Operative neurosurgery (Hagerstown, Md.)
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Oper Neurosurg (Hagerstown) · Apr 2018
Utilization of Quantitative Susceptibility Mapping for Direct Targeting of the Subthalamic Nucleus During Deep Brain Stimulation Surgery.
Deep brain stimulation of the subthalamic nucleus (STN) has demonstrated efficacy in improving motor disability in Parkinson's disease. The recently developed quantitative susceptibility mapping (QSM) technique, which can accurately map iron deposits in deep brain nuclei, promises precise targeting of the STN. ⋯ Direct targeting of the sensorimotor STN using QSM demonstrates MER correlation and can be safely used for deep brain stimulation lead placement with satisfactory clinical response. These results imply that targeting based on QSM signaling alone is sufficient to obtain reliable and reproducible outcomes in the absence of physiological recordings.
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Oper Neurosurg (Hagerstown) · Apr 2018
Pipeline Embolization Device for Pericallosal Artery Aneurysms: A Retrospective Single Center Safety and Efficacy Study.
Pericallosal artery aneurysm treatment may be challenging using traditional endovascular techniques. ⋯ Our preliminary results demonstrate feasibility of the use of flow diverter stent for treatment of aneurysms of the pericallosal artery with rate of aneurysm occlusion comparable to literature and without evidence of increased procedural or short-term morbidity. A long-term and larger cohort study is needed to validate our findings.
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Oper Neurosurg (Hagerstown) · Mar 2018
Case ReportsSpinal Cord Suspension Using Dentate Ligament Hitch Stitches: A Novel Technique for the Repair of Ventral Spinal Cord Herniation.
Idiopathic spinal cord herniation is usually repaired by releasing the spinal cord and inserting a dural patch to close the herniated segment of dura. However, reherniation is a potential limitation of this standard technique. ⋯ The dentate hitch technique can achieve repair of spinal cord herniation, with satisfactory postoperative results and minimizes the risk of reherniation.
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Oper Neurosurg (Hagerstown) · Mar 2018
Case ReportsThree-Dimensional Endoscopic Magnification for Treatment of Thoracic Spinal Dural Arteriovenous Fistulas: Technical Note.
Treatment of thoracic spinal dural arteriovenous fistulas (DAVFs) by microsurgery has recently been approached using minimally invasive spine surgery (MISS). The advantages of such an approach are offset by difficult maneuverability within the tubular retractor and by the creation of "tunnel vision" with reduced luminosity to a remote surgical target. ⋯ When approaching DAVFs via MISS, replacing the microscope with the endoscope remedies the limitations related to the "tunnel vision" created by the tubular retractor, but at the expense of losing binocular vision. We show that the 3-D endoscope resolves this latter limitation and provides an interesting option for the exclusion of spinal DAVFs.
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Oper Neurosurg (Hagerstown) · Mar 2018
Accuracy and Efficacy for Robotic Assistance in Implanting Responsive Neurostimulation Device Electrodes in Bilateral Mesial Temporal Lobe Epilepsy.
Responsive neurostimulation (RNS) is a relatively new treatment option that has been shown to be effective for patients with medically refractory focal epilepsy when resection is not possible, especially in bilateral mesial temporal onset. Robotic devices are becoming increasingly popular for use in stereotactic procedures such as stereoelectroencephalography, but have yet to be used when implanting RNS devices. ⋯ We show that implanting RNS devices with robotic assistance is feasible with excellent precision and accuracy. The advantages of using robotic assistance include higher flexibility, accuracy, precision, and consistency.