Articles: neuronavigation.
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Comparative Study
Long-term outcome of computed tomography-guided percutaneous radiofrequency thermocoagulation for classic trigeminal neuralgia patients older than 70 years.
The incidence of trigeminal neuralgia (TN) in elderly patients is higher. However, for those with poor fitness, the optimal surgical treatment for those refractory to medical treatment is controversial. The aim of current study was to investigate the long-term outcome of computed tomography (CT)-guided percutaneous radiofrequency thermocoagulation (PRT) for 304 TN patients 70 years or older. ⋯ There were no mortalities observed during or after PRT. Our result showed CT-guided PRT is safe and effective for classic TN patients 70 years or older, including poor-fitness patients (American Society of Anesthesiologists classification system physical status >II). Lower temperature (≤75°C) is recommended for PRT in the treatment of TN.
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Tokai J. Exp. Clin. Med. · Jul 2014
Visibility of ultrasound-guided echogenic needle and its potential in clinical delivery of regional anesthesia.
Ultrasound-guided regional anesthesia is recommended for nerve block due to its safety and reliability. Needle visualization is important when inserting needles into tissues in close proximity to target nerves. For safety reasons, the tip of the standard-type needle for application of nerve block is thinner than that of an interventional needle for insertion into intra-abdominal organs, and this makes it harder to determine its precise position. The purpose of this study was to evaluate the performance of an insulated echogenic needle under ultrasound guidance in phantoms and in the routine anesthetic management of patients undergoing elective surgery. ⋯ The better visibility of the tip of CCR indicates that it is superior to S in the clinical delivery of peripheral nerve block.
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Different strategies have been used to study the fiber tract anatomy of the human brain in vivo and ex vivo. Nevertheless, the ideal method to study white matter anatomy has yet to be determined because it should integrate information obtained from multiple sources. ⋯ The correlation of high-definition 7-T MRI and the white matter dissection technique with neuronavigation significantly improves the understanding of the structural connections in complex areas of the human cerebrum.
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Use of the operating microscope has become pervasive since its introduction to the neurosurgical world. Neuronavigation fused with the operating microscope has allowed accurate correlation of the focal point of the microscope and its location on the downloaded imaging study. However, the robotic ability of the Pentero microscope has not been utilized to orient the angle of the microscope or to change its focal length to hone in on a predefined target. ⋯ Integration of automatic microscope positioning into the operative workflow has potential to increase operative efficacy and safety. This technology is best suited for precise trajectories and entry points into deep-seated lesions.