{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:54:22Z","timestamp":1781657662021,"version":"3.54.5"},"reference-count":16,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"24","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,6,15]]},"abstract":"\n BACKGROUND<\/jats:title>\n Many surgeons have viewed hemophilia as a relative contraindication to elective cranial procedures given the risk of intracranial hemorrhage. However, there is a growing body of literature describing the successful perioperative management of hemophilia patients, thanks to multidisciplinary collaboration between neurosurgeons, hematologists, pharmacists, and other specialists. Previous reports have described how patients with hemophilia have navigated acute neurosurgical interventions, including trauma, tumor resection, deep brain stimulation, and surgical management of epilepsy.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n In this illustrative case, a multidisciplinary care team managed a patient with medically refractory epilepsy and hemophilia B undergoing stereotactic electroencephalography (sEEG) monitoring. Their neurological status and hematological markers were closely monitored through an 11-day hospital stay in the epilepsy monitoring unit. The key pharmacological intervention was recombinant factor IX replacement titrated to factor IX assay levels. The patient remained clinically stable without any hemorrhagic complications.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n This illustrative case demonstrates a successful management strategy for sEEG placement, monitoring, and removal in a patient with hemophilia B. A multidisciplinary care strategy is integral to this model of management.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE25892<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case25892","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:36Z","timestamp":1781049636000},"source":"Crossref","is-referenced-by-count":0,"title":["Stereotactic electroencephalogram lead placement in patient with hemophilia B: illustrative case"],"prefix":"10.3171","volume":"11","author":[{"given":"Gunnar A.","family":"Lee","sequence":"first","affiliation":[{"name":"Departments of Neurological Surgery, University of California, Davis, Sacramento, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Giermasz","sequence":"additional","affiliation":[{"name":"Hematology, University of California, Davis, Sacramento, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiran M.","family":"Kanth","sequence":"additional","affiliation":[{"name":"Neurology, University of California, Davis, Sacramento, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8710-2770","authenticated-orcid":true,"given":"Vilija","family":"Abrute","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery, University of California, Davis, Sacramento, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3224-7019","authenticated-orcid":true,"given":"David M.","family":"Brandman","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery, University of California, Davis, Sacramento, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"4","key":"bib1","series-title":"Br J Haematol","first-page":"378","article-title":"Intracranial haemorrhage in haemophilia A and B","volume":"140","author":"Ljung","year":"2008","unstructured":"Ljung RCR.Intracranial haemorrhage in haemophilia A and B. Br J Haematol. 2008;140(4):378-384. doi:10.1111\/j.1365-2141.2007.06949.x"},{"key":"bib2","series-title":"Biologics","first-page":"33","article-title":"Treatment of hemophilia B: focus on recombinant factor IX","volume":"7","author":"Franchini","year":"2013","unstructured":"Franchini MFrattini FCrestani SSissa CBonfanti C.Treatment of hemophilia B: focus on recombinant factor IX. Biologics. 2013;7:33-38. doi:10.2147\/BTT.S31582"},{"issue":"5","key":"bib3","series-title":"Haemophilia","first-page":"693","article-title":"Recommendations on multidisciplinary management of elective surgery in people with haemophilia","volume":"24","author":"Escobar","year":"2018","unstructured":"Escobar MABrewer ACaviglia HRecommendations on multidisciplinary management of elective surgery in people with haemophilia. Haemophilia. 2018;24(5):693-702. doi:10.1111\/hae.13549"},{"issue":"suppl 6","key":"bib4","series-title":"Haemophilia","first-page":"1","article-title":"WFH Guidelines for the Management of Hemophilia, 3rd edition","volume":"26","author":"Srivastava","year":"2020","unstructured":"Srivastava ASantagostino EDougall AWFH Guidelines for the Management of Hemophilia, 3rd edition. Haemophilia. 2020;26(suppl 6):1-158. doi:10.1111\/hae.14046"},{"key":"bib5","series-title":"Ther Adv Hematol","first-page":"2040620721993686","article-title":"Case report: successful perioperative management of patients with haemophilia A using an extended half-life factor VIII (efmoroctocog alfa) during neurosurgical procedures","volume":"12","author":"Kocher","year":"2021","unstructured":"Kocher FSeeber AKerschbaumer JSchmidt SWolf DFeistritzer C.Case report: successful perioperative management of patients with haemophilia A using an extended half-life factor VIII (efmoroctocog alfa) during neurosurgical procedures. Ther Adv Hematol. 2021;12:2040620721993686. doi:10.1177\/2040620721993686"},{"key":"bib6","series-title":"World Neurosurg","first-page":"158","article-title":"Deep brain stimulation surgery for essential tremor in a patient with type A hemophilia","volume":"139","author":"Palsma","year":"2020","unstructured":"Palsma RGravbrot NBina RAgastya MKasoff WS.Deep brain stimulation surgery for essential tremor in a patient with type A hemophilia. World Neurosurg. 2020;139:158-162. doi:10.1016\/j.wneu.2020.03.174"},{"issue":"5","key":"bib7","series-title":"Br J Neurosurg","first-page":"1124","article-title":"Drug-resistant epilepsy in children with hemophilia: how can we do it surgically?","volume":"37","author":"Gong","year":"2022","unstructured":"Gong MLi YChen QDrug-resistant epilepsy in children with hemophilia: how can we do it surgically? Br J Neurosurg. 2022;37(5):1124-1130. doi:10.1080\/02688697.2022.2039374"},{"key":"bib8","series-title":"World Neurosurg","first-page":"e100","article-title":"Hemorrhage rates after implantation and explantation of stereotactic electroencephalography: reevaluating patients\u2019 risk","volume":"151","author":"Triano","year":"2021","unstructured":"Triano MJSchupper AJGhatan SPanov F.Hemorrhage rates after implantation and explantation of stereotactic electroencephalography: reevaluating patients\u2019 risk. World Neurosurg. 2021;151:e100-e108. doi:10.1016\/j.wneu.2021.03.139"},{"issue":"4","key":"bib1","series-title":"Br J Haematol","first-page":"378","article-title":"Intracranial haemorrhage in haemophilia A and B","volume":"140","author":"Ljung","year":"2008","unstructured":"Ljung RCR.Intracranial haemorrhage in haemophilia A and B. Br J Haematol. 2008;140(4):378-384. doi:10.1111\/j.1365-2141.2007.06949.x"},{"key":"bib2","series-title":"Biologics","first-page":"33","article-title":"Treatment of hemophilia B: focus on recombinant factor IX","volume":"7","author":"Franchini","year":"2013","unstructured":"Franchini MFrattini FCrestani SSissa CBonfanti C.Treatment of hemophilia B: focus on recombinant factor IX. Biologics. 2013;7:33-38. doi:10.2147\/BTT.S31582"},{"issue":"5","key":"bib3","series-title":"Haemophilia","first-page":"693","article-title":"Recommendations on multidisciplinary management of elective surgery in people with haemophilia","volume":"24","author":"Escobar","year":"2018","unstructured":"Escobar MABrewer ACaviglia HRecommendations on multidisciplinary management of elective surgery in people with haemophilia. Haemophilia. 2018;24(5):693-702. doi:10.1111\/hae.13549"},{"issue":"suppl 6","key":"bib4","series-title":"Haemophilia","first-page":"1","article-title":"WFH Guidelines for the Management of Hemophilia, 3rd edition","volume":"26","author":"Srivastava","year":"2020","unstructured":"Srivastava ASantagostino EDougall AWFH Guidelines for the Management of Hemophilia, 3rd edition. Haemophilia. 2020;26(suppl 6):1-158. doi:10.1111\/hae.14046"},{"key":"bib5","series-title":"Ther Adv Hematol","first-page":"2040620721993686","article-title":"Case report: successful perioperative management of patients with haemophilia A using an extended half-life factor VIII (efmoroctocog alfa) during neurosurgical procedures","volume":"12","author":"Kocher","year":"2021","unstructured":"Kocher FSeeber AKerschbaumer JSchmidt SWolf DFeistritzer C.Case report: successful perioperative management of patients with haemophilia A using an extended half-life factor VIII (efmoroctocog alfa) during neurosurgical procedures. 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