To explore the technique and early clinical efficacy of unilateral biportal endoscopy (UBE) with the Corner approach in the treatment of low lumbar disc herniation (LDH). A retrospective analysis was conducted on the clinical data of 22 patients with low LDH who underwent treatment via the Corner approach of UBE from June 2022 to June 2023. Among these patients, there were 10 males and 12 females;their ages ranged from 37 to 82 years old, with an average of (56.8±13.8) years old;the disease duration varied from 3 to 32 months, with an average of (16.5±9.0) months. The intraoperative endoscopic operation time, postoperative drainage volume, postoperative hospital stay, and related complications were recorded and analyzed. The clinical efficacy was evaluated based on the Oswestry disability index(ODI), visual analogue scale (VAS) for low back pain and lower limb pain, and modified Macnab criteria measured preoperatively, at 1, 4, and 8 weeks postoperatively, and at the final follow-up. All patients were followed up for 6 to 12 months, with an average of(9.27±2.05) months. All patients successfully completed the operation under endoscopy. The intraoperative endoscopic operation time was(16.50±8.40) minutes for single-level cases and (32.00±10.56) minutes for double-level cases; the postoperative drainage volume was (20.00±13.50) ml for single-level cases and (38.00±21.82) ml for double-level cases. The postoperative hospital stay was (5.58±4.62) days. Compared with the preoperative data, the ODI and VAS for low back pain and lower limb pain of the patients at all postoperative time points showed statistically significant differences(P<0.05). At the final follow-up, according to the modified MacNab criteria, 17 cases were rated as excellent, 4 cases as good, and 1 case as fair. The Corner approach of UBE for the treatment of low LDH has reliable clinical efficacy, with advantages including minimal bony resection, shoter operative time, and clear visual field.
Multiligament knee injuries represent rare and challenging injuries that require complex surgical management to restore stability and function. Current evidence supports anatomic single-stage reconstructions when feasible in order to re-establish knee kinematics and enable early rehabilitation. This technique paper describes single-stage anterior cruciate ligament reconstruction with a bone-patellar tendon-bone allograft, double-bundle posterior cruciate ligament reconstruction with Achilles tendon allograft for the anterolateral bundle and tibialis anterior allograft for the posteromedial bundle, medial collateral ligament reconstruction with hamstring autograft, and anatomic posterolateral corner reconstruction with Achilles tendon allograft. Key aspects emphasized include identification and protection of the common peroneal nerve, accurate anatomic tunnel placement to avoid convergence, and a graft tensioning sequence prioritizing the posterior cruciate ligament, followed by the anterior cruciate ligament, medial collateral ligament, and then the posterolateral corner. This technique provides a reproducible single-stage strategy to address multiligament knee injuries, restoring stability across all planes and supporting functional recovery.
An osteochondral lesion at the level of the capitate head in perilunate dislocation (PLD) may worsen the patient's overall prognosis. This case report presents two cases of scaphoid excision and four-corner fusion (4CF) for acute PLD injury with severe osteochondral lesion at the level of the head of the capitate. The first case involved a 41-year-old man with a dorsal PLD, an associated ulnar styloid fracture and a highly comminuted radial styloid fracture involving the scaphoid facet of the radius. The second case involved a 35-year-old-man with a dorsal PLD on a previously unknown scaphoid nonunion (scaphoid nonunion advanced collapse [SNAC] stage 1). Both patients underwent scaphoid excision and 4CF with Kirschner wire fixation. At last follow-up (6 and 31 months, respectively), both patients had slight pain, had a functional range of motion, and achieved satisfactory functional outcomes. Radiographs confirmed 4CF union. No complications were reported. Only two other cases of scaphoid excision and 4CF for acute PLD with osteochondral lesion at the capitate head have been reported, with minimal information on clinical outcomes. This article reports two cases of acute PLD with severe osteochondral lesions at the level of the head of the capitate, accompanied by poor local conditions (SNAC stage 1 or a comminuted scaphoid facet of the radius). It highlights the interest of scaphoid excision and 4CF in the acute setting with favorable short-term outcomes, where traditional open reduction and internal fixation or carpal row carpectomy would have been unreliable.
In this IEEE Pulse Industry Corner Live interview, Editor-in-Chief Chad Andresen speaks with Ronja Muller-Bruhn, CEO and Founder of STIMIT, about the company's non-invasive transcutaneous magnetic phrenic nerve stimulation system for ICU patients. Surface coils applied to the neck activate the diaphragm in sedated or comatose patients, targeting prevention of ventilator-induced diaphragm dysfunction-a condition causing up to 50% loss of respiratory muscle function within days of mechanical ventilation onset. With Health Canada clearance secured and a U.S. FDA De Novo pivotal trial underway, STIMIT aims to fundamentally shift ICU ventilation paradigms toward active preservation of natural respiratory neuromuscular physiology.
We report the clinical and radiographic outcomes, and complications of midcarpal fusions, four corner fusion (4CF), bicolumnar (BC) and luno-capitate (LC), with a focus on endomedullary screw fixation. Between 2018 and 2024, 38 patients underwent three distinct types of midcarpal fusions: 20 underwent 4CF, 6 underwent BC and 12 underwent LC. Postoperative evaluation was conducted using X-ray and computed tomography scans to assess the degree of fusion, correction of the lunate and capitate bones, presence of possible screw prominences and secondary radio-carpal degeneration. Twenty-six patients exhibited favourable outcomes, whereas 12 were reoperated: 3 cases were converted to total wrist fusion owing to screw migration in non-union, 4 cases for screw removal alone due to screw migration and the others for revision of the arthrodesis site. In 13 cases, a loss of reduction of the semilunar bone with consequent DISI was identified and was sometimes associated with a reduction in wrist extension. Intramedullary screws have low intrinsic stability. Immobilisation is recommended for at least 6 weeks with caution during mobilisation to avoid stress on the healing site, minimise the risk of screw migration and loss of lunate reduction. Although DISI alone does not constitute a reason for surgical revision, it has the potential to limit wrist extension. In some cases, fusion may not be achieved; however, this does not necessarily constitute a problem. It is also advisable to use shorter screws, to avoid subchondral placement, owing to the possibility of secondary migration. IV.
This study hypothesizes that, in patients undergoing four-corner fusion (4CF) surgery, the choice of fixation method-either headless compression screw (HCS) or staples (ST)-will not significantly impact postoperative complication rates, union rate, and functional outcomes. A retrospective chart review was conducted on patients who underwent 4CF for scapholunate advanced collapse (SLAC) or scaphoid nonunion advanced collapse (SNAC) wrist at a single institution over thirteen years. Functional outcomes included postoperative complications, nonunion, subsequent surgery, wrist flexion-extension range of motion (ROM), Quick Disabilities of Arm, Shoulder & Hand (QuickDASH) score, and the 12-Item Short Form Survey (SF-12). Thirty-seven patients were identified with an average follow-up of 9.1 months (range: 3-24 months). Nineteen patients were treated with HCS, and 18 were treated with ST. There were no significant differences in the complication rates between the HCS and ST groups (P=0.73). In the HCS group, the main complications were pain (n=4), subsequent surgeries for revision or hardware removal (n=3), and nonunion (n=2). For the ST group, these were pain (n=5), subsequent surgeries for revision or hardware removal (n=5), and hardware loosening (n=4). Postoperatively, wrist flexion and extension ROM did not significantly change in either group. QuickDASH improved postoperatively in both groups (P<0.005). Only the ST group improved in the SF-12 physical component postoperatively (P=0.01). In this small, retrospective case series with short follow-up, fixation choice between HCS and ST in 4CF for SLAC or SNAC did not significantly impact complication rates or functional recovery. Postoperative complications occurred at similar rates, with pain and the need for subsequent surgery being the most common.
Tunnel convergence in multiligament knee surgery remains a technical challenge. Anterior cruciate ligament (ACL) femoral sockets/tunnels and lateral collateral ligament (LCL) femoral sockets/tunnels during anatomic posterolateral corner (PLC) reconstructions are particularly vulnerable to convergence. This is secondary to the limited amount of bony real estate available on the lateral distal femur. Previous studies have attempted to define a specific angle to direct the LCL tunnel away from the ACL tunnel. However, inconsistency with ACL femoral socket creation and variability in bony architecture can make this strategy unreliable. This surgical technique describes how to minimize the risk of ACL and LCL tunnel convergence during ACL and PLC reconstructions.
The 2026 closure of the Strait of Hormuz has disrupted approximately one-fifth of global petroleum transit, sending oil prices sharply upward and exposing medicine's structural dependence on petrochemicals, helium, and globalized manufacturing. This article examines how medicine's reliance on globalized commodities exposes patients to medication and device shortages during sustained supply disruption. Prior crises, including the 1973 oil embargo and the 2021 Suez blockage, revealed vulnerabilities that current just in time supply chains have deepened. We urge practice leaders, hospital administrators, and clinicians to establish supply continuity frameworks now, before scarcity forces improvised rationing and reactive procurement.
The sandwich priming paradigm, involving presenting the target as the initial prime in a masked priming sequence (e.g., white-whete-WHITE), has been shown to increase the size of masked orthographic priming effects. It also appears to increase the size of masked morphological priming effects (e.g., walk-walker-WALK > walker-WALK), although not pseudo-morphological priming effects (e.g., corn-corner-CORN = corner-CORN) (Lupker & Spinelli, Journal of Experimental Psychology: Learning, Memory, and Cognition, 49 (11), 1861-1880, 2023). The empirical question addressed in the present research was whether masked semantic priming effects (e.g., black-WHITE) would also increase when using sandwich priming (e.g., white-black-WHITE). Such a result could imply that semantic and orthographic priming have similar sources as well as that Lupker and Spinelli's presumed increase in morphological priming may have been due to the prime (e.g., walker) and target (e.g., WALK) being semantically related. The results of two experiments, one using conventional masked priming and one using sandwich priming, clearly indicated that sandwich priming does not increase the size of masked semantic priming effects, consistent with the idea that the presumed impact of sandwich priming on morphological priming effects is truly a morphologically based phenomenon.
Tibial-sided posterior cruciate ligament (PCL) avulsion fractures are a variant of PCL injury. Current literature on tibial-sided PCL injuries consists of small case reports or series in adults. There are no studies in the pediatric population describing the associated injuries and if concomitant injuries impact clinical decision-making. This study aims to identify common concomitant injuries in pediatric patients with tibial-sided PCL avulsion fractures and determine the utility of MRI in identification of concomitant injuries. A retrospective review of the electronic medical record identified all patients presenting to a single tertiary pediatric hospital with tibial-sided PCL avulsion fractures 1/2012-6/2024. MRI exams were reviewed by a musculoskeletal pediatric radiologist. Operative reports and clinical encounter notes were reviewed by a pediatric orthopedic surgeon. Twenty-seven patients met the inclusion criteria, and 26 concomitant injuries were identified in 16 (59%) patients. Twenty of 27 (74%) of patients had a preoperative MRI; 23/26 (88%) injuries were identified on MRI, and 2/26 (8%) injuries were identified clinically without MRI. One concomitant injury was identified at the time of surgery but not on preoperative MRI. The most common concomitant finding on MRI was posterolateral corner injury (7/26, 27%). Eight of 26 (31%) of the concomitant injuries required surgical intervention. Concomitant injuries occurred in the majority of patients with tibial-sided PCL avulsion fractures. Posterolateral corner injury was the most common injury and anterior cruciate ligament tear was the most common requiring surgical intervention. Radiologists and surgeons should be cognizant of the association of concomitant injury.
Radial-sided wrist pain and impingement are recognized sources of persistent symptoms following 4-corner fusion, often related to radioscaphoid contact and progressive degenerative changes. Radial styloidectomy has been described as a surgical option to address this pathology while preserving carpal stability. An arthroscopic approach offers the potential advantages of improved visualization, reduced soft tissue disruption, and concomitant treatment of intra-articular pathology. Standard wrist arthroscopy portals are established, with the 6R portal for visualization and the 3-4 portal as the working portal. Diagnostic arthroscopy allows for evaluation of the radiocarpal joint and treatment of concomitant pathology, including synovitis, which may be addressed with arthroscopic synovectomy. The 3-4 portal is then used for visualization and the 6R portal for working on the remainder of the case. The radial styloidectomy is performed arthroscopically using a 3.0 oval burr and a 4.0 bone cutter. Fluoroscopy confirms a 4 mm resection of the radial styloid to relieve impingement while maintaining the extrinsic ligaments and wrist stability. Patients start therapy at 2 weeks, moving on to strengthening at 6 weeks. Arthroscopic radial styloidectomy is an effective surgical approach for wrist pain and impingement in post-4-corner fusion patients. This minimally invasive technique provides significant pain relief and facilitates early functional recovery.
Metal-organic cages (MOCs) featuring palladium nodes have become a cornerstone in the field of supramolecular coordination chemistry. Despite the predominant emphasis on Pd(II), which has laid a fundamental basis for MOC assembly, substantial opportunities persist for the investigation of a wider array of structural building blocks. Consequently, the innovation of new palladium-based building blocks is of critical importance for realizing emergent functionalities and extending the application landscape of MOCs. In this study, we present the {Pd3(SR')3[PR3]3}+ (abbreviated as Pd3) cluster as a unique building unit characterized by accessible metal sites conducive to catalytic activity of MOCs. The cluster undergoes a one-pot coassembly with Cu2 units to yield a Pd24Cu12 cage, exhibiting a face-centered cubic architecture. Within this framework, eight Pd3 nodes are situated at the corners, while six Cu2 units are located at the face centers. The structure is maintained by 24 4-mercaptobenzoic acid ligands, where thiolate groups coordinate to the Pd3 nodes and carboxylate groups bind to the Cu2 units. Such a rigid framework, together with the electronic communication among the metal centers, accounts for the exceptional thermal and aerobic stability of the cage. Notably, the cage showcases high catalytic activity and selectivity in the hydrogenation of azobenzene. These findings not only introduce a class of catalytically active palladium nodes for the assembly of chemically different palladium-organic cages but also pave the way for further exploration of cage-based catalysts in hydrogenation processes.
The molten flux method was used to grow crystals belonging to two different classes of rare-earth hafnium molybdates, RE2Hf3(MoO4)9 and RE2Hf2(MoO4)7, whose luminescence and magnetic properties were investigated. The first structure type, RE2Hf3(MoO4)9, spans from La to Eu (except Pm) and crystallizes in the trigonal R-3c space group. In this structure, MoO4, REO9, and HfO6 are connected via their corners. The MoO4 units form open channels along the c-axis, which are occupied by columns of REO9 and HfO6 polyhedra. The second structure type, RE2Hf2(MoO4)7, includes RE = Sm, Eu, Gd, Tb, and Dy and crystallizes in the monoclinic C2/c space group. The MoO4 tetrahedra connect through their corners to HfO6 octahedra and DyO8 square antiprisms, forming a three-dimensional open framework. Magnetic and photoluminescence properties were measured on polycrystalline samples obtained from solid-state reactions. Eu2Hf3(MoO4)9 and Tb2Hf2(MoO4)7 exhibit photoluminescence under UV irradiation. Eu(III) was doped successfully into La2Hf3(MoO4)9 and characterized by single-crystal X-ray diffraction and single-crystal photoluminescence emission spectroscopy. Magnetic susceptibility vs temperature measurements were performed to investigate the magnetic behavior of Ce2Hf3(MoO4)9, Gd2Hf2(MoO4)7, and Dy2Hf2(MoO4)7.
A knee dislocation combined with a patellofemoral dislocation is an extremely rare and complex injury that reflects severe multidirectional instability and extensive soft-tissue disruption. We show an open single-stage anatomic reconstruction method for a patient with type IV tibiofemoral dislocation, patellofemoral dislocation, and bucket-handle medial meniscus tear. A midline parapatellar approach provided direct access to both the medial and lateral compartments, allowing for the identification of all ligament attachments and the repair of the meniscal tear. Cruciate, collateral, posterolateral corner, and medial patellofemoral ligament tears were reconstructed using tibialis posterior allografts. To avoid tunnel convergence, common femoral tunnels were drilled for the posterior cruciate ligament-medial collateral ligament and anterior cruciate ligament-fibular collateral ligament complexes with an additional femoral tunnel for the popliteofibular ligament. The open approach allowed for an anatomical restoration of all major stabilizers, while minimizing multiple skin incisions and avoiding the complications related to arthroscopic fluid extravasation. Early reconstruction was indicated due to gross instability of both tibiofemoral and patellofemoral joints and the associated meniscal tear. This technique provides a practical and safe alternative for comprehensive anatomic reconstruction in selected cases of complex knee dislocation with severe capsular disruption.
This study assessed the ability of three acoustic measures of vowel space, two token-based and one trajectory-based, to quantify speech differences in people with Parkinson's disease compared to controls and correlations with speech intelligibility. Fifty-six speakers (28 people with Parkinson's and 28 controls) read a custom reading passage containing corner vowels. For token-based measures, the triangular vowel space area (tVSA) in kHz2 and the unitless ratio of vowel articulation index (VAI) were calculated. For the trajectory-based measure, the articulatory-acoustic vowel space (AAVS) in kHz2 was calculated. Speakers also read five unique sentences varying in word length, which were used to collect speech intelligibility ratings. Analyses of Variance revealed that all vowel space measures yielded group differences. Binary logistic regression revealed that only the token-based measures were able to statistically discriminate PwPD from controls, however all models performed poorly (R2 < 0.113). Linear regressions showed that token-based metrics were statistically related to intelligibility and that the VAI yielded the best model for the current sample. The results support that token-based measures are well-suited for quantifying changes in acoustic vowel space and perceived speech intelligibility in people with Parkinson's. Future work should examine the generalizability of these findings to other motor speech disorders as well as across different speech stimuli.
To investigate whether tibiofemoral bone and meniscus morphology were associated with dynamic anterior tibial translation (ATTd) and internal tibial rotation (ITRd) during jump-landing tasks in anterior cruciate ligament (ACL)-reconstructed knees. Results may provide some guidance on the use of additional surgical procedures alongside (revision) ACL reconstruction (ACLR). Patients who underwent primary ACLR were included. Morphological features were measured using pre-surgery magnetic resonance images of the operated knee. Dependent variables included ATTd and ITRd during the landing of the single-leg hop for distance (SLHD) and side hop (SH), measured with three-dimensional optoelectronic motion capture. Univariate statistical parametric mapping regression analyses were conducted with morphological features as predictors. Thirty patients were included at 4.7 ± 1.8 years post-ACLR (age: 31.0 ± 4.8 years). Steeper sagittal-plane lateral posterior tibial slope and greater medial-lateral difference in posterior tibial slope were significantly associated with less ATTd (peak r = -0.75; p = 0.048) and greater ITRd (peak r = 0.75; p = 0.047) during the SLHD and SH, but only in ACL-reconstructed knees with a flat medial tibial plateau (-2° to +2°; n = 13 subgroup analysis). Steeper coronal-plane tibial slope was significantly associated with less ATTd during the SLHD (peak r = -0.45; p = 0.049), and with greater ITRd during the SH (peak r = 0.47; p = 0.047). Smaller lateral meniscal slope of the posterior horn was significantly associated with greater ITRd during the SLHD (peak r = -0.46; p = 0.047). Greater lateral femoral condyle ratio was significantly associated with greater ITRd during the SLHD (peak r = 0.46; p = 0.04) and SH (peak r = 0.56; p = 0.006). The observed associations with greater ITRd warrant further investigation into the potential role of anterolateral corner reconstruction alongside (revision) ACLR in patients with these morphological features. Since associations between posterior tibial slopes and ITRd depended on a flat medial plateau, the role of slope-reducing tibial osteotomy appears limited, as these procedures typically do not selectively target a single plateau. Level II.
The Cryomodule Repair and Maintenance Facility (CRMF), currently under construction at SLAC National Accelerator Laboratory, is designed to enable on-site testing, repair, and maintenance of Superconducting Radio-Frequency (SRF) cryomodules supporting the Linac Coherent Light Source II (LCLS-II) and its High Energy (HE) upgrade. This study presents the radiation hazard analysis establishing the shielding requirements, operational envelope, and safety systems for the facility. During cryomodule testing, field emission from niobium cavity surfaces at high accelerating gradients produces dark current electrons. The electrons interact with cavity walls and downstream components, generating bremsstrahlung photons and secondary particles, which constitute the primary radiation source term. Hazard levels depend strongly on the accelerating gradient, cavity condition, and loss location and vary across operational scenarios. A geometry-specific high fidelity Monte Carlo model was created for radiation transport analysis in FLUKA using a physics-based, time-varying field emission source model. This model integrates the Fowler-Nordheim equation with dynamic electromagnetic field transport, enabling stochastic generation and tracking of field-emitted electrons under realistic cavity conditions. Prompt and residual dose rates, airborne and groundwater radionuclide activation, ozone production, and dose to public from CRMF were evaluated across all nominal operating configurations. Effective dose rates at 30 cm from the shielded enclosure walls remained below 5 μSv h-1 (0.5 mrem h-1) under all nominal operating conditions, with localized increases at the RF penetrations and maze corners addressed through targeted shielding. Skyshine contributions to the annual public dose are negligible at the nearest publicly accessible location (≥336 m), with all azimuthal sectors well below the 1 mSv yr-1 limit. Following beam shutdown, residual dose rates across most accessible regions were on the order of 1 μSv h-1 (0.1 mrem h-1) after 1 h of cool-down, with localized maxima near the Faraday cups reaching approximately 5 μSv h-1 (0.5 mrem h-1). Airborne radionuclide concentrations, dominated by 41Ar, 15O, 13N, 11C, and 3H, corresponding to a total airborne dose rate of 13.5 × 10-2 μSv h-1 (13.5 × 10-3 mrem h-1) and an annual inhalation dose of 270 μSv (27 mrem), well below the SLAC dose management ALARA level. Groundwater activation levels of 22Na, 7Be, and 3H, and ozone production across all scenarios, remained below their respective regulatory thresholds. The CRMF shielding design and operational controls support safe cryomodule testing up to 26 MV/m, with all prompt, residual, and environmental dose metrics within regulatory limits. A key contribution was the use of a physics based field emission model in place of the conventional pencil beam source approximation. This approach represents the first implementation of a full physics-based field emission model, integrating stochastic electron generation with time-varying electromagnetic field transport, for the purpose of facility shielding design. The methodology and safety framework developed here apply to future SRF testing facilities operating under comparable conditions and provide a validated reference for radiation protection analysis in similar cryomodule testing environments.
We describe a surgical technique repairing medium-to-large anterosuperior rotator cuff (RC) tear that combines long head of the biceps tendon (LHBT) augmentation with a dermal allograft patch using a knotless double-row repair. LHBT augmentation is done using a triple-loaded anchor placed 5 mm posterior to the bicipital groove at the bone-cartilage junction. One suture strand creates a lasso-loop, rip-stop configuration to secure and posteriorly reroute the LHBT, improving anterior cable coverage. The remaining medial anchor sutures function as mattress sutures through the supraspinatus. Knots are tied, but the suture limbs are left uncut to secure the graft later to the cuff. A 3 × 3 cm, 2 × 2 mm thick dermal allograft is prepared. The uncut medial row sutures and a nonabsorbable tape suture (for lateral fixation) are passed through the graft. Using a custom cannula and traction sutures placed on the corners, the graft is shuttled and positioned on the bursal side of the repaired tendon. Once positioned, the medial sutures are secured. All remaining sutures (medial limbs, nonabsorbable tape suture, and traction sutures) are loaded into a lateral row anchor and impacted into the greater tuberosity. The final construct sandwiches the repaired tendon beneath the allograft, increasing construct thickness and ensuring complete footprint coverage.
Chapeau de gendarme (CdG) is a subtle but clinically relevant semiology that has been scarcely studied in children. Previous studies have primarily focused on its localizing value in small, surgical cohorts. This study aimed to systematically characterize frequency and clinical features of CdG across the pediatric age spectrum. We retrospectively analyzed video-electroencephalography (EEG) monitoring of 264 children with epilepsy (0-17 years). Up to 10 seizures per type were reviewed per patient. CdG was defined as a symmetrical downward contraction of both mouth corners and chin contraction lasting ≥5 s. CdG characteristics, co-occurring semiologies, and EEG patterns were assessed and compared to the cohort without CdG. CdG was identified in 28 of 264 patients (10.6%), corresponding to 73 seizures. The median age at first observed CdG was 12.3 years (range 1.3-16.8), with a trend toward increasing frequency in older children. All but one case occurred in focal epilepsies, which were significantly more frequent in the CdG cohort than in those without CdG (p = .009). CdG appeared early in the seizure course (≤5 s in 61.6%) and more often during sleep (p < .001). Hyperkinetic behavior occurred significantly more often in CdG seizures (p < .001). Progression to bilateral tonic-clonic seizures was recorded in 20.5% of CdG seizures (17.9% of patients with CdG) and occurred more frequently in the CdG cohort than in patients without CdG (p < .001). The first ictal scalp EEG pattern most frequently involved the frontal lobe (57.7%). CdG occurred in a notable proportion of pediatric patients across the entire age range, with a descriptive tendency toward higher occurrence in older children. These findings provide an essential foundation for future investigations exploring developmental and network mechanisms underlying this semiology.