Evidence map›Paper›PMID 42332303›Full record

ArticleActa neurochirurgica2026

An agentic AI framework for integrated decision support and surgical planning in intracerebral hemorrhage.

Eugen Kochuiev, Vladyslav Kaliuzhka, Mykyta Markevych, Zoia Kochuieva, Volodymyr Piatykop

Abstract read
In one paragraph

Article in Acta neurochirurgica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Eugen KochuievNational Technical University «Kharkiv Polytechnic Institute», Kharkiv, Ukraine.ORCID http://orcid.org/0009-0002-4978-6975
Vladyslav KaliuzhkaDepartment of Neurology and Neurosurgery, Kharkiv National Medical University, Kharkiv, Ukraine. vy.kaliuzhka@knmu.edu.ua.ORCID http://orcid.org/0000-0002-6243-5195
Mykyta MarkevychNeurosurgery Department, Communal Non-Commercial Enterprise of the Kharkiv Regional Council "Regional Clinical Hospital", Kharkiv, Ukraine.ORCID http://orcid.org/0000-0003-1500-754X
Zoia KochuievaNational Technical University «Kharkiv Polytechnic Institute», Kharkiv, Ukraine.ORCID http://orcid.org/0000-0002-4300-3370
Volodymyr PiatykopDepartment of Neurology and Neurosurgery, Kharkiv National Medical University, Kharkiv, Ukraine.ORCID http://orcid.org/0000-0001-8572-7644

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIntracerebral hemorrhage (ICH) remains associated with high mortality and treatment variability. Current workflows rely on fragmented imaging interpretation and operator-dependent surgical planning.

methodsThe objective was to develop and validate an agentic artificial intelligence (AI) framework integrating automated imaging analysis, guideline-based reasoning, and trajectory optimization for ICH treatment. Fifty consecutive computed tomography (CT) and computed tomography angiography (CTA) datasets from patients with spontaneous ICH were retrospectively analyzed. The system performed multi-class anatomical segmentation of skin, skull, brain, ventricles, and hematoma, followed by volumetric quantification and JavaScript Object Notation (JSON) based structured encoding of imaging biomarkers. A knowledge-based module incorporating international ICH guidelines generated risk stratification and treatment recommendations. When evacuation was indicated, an automated trajectory modeling module proposed a patient-specific minimally invasive surgical corridor.

resultsOverall agreement between AI-generated and expert treatment recommendations was 82% (41/50 cases), with substantial agreement beyond chance (Cohen's κ = 0.71). Discrepancies occurred primarily in borderline surgical indication scenarios. In evacuation candidates, the automated planner generated feasible trajectories in all 50 cases. Median angular deviation between AI-generated and expert-defined trajectories was 7.6°, interquartile range (IQR) 5.1-9.8°. AI-generated trajectories demonstrated equal or greater safety margins relative to expert planning in the majority of cases. End-to-end processing has a potential to substantially reduce simulated decision-support time compared with manual workflow.

conclusionThe proposed agentic AI framework enables structured, explainable, and workflow-integrated decision support for ICH management. This system may reduce operator variability and enhance precision in minimally invasive evacuation planning.

Indexed as

Artificial IntelligenceCerebral HemorrhageAgedComputed Tomography AngiographyFemaleHumansMaleMiddle AgedRetrospective StudiesTomography, X-Ray ComputedAgentic AIArtificial intelligenceAutomatic planningDeep learningIntracerebral hemorrhage

Identifiers

PMID42332303
PMCPMC13428004

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.