Stereotactic and functional neurosurgery
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Stereotact Funct Neurosurg · Jan 2011
Cortical areas involved in numerical processing: an intraoperative electrostimulation study.
Numerical processing is important in our everyday lives. However, very few attempts have been made to map the numerical processing function areas during lesion surgery. ⋯ To improve the quality of resection while minimizing the neurological deficits, functional boundaries of numerical processing areas should be considered during the removal of a parietal low-grade glioma. Moreover, only the left intraparietal sulcus is necessary for numerical processing, whereas the right intraparietal sulcus does not appear to be critically involved in numerical processing.
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Stereotact Funct Neurosurg · Jan 2011
Long-term surgical and hardware-related complications of deep brain stimulation.
To evaluate the incidence of surgical and hardware-associated complications of deep brain stimulation (DBS) for a range of movement disorders. ⋯ DBS surgery is a relatively safe surgery, with most of the complications being minor, without long-term morbidity. The complication rate in elderly (age ≥65 years) is comparable to that in younger patients. However, confusion is more frequent in this age group, and patients and relatives can be prepared to accept this as a transient morbidity.
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Stereotact Funct Neurosurg · Jan 2011
Case ReportsMotor cortex stimulation for trigeminal neuropathic or deafferentation pain: an institutional case series experience.
Trigeminal neuropathy is a rare, devastating condition that can be intractable and resistant to treatment. When medical treatment fails, invasive options are limited. Motor cortex stimulation (MCS) is a relatively recent technique introduced to treat central neuropathic pain. The use of MCS to treat trigeminal neuropathic or deafferentation pain is not widespread and clinical data in the medical literature that demonstrate efficacy are limited. ⋯ MCS is a safe and potentially effective therapy in certain patients with trigeminal neuropathy.
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Stereotact Funct Neurosurg · Jan 2011
Case ReportsBilateral subthalamic deep brain stimulation after bilateral pallidal deep brain stimulation for Parkinson's disease.
Globus pallidus internus (GPi) and subthalamic nucleus (STN) have successfully been targeted independently for deep brain stimulator (DBS) placement in medically intractable Parkinson's disease (PD). Bilateral implantation of STN DBS in a patient with preexisting, functioning GPi DBS to specifically treat motor fluctuations is, to our knowledge, yet unreported. ⋯ In this report we discuss the rationale, technical issues, programming nuances and outcome in a patient with preexisting bilateral GPi DBS who was implanted with bilateral STN DBS.
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Stereotact Funct Neurosurg · Jan 2011
Case ReportsSubcutaneous peripheral neurostimulation for the treatment of severe chronic poststernotomy neuralgia.
Poststernotomy pain frequently develops after sternotomy in thoracic and cardiovascular surgery, and may affect patients' quality of life. In some cases of severe poststernotomy neuralgia, pharmacologic therapy does not provide adequate relief. ⋯ SPNS may be a viable treatment option in patients with severe chronic poststernotomy neuralgia.