Stereotactic and functional neurosurgery
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Stereotact Funct Neurosurg · Jan 2017
Intraoperative Neurophysiological Monitoring (Motor and Somatosensory Evoked Potentials) in Dorsal Root Entry Zone Lesioning for Brachial Plexus Avulsion Pain.
To address the feasibility and importance of intraoperative neurophysiological monitoring (IONM) in dorsal root entry zone (DREZ) lesioning for brachial plexus avulsion pain. ⋯ Significant events on IONM were common during DREZ lesioning for brachial plexus avulsion pain and were closely related to the occurrence of postoperative neurological deficits.
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Stereotact Funct Neurosurg · Jan 2017
Optic Radiation Tractography and Visual Field Deficits in Laser Interstitial Thermal Therapy for Amygdalohippocampectomy in Patients with Mesial Temporal Lobe Epilepsy.
Laser interstitial thermal therapy (LITT) has become an alternative to open-resective surgery for refractory mesial temporal lobe epilepsy (MTLE). Occurrence of visual field defects (VFDs) following open surgery for MTLE is reported at 52-100%. We examined the rate of VFDs following LITT for amygdalohippocampectomy (AHE) and correlated the occurrence of VFDs with damage to the optic radiations, assessed by diffusion tensor tractography (DTI). ⋯ Short-term follow-up in our series suggests that laser ablation AHE may be associated with a lower rate of VFD than has been reported for open AHE. Our results suggest that incorporating optic radiation mapping through DTI may preoperatively help to minimize the risk of VFD following laser ablation AHE.
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Stereotact Funct Neurosurg · Jan 2017
Deep Brain Stimulation for the Treatment of Dejerine-Roussy Syndrome.
Patients who suffer from Dejerine-Roussy syndrome commonly experience severe poststroke hemibody pain which has historically been attributed to thalamic lesions. Despite pharmacological treatment, a significant proportion of the population is resistant to traditional therapy. Deep brain stimulation is often appropriate for the treatment of resistant populations. In this review we aim to summarize the targets that are used to treat Dejerine-Roussy syndrome and provide insight into their clinical efficacy. ⋯ Due to technological advancements in deep brain stimulation, its therapeutic effects must be reevaluated. Despite a lack of controlled evidence, deep brain stimulation has been effectively used as a therapeutic in clinical pain management. Further clinical investigation is needed to definitively evaluate the therapeutic efficacy of deep brain stimulation in treating the drug-resistant patient population.
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Stereotact Funct Neurosurg · Jan 2016
The Correlation between Intraoperative Microelectrode Recording and 3-Tesla MRI in Patients Undergoing ANT-DBS for Refractory Epilepsy.
Deep brain stimulation (DBS) of the anterior nucleus of the thalamus) (ANT) has been suggested as a treatment option in refractory epilepsy. The targeting of ANT is especially challenging due to its poor visualization in commonly used MRI sequences, lack of easily observable symptom relief during surgery and high degree of anatomical variation between individuals. ⋯ Our data suggest that MER provides clinically relevant information during implantation surgery by demonstrating both nucleus-specific neuronal firing patterns and white matter laminae between different nuclear groups.
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Stereotact Funct Neurosurg · Jan 2016
Multicenter StudySurgical Replacement of Implantable Pulse Generators in Deep Brain Stimulation: Adverse Events and Risk Factors in a Multicenter Cohort.
Deep brain stimulation (DBS) is a growing treatment modality, and most DBS systems require replacement of the implantable pulse generator (IPG) every few years. The literature regarding the potential impact of adverse events of IPG replacement on the longevity of DBS treatments is rather scarce. ⋯ The risk of postoperative infection with DBS IPG replacement increases with the number of previous procedures. There is a need to reduce the frequency of IPG replacements.