{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:44:38Z","timestamp":1792806278933,"version":"4.5.0"},"reference-count":26,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Cavernous sinus meningioma (CSM) can affect visual function and require expeditious treatment to prevent permanent visual loss. Authors of this retrospective study sought to determine the factors associated with visual functional outcomes in CSM patients treated with surgery, stereotactic radiosurgery (SRS), or stereotactic radiation therapy (SRT), alone or in combination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Consecutive patients with CSM who had presented at an academic tertiary care hospital from 2000 to 2018 were identified through retrospective chart review. Visual function\u2014visual eye deficit (VED), optic disc (OD) appearance, intraocular pressure (IOP), and extraocular movement (EOM)\u2014was assessed before and after treatment for CSM. VED with visual acuity (VA) \u2264 20\/200 and visual field defect \u2265 \u221211 dB, pale OD appearance in the ipsilateral or contralateral eye, increased ipsilateral IOP, and\/or EOM restriction were defined as a poor visual functional outcome. Multivariable logistic regression was used to evaluate the associations between pretreatment visual functional assessment and posttreatment visual outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>The study cohort included 44 patients (73% female; median age 55 years), with a median clinical follow-up of 14 months. Ipsilateral VED improved, remained stable, or worsened, respectively, in 0%, 33.4%, and 66.6% of the patients after subtotal resection (STR) alone; in 52.6%, 31.6%, and 15.8% after STR plus radiation treatment; in 28.5%, 43.0%, and 28.5% after gross-total resection (GTR) alone; and in 56.3%, 43.7%, and 0% after radiation treatment (SRS or SRT) alone. Contralateral VED remained intact in all the patients after STR alone and those with radiation treatment (SRS or SRT) alone; however, it improved, remained stable, or worsened in 10.5%, 84.2%, and 5.3% after STR plus radiation treatment and in 43.0%, 28.5%, and 28.5% after GTR alone. EOM remained intact, fully recovered, remained stable, and worsened, respectively, in 0%, 50%, 50%, and 0% of the patients after STR alone; in 36.8%, 47.4%, 15.8%, and 0% of the patients after STR with radiation treatment; in 57.1%, 0%, 28.6%, and 14.3% of the patients after GTR alone; and in 56.2%, 37.5%, 6.3%, and 0% of the patients after radiation treatment (SRS or SRT) alone.<\/jats:p>\n                    <jats:p>In multivariable analyses adjusted for age, tumor volume, and treatment modality, initial ipsilateral poor VED (OR 10.1, 95% CI 1.05\u201397.2, p = 0.04) and initial ipsilateral pale OD appearance (OR 21.1, 95% CI 1.6\u2013270.5, p = 0.02) were associated with poor ipsilateral VED posttreatment. Similarly, an initial pale OD appearance (OR 15.7, 95% CI 1.3\u2013199.0, p = 0.03), initial poor VED (OR 21.7, 95% CI 1.2\u2013398.6, p = 0.03), and a higher IOP in the ipsilateral eye (OR 55.3, 95% CI 1.7\u2013173.9, p = 0.02) were associated with an ipsilateral pale OD appearance posttreatment. Furthermore, a higher initial ipsilateral IOP (OR 35.9, 95% CI 3.3\u2013400.5, p = 0.004) was indicative of a higher IOP in the ipsilateral eye posttreatment. Finally, initial restricted EOM was indicative of restricted EOM posttreatment (OR 20.6, 95% CI 18.7\u201377.0, p = 0.02).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Pretreatment visual functional assessment predicts visual outcomes in patients with CSM and can be used to identify patients at greater risk for vision loss.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2020.2.jns193009","type":"journal-article","created":{"date-parts":[[2020,5,15]],"date-time":"2020-05-15T03:42:19Z","timestamp":1589514139000},"page":"1435-1446","source":"Crossref","is-referenced-by-count":4,"title":["Predictors of visual functional outcome following treatment for cavernous sinus meningioma"],"prefix":"10.3171","volume":"134","author":[{"given":"Nida","family":"Fatima","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria Y.","family":"Ding","sequence":"additional","affiliation":[{"name":"Quantitative Sciences Unit, Stanford University School of Medicine, Stanford, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Summer S.","family":"Han","sequence":"additional","affiliation":[{"name":"Quantitative Sciences Unit, Stanford University School of Medicine, Stanford, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven D.","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Meola","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1","key":"b1","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"20","DOI":"10.3171\/jns.1996.84.1.0020","article-title":"Petroclival meningiomas: surgical experience in 109 cases","volume":"84","author":"Couldwell\n \nWT","year":"1996","unstructured":"Couldwell\n \nWT\n\n, \n\nFukushima\n \nT\n\n, \n\nGiannotta\n \nSL\n\n, \n\nWeiss\n \nMH\n\n\n. \nPetroclival meningiomas: surgical experience in 109 cases\n. \nJ Neurosurg\n. \n1996\n;\n84\n(\n1\n):\n20\n\u2013\n28\n.\n861383110.3171\/jns.1996.84.1.0020"},{"issue":"2","key":"b2","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"245","DOI":"10.3171\/jns.1994.81.2.0245","article-title":"Outcome of aggressive removal of cavernous sinus meningiomas","volume":"81","author":"DeMonte\n \nF","year":"1994","unstructured":"DeMonte\n \nF\n\n, \n\nSmith\n \nHK\n\n, \n\nal-Mefty\n \nO\n\n\n. \nOutcome of aggressive removal of cavernous sinus meningiomas\n. \nJ Neurosurg\n. \n1994\n;\n81\n(\n2\n):\n245\n\u2013\n251\n.\n10.3171\/jns.1994.81.2.02458027808"},{"issue":"2","key":"b3","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"252","DOI":"10.3171\/jns.1994.81.2.0252","article-title":"Infiltration of the carotid artery by cavernous sinus meningioma","volume":"81","author":"Kotapka\n \nMJ","year":"1994","unstructured":"Kotapka\n \nMJ\n\n, \n\nKalia\n \nKK\n\n, \n\nMartinez\n \nAJ\n\n, \n\nSekhar\n \nLN\n\n\n. \nInfiltration of the carotid artery by cavernous sinus meningioma\n. \nJ Neurosurg\n. \n1994\n;\n81\n(\n2\n):\n252\n\u2013\n255\n.\n10.3171\/jns.1994.81.2.02528027809"},{"issue":"2","key":"b4","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1097\/00006123-199908000-00003","article-title":"Proposed grading system to predict the extent of resection and outcomes for cranial base meningiomas","volume":"45","author":"Levine\n \nZT","year":"1999","unstructured":"Levine\n \nZT\n\n, \n\nBuchanan\n \nRI\n\n, \n\nSekhar\n \nLN\n\n, \n\n\n \nProposed grading system to predict the extent of resection and outcomes for cranial base meningiomas\n. \nNeurosurgery\n. \n1999\n;\n45\n(\n2\n):\n221\n\u2013\n230\n.\n1044906510.1097\/00006123-199908000-00003"},{"issue":"4","key":"b5","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"535","DOI":"10.3171\/jns.1997.87.4.0535","article-title":"Meningiomas involving the cavernous sinus: histological factors affecting the degree of resection","volume":"87","author":"Sen\n \nC","year":"1997","unstructured":"Sen\n \nC\n\n, \n\nHague\n \nK\n\n\n. \nMeningiomas involving the cavernous sinus: histological factors affecting the degree of resection\n. \nJ Neurosurg\n. \n1997\n;\n87\n(\n4\n):\n535\n\u2013\n543\n.\n10.3171\/jns.1997.87.4.05359322844"},{"issue":"1","key":"b6","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1227\/00006123-199507000-00001","article-title":"The results of surgery for benign tumors of the cavernous sinus","volume":"37","author":"Cusimano\n \nMD","year":"1995","unstructured":"Cusimano\n \nMD\n\n, \n\nSekhar\n \nLN\n\n, \n\nSen\n \nCN\n\n, \n\n\n \nThe results of surgery for benign tumors of the cavernous sinus\n. \nNeurosurgery\n. \n1995\n;\n37\n(\n1\n):\n1\n\u2013\n10\n.\n858766710.1227\/00006123-199507000-00001"},{"issue":"2","key":"b7","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"238","DOI":"10.1097\/00006123-199702000-00003","article-title":"The surgical resectability of meningiomas of the cavernous sinus","volume":"40","author":"O\u2019Sullivan\n \nMG","year":"1997","unstructured":"O\u2019Sullivan\n \nMG\n\n, \n\nvan Loveren\n \nHR\n\n, \n\nTew\n \nJM\n \nJr\n\n\n. \nThe surgical resectability of meningiomas of the cavernous sinus\n. \nNeurosurgery\n. \n1997\n;\n40\n(\n2\n):\n238\n\u2013\n247\n.\n900785510.1097\/00006123-199702000-00003"},{"issue":"5","key":"b8","series-title":"Neurosurgery","first-page":"950","article-title":"Optic nerve sheath meningiomas: visual improvement after stereotactic radiotherapy","volume":"50","author":"Liu\n \nJK","year":"2002","unstructured":"Liu\n \nJK\n\n, \n\nForman\n \nS\n\n, \n\nHershewe\n \nGL\n\n, \n\n\n \nOptic nerve sheath meningiomas: visual improvement after stereotactic radiotherapy\n. \nNeurosurgery\n. \n2002\n;\n50\n(\n5\n):\n950\n\u2013\n957\n.\n11950397"},{"key":"b9","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1373","DOI":"10.1097\/00006123-200212000-00007","article-title":"Linear accelerator radiosurgery for meningiomas in and around the cavernous sinus","volume":"51","author":"Spiegelmann\n \nR","year":"2002","unstructured":"Spiegelmann\n \nR\n\n, \n\nNissim\n \nO\n\n, \n\nMenhel\n \nJ\n\n, \n\n\n \nLinear accelerator radiosurgery for meningiomas in and around the cavernous sinus\n. \nNeurosurgery\n. \n2002\n;\n51\n:\n1373\n\u2013\n1380\n.\n10.1097\/00006123-200212000-0000712445342"},{"issue":"3","key":"b10","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1227\/01.NEU.0000079506.75164.F4","article-title":"Meningiomas involving the optic nerve: technical aspects and outcomes for a series of 50 patients","volume":"53","author":"Margalit\n \nNS","year":"2003","unstructured":"Margalit\n \nNS\n\n, \n\nLesser\n \nJB\n\n, \n\nMoche\n \nJ\n\n, \n\nSen\n \nC\n\n\n. \nMeningiomas involving the optic nerve: technical aspects and outcomes for a series of 50 patients\n. \nNeurosurgery\n. \n2003\n;\n53\n(\n3\n):\n523\n\u2013\n533\n.\n1294356910.1227\/01.NEU.0000079506.75164.F4"},{"issue":"12","key":"b11","series-title":"Br J Ophthalmol","doi-asserted-by":"publisher","first-page":"960","DOI":"10.1136\/bjo.73.12.960","article-title":"Primary optic nerve sheath meningioma","volume":"73","author":"Wright\n \nJE","year":"1989","unstructured":"Wright\n \nJE\n\n, \n\nMcNab\n \nAA\n\n, \n\nMcDonald\n \nWI\n\n\n. \nPrimary optic nerve sheath meningioma\n. \nBr J Ophthalmol\n. \n1989\n;\n73\n(\n12\n):\n960\n\u2013\n966\n.\n261119210.1136\/bjo.73.12.960"},{"issue":"3","key":"b12","series-title":"J Neurooncol","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1007\/s11060-009-9874-8","article-title":"Fractionated stereotactic radiation therapy in the management of primary optic nerve sheath meningiomas","volume":"94","author":"Milker-Zabel\n \nS","year":"2009","unstructured":"Milker-Zabel\n \nS\n\n, \n\nHuber\n \nP\n\n, \n\nSchlegel\n \nW\n\n, \n\n\n \nFractionated stereotactic radiation therapy in the management of primary optic nerve sheath meningiomas\n. \nJ Neurooncol\n. \n2009\n;\n94\n(\n3\n):\n419\n\u2013\n424\n.\n10.1007\/s11060-009-9874-819337693"},{"issue":"8","key":"b13","series-title":"Clin Oncol (R Coll Radiol).","doi-asserted-by":"publisher","first-page":"e106","DOI":"10.1016\/j.clon.2012.03.015","article-title":"Fractionated stereotactic conformal radiotherapy for optic nerve sheath meningiomas","volume":"24","author":"Sold\u00e0\n \nF","year":"2012","unstructured":"Sold\u00e0\n \nF\n\n, \n\nWharram\n \nB\n\n, \n\nGunapala\n \nR\n\n, \n\nBrada\n \nM\n\n\n. \nFractionated stereotactic conformal radiotherapy for optic nerve sheath meningiomas\n. \nClin Oncol (R Coll Radiol).\n \n2012\n;\n24\n(\n8\n):\ne106\n\u2013\ne112\n.\n10.1016\/j.clon.2012.03.01522626521"},{"issue":"5","key":"b14","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1007\/s00701-008-1554-5","article-title":"Visual outcome after surgery for cavernous sinus meningioma","volume":"150","author":"Jacob\n \nM","year":"2008","unstructured":"Jacob\n \nM\n\n, \n\nWydh\n \nE\n\n, \n\nVighetto\n \nA\n\n, \n\nSindou\n \nM\n\n\n. \nVisual outcome after surgery for cavernous sinus meningioma\n. \nActa Neurochir (Wien)\n. \n2008\n;\n150\n(\n5\n):\n421\n\u2013\n429\n.\n10.1007\/s00701-008-1554-518421411"},{"key":"b15","series-title":"The Unseen Minority: A Social History of Blindness in the United States","author":"Koestler\n \nFA","year":"1976","unstructured":"Koestler\n \nFA\n\n\n. \nThe Unseen Minority: A Social History of Blindness in the United States\n. \nDavid McKay Co\n; \n1976\n."},{"issue":"6","key":"b16","series-title":"Oper Neurosurg (Hagerstown)","doi-asserted-by":"publisher","first-page":"E91","DOI":"10.1093\/ons\/opy019","article-title":"Microsurgical resection of cavernous sinus meningioma: 2-dimensional operative video","volume":"15","author":"C\u00e2ndido\n \nDNC","year":"2018","unstructured":"C\u00e2ndido\n \nDNC\n\n, \n\nde Oliveira\n \nJG\n\n, \n\nBorba\n \nLAB\n\n\n. \nMicrosurgical resection of cavernous sinus meningioma: 2-dimensional operative video\n. \nOper Neurosurg (Hagerstown)\n. \n2018\n;\n15\n(\n6\n):\nE91\n.\n10.1093\/ons\/opy01929514273"},{"issue":"5","key":"b17","series-title":"Chin Med J (Engl).","first-page":"406","article-title":"Vascular architecture of the human optic chiasm and bitemporal field defects","volume":"103","author":"Lao\n \nYX","year":"1990","unstructured":"Lao\n \nYX\n\n, \n\nGao\n \nH\n\n, \n\nXu\n \nJM\n\n\n. \nVascular architecture of the human optic chiasm and bitemporal field defects\n. \nChin Med J (Engl).\n \n1990\n;\n103\n(\n5\n):\n406\n\u2013\n414\n.\n2118058"},{"issue":"1","key":"b18","series-title":"J Neuroophthalmol","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1097\/00041327-200503000-00011","article-title":"A mechanical theory to account for bitemporal hemianopia from chiasmal compression","volume":"25","author":"McIlwaine\n \nGG","year":"2005","unstructured":"McIlwaine\n \nGG\n\n, \n\nCarrim\n \nZI\n\n, \n\nLueck\n \nCJ\n\n, \n\nChrisp\n \nTM\n\n\n. \nA mechanical theory to account for bitemporal hemianopia from chiasmal compression\n. \nJ Neuroophthalmol\n. \n2005\n;\n25\n(\n1\n):\n40\n\u2013\n43\n.\n1575613310.1097\/00041327-200503000-00011"},{"issue":"3","key":"b19","series-title":"J Stroke","doi-asserted-by":"publisher","first-page":"344","DOI":"10.5853\/jos.2015.17.3.344","article-title":"Anterior optic pathway compression due to internal carotid artery aneurysms: neurosurgical management and outcomes","volume":"17","author":"Park\n \nW","year":"2015","unstructured":"Park\n \nW\n\n, \n\nPark\n \nJC\n\n, \n\nHan\n \nK\n\n, \n\n\n \nAnterior optic pathway compression due to internal carotid artery aneurysms: neurosurgical management and outcomes\n. \nJ Stroke\n. \n2015\n;\n17\n(\n3\n):\n344\n\u2013\n353\n.\n2643800010.5853\/jos.2015.17.3.344"},{"issue":"1","key":"b20","series-title":"Arch Pathol Lab Med","doi-asserted-by":"publisher","first-page":"162","DOI":"10.5858\/arpa.2016-0027-RS","article-title":"Pathology of ischemic optic neuropathy","volume":"141","author":"Patel\n \nHR","year":"2017","unstructured":"Patel\n \nHR\n\n, \n\nMargo\n \nCE\n\n\n. \nPathology of ischemic optic neuropathy\n. \nArch Pathol Lab Med\n. \n2017\n;\n141\n(\n1\n):\n162\n\u2013\n166\n.\n10.5858\/arpa.2016-0027-RS28029908"},{"issue":"6","key":"b21","series-title":"Curr Opin Ophthalmol","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1097\/ICU.0b013e3283112bc8","article-title":"Nonarteritic anterior ischaemic optic neuropathy","volume":"19","author":"Ho\n \nSF","year":"2008","unstructured":"Ho\n \nSF\n\n, \n\nDhar-Munshi\n \nS\n\n\n. \nNonarteritic anterior ischaemic optic neuropathy\n. \nCurr Opin Ophthalmol\n. \n2008\n;\n19\n(\n6\n):\n461\n\u2013\n467\n.\n1885469010.1097\/ICU.0b013e3283112bc8"},{"issue":"2","key":"b22","series-title":"Anat Rec","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1002\/1097-0185(20001001)260:2<124::AID-AR20>3.0.CO;2-D","article-title":"Neuronal density in the human retinal ganglion cell layer from 16-77 years","volume":"260","author":"Harman\n \nA","year":"2000","unstructured":"Harman\n \nA\n\n, \n\nAbrahams\n \nB\n\n, \n\nMoore\n \nS\n\n, \n\nHoskins\n \nR\n\n\n. \nNeuronal density in the human retinal ganglion cell layer from 16-77 years\n. \nAnat Rec\n. \n2000\n;\n260\n(\n2\n):\n124\n\u2013\n131\n.\n10.1002\/1097-0185(20001001)260:2<124::AID-AR20>3.0.CO;2-D10993949"},{"issue":"18","key":"b23","series-title":"Neurology","doi-asserted-by":"publisher","first-page":"1866","DOI":"10.1212\/WNL.0b013e318271f755","article-title":"Sex-specific differences in retinal nerve fiber layer thinning after acute optic neuritis","volume":"79","author":"Costello\n \nF","year":"2012","unstructured":"Costello\n \nF\n\n, \n\nHodge\n \nW\n\n, \n\nPan\n \nYI\n\n, \n\n\n \nSex-specific differences in retinal nerve fiber layer thinning after acute optic neuritis\n. \nNeurology\n. \n2012\n;\n79\n(\n18\n):\n1866\n\u2013\n1872\n.\n2307701210.1212\/WNL.0b013e318271f755"},{"issue":"5","key":"b24","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1087","DOI":"10.3171\/2010.3.JNS091807","article-title":"Factors affecting outcome following treatment of patients with cavernous sinus meningiomas","volume":"113","author":"Sughrue\n \nME","year":"2010","unstructured":"Sughrue\n \nME\n\n, \n\nRutkowski\n \nMJ\n\n, \n\nAranda\n \nD\n\n, \n\n\n \nFactors affecting outcome following treatment of patients with cavernous sinus meningiomas\n. \nJ Neurosurg\n. \n2010\n;\n113\n(\n5\n):\n1087\n\u2013\n1092\n.\n2045027410.3171\/2010.3.JNS091807"},{"issue":"5","key":"b25","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"873","DOI":"10.1227\/01.NEU.0000179924.76551.cd","article-title":"Evaluation of fractionated radiotherapy and gamma knife radiosurgery in cavernous sinus meningiomas: treatment strategy","volume":"57","author":"Metellus\n \nP","year":"2005","unstructured":"Metellus\n \nP\n\n, \n\nRegis\n \nJ\n\n, \n\nMuracciole\n \nX\n\n, \n\n\n \nEvaluation of fractionated radiotherapy and gamma knife radiosurgery in cavernous sinus meningiomas: treatment strategy\n. \nNeurosurgery\n. \n2005\n;\n57\n(\n5\n):\n873\n\u2013\n886\n.\n10.1227\/01.NEU.0000179924.76551.cd16284558"},{"issue":"suppl 3","key":"b26","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"390","DOI":"10.3171\/sup.2004.101.supplement3.0390","article-title":"Dose fractionation in stereotactic radiotherapy for parasellar meningiomas: radiobiological considerations of efficacy and optic nerve tolerance","volume":"101","author":"Shrieve\n \nDC","year":"2004","unstructured":"Shrieve\n \nDC\n\n, \n\nHazard\n \nL\n\n, \n\nBoucher\n \nK\n\n, \n\nJensen\n \nRL\n\n\n. \nDose fractionation in stereotactic radiotherapy for parasellar meningiomas: radiobiological considerations of efficacy and optic nerve tolerance\n. \nJ Neurosurg\n. \n2004\n;\n101\n(\nsuppl 3\n):\n390\n\u2013\n395\n.\n1553719410.3171\/sup.2004.101.supplement3.0390"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/134\/5\/article-p1435.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/134\/5\/article-p1435.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/134\/5\/article-p1435.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:13:29Z","timestamp":1792804409000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/134\/5\/article-p1435.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5]]},"references-count":26,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3171\/2020.2.jns193009","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5]]}}}