Stereotactic and functional neurosurgery
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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
Capability of identifying red nuclei in different pulse sequences of regular 1.5-tesla magnetic resonance images.
To investigate the optimal pulse sequences of commonly used 1.5-tesla MRI for identifying the red nucleus (RN) to aid targeting of the subthalamic nucleus (STN). ⋯ T2FLAIR is an alternative to FSE-T2WI that can readily demarcate the RN to help target the STN.
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Stereotact Funct Neurosurg · Jan 2012
Deep brain stimulation hardware complications in patients with movement disorders: risk factors and clinical correlations.
Deep brain stimulation (DBS) has proven to be an effective treatment for Parkinson's disease (PD) and other movement disorders, but its usefulness is limited by complications related to the hardware. ⋯ DBS is a safe intervention with a relatively low rate of hardware complications.
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Stereotact Funct Neurosurg · Jan 2012
Comparative StudyChanging practice patterns of deep brain stimulation in Parkinson's disease and essential tremor in the USA.
Randomized controlled studies have shown deep brain stimulation (DBS) to be an effective treatment for Parkinson's disease (PD). Outside of large-center studies, little is known about trends in DBS use in the USA. ⋯ Patients who underwent DBS in the 2007 sample were older and had more comorbidities than those in the 2000 sample; in-hospital complications remained low. Understanding trends in DBS is helpful in assessing how the technology is adopted and what relationships should be further explored.
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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.