Abstract:
:Deep brain stimulation (DBS) is the treatment of choice for otherwise healthy patients with advanced Parkinson disease who are suffering from disabling dyskinesias and motor fluctuations related to dopaminergic therapy. As DBS is an elective procedure, it is essential to minimize the risk of morbidity. Further, precision in targeting deep brain structures is critical to optimize efficacy in controlling motor features. The authors have already established an operational checklist in an effort to minimize errors made during DBS surgery. Here, they set out to standardize a strict, step-by-step approach to the DBS surgery used at their institution, including preoperative evaluation, the day of surgery, and the postoperative course. They provide careful instruction on Leksell frame assembly and placement as well as the determination of indirect coordinates derived from MR images used to target deep brain structures. Detailed descriptions of the operative procedure are provided, outlining placement of the stereotactic arc as well as determination of the appropriate bur hole location, lead placement using electrophysiology, and placement of the internal pulse generator. The authors also include their approach to preventing postoperative morbidity. They believe that a strategic, step-by-step approach to DBS surgery combined with a standardized checklist will help to minimize operating room mistakes that can compromise targeting and increase the risk of complication.
journal_name
Neurosurg Focusjournal_title
Neurosurgical focusauthors
Kramer DR,Halpern CH,Buonacore DL,McGill KR,Hurtig HI,Jaggi JL,Baltuch GHdoi
10.3171/2010.4.FOCUS10103subject
Has Abstractpub_date
2010-08-01 00:00:00pages
E3issue
2issn
1092-0684journal_volume
29pub_type
杂志文章abstract::OBJECTIVE Sagittal malalignment decreases patients' quality of life and may require surgical correction to achieve realignment goals. High-risk posterior-based osteotomy techniques are the current standard treatment for addressing sagittal malalignment. More recently, anterior lumbar interbody fusion, anterior column ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2017.8.FOCUS17423
更新日期:2017-12-01 00:00:00
abstract::Choroid plexus tumors consist of papillomas and carcinomas. A variety of germline and somatic genetic changes have been demonstrated for each of these subtypes. In this paper, the authors summarize the current knowledge of the genetic bases of these tumors. ...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2006.20.1.11
更新日期:2006-01-15 00:00:00
abstract::Deep brain stimulation (DBS) has been used to treat various neurological and psychiatric disorders. Over the years, the most suitable surgical candidates and targets for some of these conditions have been characterized and the benefits of DBS well demonstrated in double-blinded randomized trials. This review will disc...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2009.4.FOCUS0982
更新日期:2009-07-01 00:00:00
abstract:OBJECT:Experience with minimal-access surgical approaches for revision lumbar surgery has not been previously reported. METHODS:During a 7-month period, 10 consecutive patients with recurrent disc herniations underwent revision operations in which microendoscopic discectomy (MED) was performed. Perioperative data and ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2003.15.3.12
更新日期:2003-09-15 00:00:00
abstract::OBJECTIVE The objective of this study was to compare postoperative sagittal alignment among 3 rod constructs with different rigidity profiles. METHODS This was a dual-center retrospective cohort study involving 2 consecutive cohorts in which patients were surgically treated for adolescent idiopathic scoliosis. Lenke T...
journal_title:Neurosurgical focus
pub_type: 杂志文章,多中心研究
doi:10.3171/2017.7.FOCUS17351
更新日期:2017-10-01 00:00:00
abstract::In an effort to make thoracic discectomy simple and less invasive while using direct visualization, a 70 degrees -angled lens endoscope has been adopted to visualize the ventral aspect of the spinal cord dura mater during microsurgical thoracic discectomy via a transpedicular approach. The patient is positioned in a 6...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.1998.4.2.8
更新日期:1998-02-15 00:00:00
abstract::In the treatment of acoustic neuroma, operative results have improved greatly during recent years, with high rates of functional cranial nerve preservation. Because of this, it has become more important to consider issues of patient satisfaction and quality of life (QOL) following treatment for these lesions. The auth...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:
更新日期:1998-09-15 00:00:00
abstract:OBJECTIVE:Incidental aneurysms pose a challenge for physicians, who need to weigh the rupture risk against the risks associated with treatment and its complications. A statistical model could potentially support such treatment decisions. A recently developed aneurysm rupture probability model performed well in the US d...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2019.4.FOCUS19145
更新日期:2019-07-01 00:00:00
abstract::Medulloblastoma and primitive neuroectodermal tumors (PNETs) are the most common malignant brain tumors in children. The concern for late sequelae of neuraxis irradiation and the obligation to improve disease-free survival in children who harbor malignant brain tumors has led to the additional provision of systemic ch...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.1999.7.2.3
更新日期:1999-08-15 00:00:00
abstract::The authors report the history of the Tabulae Anatomicae of Bartolomeo Eustachio (ca. 1510-1574). In the tables, the anatomical illustrations were drawn inside a numerical frame, with pairs of numbers on the y- and x-axes to identify single anatomical details in the reference table. The measures and the references cou...
journal_title:Neurosurgical focus
pub_type: 传,历史文章,杂志文章
doi:10.3171/2019.6.FOCUS19339
更新日期:2019-09-01 00:00:00
abstract::OBJECTIVE The object of this study was to determine the percentage of high-dose (1800-2600 cGy) single-fraction stereotactic radiosurgery (SF-SRS) treatments to the spine that result in peripheral nervous system (PNS) injury. METHODS All patients treated with SF-SRS for primary or metastatic spine tumors between Janua...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2016.11.FOCUS16348
更新日期:2017-03-01 00:00:00
abstract::Pituitary macroadenomas most frequently present with visual loss. Although transsphenoidal surgery remains the treatment of choice for patients with neurological manifestations, there have been several advances in its implementation over the last 5 years. Intraoperative magnetic resonance (MR) imaging has emerged as a...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/FOC-07/11/E12
更新日期:2007-01-01 00:00:00
abstract:OBJECT:The authors undertook a study to compare two intraoperative imaging modalities, low-field magnetic resonance (MR) imaging and a prototype of a three-dimensional (3D)-navigated ultrasonography in terms of imaging quality in lesion detection and intraoperative resection control. METHODS:Low-field MR imaging was u...
journal_title:Neurosurgical focus
pub_type: 临床试验,杂志文章
doi:10.3171/foc.2001.10.2.4
更新日期:2001-02-15 00:00:00
abstract:OBJECT:Currently, reliable low-cost and noninvasive techniques to assess cerebral perfusion in the operating room are not available. The authors report on their first clinical experience with laser speckle contrast analysis (LASCA) as a complementary imaging tool for the noninvasive and dynamic assessment of cerebral b...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2009.8.FOCUS09148
更新日期:2009-10-01 00:00:00
abstract::Chronic subarachnoid hemorrhage may cause deposition of hemosiderin on the leptomeninges and subpial layers of the neuraxis, leading to superficial siderosis (SS). The symptoms and signs of SS are progressive and fatal. Exploration of potential sites responsible for intrathecal bleeding and subsequent hemosiderin depo...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2004.16.5.11
更新日期:2004-05-15 00:00:00
abstract:OBJECT:Clinoidal meningiomas remain a major neurosurgical challenge. Surgery-related outcome has been less than desirable in the past, and little attention has been directed toward improving visual deficits. The authors advocate a skull base technique for the removal of these difficult tumors and describe its advantage...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2003.14.6.5
更新日期:2003-06-15 00:00:00
abstract::Electrodiagnostic testing in patients who have upper-extremity symptoms, which may include carpal tunnel syndrome (CTS), has been the gold standard for diagnosis for many years. Despite their value, these tests are underutilized. The authors examined the use patterns of electrodiagnostic testing at the University of V...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.1997.3.1.5
更新日期:1997-07-15 00:00:00
abstract:OBJECTIVE:Cavernoma-related epilepsy (CRE) is a frequent symptom in patients with cerebral cavernous malformations (CCMs). Reports on surgical management and seizure outcome of epileptogenic CCM often focus on intracranial cavernoma in general. Therefore, data on CCMs within the temporal lobe are scarce. The authors th...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2020.1.FOCUS19920
更新日期:2020-04-01 00:00:00
abstract::Vagus nerve stimulation (VNS) is a key tool in the treatment of patients with medically refractory epilepsy. Although the mechanism of action of VNS remains poorly understood, this modality is now the most widely used nonpharmacological treatment for drug-resistant epilepsy. The goal of this work is to review the hist...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2009.6.FOCUS09126
更新日期:2009-09-01 00:00:00
abstract::Primary leiomyosarcoma of the central nervous system is rare and has been described both de novo and following temporally remote radiotherapy for a different unrelated malignancy. The authors report the case of a 42-year-old man in whom 60Co radiation treatment had been performed for an unknown primary mass in the bra...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2002.12.6.13
更新日期:2002-06-15 00:00:00
abstract:OBJECTIVE:Sub-Saharan Africa (SSA) represents 17% of the world's land, 14% of the population, and 1% of the gross domestic product. Previous reports have indicated that 81/500 African neurosurgeons (16.2%) worked in SSA-i.e., 1 neurosurgeon per 6 million inhabitants. Over the past decades, efforts have been made to imp...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2019.12.FOCUS19853
更新日期:2020-03-01 00:00:00
abstract::The author addresses the issue of neurofibroma classification and implications for treatment. He emphasizes the importance of understanding that not all neurofibromas are the same and that the key differences between the types of neurofibromas involve which portions of the nerve sheath contribute to the distinctive be...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2007.22.6.4
更新日期:2007-06-15 00:00:00
abstract::Vein of Galen malformations are rare congenital intracranial vascular malformations. Based on reports in the literature, spontaneous thrombosis or regression of these lesions is rare. Patients have variable outcomes from an asymptomatic course to death. The reasons behind spontaneous thrombosis are not entirely unders...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2009.8.FOCUS09162
更新日期:2009-11-01 00:00:00
abstract::OBJECTIVE The long-term effects on adjacent-segment pathology after nonfusion dynamic stabilization is unclear, and, in particular, changes at the adjacent facet joints have not been reported in a clinical study. This study aims to compare changes in the adjacent facet joints after lumbar spinal surgery. METHODS Patie...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2015.10.FOCUS15456
更新日期:2016-01-01 00:00:00
abstract:OBJECT:Resorbable polymer implants have become a compelling option in the treatment of acquired and congenital craniofacial deformities. In particular, the resorbable polylactide and polyglycolide polymers have demonstrated excellent safety profiles in multiple in vitro, animal, and clinical studies and are currently b...
journal_title:Neurosurgical focus
pub_type: 临床试验,杂志文章
doi:10.3171/foc.2004.16.3.13
更新日期:2004-03-15 00:00:00
abstract::Healthcare spending has become a grave concern to national budgets worldwide, and to a greater extent in low-income countries. Brain tumors are a serious disease that affects a significant percentage of the population, and thus proper allocation of healthcare provisions for these patients to achieve acceptable outcome...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2018.7.FOCUS18258
更新日期:2018-10-01 00:00:00
abstract:OBJECT:The management of pediatric intraventricular tumors is highly dependent on identification of the tumor type. Choroid plexus papillomas, a common intraventricular tumor in children, can be difficult to distinguish radiographically from choroid plexus carcinomas and other common pediatric central nervous system (C...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:
更新日期:2005-06-15 00:00:00
abstract::With the aid of a computer model, this investigation describes the relationship between mean arterial pressure (MAP) reduction and its effect on total arteriovenous malformation (AVM) shunt flow, feeding artery velocities, and cerebral blood flow in hypotensive, structurally normal vascular beds adjacent to the AVM ni...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.1997.2.6.6
更新日期:1997-06-15 00:00:00
abstract::Intravenous and intraarterial recombinant tissue plasminogen activator remains underutilized in the treatment of acute ischemic stroke, largely due to strict adherence to the concept of the therapeutic time window for administration. Recent efforts to expand the number of patients eligible for thrombolysis have been m...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2011.4.FOCUS10296
更新日期:2011-06-01 00:00:00
abstract::Arteriovenous malformation (AVM) presenting with epilepsy significantly impacts patient quality of life, and it should be considered very much a seizure disorder. Although hemorrhage prevention is the primary treatment aim of AVM surgery, seizure control should also be at the forefront of therapeutic management. Sever...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2020.1.FOCUS19899
更新日期:2020-04-01 00:00:00