Articles: neuronavigation.
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Journal of neurosurgery · May 2015
Streamlining deep brain stimulation surgery by reversing the staging order.
Deep brain stimulation (DBS) is approved for several clinical indications; however, the sequencing of DBS surgery and the timeline for implementing stimulation therapy are not standardized. In over 140 cases so far, the authors have reversed the sequencing for staged implantation of DBS systems that was conducive to minimizing patient anxiety and discomfort while providing the opportunity to shorten the time between implantation and programming for therapeutic management of symptoms. Stage I was performed with the patient under general anesthesia and consisted of implantation of the pulse generator and lead extensions and placement of the bur holes. ⋯ All patients tolerated the procedures and received a complete implanted system. Deep brain stimulation therapy was typically initiated on the same day as lead implantation. When sequencing was reversed and bur holes were placed during the first stage while a patient was under general anesthesia, the patient was able to tolerate the second awake stage and was able to begin stimulation therapy within 48 hours of the second stage.
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Clin Neurol Neurosurg · May 2015
Does CT wand guidance improve shunt placement in patients with hydrocephalus?
To evaluate the effectiveness of stereotactic navigation in enhancing the accuracy of ventricular shunt placement in patients with hydrocephalus. ⋯ CT guided navigation did not significantly improve the accuracy of ventricular shunt placement in adults with hydrocephalus for an experienced surgeon. Further studies are required to assess the utility of CT guided navigation for less experienced surgeons and patients with small or dysmorphic ventricles.
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OBJECT Most cases of traumatic spondylolisthesis of the axis (hangman's fracture) can be treated nonoperatively with reduction and subsequent immobilization in a rigid cervical collar or halo. However, in some instances, operative management is necessary and can be accomplished by using either anterior or posterior fusion techniques. Because open posterior procedures can result in significant blood loss, pain, and limited cervical range of motion, other less invasive options for posterior fixation are needed. ⋯ This technique may be appropriate, depending on circumstances, for all L-E Type I and II hangman's fractures; however, the degree of associated ligament injury and disc disruption must be accounted for. Percutaneous fixation is not appropriate for L-E Type III fractures because of significant displacement and ligament and disc disruption. This report is meant to serve as a feasibility study and is not meant to show superiority of this procedure over other surgical options.
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Zhonghua Wai Ke Za Zhi · May 2015
[Intraoperative high-field magnetic resonance imaging combined with functional neuronavigation in resection of low-grade temporal lobe tumors involving optic radiation].
To investigate the clinical value of high-field-strength intraoperative magnetic resonance imaging (iMRI) combined with optic radiation neuro-navigation for the resection of temporal lobe low-grade gliomas. ⋯ With iMRI and functional neuro-navigation, the optic radiation can be accurately located, while extent of resection can be evaluated intra-operatively. This technique is safe and helpful for preservation of visual field for the resection of temporal lobe low-grade gliomas involving optic radiation.