Stereotactic and functional neurosurgery
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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
Clinical TrialLong-term outcome of anterior thalamic nucleus stimulation for intractable epilepsy.
Many patients with epilepsy have persistent seizures despite treatment with maximal antiepileptic drug therapy and are not candidates for resective brain surgery. ⋯ It seems to be important that the short-term outcome of ATN DBS reflects the long-term outcome directly. The correlation between the seizure type, characteristics and anticonvulsant effects of ATN DBS did not exhibit significance because of the small number of cases. Therefore, a longer-term follow-up with a larger group of patients is required to fully evaluate the safety and effectiveness of this treatment modality.
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Stereotact Funct Neurosurg · Jan 2012
Case ReportsFour-decade maintenance of analgesia with percutaneous cordotomy.
The management of severe, medically intractable pain is a significant challenge for neurosurgeons and pain management physicians. An existing technique that can effectively alleviate contralateral chronic pain is cordotomy, interruption of the lateral spinothalamic tract of the spinal cord. ⋯ Here we describe a case with a 41-year follow-up of percutaneous cordotomy for noncancer pain that resulted in over 35 years of complete analgesia, the longest recorded in the literature to date. This case demonstrates that percutaneous cordotomy can provide long-lasting, complete analgesia in some patients and merits continuation as a part of the neurosurgical arsenal of pain therapies.
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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
Rate of recurrence following stereotactic aspiration of colloid cysts of the third ventricle.
The rate of recurrence following stereotactic aspiration of colloid cysts is not defined in the literature. ⋯ Stereotactic aspiration of colloid cysts remains a valid surgical option as complete aspiration leads to a good long-term outcome in several patients. Partial aspiration of the cyst should be followed by excision of the cyst, due to the high rate of symptomatic recurrence. However, periodic follow-up imaging is mandatory even after complete aspiration as delayed recurrences are possible.