Stereotactic and functional neurosurgery
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Stereotact Funct Neurosurg · Jan 2012
Case ReportsShielded battery syndrome: a new hardware complication of deep brain stimulation.
Deep brain stimulation hardware is constantly advancing. The last few years have seen the introduction of rechargeable cell technology into the implanted pulse generator design, allowing for longer battery life and fewer replacement operations. The Medtronic® system requires an additional pocket adaptor when revising a non-rechargeable battery such as their Kinetra® to their rechargeable Activa® RC. This additional hardware item can, if it migrates superficially, become an impediment to the recharging of the battery and negate the intended technological advance. ⋯ We describe strategies to minimise the occurrence of the shielded battery syndrome and advise vigilance in all patients who experience difficulty with recharging after replacement surgery of this type for the implanted pulse generator.
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Stereotact Funct Neurosurg · Jan 2012
Stereotactic placement of ventricular catheters: does it affect proximal malfunction rates?
The majority of ventriculoperitoneal (VP) shunt malfunctions are due to proximal catheter failure. Ideal placement of Ommaya reservoirs is desired to avoid toxicity from intraparenchymal chemotherapy infusion. ⋯ In terms of results corroborating decreased proximal malfunction rates, we present the largest series of stereotactic-guided ventricular catheter placements to date. Though time in the operating room is increased due to navigation registration, actual operative time is comparable to procedures without navigation. A longer-term follow-up is needed to assess the longevity of our positive short-term results.
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Stereotact Funct Neurosurg · Jan 2012
Effects of relative low-frequency bilateral globus pallidus internus stimulation for treatment of cervical dystonia.
To assess the effect of relative lower amplitude and frequency for globus pallidus internus (GPi) deep brain stimulation (DBS) of cervical dystonia (CD). ⋯ According to our results, the initial settings of low amplitude and especially relatively low frequency are safe and effective for treatment of CD.
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Stereotact Funct Neurosurg · Jan 2012
Intraoperative facial electromyography and brainstem auditory evoked potential findings in microvascular decompression for hemifacial spasm: correlation with postoperative delayed facial palsy.
Delayed facial palsy (DFP) after microvascular decompression (MVD) in patients with hemifacial spasm (HFS) is not uncommon, but the cause remains unknown. ⋯ The usefulness of intraoperative facial EMG and BAEP is limited and cannot predict DFP after MVD for HFS. We speculate that DFP after MVD is not associated with permanent nerve damage according to the EMG findings.
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Stereotact Funct Neurosurg · Jan 2012
Use of endotracheal tube electrodes in treating glossopharyngeal neuralgia: technical note.
This paper describes the use of endotracheal tube surface electrodes to help delineate the sensory and motor vagal rootlets which may be sacrificed during the surgical treatment of glossopharyngeal neuralgia. ⋯ Due to the ease of use and reduced trauma, compared to needle electrodes, we would advocate endotracheal tube surface electrode monitoring in all patients undergoing surgical treatment of their glossopharyngeal neuralgia or any intracranial procedure where the integrity of the vagal nerve is in jeopardy.