Stereotactic and functional neurosurgery
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Stereotact Funct Neurosurg · Jan 2013
Review Case ReportsStereotactic radiosurgery of a papillary tumor of the pineal region: case report and review of the literature.
Papillary tumors of the pineal region are a recently described very rare group of primary CNS neoplasms. Because of their rarity, it has proven to be difficult to establish the optimal therapy. Furthermore, microsurgical resection of pineal region neoplasms is associated with quite a high morbidity. We report the first case of stereotactic radiosurgery of a histologically confirmed papillary tumor of the pineal region. ⋯ Stereotactic radiosurgery should be considered a treatment option in these surgically challenging tumors.
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Stereotact Funct Neurosurg · Jan 2013
ReviewPosttraumatic stress disorder: neurocircuitry and implications for potential deep brain stimulation.
Posttraumatic stress disorder (PTSD) is a prevalent and highly disabling psychiatric disorder that is notoriously difficult to treat. At some point in their lifetimes, 5-8% of men, 10-14% of women, and up to a quarter of combat veterans carry this diagnosis. ⋯ Deep brain stimulation modulates CSPTC circuits in movement and other neuropsychiatric disorders. In this review, we discuss the salient clinical features and neurocircuitry of PTSD and propose a neuromodulation strategy for the disorder.
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Stereotact Funct Neurosurg · Jan 2013
Comparative StudyPossible mechanisms involved in subthalamotomy-induced dyskinesia in patients with Parkinson's disease.
Operation-induced dyskinesia (OID) occurs in approximately 10% of patients submitted to subthalamotomy. The goal of the authors was to determine the possible causes of this feared complication. ⋯ Damage to the dorsolateral territory of the STN and sparing of the ZI seem to be essential for the development of OID. SID and, to a lesser extent, LID are apparently significant risk factors for the development of this complication.
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Stereotact Funct Neurosurg · Jan 2013
Long-term changes in the personality and psychopathological profile of opiate addicts after nucleus accumbens ablative surgery are associated with treatment outcome.
To investigate the long-term outcome and changes of the personality and psychopathological profile of opiate addicts after bilateral stereotactic nucleus accumbens (NAc) ablative surgery. ⋯ The bilateral ablation of NAc by stereotactic neurosurgery was a feasible method for alleviating psychological dependence on opiate drugs and preventing a relapse. Long-term follow-up suggested that surgery can improve the personality and psychopathological profile of opiate addicts with a trend towards normal levels, provided persistent abstinence can be maintained; relapse, on the other hand, may ruin this effect.
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Stereotact Funct Neurosurg · Jan 2013
Safety and efficacy of motor mapping utilizing short pulse train direct cortical stimulation.
A major goal of intracranial surgery is to maximize resection while minimizing neurological morbidity, particularly motor dysfunction. Direct cortical stimulation (DCS) is a common intraoperative adjunct used to identify functional motor cortex. In this study, we report on the safety/efficacy of short pulse train DCS (direct cortical stimulation motor-evoked potential, dcMEP) for motor mapping and monitoring during intracranial surgery. ⋯ dcMEP is an effective method for mapping motor function and may prove useful for continuous CST monitoring.