Stereotactic and functional neurosurgery
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Stereotact Funct Neurosurg · Jan 2016
Teflon Might Be a Factor Accounting for a Failed Microvascular Decompression in Hemifacial Spasm: A Technical Note.
Although Teflon is widely adopted for microvascular decompression (MVD) surgery, it has never been addressed for failure analysis. This study analyzed the reasons for failed MVDs with emphasis on the Teflon sponge. ⋯ Although it is not difficult for an experienced neurosurgeon to discover a neurovascular conflict during the MVD process, the size, shape and location of the Teflon sponge should not be ignored. Basically, the Teflon insert is used to keep the offending artery away from the facial nerve root rather than to isolate it. Therefore, the ideal Teflon sponge should be just small enough to produce a neurovascular separation.
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Stereotact Funct Neurosurg · Jan 2016
Effect of Subthalamic Nucleus Stimulation on Pedunculopontine Nucleus Neural Activity.
The pedunculopontine nucleus has recently been proposed as an alternative target for deep brain stimulation for the treatment of medically intractable Parkinson's disease. The suggested indication for pedunculopontine nucleus deep brain stimulation is severe and medically intractable axial symptoms such as gait and postural impairment. ⋯ The result of this study provides additional evidence to improve our understanding of the mechanism of subthalamic nucleus-deep brain stimulation, and its physiological consequences.
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Stereotact Funct Neurosurg · Jan 2015
A Prospective Study of the Intra- and Postoperative Efficacy of Intraoperative Neuromonitoring in Spinal Cord Stimulation.
Accurate lead placement is critical for spinal cord stimulation (SCS) efficacy. The traditional gold standard of awake placement is often technically difficult. While there is retrospective evidence supporting the use of intraoperative neurophysiological monitoring (IOM) as an alternative, a prospective assessment has not yet been performed. ⋯ We provide prospective evidence that IOM can be used to verify SCS placement. Additionally, EMG may help to streamline device programming and thereby improve outcomes by predicting the ideal stimulation contacts in many cases.
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Stereotact Funct Neurosurg · Jan 2015
Long-term results of motor cortex stimulation in the treatment of chronic, intractable neuropathic pain.
Although motor cortex stimulation (MCS) has been used for more than 20 years in the treatment of chronic neuropathic pain, there is still a debate about the efficacy of MCS. ⋯ MCS was more effective in the treatment of chronic neuropathic pain of central poststroke pain and peripheral neuropathic pain types than in the treatment of SCI pain in the long-term follow-up.
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Stereotact Funct Neurosurg · Jan 2015
Treatment of postherpetic neuralgia using DREZotomy guided by spinal cord stimulation.
Postherpetic neuralgia (PHN) is the most common complication following an episode of acute herpes zoster. The curative effect of current treatments is limited. ⋯ Microsurgical DREZotomy assisted with SCS for target localization is an effective remedy for PHN.