Stereotactic and functional neurosurgery
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Stereotact Funct Neurosurg · Jan 2011
Case ReportsMotor cortex stimulation for trigeminal neuropathic or deafferentation pain: an institutional case series experience.
Trigeminal neuropathy is a rare, devastating condition that can be intractable and resistant to treatment. When medical treatment fails, invasive options are limited. Motor cortex stimulation (MCS) is a relatively recent technique introduced to treat central neuropathic pain. The use of MCS to treat trigeminal neuropathic or deafferentation pain is not widespread and clinical data in the medical literature that demonstrate efficacy are limited. ⋯ MCS is a safe and potentially effective therapy in certain patients with trigeminal neuropathy.
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Stereotact Funct Neurosurg · Jan 2011
Case ReportsSubcutaneous peripheral neurostimulation for the treatment of severe chronic poststernotomy neuralgia.
Poststernotomy pain frequently develops after sternotomy in thoracic and cardiovascular surgery, and may affect patients' quality of life. In some cases of severe poststernotomy neuralgia, pharmacologic therapy does not provide adequate relief. ⋯ SPNS may be a viable treatment option in patients with severe chronic poststernotomy neuralgia.
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Stereotact Funct Neurosurg · Jan 2011
Intraoperative image fusion to ascertain adequate lead placement.
In order to view the position of the deep brain stimulator (DBS) lead in relation to the stereotactic target on 3-tesla magnetic resonance (3T-MR) images prior to the conclusion of the procedure, intraoperative postimplantation computed tomography (CT) images were fused with preoperative 3T-MR images. The method to do this is described and discussed in this paper. ⋯ This is a simple method to intraoperatively visualize DBS lead position on high-quality 3T-MR images. It gives the surgeon the capability to detect errors and correct them prior to the conclusion of the procedure.
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Stereotact Funct Neurosurg · Jan 2011
ReviewSpinal cord stimulation and cerebral hemodynamics: updated mechanism and therapeutic implications.
The effects of spinal cord stimulation (SCS) on cerebral blood flow (CBF) are well known based on experimental investigations, and its vasodilator effect on peripheral arteries is widely used in clinical settings in the treatment of peripheral vascular disease. Since Hosobuchi's [Appl Neurophysiol 1985;48:372-376] first observations on the effects of SCS on CBF were published 22 years ago, many advances have been made in understanding SCS-mediated effects on CBF. ⋯ The authors revised the published experiences in humans with hypoperfusion syndromes and 'adjuvant' locoregional CBF increase in chemotherapy of brain tumors. SCS represents a new perspective in challenging neurosurgical clinical fields such as cerebral ischemia and vasospasm, and seems promising as a new trend of functional neurosurgery in cerebrovascular diseases.