Abstract:
BACKGROUND:Targeting for functional stereotactic procedures is traditionally carried out in a noninteractive fashion, without real-time positional feedback. In addition, stereotactic frames are uncomfortable for patients and may impede intraoperative neurological evaluation. As an initial step toward a fully frameless approach to functional surgery, we have investigated the use of an image-guided microdrive coupled to a stereotactic frame system. METHODS:For initial laboratory tests, a stereotactic phantom was imaged using high-resolution CT scanning. Three representative targets were chosen within the phantom. Targeting was carried out in the usual fashion using the StealthStation planning suite, utilizing the Radionics CRW system. An LED-equipped reference arc was attached to the CRW base ring. Registration of the base ring was accomplished using a spherical probe. A custom-built microdrive was fitted with an LED array, mounted on the CRW arc and tracked by the StealthStation. The distance between the Stealth real-time localization and the CRW localization was measured on-screen. To evaluate the accuracy of the system in the operating room, a similar procedure was carried out in 13 functional neurosurgical operations (pallidotomy or deep brain stimulator placement). RESULTS:Errors of localization in the laboratory setting ranged from 0.53 to 0.70 mm. In 11 operative cases, the average difference between the CRW localization and the Stealth localization was 1.77 mm. In the remaining 2 cases, equipment malfunction prevented measurement of localization error. CONCLUSIONS:Frameless image-guided localization compares favorably to targeting performed noninteractively. In addition, real-time positional feedback confers advantages in target region visualization and confidence in placement of lesions and stimulators for functional procedures. With small improvements in accuracy and system reliability, fully frameless functional procedures could be safely carried out.
journal_name
Stereotact Funct Neurosurgjournal_title
Stereotactic and functional neurosurgeryauthors
Henderson JMdoi
10.1159/000081345keywords:
subject
Has Abstractpub_date
2004-01-01 00:00:00pages
135-41issue
4eissn
1011-6125issn
1423-0372pii
81345journal_volume
82pub_type
杂志文章abstract:BACKGROUND/AIMS:Our study aimed to evaluate the efficiency and morbidity of Gamma Knife radiosurgery (GKS) in the treatment of hemorrhagic brainstem cavernous malformations (CMs). METHODS:We included in this study all patients who underwent GKS for the treatment of a hemorrhagic brainstem CM(s) in our institution betw...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000452844
更新日期:2016-01-01 00:00:00
abstract::We present a system for surgical navigation using stereo overlays in the operating microscope aligned to the operative scene. This augmented reality system provides 3D information about nearby structures and offers a significant advancement over pointer-based guidance, which provides only the location of one point and...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000029708
更新日期:1999-01-01 00:00:00
abstract::Fractionated stereotactic radiotherapy is a method which attempts to combine the radiobiological advantages offered by dose fractionation with a technique for focal delivery of radiation. At McGill University, fractionated stereotactic radiotherapy is given with a linear accelerator-based dynamic stereotactic radiosur...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000098941
更新日期:1992-01-01 00:00:00
abstract::Posttraumatic stress disorder (PTSD) is a prevalent and highly disabling psychiatric disorder that is notoriously difficult to treat. At some point in their lifetimes, 5-8% of men, 10-14% of women, and up to a quarter of combat veterans carry this diagnosis. Despite pharmacological and behavioral therapies, up to 30% ...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章,评审
doi:10.1159/000343148
更新日期:2013-01-01 00:00:00
abstract::Autologous transplantation of the superior cervical ganglion (SCG) into the caudate nuclei of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-induced parkinsonian monkey was studied in regard to animal behavior and catecholamine (CA) metabolites in cerebrospinal fluid. Monkeys which had undergone autotransplantation of t...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000100231
更新日期:1990-01-01 00:00:00
abstract::In nearly all deep brain stimulation (DBS) applications, the same quadripolar electrode design is used for different anatomical targets even if shape and volume differences exist between nuclei. Taking into account the electrode location within the internal globus pallidus (GPi) and the size of the GPi, 2 electrodes w...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000303524
更新日期:2010-01-01 00:00:00
abstract::Stereotactic guidance is useful for planning an accurate trajectory to the third ventricle. A guiding block with a ball joint was developed for frame-based endoscopy and adaptors for arm-based and armless navigation systems. Between 1992 and 1996, 52 patients were operated on endoscopically in the third ventricle unde...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000099907
更新日期:1997-01-01 00:00:00
abstract::Stereotactic radiosurgery under local anesthesia with the Leksell Gamma Knife can effectively treat some patients with recurrent tic douloureux after unsuccessful medical/surgical procedures. Seven of 12 patients have shown complete relief or improvement of their trigeminal neuralgia. No complications have been observ...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000100663
更新日期:1993-01-01 00:00:00
abstract:PURPOSE:To evaluate dose conformity and mean target dose in light of previous comparative studies and state-of-the-art radiosurgery delivery modalities. MATERIALS AND METHODS:Seven patients with acoustic neuromas deemed clinically suitable for linear accelerator or Gamma Knife radiosurgery were planned such that the m...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000089987
更新日期:2005-01-01 00:00:00
abstract::Stereotactic interventions at thalamic/subthalamic levels for parkinsonian tremor give the chance to investigate the influence of the supraspinal proprioceptive loops on the tonic component of motor tasks. Studies demonstrate not only a normalization of the late stretch reflex component and a decrease of the pre-refle...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000100603
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND/AIMS:During the placement of electrodes for deep brain stimulation (DBS), patients are commonly in a seated position, awake, and spontaneously breathing. Air may be entrained through bone or dural veins causing venous air emboli (VAE) and this phenomenon can result in significant hemodynamic changes. Althoug...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000177625
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:To maintain the efficacy of deep brain stimulation (DBS) on dystonic symptoms, slight incremental increase in voltage may be necessary over years after a steady state has been reached following the initial programming of optimal settings. So far however, no data are available regarding the adjustment of volt...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000319958
更新日期:2010-01-01 00:00:00
abstract::The longevity of batteries in internal pulse generators (IPGs) used clinically for deep brain stimulation is not known. We conducted a study to assess the life span of these batteries. From 1993 to 2000, 163 single-channel batteries were surgically implanted in our institution. The electrical settings utilized in pati...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000075161
更新日期:2003-01-01 00:00:00
abstract::Stiff limb syndrome (SLS) is a rare chronic condition which can result in significant debility. We report the case of a 44-year-old man suffering from severe painful spasms in his right leg with a diagnosis of SLS. He had been initially treated for his pain with a spinal cord stimulator but presented with exacerbation...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000313871
更新日期:2010-01-01 00:00:00
abstract::The management of cerebral arteriovenous malformations (AVMs) continues to present a challenge to neurosurgeons. The natural history of this condition, as well as the morbidity and mortality of therapeutic interventions, remains incompletely elucidated. Predictive factors and grading scales in AVM management allow ris...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章,评审
doi:10.1159/000126945
更新日期:2008-01-01 00:00:00
abstract::Background: Stimulation parameters are crucial for the efficacy and safety of motor cortex stimulation (MCS). Motor threshold (MT) can be defined as the lowest voltage that produces motor contraction. The final stimulation parameters are always a smaller percentage of MT in order to avoid seizures. We determined how p...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000369355
更新日期:2015-01-01 00:00:00
abstract::Stereotactic techniques were used to transplant adrenal medullary tissue to the head of the right caudate nucleus in 12 patients with Parkinson's disease. No significant lasting complications were seen. All patients had an initial improvement. 11 of the 12 patients remain improved over their preoperative condition aft...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000100221
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:Up to 60% of Parkinson's disease (PD) patients suffer from low back pain (LBP) during the course of their disease. How LBP affects daily functional status and how to manage this aspect of PD has not been adequately explored. METHODS:We examined 16 patients undergoing bilateral subthalamic nucleus deep brain...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000380827
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVES:To investigate the effects of low- and high-frequency deep brain stimulation (DBS) on the nucleus accumbens (ACC) and the adjacent internal capsule in 3 patients with obsessive-compulsive disorder (OCD) using blood oxygenation level-dependent (BOLD) functional magnetic resonance imaging (fMRI) under intraope...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000368805
更新日期:2015-01-01 00:00:00
abstract::Postoperative magnetic resonance imaging (MRI) of basal ganglia functional lesions illustrates the accuracy of preoperative target localization. The technique of perioperative MRI and CT localization for pallidotomy will be discussed and correlated with the center of the lesion on postoperative standard MRI as well as...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000098598
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:The optimum target in surgery for Parkinson's disease (PD) is still controversial, especially in patients with tremor-dominant PD. We aim to compare results in tremor-dominant patients undergoing pallidotomy vs. those undergoing simultaneous posteroventral pallidotomy (PVP) and ventral intermediate nucleus (...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000492229
更新日期:2018-01-01 00:00:00
abstract::Background: Trigeminal neuralgia (TN) is mostly caused by vascular compression of the nerve's root entry zone due to an ectatic artery. Rarer causes include compression from tumors, vascular malformations or multiple sclerosis plaques. Developmental venous anomalies (DVAs) are benign, aberrantly appearing venous struc...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000369562
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVE:To perform a preliminary study on the effects and safety of bilateral cingulotomy and anterior capsulotomy in patients with aggressive behavior. PATIENTS AND METHODS:Twenty-three psychiatric patients showing aggressive behavior refractory to conventional treatment were initially evaluated. The subjects were ...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000336746
更新日期:2012-01-01 00:00:00
abstract::Reinstallation of the Sheffield Gamma Knife Unit was completed in early November, 1991, following the replacement of the cobalt sources. Two methods were used to evaluate the isodose configuration within the replenished unit. The first method used a scanning microdensitometer to interrogate films exposed within a sphe...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000100672
更新日期:1993-01-01 00:00:00
abstract::Twenty-five gliomas of the cerebral hemisphere in children were examined. Most hemispheric gliomas in children have relatively clear margins and less infiltrative potential. Radiosurgery has a role in the treatment of these tumors in addition to reducing the risk of radiation injuries developing later. Fifteen patient...
journal_title:Stereotactic and functional neurosurgery
pub_type: 临床试验,杂志文章
doi:10.1159/000099819
更新日期:1996-01-01 00:00:00
abstract::Interstitial hyperthermia of malignant brain tumors has been produced by a heated ferromagnetic implant with a low Curie point. Induction heating of the implant, which is stereotactically implanted in a tumor, is obtained by eddy currents in a high-frequency magnetic field. Safe, repeated and long-term treatment of 35...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000098928
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:Adjustment of the motor circuitry has been described in the treatment of Parkinson disease (PD). OBJECTIVES:To evaluate the modulation of the motor circuitry of PD patients by subthalamic deep brain stimulation (STN DBS) using 18F-fluorodeoxyglucose (FDG) and positron emission tomography (PET). METHODS:Res...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000455930
更新日期:2017-01-01 00:00:00
abstract::Corpus callosotomy is a viable treatment for patients with refractory generalized or multifocal epilepsy, particularly those who have drop attacks. Laser interstitial thermal therapy (LITT) is a minimally invasive surgical option for various intracranial lesions. In this report, we present a 2-trajectory thermal ablat...
journal_title:Stereotactic and functional neurosurgery
pub_type:
doi:10.1159/000495414
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:The neuropathological consequences of Gamma Knife radiosurgery (GK) on hypothalamic hamartoma (HH) are unknown. OBJECTIVE:In a cohort of patients undergoing surgery for treatment-resistant epilepsy, we compared surgically resected HH tissue from patients without (group I; n = 19) and with (group II; n = 10)...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000341076
更新日期:2013-01-01 00:00:00
abstract::At the 1989 meeting of the World Society for Stereotactic and Functional Neurosurgery in Maebashi, the authors presented the concept and design of a stereotactic neurosurgical robot. The first prototype has now been completed and has entered clinical testing. The characteristics are as follows. The robot is positioned...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000100300
更新日期:1994-01-01 00:00:00