Neurol Neurochir Pol
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Neurol Neurochir Pol · Jul 2011
Surgical treatment of insular tumours with tractography, functional magnetic resonance imaging, transcranial electrical stimulation and direct subcortical stimulation support.
Surgical treatment of insular tumours carries significant risks of limb paresis or speech disturbances due to their localization. The development of intraoperative neuromonitoring techniques that involve evoked motor potentials induced via both direct and transcranial cortical electrical stimulation as well as direct subcortical white matter stimulation, intraoperative application of preoperative tractography and functional magnetic resonance imaging (fMRI) in conjunction with neuronavigation resulted in significant reduction of postoperative disabilities that enabled widening of indications for surgical treatment. The aim of this study was to present the authors' own experience with surgical treatment of insular gliomas. ⋯ Implementation of TES, direct subcortical white master stimulation, DTI and fMRI into the management protocol of the surgical treatment of insular tumours resulted in total and subtotal resections in 66% of cases with permanent motor disability in 6.6% of patients. Poor prognosis for independent living after surgery mainly affects patients with WHO grade III or IV.
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Neurol Neurochir Pol · May 2011
Review[Approach to the jugular foramen and related structures - an analysis of the surgical technique based on cadaver simulation].
This study presents consecutive stages of the approach to the jugular foramen and related structures. Eleven simulations of the approach were performed on non-fixed human cadavers without any known pathologies in the head and neck. The consecutive stages of the procedure were documented with photographs and schematic diagrams. ⋯ Widening of the approach enables penetration of the jugular foramen from above and the front. Approach to the jugular foramen is a reproducible technique, which provides surgical penetration of this foramen and related structures. This approach is particularly useful in the surgical treatment of tumours expanding in the petrous pyramid, surroundings of the petrosal part of the internal carotid artery, cerebellopontine angle, subtemporal fossa and nervous-vascular bundle of the neck.
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Neurol Neurochir Pol · Jan 2011
Review[Hypothalamic deep brain stimulation for treatment of cluster headache].
Extremely severe, unilateral, recurrent facial pain and headache, accompanied by autonomic symptoms and signs, can be identified as cluster headache attacks (CH). Despite optimal pharmacological treatment, 20% of patients will not achieve satisfactory improvement. ⋯ The authors present current opinions about DBS treatment in CH. A socioeconomic analysis of neuromodulatory treatment of CH is presented.
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Neurol Neurochir Pol · Jan 2011
Thalamic deep brain stimulation in the treatment of essential tremor.
Quality of life can be severely impaired by essential tremor (ET) being the main cause of the patient's disability. The authors present a group of ET patients treated with deep brain stimulation of the ventral intermediate nucleus of the thalamus (Vim DBS). The aim of the study was to evaluate the efficacy and safety of Vim DBS in the treatment of ET. ⋯ Vim DBS is a safe and effective method of ET treatment. Vim DBS improves activities of daily living of ET patients.
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Neurol Neurochir Pol · Jan 2011
Subthalamic deep brain stimulation for the treatment of Parkinson disease.
The role of subthalamic nucleus deep brain stimulation (STN DBS) in the treatment of Parkinson disease (PD) is well established. The authors present a group of patients diagnosed with PD who were treated with STN DBS. ⋯ Cardinal symptoms of Parkinson's disease can be safely and effectively treated with STN DBS in selected group of patients.