Stereotactic and functional neurosurgery
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Stereotact Funct Neurosurg · Jan 2008
Case ReportsLow-frequency bilateral hypothalamic stimulation for treatment of drug-resistant aggressiveness in a young man with mental retardation.
Stereotactic bilateral electrode implantation in the medial portion of the posterior hypothalamus was performed on a 22-year-old male with drug-resistant aggressiveness. To localize the targets during implantation, microrecording was performed, and the clinical and electroencephalographic responses to intraoperative stimulation were monitored. The patient had an improved response to low-frequency stimulation that was sustained 18 months later at a follow-up examination.
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Twiddler's syndrome describes the intentional external manipulation or spontaneous rotation of implanted devices such as cardiac pacemakers. Here we report the same phenomenon occurring in a patient with an implanted deep brain stimulator generator. The clinical syndrome is described and potential technical nuances to prevent its occurrence are suggested.
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Stereotact Funct Neurosurg · Jan 2008
Comparative StudyBrain shift during deep brain stimulation surgery for Parkinson's disease.
Brain shift may occur during deep brain stimulation (DBS) surgery, which may affect the position of subcortical structures, compromising target localization. ⋯ Subcortical structures shift during DBS surgery. This shift appears to be gravity-dependent since structures only shifted posteriorly, and patients were primarily in the supine position. Posterior shift of RN may indicate STN displacement. Such positional change may compromise target localization, requiring multiple microelectrode adjustments. This may provide indirect justification for the necessity of microelectrode recordings during DBS surgery.
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Stereotact Funct Neurosurg · Jan 2008
Comparative StudyStereotactic MRI in DYT1 dystonia: focal signal abnormalities in the basal ganglia do not contraindicate deep brain stimulation.
To study stereotactic magnetic resonance imaging (MRI) features of the basal ganglia in DYT1 primary dystonia. ⋯ T(1)-hypointense/T(2)-hyperintense signal abnormalities are common findings in the putamen and globus pallidus of DYT1 patients but do not contraindicate DBS. However, their presence within the GPi may reduce the efficacy of DBS treatment.
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Stereotact Funct Neurosurg · Jan 2008
Case ReportsOccipital nerve stimulation for refractory occipital pain after occipitocervical fusion: expanding indications.
Occipital nerve stimulation is being used for various pain syndromes. Here, we expand its use for the treatment of refractory occipital pain after occipitocervical fusion. ⋯ Occipital nerve stimulation for medical refractory occipital neuralgia after occipitocervical fusion is an effective method expanding the indications for its use.