, Kyle W. Scott, Visish M. Srinivasan

引用次数: 0

Toward a Personalized Paradigm for Extracranial Pseudoaneurysm Treatment 颅内外假性动脉瘤治疗的个性化范例。

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery

Pub Date : 2025-02-01 DOI: 10.1016/j.wneu.2024.11.071

Emmanuel O. Mensah, Jean Filo, Christopher S. Ogilvy

引用次数: 0