Stereotactic and functional neurosurgery
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Stereotact Funct Neurosurg · Jan 2008
ReviewReview of the treatment of trigeminal neuralgia with gamma knife radiosurgery.
Trigeminal neuralgia is a debilitating condition caused by compression of the trigeminal nerve, ganglions, or divisions. Gamma knife radiosurgery has been increasingly used in the treatment of trigeminal neuralgia as a non-invasive alternative to microvascular decompression and rhizotomies. ⋯ The growing body of literature suggests that the low rates of complications of gamma knife radiosurgery, coupled with the high success rates and patient satisfaction, allow it to be increasingly used as primary intervention for trigeminal neuralgia for appropriate patients.
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Stereotact Funct Neurosurg · Jan 2008
Case ReportsLow-frequency bilateral hypothalamic stimulation for treatment of drug-resistant aggressiveness in a young man with mental retardation.
Stereotactic bilateral electrode implantation in the medial portion of the posterior hypothalamus was performed on a 22-year-old male with drug-resistant aggressiveness. To localize the targets during implantation, microrecording was performed, and the clinical and electroencephalographic responses to intraoperative stimulation were monitored. The patient had an improved response to low-frequency stimulation that was sustained 18 months later at a follow-up examination.
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Stereotact Funct Neurosurg · Jan 2008
Comparative StudySubthalamic stimulation for essential tremor. Short- and long-term results and critical target area.
In order to explore the usefulness and long-term result of subthalamic nucleus (STN) stimulation for the treatment of essential tremor (ET), we evaluated 3 groups of patients undergoing deep brain stimulation (DBS) for ET. ⋯ Provided that intra-operative test stimulation produces satisfactory tremor control, STN is a good target for long-term treatment of ET. For patients above the age of 70 years, however, the Vim is a preferable target.
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Stereotact Funct Neurosurg · Jan 2008
ReviewA comprehensive review of radiosurgery for cerebral arteriovenous malformations: outcomes, predictive factors, and grading scales.
The management of cerebral arteriovenous malformations (AVMs) continues to present a challenge to neurosurgeons. The natural history of this condition, as well as the morbidity and mortality of therapeutic interventions, remains incompletely elucidated. Predictive factors and grading scales in AVM management allow risk-benefit analysis of treatment options and comparison of outcomes. ⋯ Lesion characteristics and postsurgical complications differ markedly in patientstreated by radiosurgery versus microsurgery. Radiosurgery-based grading systems account for factors that have been associated with various aspects of radiosurgical outcomes including obliteration, hemorrhage, and postoperative complications, particularly those induced by radiation. The purpose of this paper is to describe the most current predictive factors and grading systems for radiosurgical treatment of cerebral AVMs.