Stereotactic and functional neurosurgery
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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.
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Stereotact Funct Neurosurg · Jan 2012
Gamma knife stereotactic radiosurgery for radiation-induced meningiomas.
Radiation-induced meningiomas present a unique clinical dilemma given the fact that patients with these tumors have often received a prior full course of radiotherapy. As such, traditional radiotherapy is limited by lifetime tissue tolerances to radiation, leaving surgery and radiosurgery as attractive treatment options. ⋯ Gamma Knife radiosurgery is both a safe and effective treatment for radiation-induced meningiomas.
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Stereotact Funct Neurosurg · Jan 2012
An evaluation of hardware and surgical complications with deep brain stimulation based on diagnosis and lead location.
Deep brain stimulation is the most frequently performed neurosurgical procedure for movement disorders. This procedure is well tolerated, but not free of complications. Analysis of hardware complications based on patient diagnosis and lead location could prove valuable in recognizing potential pitfalls and patients at higher risk. ⋯ This large series of patients and long-term follow-up demonstrate that risks of complications are not universal among movement disorder patients. Diagnosis and lead location are important risk stratification factors in determining complications.