Stereotactic and functional neurosurgery
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Stereotact Funct Neurosurg · Jan 2012
Comparative StudyThe effect of intraventricular trajectory on brain shift in deep brain stimulation.
Brain shift during deep brain stimulation (DBS) surgery may compromise target localization. Loss of cerebrospinal fluid is believed to be the underlying mechanism, thus an intraventricular trajectory during DBS surgery may be associated with increased shift, in addition to other complications, such as intraventricular hemorrhage. ⋯ Intraventricular trajectories during DBS surgery do not appear to compromise safety or targeting accuracy.
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Stereotact Funct Neurosurg · Jan 2012
Stereotactic placement of ventricular catheters: does it affect proximal malfunction rates?
The majority of ventriculoperitoneal (VP) shunt malfunctions are due to proximal catheter failure. Ideal placement of Ommaya reservoirs is desired to avoid toxicity from intraparenchymal chemotherapy infusion. ⋯ In terms of results corroborating decreased proximal malfunction rates, we present the largest series of stereotactic-guided ventricular catheter placements to date. Though time in the operating room is increased due to navigation registration, actual operative time is comparable to procedures without navigation. A longer-term follow-up is needed to assess the longevity of our positive short-term results.
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Stereotact Funct Neurosurg · Jan 2012
Effects of relative low-frequency bilateral globus pallidus internus stimulation for treatment of cervical dystonia.
To assess the effect of relative lower amplitude and frequency for globus pallidus internus (GPi) deep brain stimulation (DBS) of cervical dystonia (CD). ⋯ According to our results, the initial settings of low amplitude and especially relatively low frequency are safe and effective for treatment of CD.
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Stereotact Funct Neurosurg · Jan 2012
ReviewDeep brain stimulation for Tourette syndrome: target selection.
Tourette syndrome (TS) is a complex neurological disorder manifested chiefly by motor and phonic tics and a variety of behavioral comorbidities, including attention disorder, obsessive-compulsive disorder and impulse control problems. Surgical treatment is increasingly considered when tics become troublesome or even disabling or self-injurious despite optimal medical therapy. In this review, we describe the surgical techniques, stimulation parameters, outcomes of deep brain stimulation (DBS) in TS, and critically review target choices. ⋯ Determination of the optimal surgical target will require a multicenter, randomized trial, and an expanded understanding of the neurobiology of TS.