Stereotactic and functional neurosurgery
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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.
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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.
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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.
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Stereotact Funct Neurosurg · Jan 2000
Comparative StudyIn vivo proton magnetic resonance spectroscopy of brain tumors.
The ability of magnetic resonance spectroscopy (MRS) to differentiate neoplastic brain cells and their metabolic and structural characteristics is evaluated. We examined 120 patients with brain tumors using a 1.5-tesla MRI unit and MRS. The peak areas of N-acetyl-aspartate (NAA), phosphocreatine-creatine (Pcr-Cr), choline-containing compounds (Cho), lactate, lipids, myoinositol, amino acids and the ratios of NAA/Pcr-Cr, NAA/Cho and Cho/Pcr-Cr were calculated by a standard integral algorithm. ⋯ The greater this ratio, the higher the grade of the astrocytoma. NAA/Pcr-Cr together with Cho/Pcr-Cr help specify the presence or absence of a neoplasm. Proton MRS is a useful and promising diagnostic modality not only in diagnosing but also in grading solid brain tumors.
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Stereotact Funct Neurosurg · Jan 2000
Combined treatment with stereotactic intracavitary irradiation and gamma knife surgery for craniopharyngiomas.
To evaluate the effectiveness of the combined treatment of stereotactic intracavitary irradiation and Gamma Knife surgery on craniopharyngiomas. ⋯ Gamma Knife surgery plays an important role in the treatment of the solid component of craniopharyngiomas and the combination of treatment is a simple, safe and effective method for treatment of craniopharyngiomas, especially for the recurrent mixed solid and cystic tumors.