Stereotactic and functional neurosurgery
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Stereotact Funct Neurosurg · Jan 2008
Endocrine response after gamma knife-based stereotactic radiosurgery for secretory pituitary adenoma.
To examine treatment outcomes of Gamma Knife-based stereotactic radiosurgery (GK-based SRS) for secretory pituitary adenomas. ⋯ GK-based SRS provides a reasonable rate of endocrine normalization of secretory pituitary adenoma. The time to endocrine response is shorter than reported for fractionated external beam radiotherapy. There is a low risk of optic neuropathy.
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Twiddler's syndrome describes the intentional external manipulation or spontaneous rotation of implanted devices such as cardiac pacemakers. Here we report the same phenomenon occurring in a patient with an implanted deep brain stimulator generator. The clinical syndrome is described and potential technical nuances to prevent its occurrence are suggested.
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Stereotact Funct Neurosurg · Jan 2008
Pain relief after cervical ganglionectomy (C2 and C3) for the treatment of medically intractable occipital neuralgia.
Occipital neuralgia (ON) presents a diagnostic challenge because of the wide variety of symptoms, surgical findings, and postsurgical outcomes. Surgical removal of the second (C2) or third (C3) cervical sensory dorsal root ganglion is an option to treat ON. The goal of this study was to evaluate the short-term and the long-term efficacy of these procedures for management of cervical and occipital neuropathic pain. ⋯ Cervical ganglionectomy offers relief to a majority of patients, immediately after procedure, but the effect is short lived. Nerve blocks are helpful in predicting short-term success, but a positive block result does not necessarily predict long-term benefit and therefore cannot justify surgery by itself. However, since 60% of patients report excellent-moderate results, cervical ganglionectomy continues to have a role in the treatment of intractable ON.
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Stereotact Funct Neurosurg · Jan 2008
Case ReportsOccipital nerve stimulation for refractory occipital pain after occipitocervical fusion: expanding indications.
Occipital nerve stimulation is being used for various pain syndromes. Here, we expand its use for the treatment of refractory occipital pain after occipitocervical fusion. ⋯ Occipital nerve stimulation for medical refractory occipital neuralgia after occipitocervical fusion is an effective method expanding the indications for its use.
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Stereotact Funct Neurosurg · Jan 2008
Comment LetterThe paradoxical role of dopamine after subthalamic nucleus deep brain stimulation--downstream is upstream in a circuit diagram. Comment on "Does dopamine still have a leading role in advanced Parkinson's disease after subthalamic stimulation?" (Stereotact Funct Neurosurg 2008;86: 184-186).