Neurosurgery clinics of North America
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Neurosurg. Clin. N. Am. · Apr 2009
ReviewImplantation of deep brain stimulator electrodes using interventional MRI.
The authors describe a method for placement of deep brain stimulator electrodes using interventional MRI in conjunction with a skull-mounted aiming device (Medtronic Nexframe). This approach adapts the procedure to a standard-configuration 1.5-T diagnostic MRI scanner in a radiology suite. ⋯ The method is conceptually simpler than the current standard technique for deep brain stimulator placement, as it eliminates the stereotactic frame, the subsequent requirement for registration of the brain in stereotactic space, physiologic testing, and the need for patient cooperation. With further technical refinement, the interventional MRI method should improve the accuracy, safety, and speed of deep brain stimulator electrode placement.
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Intraoperative MRI (iMRI) can be applied in several surgical settings. The incorporation of MRI technology into the operating room requires special considerations. ⋯ Incorporating the MRI technology into the operating room presents a new challenge in a transdisciplinary environment. The use of the iMRI technology has provided revolutionary tools for the new generation of medical practice.
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Neurosurg. Clin. N. Am. · Jan 2009
ReviewFrom the battlefront: peripheral nerve surgery in modern day warfare.
Warfare historically causes a large number of peripheral nerve injuries. During the current global war on terror, an increased use of advanced regional anesthesia techniques appears to have significantly reduced pain syndromes that have been previously reported with missile-induced nerve injuries. Additionally, a new program has been established to develop advanced prosthetic devises that can interface with neural tissue to obtain direct neural control. As this technology matures, the functional restoration gained from these new generation prosthetic devices may exceed that which can be obtained by standard nerve repair techniques.
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Neurosurg. Clin. N. Am. · Jan 2009
Review Case ReportsBrachial plexus injury: the London experience with supraclavicular traction lesions.
In this article, the author details the experiences of his hospital and other London hospitals in treating brachial plexus injury. As noted, important advances have been made in methods of diagnosis and repair. Myelography was replaced by CT scan and later by MRI. ⋯ This is part of a Point-Counterpoint discussion with Dr. David G. Kline's presentation of "A Personal Experience."