Journal of neurosurgery
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Journal of neurosurgery · Apr 2016
Parkinson's disease outcomes after intraoperative CT-guided "asleep" deep brain stimulation in the globus pallidus internus.
Recent studies show that deep brain stimulation can be performed safely and accurately without microelectrode recording ortest stimulation but with the patient under general anesthesia. The procedure couples techniques for direct anatomical targeting on MRI with intraoperative imaging to verify stereotactic accuracy. However, few authors have examined the clinical outcomes of Parkinson's disease (PD) patients after this procedure. The purpose of this study was to evaluate PD outcomes following "asleep" deep brain stimulation in the globus pallidus internus (GPi). ⋯ Globus pallidus internus leads placed with the patient under general anesthesia by using direct anatomical targeting resulted in significantly improved outcomes as measured by the improvement in the off-medication motor score at 6 months after surgery.
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Journal of neurosurgery · Apr 2016
Case ReportsDural incision in the petrosal approach with preservation of the superior petrosal vein.
The petrosal approach has been applied for the treatment of many lesions in the posterior fossa, but the location and preservation of the superior petrosal veins (SPVs) during this approach are usually not particularly considered. The authors developed a technique of dural incision with special consideration of the location of the SPVto preserve venous flow during the petrosal approach. ⋯ The SPVs should be considered critical structures in the petrosal approach. Preoperative evaluation of the SPV anatomy should be performed in patients undergoing such surgical treatment, and the dural opening must be performed with special attention to the SPVto avoid intraoperative injury and postoperative complications.