Stereotactic and functional neurosurgery
-
Stereotact Funct Neurosurg · Jan 2000
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialTechnical data and complications of spinal cord stimulation: data from a randomized trial on critical limb ischemia.
This study was done to evaluate the effect of spinal cord stimulation (SCS) on critical limb ischemia and to report technical problems and complications. One hundred and twenty patients with critical limb ischemia were eligible for randomization between medical treatment and medical treatment plus SCS. Sixty received a spinal cord stimulator (Itrel II; Medtronic, Minneapolis, Minn., USA). ⋯ Lead displacement remains the major technical problem. The search for prognostic factors of limb salvage is important. One microcirculatory measurement (TcpO2) seems to have a prognostic value, which remains to be described more precisely.
-
Stereotact Funct Neurosurg · Jan 2000
ReviewCerebral protection before, during and after neurosurgical procedures.
Not only the pathology but also the neurosurgical procedure itself can lead to an impairment of cerebral structures. This may cause neurological symptoms like confusion, disorientation or cognitive deficits which have hardly been noticed until now. ⋯ As an example of the effectiveness, based on our own experiences and international trials, two different medical drugs, Nimodipine and Cerebrolysin, are presented. In conclusion one has to realize that nowadays neurosurgeons have to focus their interest more and more to neuroprotective adjuvant treatment possibilities.
-
Stereotact Funct Neurosurg · Jan 2000
ReviewThe idea of stereotaxy toward minimally invasive neurosurgery.
The idea of stereotaxy in modern neurosurgery is reviewed. Stereotactic surgery has been one of the particular neurosurgical techniques mainly used for functional disorders. ⋯ Functional neurosurgery itself is also changing in the sense that many alternative surgical procedures are now available due to the progress in neuroscience. The original premise of stereotaxy is exactly the same as that of minimally invasive neurosurgery today.
-
Stereotact Funct Neurosurg · Jan 2000
Case ReportsIpsilateral thalamic stimulation after thalamotomy for essential tremor. A case report.
We report a patient with severe essential tremor who was treated with thalamic stimulation ipsilateral to a prior thalamotomy. Thalamotomy performed 30 years prior to stimulator implantation provided tremor reduction for one year before the tremor recurred. An electrode lead was implanted in the thalmaic nucleus ventralis intermedius (Vim) with nearly complete control of his tremor with sustained benefit over an 18-month follow-up period. Vim thalamic stimulation is an effective treatment option for recurrent tremor in patients who have undergone ipsilateral thalamotomy.
-
Stereotact Funct Neurosurg · Jan 2000
Clinical TrialContinuous intrathecal clonidine administration for the treatment of neuropathic pain.
In many cases, the treatment of neuropathic pain by intrathecal opioids fails to meet expectations. In a trial involving 10 patients, the intrathecal administration of clonidine combined with opioids in the treatment of chronic pain was introduced in our department for the first time. ⋯ Residual non-neuropathic pain in 4 of 8 patients was successfully treated with clonidine and low doses of opioids. On the basis of the results achieved so far, we recommend that clonidine should be routinely tested for intrathecal drug administration, especially in patients with a prominent neuropathic pain component.