Neurosurgery clinics of North America
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Neurosurg. Clin. N. Am. · Apr 1999
Review Clinical TrialRadiosurgery for trigeminal neuralgia and epilepsy.
The role of Gamma Knife surgery in the field of functional surgery recently has evolved dramatically. For treatment of trigeminal neuralgia, Gamma Knife surgery is the least invasive procedure, with a low rate of hypesthesia. ⋯ The authors present their experience with a group of 16 patients with mesial temporal lobe epilepsy who have been treated successfully (15 completely seizure-free and 1 with rare, nondisabling seizures) without significant complication. After additional follow-up to demonstrate the absence of long-term consequences, this fascinating new approach could change epilepsy surgery practice dramatically.
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Neurosurg. Clin. N. Am. · Apr 1999
Review Clinical TrialThe treatment of movement disorders using Gamma Knife stereotactic radiosurgery.
In this era of modern neurosurgery, we are able to provide adequate amelioration of disabling symptoms for the small subset of patients who have conditions that may make them unacceptable candidates for invasive stereotactic neurosurgical intervention. Gamma Knife radiosurgical thalamotomy is an effective and useful alternative to invasive radiofrequency techniques for patients at high surgical risk. The mechanical accuracy of the gamma unit combined with the anatomical accuracy of high-resolution magnetic resonance imaging makes radiosurgical lesioning safe and precise.
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Neurosurg. Clin. N. Am. · Apr 1999
ReviewLinear accelerator radiosurgery in brain tumor management.
This article begins with a brief introduction to the concepts and techniques of linear accelerator-based stereotactic radiosurgery. The expanding role of radiosurgery in the treatment of brain tumors is explored in depth, including detailed discussions of the five intracranial neoplasms most frequently treated with radiosurgery. ⋯ For each of these, a thorough review of published radiosurgical results is presented along with a discussion of common treatment modalities. The role of radiosurgery in the treatment of brain tumors continues to be defined, but an effort is made to provide reasonable indications for and against radiosurgery based on the current state of the art.
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Neurosurg. Clin. N. Am. · Apr 1999
ReviewStereotactic radiosurgery for arteriovenous malformations.
Arteriovenous malformations (AVMs) were one of the first indications for radiosurgery. Radiosurgery has been shown to be an important management strategy for properly selected AVM patients. Radiosurgery is especially useful for patients with AVMs in deep brain locations and critical lobar areas. This article outlines the results and expectations of contemporary AVM radiosurgery and discusses the role of radiosurgery in the management of patients with AVMs.
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Neurosurg. Clin. N. Am. · Oct 1998
ReviewRevascularization and bypass procedures for cerebral aneurysms.
Revascularization and bypass procedures are useful in the treatment of complex aneurysms. Extracranial to intracranial bypass grafts are used to augment the distal circulation as an adjunct to proximal vessel occlusion for aneurysm treatment. ⋯ Intracranial interposition grafts are used to reconstruct arteries harboring aneurysms that cannot be occluded directly using clip or coil techniques. These techniques in the treatment of cerebral aneurysms are discussed.