Stereotactic and functional neurosurgery
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Stereotact Funct Neurosurg · Jan 2011
Comparative StudySubthalamic deep brain stimulation in Parkinson's disease under different anesthetic modalities: a comparative cohort study.
The efficacy and feasibility of bilateral subthalamic deep brain stimulation (STN-DBS) for Parkinson's disease (PD) under general anesthesia (GA) has not been evaluated. ⋯ Desflurane GA was shown to be a good alternative anesthetic method for PD patients undergoing DBS. Although the motor outcomes were comparable, a significant cognitive decline may be seen in the GA group with a higher occurrence of stimulation side effects.
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Stereotact Funct Neurosurg · Jan 2011
Comparative StudyMRI-guided subthalamic nucleus deep brain stimulation without microelectrode recording: can we dispense with surgery under local anaesthesia?
Subthalamic nucleus (STN) deep brain stimulation (DBS) for Parkinson's disease (PD) is traditionally performed under local anaesthetic (LA). STN visualization and routine validation of electrode location on stereotactic MRI may allow surgery under general anaesthesia (GA). This study compares the clinical outcome of MRI-guided STN DBS performed under LA or GA in a consecutive patient series. ⋯ MRI-guided STN DBS under GA with routine stereotactic verification of lead location did not have a negative effect on efficacy or safety. Surgery under GA is a viable option in patients who would find it hard to tolerate awake surgery due to disease severity, comorbidities or anxiety.
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Stereotact Funct Neurosurg · Jan 2011
Stereotactic radiosurgery to the resection cavity of brain metastases: a retrospective analysis and literature review.
The aim of this study was to analyze results of stereotactic radiosurgery (SRS) as adjuvant therapy for resected brain metastases. ⋯ Adjuvant radiosurgery to the tumor cavity of resected brain metastases is well-tolerated and achieves LC in the majority of patients.
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Stereotact Funct Neurosurg · Jan 2011
Case ReportsBilateral subthalamic deep brain stimulation after bilateral pallidal deep brain stimulation for Parkinson's disease.
Globus pallidus internus (GPi) and subthalamic nucleus (STN) have successfully been targeted independently for deep brain stimulator (DBS) placement in medically intractable Parkinson's disease (PD). Bilateral implantation of STN DBS in a patient with preexisting, functioning GPi DBS to specifically treat motor fluctuations is, to our knowledge, yet unreported. ⋯ In this report we discuss the rationale, technical issues, programming nuances and outcome in a patient with preexisting bilateral GPi DBS who was implanted with bilateral STN DBS.
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Stereotact Funct Neurosurg · Jan 2011
Comparative StudyLongevity analysis of currently available deep brain stimulation devices.
There continues to be debate about the surgical technique, electrophysiology, and hardware used in deep brain stimulation (DBS), despite its widespread use in medically intractable Parkinson's disease and essential tremor. This article is the first, to our knowledge, to compare the longevity of the available internal pulse generators (IPGs) of DBS (Kinetra and Soletra, Medtronics). ⋯ Our findings support superior battery life and a greater capacity for titration to symptom control with bilateral Soletra IPGs.