Stereotactic and functional neurosurgery
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Stereotact Funct Neurosurg · Jan 2012
Microelectrode recording duration and spatial density constraints for automatic targeting of the subthalamic nucleus.
Accurate detection of the boundaries of the subthalamic nucleus (STN) in deep brain stimulation (DBS) surgery using microelectrode recording (MER) is considered to refine localization and may therefore improve clinical outcome. However, MER tends to extend operation time and its cost-utility balance has been debated. ⋯ STN entry detection error was about half of the step size. Sampling duration of STN activity can be minimized to 1 s/record without compromising accuracy. We conclude that bilateral DBS surgery time utilizing MER may be significantly shortened without compromising targeting accuracy.
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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
Review Case ReportsLaser interstitial thermal therapy for focal cerebral radiation necrosis: a case report and literature review.
Whole-brain radiotherapy and stereotactic radiosurgery (SRS) play a central role in the treatment of metastatic brain tumors. Radiation necrosis occurs in 5% of patients and can be very difficult to treat. The available treatment options for radiation necrosis include prolonged high-dose corticosteroids, hyperbaric oxygen, anticoagulation, bevacizumab, and surgical resection. ⋯ Additionally, the patient was completely weaned off steroids. To our knowledge this is the first report using LITT for the treatment of focal radiation necrosis. LITT may be an effective treatment modality for patients with medically refractory radiation necrosis with lesions not amenable to surgical decompression.
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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.
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Stereotact Funct Neurosurg · Jan 2012
Weight change after globus pallidus internus or subthalamic nucleus deep brain stimulation in Parkinson's disease and dystonia.
Weight gain has been described in Parkinson's disease (PD) patients after subthalamic nucleus (STN) deep brain stimulation (DBS). ⋯ Our results support previous reports of weight gain after DBS in PD. This is the first report to suggest a target-specific increase in weight following STN DBS in dystonia patients.