Stereotactic and functional neurosurgery
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Stereotact Funct Neurosurg · Jan 2014
Clinical TrialSimultaneous trial of deep brain and motor cortex stimulation in chronic intractable neuropathic pain.
Both motor cortex stimulation (MCS) and deep brain stimulation (DBS) of the ventralis caudalis (Vc) thalamus have been shown to be effective in chronic neuropathic pain, and the modulation of thalamic and thalamocortical activity is regarded as a possible mechanism. Although Vc DBS and MCS have a common analgesic mechanism, the application of MCS and DBS is still considered empirical, and there is no consensus on which method is better. ⋯ Considering the initial success rate and the less invasive nature of epidural MCS compared with DBS, we think that MCS would be a more reasonable initial means of treatment for chronic intractable neuropathic pain.
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Stereotact Funct Neurosurg · Jan 2014
Reuse of internal pulse generator in cases of infection after deep brain stimulation surgery.
Hardware-related infection after deep brain stimulation (DBS) is one of the most serious complications and may need additional interventions. ⋯ Management of hardware-related infections can be challenging. The medical and economic costs associated with these infections are enormous. The IPG can often be saved in infected patients. Thus, a significant cost burden is eliminated. Properly executed, reuse of IPG should markedly reduce the costs of these devices.
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Stereotact Funct Neurosurg · Jan 2014
Case ReportsHuman striatum remodelling after neurotransplantation in Huntington's disease.
Restoration of functions in Huntington's disease (HD) by neurotransplantation stems from the formation of a striatum-like structure capable of establishing host connections as a result of grafted striatal neuroblast maturation. For the first time, we demonstrated some developmental steps accomplished by progenitor cells in the brain of an HD patient and analysed the molecular asset of the human primordium. ⋯ The striatal primordium grew into the host brain and this process was associated with metabolic change and some clinical benefit. The study suggests the plasticity and reparative potential of un-manipulated primordium in an era where promising cell-based therapies are still in their infancy.
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Stereotact Funct Neurosurg · Jan 2014
Easy-to-use augmented reality neuronavigation using a wireless tablet PC.
Augmented reality (AR) technology solves the problem of view switching in traditional image-guided neurosurgery systems by integrating computer-generated objects into the actual scene. However, the state-of-the-art AR solution using head-mounted displays has not been widely accepted in clinical applications because it causes some inconvenience for the surgeon during surgery. ⋯ The easy-to-use Tablet-AR system presented in this study is accurate and feasible in clinical applications and has the potential to become a routine device in AR neuronavigation.
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Stereotact Funct Neurosurg · Jan 2014
Integration of magnetoencephalography-generated functional brain maps into dose planning during arteriovenous malformation radiosurgery.
Magnetoencephalography (MEG) can delineate critical regions of the cortex and facilitate conformal stereotactic radiosurgery (SRS) dose planning. Despite the substantial role of Gamma Knife® SRS in arteriovenous malformation (AVM) management, MEG-generated maps of critical regions have never been utilized to improve dose planning. ⋯ Coregistration of MEG data improves the accuracy and dose sparing needed for optimal planning during Gamma Knife SRS.