World Neurosurg
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Review Historical Article
History of psychosurgery: a psychiatrist's perspective.
Interest in using neuromodulation to treat psychiatric disorders is rapidly increasing. The development of novel tools and techniques, such as deep brain stimulation (DBS), increases precision and minimizes risk. This article reviews the history of psychosurgical interventions and recent developments of DBS to provide a framework for understanding current options and future goals. ⋯ We focus the discussion on two psychiatric disorders that have been targets of neurosurgical interventions: obsessive-compulsive disorder and mood disorders such as major depressive disorder. Evidence from studies of DBS in psychiatric disorders, including efficacy and tolerability, is reviewed. Finally, we look to the future, exploring the possibilities for these approaches to increase understanding, transform societal views of mental illness, and improve treatment.
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Review Historical Article
Anatomic hemispherectomy: historical perspective.
The history of surgical treatment for hemispheric epilepsy is rich with colorful twists and turns. The authors trace the evolution of the surgical treatment of hemispheric epilepsy from radical anatomic resections to current less invasive disconnection procedures. Anatomic hemispherectomy (AH) was first described by Dandy in 1928 as a treatment for gliomas. ⋯ Thus, surgery for hemispheric epilepsy has undergone dramatic transformation since the technique was first introduced. Less invasive techniques have been developed to reduce surgical morbidity. Although optimal seizure control is best achieved with radical AH, the newer less invasive disconnection techniques appear to achieve near-comparable postoperative seizure control with a significantly lower rate of complications.
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Review Case Reports Historical Article
Electrical stimulation of the inferior thalamic peduncle in the treatment of major depression and obsessive compulsive disorders.
Stimulation of the inferior thalamic peduncle (ITP) is emerging as a promising new therapeutic target in certain psychiatric disorders. The circuitry that includes the nonspecific thalamic system (NSTS), which projects via the ITP to the orbitofrontal cortex (OFC), is involved in the physiopathology of major depression disorder (MDD) and obsessive compulsive disorder (OCD). The safety and efficacy of chronic ITP stimulation in cases of MDD and OCD refractory to medical treatment is presented. ⋯ Deep brain stimulation in the ITP is safe and may be effective in the treatment of OCD. A multicenter evaluation of the safety and efficacy of ITP in OCD is currently in process.
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The purpose of this study was to report our neurosurgical experience with traumatic brain injury (TBI) at a departmental teaching hospital in Benin. ⋯ Surgical treatment of TBI is a common activity in our practice, despite the difficulties. Good imaging and enhanced prevention could improve care and reduce TBI severity.
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Review Historical Article
Deep brain stimulation for treatment-resistant depression.
Major depressive disorder is a common and disabling illness and is the leading cause of disability worldwide. Despite aggressive medical, behavioral, and electroconvulsive therapies, a significant number of patients remain refractory to treatment. Deep brain stimulation (DBS) has proven efficacy in neurobehavioral disorders and, in a general sense, works by modulation of corticostriatopallidothalamocortical circuits implicated in these disorders. ⋯ Early work suggests DBS may become a therapeutic option in treatment-resistant depression. Further study is justified given the immense burden of disease.