Stereotactic and functional neurosurgery
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Stereotact Funct Neurosurg · Jan 2000
ReviewThe idea of stereotaxy toward minimally invasive neurosurgery.
The idea of stereotaxy in modern neurosurgery is reviewed. Stereotactic surgery has been one of the particular neurosurgical techniques mainly used for functional disorders. ⋯ Functional neurosurgery itself is also changing in the sense that many alternative surgical procedures are now available due to the progress in neuroscience. The original premise of stereotaxy is exactly the same as that of minimally invasive neurosurgery today.
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Stereotact Funct Neurosurg · Jan 2000
Clinical TrialContinuous intrathecal clonidine administration for the treatment of neuropathic pain.
In many cases, the treatment of neuropathic pain by intrathecal opioids fails to meet expectations. In a trial involving 10 patients, the intrathecal administration of clonidine combined with opioids in the treatment of chronic pain was introduced in our department for the first time. ⋯ Residual non-neuropathic pain in 4 of 8 patients was successfully treated with clonidine and low doses of opioids. On the basis of the results achieved so far, we recommend that clonidine should be routinely tested for intrathecal drug administration, especially in patients with a prominent neuropathic pain component.
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Stereotact Funct Neurosurg · Jan 2000
Comparative StudyIn vivo proton magnetic resonance spectroscopy of brain tumors.
The ability of magnetic resonance spectroscopy (MRS) to differentiate neoplastic brain cells and their metabolic and structural characteristics is evaluated. We examined 120 patients with brain tumors using a 1.5-tesla MRI unit and MRS. The peak areas of N-acetyl-aspartate (NAA), phosphocreatine-creatine (Pcr-Cr), choline-containing compounds (Cho), lactate, lipids, myoinositol, amino acids and the ratios of NAA/Pcr-Cr, NAA/Cho and Cho/Pcr-Cr were calculated by a standard integral algorithm. ⋯ The greater this ratio, the higher the grade of the astrocytoma. NAA/Pcr-Cr together with Cho/Pcr-Cr help specify the presence or absence of a neoplasm. Proton MRS is a useful and promising diagnostic modality not only in diagnosing but also in grading solid brain tumors.
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Stereotact Funct Neurosurg · Jan 2000
Combined treatment with stereotactic intracavitary irradiation and gamma knife surgery for craniopharyngiomas.
To evaluate the effectiveness of the combined treatment of stereotactic intracavitary irradiation and Gamma Knife surgery on craniopharyngiomas. ⋯ Gamma Knife surgery plays an important role in the treatment of the solid component of craniopharyngiomas and the combination of treatment is a simple, safe and effective method for treatment of craniopharyngiomas, especially for the recurrent mixed solid and cystic tumors.
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We treated 126 patients with different neurosurgical diseases by performing endoscopic neurosurgery, endoscopy-controlled microneurosurgery and endoscopy-assisted microneurosurgery. The indications were intracranial cysts in 51 patients, brain cysticercosis in 10 patients, hydrocephalus in 31 patients, and epidermoid cysts in 34 patients. ⋯ After operation, 115 of 126 patients had improvement in their initial symptoms, 7 had no change and 4 developed complications, including subarachnoid hemorrhage (SAH), intraventricular hemorrhage, and transient cardiopulmonary dysfunction. It is concluded that (1) neuroendoscopic techniques show a distinct value in the treatment of deep-seated, intracranial diseases, or ventricle and cistern lesions; (2) neuroendoscopic techniques play an important role in microneurosurgery and consequently improve surgical quality; (3) the benefits of neuroendoscopic techniques include less surgical manipulation and trauma, milder postoperative reaction, decreased expenses and shortened hospitalizations.