Stereotactic and functional neurosurgery
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Stereotact Funct Neurosurg · Jan 2011
Changes in motor function induced by chronic motor cortex stimulation in post-stroke pain patients.
In well-designed multicenter studies, the protocol of continuing motor cortex stimulation (MCS) temporarily for 3-6 weeks was employed with rehabilitation therapy, and these studies showed some recovery of motor weakness in post-stroke patients. ⋯ These findings indicate that MCS could be a new therapeutic approach to improving motor performance after stroke by attenuating rigidity and/or spasticity. However, it may be important to define the appropriate number of hours and conditions of daily MCS.
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Stereotact Funct Neurosurg · Jan 2011
Intraoperative image fusion to ascertain adequate lead placement.
In order to view the position of the deep brain stimulator (DBS) lead in relation to the stereotactic target on 3-tesla magnetic resonance (3T-MR) images prior to the conclusion of the procedure, intraoperative postimplantation computed tomography (CT) images were fused with preoperative 3T-MR images. The method to do this is described and discussed in this paper. ⋯ This is a simple method to intraoperatively visualize DBS lead position on high-quality 3T-MR images. It gives the surgeon the capability to detect errors and correct them prior to the conclusion of the procedure.
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Stereotact Funct Neurosurg · Jan 2011
Comparative StudySubthalamic deep brain stimulation in Parkinson's disease under different anesthetic modalities: a comparative cohort study.
The efficacy and feasibility of bilateral subthalamic deep brain stimulation (STN-DBS) for Parkinson's disease (PD) under general anesthesia (GA) has not been evaluated. ⋯ Desflurane GA was shown to be a good alternative anesthetic method for PD patients undergoing DBS. Although the motor outcomes were comparable, a significant cognitive decline may be seen in the GA group with a higher occurrence of stimulation side effects.
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Stereotact Funct Neurosurg · Jan 2011
Case ReportsA technique of distal to proximal revision of peripheral neurostimulator leads: technical note.
Peripheral nerve stimulation for chronic pain states is a safe and efficacious technique, being used with increasing frequency. The incidence of hardware-related complications requiring revision remains high. ⋯ The distal to proximal neurostimulator lead revision technique quickly and safely adjusts lead position, including both lead depth and lead tip location, without a need for replacement of components or revision of the entire system.
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Stereotact Funct Neurosurg · Jan 2011
ReviewSpinal cord stimulation and cerebral hemodynamics: updated mechanism and therapeutic implications.
The effects of spinal cord stimulation (SCS) on cerebral blood flow (CBF) are well known based on experimental investigations, and its vasodilator effect on peripheral arteries is widely used in clinical settings in the treatment of peripheral vascular disease. Since Hosobuchi's [Appl Neurophysiol 1985;48:372-376] first observations on the effects of SCS on CBF were published 22 years ago, many advances have been made in understanding SCS-mediated effects on CBF. ⋯ The authors revised the published experiences in humans with hypoperfusion syndromes and 'adjuvant' locoregional CBF increase in chemotherapy of brain tumors. SCS represents a new perspective in challenging neurosurgical clinical fields such as cerebral ischemia and vasospasm, and seems promising as a new trend of functional neurosurgery in cerebrovascular diseases.