Stereotactic and functional neurosurgery
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Stereotact Funct Neurosurg · Jan 2012
Stereotactic placement of ventricular catheters: does it affect proximal malfunction rates?
The majority of ventriculoperitoneal (VP) shunt malfunctions are due to proximal catheter failure. Ideal placement of Ommaya reservoirs is desired to avoid toxicity from intraparenchymal chemotherapy infusion. ⋯ In terms of results corroborating decreased proximal malfunction rates, we present the largest series of stereotactic-guided ventricular catheter placements to date. Though time in the operating room is increased due to navigation registration, actual operative time is comparable to procedures without navigation. A longer-term follow-up is needed to assess the longevity of our positive short-term results.
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Stereotact Funct Neurosurg · Jan 2012
Effects of relative low-frequency bilateral globus pallidus internus stimulation for treatment of cervical dystonia.
To assess the effect of relative lower amplitude and frequency for globus pallidus internus (GPi) deep brain stimulation (DBS) of cervical dystonia (CD). ⋯ According to our results, the initial settings of low amplitude and especially relatively low frequency are safe and effective for treatment of CD.
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Stereotact Funct Neurosurg · Jan 2012
Case ReportsGamma knife radiosurgery for recurrent glossopharyngeal neuralgia after microvascular decompression.
We report the first application of Gamma Knife radiosurgery (GKR) for recurrent glossopharyngeal neuralgia (GN) after microvascular decompression (MVD). The patient is a 51-year-old male with left-sided GN. He underwent MVD and did well for almost 4 years. Later on, the patient started to experience recurrent intolerable throat pain, frequently 10/10 in intensity. Based on the application of radiosurgery for trigeminal neuralgia, GKR was offered to the patient. ⋯ GKR, which is now widely used for refractory trigeminal neuralgia, can be considered for refractory or recurrent GN. With a multidisciplinary approach and advanced neuroimaging, GKR is feasible for GN after MVD, despite the shortness of the intracranial cisternal nerve portion. Further studies are necessary to establish the role of GKR for refractory GN after MVD; however, given its rarity and the lack of experience with GKR for this condition, retrospective studies with dozens of patients are almost impossible at this time.
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Stereotact Funct Neurosurg · Jan 2012
An evaluation of hardware and surgical complications with deep brain stimulation based on diagnosis and lead location.
Deep brain stimulation is the most frequently performed neurosurgical procedure for movement disorders. This procedure is well tolerated, but not free of complications. Analysis of hardware complications based on patient diagnosis and lead location could prove valuable in recognizing potential pitfalls and patients at higher risk. ⋯ This large series of patients and long-term follow-up demonstrate that risks of complications are not universal among movement disorder patients. Diagnosis and lead location are important risk stratification factors in determining complications.
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Stereotact Funct Neurosurg · Jan 2012
Rechargeable deep brain stimulators in the management of paediatric dystonia: well tolerated with a low complication rate.
Deep brain stimulation (DBS) is a recognised method of treatment for primary and secondary dystonia. The size of non-rechargeable batteries has limited their use in small children. Our severe dystonia patients have required battery replacement every 20-24 months. ⋯ Activa was found to offer reliable stimulation with a low rate of significant complications and a suitable treatment option for children with dystonia.