Stereotactic and functional neurosurgery
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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.
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Stereotact Funct Neurosurg · Jan 2014
Treatment of chronic pain: diffusion tensor imaging identification of the ventroposterolateral nucleus confirmed with successful deep brain stimulation.
A variety of pain syndromes have been treated successfully with deep brain stimulation (DBS) by targeting the thalamic ventroposterolateral (VPL) nucleus. The purpose of this study was to preoperatively identify the thalamic VPL nucleus by diffusion tensor imaging (DTI) fiber tractography (FT) and confirm it intraoperatively. ⋯ DTI has the potential to identify the thalamic nuclei in individuals, which would be more accurate than anatomical localization and likely identical to intraoperative physiological testing. Postoperative DBS electrode placement and the affected cortical areas can be confirmed with coregistration of CT and FT using the electrode as a seed ROI.