Stereotactic and functional neurosurgery
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Stereotact Funct Neurosurg · Jan 2013
Long-term changes in the personality and psychopathological profile of opiate addicts after nucleus accumbens ablative surgery are associated with treatment outcome.
To investigate the long-term outcome and changes of the personality and psychopathological profile of opiate addicts after bilateral stereotactic nucleus accumbens (NAc) ablative surgery. ⋯ The bilateral ablation of NAc by stereotactic neurosurgery was a feasible method for alleviating psychological dependence on opiate drugs and preventing a relapse. Long-term follow-up suggested that surgery can improve the personality and psychopathological profile of opiate addicts with a trend towards normal levels, provided persistent abstinence can be maintained; relapse, on the other hand, may ruin this effect.
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The use of functional neuroimaging holds the promise of improving neurosurgical outcomes by providing preoperative localization of critical brain functions. The brain representation of somatosensory function can be effectively localized using magnetoencephalography (MEG) in both normal subjects and in patients with tumors, vascular malformation, and epilepsy. This study investigates the pattern of somatosensory localization in 45 patients. ⋯ Results showed that this peak localized either to the central or postcentral sulcus of the somatosensory cortex. We found that neither age nor the presence of brain pathologies had significant effect on the recognition of the somatosensory cortex. Patients who underwent surgery after presurgical planning using MEG suffered no new somatosensory deficits, indicating the valuable role of pre-surgical mapping using MEG in the surgical planning.
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Stereotact Funct Neurosurg · Jan 2013
Long-term efficacy of stereotactic bilateral anterior cingulotomy and bilateral anterior capsulotomy as a treatment for refractory obsessive-compulsive disorder.
To investigate the long-term efficacy and adverse effects of stereotactic bilateral anterior cingulotomy (BACI) and bilateral anterior capsulotomy (BACA) as a treatment for refractory obsessive-compulsive disorder (OCD) patients. ⋯ The BACI and BACA were effective for the treatment of refractory OCD, and no significant adverse effects on long-term follow-up were found.
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Stereotact Funct Neurosurg · Jan 2012
Review Case ReportsLaser interstitial thermal therapy for focal cerebral radiation necrosis: a case report and literature review.
Whole-brain radiotherapy and stereotactic radiosurgery (SRS) play a central role in the treatment of metastatic brain tumors. Radiation necrosis occurs in 5% of patients and can be very difficult to treat. The available treatment options for radiation necrosis include prolonged high-dose corticosteroids, hyperbaric oxygen, anticoagulation, bevacizumab, and surgical resection. ⋯ Additionally, the patient was completely weaned off steroids. To our knowledge this is the first report using LITT for the treatment of focal radiation necrosis. LITT may be an effective treatment modality for patients with medically refractory radiation necrosis with lesions not amenable to surgical decompression.
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Stereotact Funct Neurosurg · Jan 2012
Capability of identifying red nuclei in different pulse sequences of regular 1.5-tesla magnetic resonance images.
To investigate the optimal pulse sequences of commonly used 1.5-tesla MRI for identifying the red nucleus (RN) to aid targeting of the subthalamic nucleus (STN). ⋯ T2FLAIR is an alternative to FSE-T2WI that can readily demarcate the RN to help target the STN.