{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T04:11:51Z","timestamp":1770351111584,"version":"3.49.0"},"reference-count":38,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"10","license":[{"start":{"date-parts":[[2024,3,4]],"date-time":"2024-03-04T00:00:00Z","timestamp":1709510400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3,4]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Normal pressure hydrocephalus (NPH) treatment consists of using valves for drainage, as it is for hydrocephalus in general. Despite this, complications can occur, putting the patient at risk, and neurological monitoring is crucial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 61-year-old male, who had been diagnosed with NPH 3 years prior and was being treated with a ventriculoperitoneal shunt with a programmable valve, presented to the emergency department because of a traumatic brain injury due to a fall from standing height. No previous complications were reported. He had an altered intracranial pressure (ICP) waveform in the emergency room when monitored with the brain4care device, with a P2\/P1 ratio of 1.6. Imaging helped to confirm shunt dysfunction. Revision surgery normalized the ratio to 1.0, and the patient was discharged. Upon return after 14 days, an outpatient analysis revealed a ratio of 0.6, indicating improvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>In selected cases of NPH, noninvasive ICP waveform morphology analysis can be effective as a diagnostic aid, as well as in the pre- and postsurgical follow-up, given the possibility of comparing the values of ICP preoperatively and immediately postoperatively and the outpatient P2\/P1 ratio, helping to manage these patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case23437","type":"journal-article","created":{"date-parts":[[2024,3,4]],"date-time":"2024-03-04T12:23:03Z","timestamp":1709554983000},"source":"Crossref","is-referenced-by-count":2,"title":["Management of shunt dysfunction using noninvasive intracranial pressure waveform monitoring: illustrative case"],"prefix":"10.3171","volume":"7","author":[{"given":"Raphael","family":"Bertani","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Cerebral Hydrodynamics Group, University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caio","family":"Perret","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Municipal Miguel Couto, Rio de Janeiro, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Koester","sequence":"additional","affiliation":[{"name":"School of Medicine, Vanderbilt University, Nashville, Tennessee;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paulo","family":"Santa Maria","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Municipal Miguel Couto, Rio de Janeiro, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Savio","family":"Batista","sequence":"additional","affiliation":[{"name":"Medical School, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophia de Andrade","family":"Cavicchioli","sequence":"additional","affiliation":[{"name":"Medical School, Universidade de Araraquara, Araraquara, S\u00e3o Paulo, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sany Tomomi de Almeida Rocha","family":"Arita","sequence":"additional","affiliation":[{"name":"Medical School, Faculdade Santa Marcelina, S\u00e3o Paulo, Brazil; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruy","family":"Monteiro","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Municipal Miguel Couto, Rio de Janeiro, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianne","family":"Lucchesi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Municipal Miguel Couto, Rio de Janeiro, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernando Augusto","family":"Vasconcellos","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Municipal Miguel Couto, Rio de Janeiro, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matheus","family":"Miranda","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Cerebral Hydrodynamics Group, University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wellingson Silva","family":"Paiva","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernando Gomes","family":"Pinto","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Cerebral Hydrodynamics Group, University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"5","key":"b1","series-title":"PLoS One.","first-page":"e0217705","article-title":"Prevalence of idiopathic normal pressure hydrocephalus: A prospective, population-based study","volume":"14","author":"Andersson J","year":"2019","unstructured":"Andersson J, Rosell M, Kockum K, Lilja-Lund O, S\u00f6derstr\u00f6m L, Laurell K Prevalence of idiopathic normal pressure hydrocephalus: A prospective, population-based study. PLoS One. 2019;14(5):e0217705."},{"issue":"2","key":"b2","series-title":"JAAPA.","first-page":"35","article-title":"Normal-pressure hydrocephalus: a rare cause of reversible dementia","volume":"35","author":"Liang K","year":"2022","unstructured":"Liang K, Chebrolu P Normal-pressure hydrocephalus: a rare cause of reversible dementia. JAAPA. 2022;35(2):35\u201338."},{"key":"b3","series-title":"Neurol India.","first-page":"S561","article-title":"Natural history, treatment outcomes and quality of life in idiopathic normal pressure hydrocephalus (iNPH)","volume":"69","author":"Isaacs AM","year":"2021","unstructured":"Isaacs AM, Hamilton M Natural history, treatment outcomes and quality of life in idiopathic normal pressure hydrocephalus (iNPH). Neurol India. 2021;69(suppl):S561\u2013S568."},{"issue":"1","key":"b4","series-title":"Semin Pediatr Neurol.","first-page":"9","article-title":"A contemporary definition and classification of hydrocephalus","volume":"16","author":"Rekate HL","year":"2009","unstructured":"Rekate HL A contemporary definition and classification of hydrocephalus. Semin Pediatr Neurol. 2009;16(1):9\u201315."},{"issue":"1","key":"b5","series-title":"Oper Neurosurg (Hagerstown).","first-page":"25","article-title":"Transesophageal echocardiography-guided ventriculoatrial shunt insertion","volume":"19","author":"Isaacs AM","year":"2020","unstructured":"Isaacs AM, Krahn D, Walker AM, Hurdle H, Hamilton MG Transesophageal echocardiography-guided ventriculoatrial shunt insertion. Oper Neurosurg (Hagerstown). 2020;19(1):25\u201331."},{"key":"b6","series-title":"Brain and Spine Surgery in the Elderly.","first-page":"469","article-title":"Hydrocephalus in the elderly: surgical management of idiopathic normal pressure hydrocephalus","author":"Isaacs AM","year":"2017","unstructured":"Isaacs AM, Williams MA, Hamilton MG Hydrocephalus in the elderly: surgical management of idiopathic normal pressure hydrocephalus. In Berhouma M, Krolak-Salmon P, eds. Brain and Spine Surgery in the Elderly. Springer International Publishing; 2017:469\u2013500."},{"issue":"1","key":"b7","series-title":"J Neurosurg.","first-page":"300","article-title":"Acute low-pressure hydrocephalus: a case series and systematic review of 195 patients","volume":"135","author":"Keough MB","year":"2020","unstructured":"Keough MB, Isaacs AM, Urbaneja G, Dronyk J, Lapointe AP, Hamilton MG Acute low-pressure hydrocephalus: a case series and systematic review of 195 patients. J Neurosurg. 2020;135(1):300\u2013308."},{"issue":"3","key":"b8","series-title":"Rev Bras Ter Intensiva.","first-page":"469","article-title":"The use of a noninvasive intracranial pressure monitoring method in the intensive care unit to improve neuroprotection in postoperative cardiac surgery patients after extracorporeal circulation","volume":"33","author":"Rojas SSO","year":"2021","unstructured":"Rojas SSO, Ordinola AAM, Veiga VC, Souza JM The use of a noninvasive intracranial pressure monitoring method in the intensive care unit to improve neuroprotection in postoperative cardiac surgery patients after extracorporeal circulation. Rev Bras Ter Intensiva. 2021;33(3):469\u2013476."},{"key":"b9","series-title":"Acta Neurochir Suppl (Wien).","first-page":"135","article-title":"Comparison of waveforms between noninvasive and invasive monitoring of intracranial pressure","volume":"131","author":"Gomes I","year":"2021","unstructured":"Gomes I, Shibaki J, Padua B, et\u00a0al. Comparison of waveforms between noninvasive and invasive monitoring of intracranial pressure. Acta Neurochir Suppl (Wien). 2021;131:135\u2013140."},{"issue":"9","key":"b10","series-title":"Braz J Med Biol Res.","first-page":"e6392","article-title":"Noninvasive intracranial pressure monitoring for HIV-associated cryptococcal meningitis","volume":"50","author":"Bollela VR","year":"2017","unstructured":"Bollela VR, Frigieri G, Vilar FC, et\u00a0al. Noninvasive intracranial pressure monitoring for HIV-associated cryptococcal meningitis. Braz J Med Biol Res. 2017;50(9):e6392."},{"issue":"1","key":"b11","series-title":"Clin Pediatr Emerg Med.","first-page":"28","article-title":"Current concepts in the acute management of severe pediatric head trauma","volume":"2","author":"Enrione MA","year":"2001","unstructured":"Enrione MA Current concepts in the acute management of severe pediatric head trauma. Clin Pediatr Emerg Med. 2001;2(1):28\u201340."},{"key":"b12","series-title":"Acta Neurochir Suppl (Wien).","first-page":"117","article-title":"The new ICP minimally invasive method shows that the Monro-Kellie doctrine is not valid","volume":"114","author":"Mascarenhas S","year":"2012","unstructured":"Mascarenhas S, Vilela GHF, Carlotti C, et\u00a0al. The new ICP minimally invasive method shows that the Monro-Kellie doctrine is not valid. Acta Neurochir Suppl (Wien). 2012;114:117\u2013120."},{"issue":"2","key":"b13","series-title":"Neurol Med Chir (Tokyo).","first-page":"63","article-title":"Guidelines for Management of Idiopathic Normal Pressure Hydrocephalus (Third Edition): endorsed by the Japanese Society of Normal Pressure Hydrocephalus","volume":"61","author":"Nakajima M","year":"2021","unstructured":"Nakajima M, Yamada S, Miyajima M, et\u00a0al. Guidelines for Management of Idiopathic Normal Pressure Hydrocephalus (Third Edition): endorsed by the Japanese Society of Normal Pressure Hydrocephalus. Neurol Med Chir (Tokyo). 2021;61(2):63\u201397."},{"issue":"20","key":"b14","series-title":"IEEE Sens J.","first-page":"22270","article-title":"A nanometer resolution wearable wireless medical device for non invasive intracranial pressure monitoring","volume":"21","author":"Andrade R de AP","year":"2021","unstructured":"Andrade R de AP, Oshiro HE, Miyazaki CK, et\u00a0al. A nanometer resolution wearable wireless medical device for non invasive intracranial pressure monitoring. IEEE Sens J. 2021;21(20):22270\u201322284."},{"issue":"2","key":"b15","series-title":"Curr Opin Crit Care.","first-page":"101","article-title":"Intracranial pressure management: moving beyond guidelines","volume":"28","author":"Rubiano AM","year":"2022","unstructured":"Rubiano AM, Figaji A, Hawryluk GW Intracranial pressure management: moving beyond guidelines. Curr Opin Crit Care. 2022;28(2):101\u2013110."},{"issue":"1","key":"b16","series-title":"Neurocrit Care.","first-page":"219","article-title":"Waveform morphology as a surrogate for ICP monitoring: a comparison between an invasive and a noninvasive method","volume":"37","author":"de Moraes FM","year":"2022","unstructured":"de Moraes FM, Rocha E, Barros FCD, et\u00a0al. Waveform morphology as a surrogate for ICP monitoring: a comparison between an invasive and a noninvasive method. Neurocrit Care. 2022;37(1):219\u2013227."},{"issue":"12","key":"b17","series-title":"J Pers Med.","first-page":"1302","article-title":"A novel noninvasive technique for intracranial pressure waveform monitoring in critical care","volume":"11","author":"Brasil S","year":"2021","unstructured":"Brasil S, Solla DJF, Nogueira RC, Teixeira MJ, Malbouisson LMS, Paiva WDS A novel noninvasive technique for intracranial pressure waveform monitoring in critical care. J Pers Med. 2021;11(12):1302."},{"issue":"3","key":"b18","series-title":"Neurocrit Care.","first-page":"591","article-title":"Assessment of cerebral autoregulation using invasive and noninvasive methods of intracranial pressure monitoring","volume":"38","author":"Hassett CE","year":"2023","unstructured":"Hassett CE, Uysal SP, Butler R, Moore NZ, Cardim D, Gomes JA Assessment of cerebral autoregulation using invasive and noninvasive methods of intracranial pressure monitoring. Neurocrit Care. 2023;38(3):591\u2013599."},{"issue":"3","key":"b19","series-title":"J Clin Monit Comput.","first-page":"753","article-title":"Noninvasive intracranial pressure waveforms for estimation of intracranial hypertension and outcome prediction in acute brain-injured patients","volume":"37","author":"Brasil S","year":"2023","unstructured":"Brasil S, Frigieri G, Taccone FS, et\u00a0al. Noninvasive intracranial pressure waveforms for estimation of intracranial hypertension and outcome prediction in acute brain-injured patients. J Clin Monit Comput. 2023;37(3):753\u2013760."},{"issue":"5","key":"b1","series-title":"PLoS One.","first-page":"e0217705","article-title":"Prevalence of idiopathic normal pressure hydrocephalus: A prospective, population-based study","volume":"14","author":"Andersson J","year":"2019","unstructured":"Andersson J, Rosell M, Kockum K, Lilja-Lund O, S\u00f6derstr\u00f6m L, Laurell K Prevalence of idiopathic normal pressure hydrocephalus: A prospective, population-based study. PLoS One. 2019;14(5):e0217705."},{"issue":"2","key":"b2","series-title":"JAAPA.","first-page":"35","article-title":"Normal-pressure hydrocephalus: a rare cause of reversible dementia","volume":"35","author":"Liang K","year":"2022","unstructured":"Liang K, Chebrolu P Normal-pressure hydrocephalus: a rare cause of reversible dementia. JAAPA. 2022;35(2):35\u201338."},{"key":"b3","series-title":"Neurol India.","first-page":"S561","article-title":"Natural history, treatment outcomes and quality of life in idiopathic normal pressure hydrocephalus (iNPH)","volume":"69","author":"Isaacs AM","year":"2021","unstructured":"Isaacs AM, Hamilton M Natural history, treatment outcomes and quality of life in idiopathic normal pressure hydrocephalus (iNPH). Neurol India. 2021;69(suppl):S561\u2013S568."},{"issue":"1","key":"b4","series-title":"Semin Pediatr Neurol.","first-page":"9","article-title":"A contemporary definition and classification of hydrocephalus","volume":"16","author":"Rekate HL","year":"2009","unstructured":"Rekate HL A contemporary definition and classification of hydrocephalus. Semin Pediatr Neurol. 2009;16(1):9\u201315."},{"issue":"1","key":"b5","series-title":"Oper Neurosurg (Hagerstown).","first-page":"25","article-title":"Transesophageal echocardiography-guided ventriculoatrial shunt insertion","volume":"19","author":"Isaacs AM","year":"2020","unstructured":"Isaacs AM, Krahn D, Walker AM, Hurdle H, Hamilton MG Transesophageal echocardiography-guided ventriculoatrial shunt insertion. Oper Neurosurg (Hagerstown). 2020;19(1):25\u201331."},{"key":"b6","series-title":"Brain and Spine Surgery in the Elderly.","first-page":"469","article-title":"Hydrocephalus in the elderly: surgical management of idiopathic normal pressure hydrocephalus","author":"Isaacs AM","year":"2017","unstructured":"Isaacs AM, Williams MA, Hamilton MG Hydrocephalus in the elderly: surgical management of idiopathic normal pressure hydrocephalus. In Berhouma M, Krolak-Salmon P, eds. Brain and Spine Surgery in the Elderly. Springer International Publishing; 2017:469\u2013500."},{"issue":"1","key":"b7","series-title":"J Neurosurg.","first-page":"300","article-title":"Acute low-pressure hydrocephalus: a case series and systematic review of 195 patients","volume":"135","author":"Keough MB","year":"2020","unstructured":"Keough MB, Isaacs AM, Urbaneja G, Dronyk J, Lapointe AP, Hamilton MG Acute low-pressure hydrocephalus: a case series and systematic review of 195 patients. J Neurosurg. 2020;135(1):300\u2013308."},{"issue":"3","key":"b8","series-title":"Rev Bras Ter Intensiva.","first-page":"469","article-title":"The use of a noninvasive intracranial pressure monitoring method in the intensive care unit to improve neuroprotection in postoperative cardiac surgery patients after extracorporeal circulation","volume":"33","author":"Rojas SSO","year":"2021","unstructured":"Rojas SSO, Ordinola AAM, Veiga VC, Souza JM The use of a noninvasive intracranial pressure monitoring method in the intensive care unit to improve neuroprotection in postoperative cardiac surgery patients after extracorporeal circulation. Rev Bras Ter Intensiva. 2021;33(3):469\u2013476."},{"key":"b9","series-title":"Acta Neurochir Suppl (Wien).","first-page":"135","article-title":"Comparison of waveforms between noninvasive and invasive monitoring of intracranial pressure","volume":"131","author":"Gomes I","year":"2021","unstructured":"Gomes I, Shibaki J, Padua B, et\u00a0al. Comparison of waveforms between noninvasive and invasive monitoring of intracranial pressure. Acta Neurochir Suppl (Wien). 2021;131:135\u2013140."},{"issue":"9","key":"b10","series-title":"Braz J Med Biol Res.","first-page":"e6392","article-title":"Noninvasive intracranial pressure monitoring for HIV-associated cryptococcal meningitis","volume":"50","author":"Bollela VR","year":"2017","unstructured":"Bollela VR, Frigieri G, Vilar FC, et\u00a0al. Noninvasive intracranial pressure monitoring for HIV-associated cryptococcal meningitis. Braz J Med Biol Res. 2017;50(9):e6392."},{"issue":"1","key":"b11","series-title":"Clin Pediatr Emerg Med.","first-page":"28","article-title":"Current concepts in the acute management of severe pediatric head trauma","volume":"2","author":"Enrione MA","year":"2001","unstructured":"Enrione MA Current concepts in the acute management of severe pediatric head trauma. Clin Pediatr Emerg Med. 2001;2(1):28\u201340."},{"key":"b12","series-title":"Acta Neurochir Suppl (Wien).","first-page":"117","article-title":"The new ICP minimally invasive method shows that the Monro-Kellie doctrine is not valid","volume":"114","author":"Mascarenhas S","year":"2012","unstructured":"Mascarenhas S, Vilela GHF, Carlotti C, et\u00a0al. The new ICP minimally invasive method shows that the Monro-Kellie doctrine is not valid. Acta Neurochir Suppl (Wien). 2012;114:117\u2013120."},{"issue":"2","key":"b13","series-title":"Neurol Med Chir (Tokyo).","first-page":"63","article-title":"Guidelines for Management of Idiopathic Normal Pressure Hydrocephalus (Third Edition): endorsed by the Japanese Society of Normal Pressure Hydrocephalus","volume":"61","author":"Nakajima M","year":"2021","unstructured":"Nakajima M, Yamada S, Miyajima M, et\u00a0al. Guidelines for Management of Idiopathic Normal Pressure Hydrocephalus (Third Edition): endorsed by the Japanese Society of Normal Pressure Hydrocephalus. Neurol Med Chir (Tokyo). 2021;61(2):63\u201397."},{"issue":"20","key":"b14","series-title":"IEEE Sens J.","first-page":"22270","article-title":"A nanometer resolution wearable wireless medical device for non invasive intracranial pressure monitoring","volume":"21","author":"Andrade R de AP","year":"2021","unstructured":"Andrade R de AP, Oshiro HE, Miyazaki CK, et\u00a0al. A nanometer resolution wearable wireless medical device for non invasive intracranial pressure monitoring. IEEE Sens J. 2021;21(20):22270\u201322284."},{"issue":"2","key":"b15","series-title":"Curr Opin Crit Care.","first-page":"101","article-title":"Intracranial pressure management: moving beyond guidelines","volume":"28","author":"Rubiano AM","year":"2022","unstructured":"Rubiano AM, Figaji A, Hawryluk GW Intracranial pressure management: moving beyond guidelines. Curr Opin Crit Care. 2022;28(2):101\u2013110."},{"issue":"1","key":"b16","series-title":"Neurocrit Care.","first-page":"219","article-title":"Waveform morphology as a surrogate for ICP monitoring: a comparison between an invasive and a noninvasive method","volume":"37","author":"de Moraes FM","year":"2022","unstructured":"de Moraes FM, Rocha E, Barros FCD, et\u00a0al. Waveform morphology as a surrogate for ICP monitoring: a comparison between an invasive and a noninvasive method. Neurocrit Care. 2022;37(1):219\u2013227."},{"issue":"12","key":"b17","series-title":"J Pers Med.","first-page":"1302","article-title":"A novel noninvasive technique for intracranial pressure waveform monitoring in critical care","volume":"11","author":"Brasil S","year":"2021","unstructured":"Brasil S, Solla DJF, Nogueira RC, Teixeira MJ, Malbouisson LMS, Paiva WDS A novel noninvasive technique for intracranial pressure waveform monitoring in critical care. J Pers Med. 2021;11(12):1302."},{"issue":"3","key":"b18","series-title":"Neurocrit Care.","first-page":"591","article-title":"Assessment of cerebral autoregulation using invasive and noninvasive methods of intracranial pressure monitoring","volume":"38","author":"Hassett CE","year":"2023","unstructured":"Hassett CE, Uysal SP, Butler R, Moore NZ, Cardim D, Gomes JA Assessment of cerebral autoregulation using invasive and noninvasive methods of intracranial pressure monitoring. Neurocrit Care. 2023;38(3):591\u2013599."},{"issue":"3","key":"b19","series-title":"J Clin Monit Comput.","first-page":"753","article-title":"Noninvasive intracranial pressure waveforms for estimation of intracranial hypertension and outcome prediction in acute brain-injured patients","volume":"37","author":"Brasil S","year":"2023","unstructured":"Brasil S, Frigieri G, Taccone FS, et\u00a0al. Noninvasive intracranial pressure waveforms for estimation of intracranial hypertension and outcome prediction in acute brain-injured patients. J Clin Monit Comput. 2023;37(3):753\u2013760."}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/7\/10\/article-CASE23437.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/7\/10\/article-CASE23437.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/7\/10\/article-CASE23437.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T14:26:18Z","timestamp":1770301578000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/7\/10\/article-CASE23437.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,4]]},"references-count":38,"journal-issue":{"issue":"10"},"URL":"https:\/\/doi.org\/10.3171\/case23437","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,4]]}}}