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Stereotactic and Functional Neurosurgery

Pavlos Texakalidis, Muhibullah S Tora, Nicholas M Boulis
BACKGROUND/AIMS: Postherpetic neuralgia (PHN) can be refractory to both medical and minimally invasive treatments. Its complex pathophysiology explains the numerous neurosurgical procedures that have been implemented through the years. Our objective was to summarize all available neurosurgical strategies for the management of resistant PHN and evaluate their respective safety and efficacy outcomes. METHODS: A comprehensive systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
April 17, 2019: Stereotactic and Functional Neurosurgery
Syed M Adil, Jing L Han, Beth A Parente, Patrick Hickey, Shivanand P Lad
BACKGROUND: Spinal cord stimulation (SCS) is a well-established therapy for chronic pain syndromes, with growing applicability to other conditions. Restless legs syndrome (RLS) is a widespread, chronic movement disorder managed primarily and incompletely by medication, and its etiology can be classified as idiopathic or secondary. METHODS: Three patients underwent SCS implantation for chronic back and/or leg pain with concomitant targeting of RLS: (1) a 34-year-old man with sporadic RLS symptoms that strongly intensified after military-related spinal fractures, (2) a 54-year-old man with RLS likely secondary to meralgia paresthetica, and (3) a 42-year-old man with low back and right lower extremity pain after a military motor vehicle accident...
April 4, 2019: Stereotactic and Functional Neurosurgery
Haewon Roh, Junwon Kim, Kyuha Chong, Won Ki Yoon, Taek-Hyun Kwon, Jong Hyun Kim
For most fractionated stereotactic radiosurgery treatment plans, daily imaging is not routinely performed, because there is little expectation that lesions will change significantly in the short term. However, here, we present the case of an abrupt increase and decrease in tumor volume during fractionated gamma knife radiosurgery (GKRS) for metastatic brain cancer. A 65-year-old man with a history of nephrectomy due to renal cell carcinoma was admitted to our hospital because of mild cognitive disorder and gait disturbance...
April 4, 2019: Stereotactic and Functional Neurosurgery
Pavan S Upadhyayula, Robert C Rennert, Reid Hoshide, Shifteh Sattar, David D Gonda
BACKGROUND: Nonlesional cingulate gyrus epilepsy is rare, difficult to diagnose, and challenging to treat. METHODS: We report the use of ROSA (Medtech Surgical, Inc., New York, NY, USA) robotic assistance for stereotactic EEG (S-EEG) localization and therapeutic thermal laser ablation of a nonlesional cingulate gyrus epileptogenic zone in a 17-year-old female with intractable partial epilepsy. RESULTS: After an inconclusive exhaustive initial workup, robotic-assisted S-EEG localized the patient's seizure focus to the right cingulate gyrus...
April 3, 2019: Stereotactic and Functional Neurosurgery
Chanho Kong, Jaewoo Shin, Chin-Su Koh, Jihyeon Lee, Min-Sik Yoon, Yoon Kyung Cho, Soonyoung Kim, Sang Beom Jun, Hyun Ho Jung, Jin Woo Chang
BACKGROUND: The medial forebrain bundle (MFB) is involved in the integration of pleasure and reward. Previous studies have used various stimulation parameters for operant conditioning, though the effectiveness of these parameters has not been systematically studied. OBJECTIVES: The purpose of the present study was to investigate the optimal MFB stimulation parameters for controlling the conditioned behavior of rats. METHODS: We evaluated four factors, including intensity, frequency, pulse duration, and train duration, to determine the effect of each on lever pressure applied by animals...
April 1, 2019: Stereotactic and Functional Neurosurgery
John P Sheehy, Tsinsue Chen, Michael A Bohl, Michael A Mooney, Zaman Mirzadeh, Francisco A Ponce
BACKGROUND: Many surgeons utilize assistants to perform procedures in more than one operating room at a given time using a practice known as overlapping surgery. Debate has continued as to whether overlapping surgery improves the efficiency and access to care or risks patient safety and outcomes. OBJECTIVE: To examine effects of overlapping surgery in deep brain stimulation (DBS) for movement disorders. METHODS: In this retrospective analysis of overlapping and non-overlapping cases, we evaluated stereotactic accuracy, operative duration, length of hospital stay, and the presence of hemorrhage, wound-related complications, and hardware-related complications requiring revision in adults with movement disorders undergoing DBS...
March 21, 2019: Stereotactic and Functional Neurosurgery
Shala G Berntsson, Helena Gauffin, Atle Melberg, Anders Holtz, Anne Marie Landtblom
BACKGROUND: Intrathecal baclofen (ITB) treatment is considered a powerful tool in the management of severe spasticity in neurological conditions such as multiple sclerosis, cerebral palsy, and traumatic spinal cord and brain injury. OBJECTIVES: The objective of this study was to assess the effectiveness of the ITB in patients with inherited ataxia suffering from severe painful spasms and/or spasticity. METHOD: A total of 5 patients with spinocerebellar ataxia 3 or 7 or Friedreich's ataxia were included in this observational multicenter study...
March 14, 2019: Stereotactic and Functional Neurosurgery
David M McDermott, Joshua D Hack, Christoper P Cifarelli, John A Vargo
BACKGROUND: Significant heterogeneity exists in target volumes for postoperative stereotactic radiosurgery (SRS) for brain metastases. A set of contouring guidelines was recently published, and we investigated the impact of deviations. METHODS: Patients (n = 41) undergoing single-fraction Gamma Knife SRS following surgical resection of brain metastases from 2011 to 2017 were retrospectively reviewed. SRS included the entire contrast-enhancing cavity with heterogeneity in inclusion of the surgical tract and no routine margin along the dura or clinical target volume margin...
February 14, 2019: Stereotactic and Functional Neurosurgery
Lara Rzesnitzek, Marwan Hariz, Joachim K Krauss
In order to shed light on the first application of human functional stereotactic neurosurgery, whether it was in the realm of movement disorders, as has been claimed repeatedly, or in the realm of psychiatry, a review of the original scholarly literature was conducted. Tracking and scrutinising original publications by Spiegel and Wycis, the pioneers of human stereotactic neurosurgery, it was found that its origin and the very incentive for its development and first clinical use were to avoid the side effects of frontal leucotomy...
February 13, 2019: Stereotactic and Functional Neurosurgery
L Dade Lunsford
No abstract text is available yet for this article.
January 17, 2019: Stereotactic and Functional Neurosurgery
Manjul Tripathi, Anshul Kulshreshtha, Arun S Oinam, Narendra Kumar, Aman Batish, Harsh Deora, Abhinav Agrahari, Hemant Bhagat
No abstract text is available yet for this article.
January 17, 2019: Stereotactic and Functional Neurosurgery
Drew S Kern, Marina Picillo, John A Thompson, Francesco Sammartino, Lazzaro di Biase, Renato P Munhoz, Alfonso Fasano
BACKGROUND/AIMS: Interleaving stimulation (ILS) in deep brain stimulation (DBS) provides individualized stimulation of 2 contacts delivered in alternating order. Currently, limited information on the utility of ILS exists. The aims of this study were to determine the practical applications and outcomes of ILS DBS in Parkinson's disease (PD), tremor, and dystonia. METHODS: We performed a single-center, unblinded, retrospective chart review of all patients with DBS attempted on ILS at our referral center assessing for rationale and outcomes...
January 17, 2019: Stereotactic and Functional Neurosurgery
Wolfgang Hamel, Johannes A Köppen, Dieter Müller, Marwan Hariz, Christian K E Moll, Paul Krack
Before the advent of levodopa, pallidotomy was initially the most effective treatment for Parkinson disease, but it was soon superseded by thalamotomy. It is widely unknown that, similar to Leksell, 2 neurologists from Göttingen, Orthner and Roeder, perpetuated pallidotomy against the mainstream of their time. Postmortem studies demonstrated that true posterior and ventral pallidoansotomy sparing the overwhelming mass of the pallidum was accomplished. This was due to a unique and individually tailored stereotactic technique even allowing bilateral staged pallidotomies...
January 16, 2019: Stereotactic and Functional Neurosurgery
Josue M Avecillas-Chasin, Anujan Poologaindran, Murray D Morrison, Linda A Rammage, Christopher R Honey
BACKGROUND: Voice tremor (VT) is the involuntary and rhythmical phonatory instability of the voice. Recent findings suggest that unilateral deep brain stimulation of the ventral intermediate nucleus (Vim-DBS) can sometimes be effective for VT. In this exploratory analysis, we investigated the effect of Vim-DBS on VT and tested the hypothesis that unilateral thalamic stimulation is effective for patients with VT. METHODS: Seven patients with VT and previously implanted bilateral Vim-DBS were enrolled in the study...
January 9, 2019: Stereotactic and Functional Neurosurgery
Jonathan J Lee, Saeed S Sadrameli, Virendra R Desai, Ryan J Austerman, Dean M Leonard, Brian D Dalm
BACKGROUND: Spinal cord stimulation (SCS) is a well-established treatment modality for chronic pain. Thoracic radiculopathy has been reported as a complication of SCS paddle lead implantation by several authors and commonly presents as abdominal pain. METHODS: We performed a search of all patients who underwent either placement of a new epidural paddle lead electrode or revision of an epidural paddle lead electrode for SCS in the thoracic region from January 2017 to January 2018...
January 3, 2019: Stereotactic and Functional Neurosurgery
Nina Zech, Milena Seemann, Timo F Seyfried, Max Lange, Juergen Schlaier, Ernil Hansen
BACKGROUND: Sedatives and opioids used during deep brain stimulation (DBS) surgery interfere with optimal target localization and add to side effects and risks, and thus should be minimized. OBJECTIVE: To retrospectively test the actual need for sedatives and opioids when cranial nerve blocks and specific therapeutic communication are applied. METHODS: In a case series, 64 consecutive patients treated with a strong rapport, constant contact, non-verbal communication and hypnotic suggestions, such as dissociation to a "safe place," reframing of disturbing noises and self-confirmation, were compared to 22 preceding patients under standard general anaesthesia or conscious sedation...
December 5, 2018: Stereotactic and Functional Neurosurgery
April A Carlson, Ueli Rutishauser, Adam N Mamelak
BACKGROUND: Invasive electrode monitoring provides more precise localization of epileptogenic foci in patients with medically refractory epilepsy. The use of hybrid depth electrodes that include microwires for simultaneous single-neuron monitoring is becoming more widespread. OBJECTIVE: To determine the safety and utility of hybrid depth electrodes for intracranial monitoring of medically refractory epilepsy. METHODS: We reviewed the medical charts of 53 cases of medically refractory epilepsy operated on from 2006 to 2017, where both non-hybrid and hybrid microwire depth electrodes were used for intracranial monitoring...
October 16, 2018: Stereotactic and Functional Neurosurgery
Jonathan R Ellenbogen, Ruth Tuura, Keyoumars Ashkan
No abstract text is available yet for this article.
October 10, 2018: Stereotactic and Functional Neurosurgery
Antti Huotarinen, Riku Kivisaari, Marwan Hariz
BACKGROUND: The widespread use of deep brain stimulation (DBS) for movement disorders has renewed the interest in DBS for psychiatric disorders. Lauri Laitinen was a pioneer of stereotactic psychosurgery in the 1950s to 1970s, especially by introducing the subgenual cingulotomy. Our aim here was to verify the anatomical target used by Laitinen, to report on a patient who underwent this procedure, and to review the literature. MATERIALS AND METHODS: The records of Helsinki University Hospital were searched for psychosurgical cases performed between 1970 and 1974...
October 2, 2018: Stereotactic and Functional Neurosurgery
Mattias Åström, Jennifer Samuelsson, Jonas Roothans, Anders Fytagoridis, Maxim Ryzhkov, Rutger Nijlunsing, Patric Blomstedt
BACKGROUND/AIM: Deep brain stimulation (DBS) is an established neurosurgical treatment that can be used to alleviate symptoms in essential tremor (ET) and other movement disorders. The aim was to develop a method and software tool for the prediction of effective DBS electrode contacts based on probabilistic stimulation maps (PSMs) in patients with ET treated with caudal zona incerta (cZi) DBS. METHODS: A total of 33 patients (37 leads) treated with DBS were evaluated with the Essential Tremor Rating Scale (ETRS) 12 months after surgery...
September 28, 2018: Stereotactic and Functional Neurosurgery
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