Stereotactic and functional neurosurgery
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Stereotact Funct Neurosurg · Jan 2016
Teflon Might Be a Factor Accounting for a Failed Microvascular Decompression in Hemifacial Spasm: A Technical Note.
Although Teflon is widely adopted for microvascular decompression (MVD) surgery, it has never been addressed for failure analysis. This study analyzed the reasons for failed MVDs with emphasis on the Teflon sponge. ⋯ Although it is not difficult for an experienced neurosurgeon to discover a neurovascular conflict during the MVD process, the size, shape and location of the Teflon sponge should not be ignored. Basically, the Teflon insert is used to keep the offending artery away from the facial nerve root rather than to isolate it. Therefore, the ideal Teflon sponge should be just small enough to produce a neurovascular separation.
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Stereotact Funct Neurosurg · Jan 2016
ReviewMRI Conditionality in Patients with Spinal Cord Stimulation Devices.
Because of the commonality of diagnostic magnetic resonance imaging (MRI), MRI conditional technology has increased throughout the device industry. It is often difficult to be aware of MRI specifications for each device. ⋯ By describing SCS device specifications and reviewing the literature, we provide a guide to implanting and treating physicians on obtaining MRIs in patients who have SCS devices.
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Stereotact Funct Neurosurg · Jan 2016
Multicenter StudySurgical Replacement of Implantable Pulse Generators in Deep Brain Stimulation: Adverse Events and Risk Factors in a Multicenter Cohort.
Deep brain stimulation (DBS) is a growing treatment modality, and most DBS systems require replacement of the implantable pulse generator (IPG) every few years. The literature regarding the potential impact of adverse events of IPG replacement on the longevity of DBS treatments is rather scarce. ⋯ The risk of postoperative infection with DBS IPG replacement increases with the number of previous procedures. There is a need to reduce the frequency of IPG replacements.
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Stereotact Funct Neurosurg · Jan 2016
The Correlation between Intraoperative Microelectrode Recording and 3-Tesla MRI in Patients Undergoing ANT-DBS for Refractory Epilepsy.
Deep brain stimulation (DBS) of the anterior nucleus of the thalamus) (ANT) has been suggested as a treatment option in refractory epilepsy. The targeting of ANT is especially challenging due to its poor visualization in commonly used MRI sequences, lack of easily observable symptom relief during surgery and high degree of anatomical variation between individuals. ⋯ Our data suggest that MER provides clinically relevant information during implantation surgery by demonstrating both nucleus-specific neuronal firing patterns and white matter laminae between different nuclear groups.
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Stereotact Funct Neurosurg · Jan 2016
Deep Brain Stimulation of the Caudal Zona Incerta: Tremor Control in Relation to the Location of Stimulation Fields.
The caudal zona incerta (cZi) and posterior subthalamic area (PSA) are an emerging deep brain stimulation (DBS) target for essential tremor (ET). ⋯ PSMs may serve as a useful tool for defining the most efficacious anatomical location of stimulation. The best tremor control in this series of cZi DBS was achieved with stimulation of the superior part of the PSA, which corresponds to the final part of the cerebellothalamic projections before they reach the ventral lateral thalamus.