Stereotactic and functional neurosurgery
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Stereotact Funct Neurosurg · Jan 1991
Historical ArticleFunctional neurosurgery for psychiatric disorders: a historical perspective.
Functional neurosurgery for psychiatric disorders ('psychosurgery') has a colorful, and sometimes dubious, history. From the time of the first operations in 1935 to today, its usefulness has been overshadowed by doubts and ethical questions. Psychosurgery became popular in the 1940s and early 1950s, especially in the United States. ⋯ The indications remain as affective, anxiety, and obsessive-compulsive disorders. Despite approval by the United States Department of Health, Education, and Welfare in 1978, psychosurgery is still not a common treatment. This low acceptance is perhaps due to continued concern over ethical problems and inadequate reporting of outcomes.
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Stereotact Funct Neurosurg · Jan 1990
Electrophrenic respiration in patients with craniocervical trauma.
We implanted electrophrenic respiration (EPR) units in 15 apneic quadriplegic patients with brain stem or high cervical cord injury. 11 of the patients achieved full-time respiration with EPR and another 2 achieved half-time respiration. Despite the loss of patients due to unrelated problems, 7 now use EPR continuously, 1 for 18 years. The factors involved in the significant success rate with EPR are discussed from the point of view of a neurosurgeon.
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Stereotact Funct Neurosurg · Jan 1990
Integration of stereoscopic DSA with three-dimensional image reconstruction for stereotactic planning.
Following 4 years of experience using a microcomputer-based system for the planning of stereotactic neurosurgery, we have now developed a workstation with the capability of displaying and analyzing three-dimensional images for this purpose. In addition to viewing volumetrically rendered three-dimensional computer tomograms and magnetic resonance images, we may directly view and analyze stereoscopic digital angiograms. In addition to each set of images being viewed in isolation, we may also combine the three-dimensional anatomical images with the stereoscopic angiograms. This new system is based on a computer equipped with a light polarization switched screen capable of displaying stereoscopic images directly to the observer, thus permitting him to interact with the three-dimensional volume directly, determining coordinates and positioning probe trajectories.
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Stereotact Funct Neurosurg · Jan 1989
Transcutaneous electrical nerve stimulation and spinal cord stimulation for pain relief in reflex sympathetic dystrophy.
35 patients with the diagnosis of reflex sympathetic dystrophy in a late stage have been treated with transcutaneous electrical nerve stimulation (TENS). 6 out of the 35 were also submitted to spinal cord stimulation (SCS). The follow-up was from 10 to 36 months. ⋯ In the long run these results are better than those obtained with sympathetic blocks and sympathectomy. TENS and SCS have no effect on osteoporosis or ankylosis.
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Stereotact Funct Neurosurg · Jan 1989
Epidural spinal cord stimulation in the management of reflex sympathetic dystrophy.
Eighteen subjects with intractable pain due to reflex sympathetic dystrophy (RSD) underwent treatment by epidural spinal cord stimulation (SCS). All the patients had previously undergone multiple sympathetic blocks and/or surgical sympathectomy with either no results or only temporary therapeutic effects. Four subjects did not experience any beneficial effects during a 1-week trial and the electrode was removed, and 14 patients had the system internalized surgically. ⋯ All the problems were corrected surgically under local anesthesia. SCS has some value in the management of refractory RSD pain in selected cases. Because of the limited series and follow-up, its value in the comprehensive management of RSD requires further investigation.