Deep brain stimulation and frameless stereotactic radiosurgery in the treatment of bilateral parkinsonian tremor: target selection and case report of two patients.


:Considerable positive experience in functional radiosurgery has been reported since Leksell's first experience in 1951, but the development of frameless radiosurgery was been limited because of the difficulty of identifying invisible functional targets. In this paper we report on two cases of bilateral parkinsonian tremor successfully treated with DBS on one side and with frameless radiosurgery on the contralateral side. We focus on the methodology developed to define the three-dimensional target coordinates for frameless radiosurgery. Two patients suffering from a disabling upper-limb parkinsonian tremor underwent frameless radiosurgical thalamotomy. To accurately identify the treatment target the CT gantry was treated as a stereotactic frame; a rototranslation between the origin of the screen and the origin of the stereotactic atlas allowed us to obtain atlas-registered 3D coordinates of each point on the CT axial brain slices. Both patients achieved complete bilateral tremor control by unilateral radiosurgery and contralateral DBS. We developed a method for determining the 3D coordinates of a known functional target to treat with frameless radiosurgery. Based on the initial experiences, frameless radiosurgery appears to be an alternative treatment for Parkinsonian upper limb tremor in the presence of increased surgical risks for DBS placement.


Acta Neurochir (Wien)


Acta neurochirurgica


Franzini A,Marchetti M,Brait L,Milanesi I,Messina G,Forapani E,Broggi G,Fariselli L




Has Abstract


2011-05-01 00:00:00












  • Belgian doctors' attitudes on the management of patients in persistent vegetative state (PVS): ethical and regulatory aspects.

    abstract:BACKGROUND:The best care and management of patients in persistent vegetative state (PVS) has been the subject of sustained moral and legal debate for a number of years. However, the views of specialist doctors in Belgium involved in the care for patients in PVS are largely unknown. METHODS:A postal questionnaire was s...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章


    authors: Dierickx K,Schotsmans P,Grubb A,Walsh P,Lambe N

    更新日期:1998-01-01 00:00:00

  • Cranial nerve monitoring during subpial dissection in temporomesial surgery.

    abstract:OBJECTIVE:Cranial nerves (CNs) crossing between the brainstem and skull base at the level of the tentorial hiatus may be at risk in temporomesial surgery involving subpial dissection and/or tumorous growth leading to distorted anatomy. We aimed to identify the surgical steps most likely to result in CN damage in this t...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章


    authors: Ortler M,Fiegele T,Walser G,Trinka E,Eisner W

    更新日期:2011-06-01 00:00:00

  • A four lumen screwing device for multiparametric brain monitoring.

    abstract::We describe multiparametric monitoring in severe head trauma using a new screwing device. Our aim was to create a screw which would make the implantation of the probes and thus multiparametric monitoring easier. The new screw allows us to implant 3 probes (microdialysis, Paratrend and an intracranial pressure device) ...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章


    authors: Feuerstein TH,Langemann H,Gratzl O,Mendelowitsch A

    更新日期:2000-01-01 00:00:00

  • Evaluation of surgically treated Nelson's syndrome.

    abstract::In 17 primary transnasal operations on Nelson tumours long-term results are assessed measuring ACTH plasma levels and performing regular neuroradiological controls. In small intrasellar adenomas only one recurrent ACTH elevation near to pretreatment levels without symptoms from tumour growth was observed after 10 year...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章


    authors: Lüdecke DK,Breustedt HJ,Brämswig J,Köbberling J,Saeger W

    更新日期:1982-01-01 00:00:00

  • Recovery of the electrocorticogram after incomplete and complete ischaemia of the brain.

    abstract::Incomplete cerebral ischaemia of 10 to 60 minutes duration was performed by reducing the perfusion pressure of completely isolated canine heads at brain temperatures of 37 and 32 degrees C. Complete cerebral ischaemia of the same duration was performed by complete stopping of the perfusion. The latency of recovery of ...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章


    authors: Hirsch H

    更新日期:1982-01-01 00:00:00

  • Surgical resection of gliomas WHO grade II and III located in the opercular region.

    abstract:BACKGROUND:Surgery in the opercular region especially in the dominant hemisphere impose a major challenge for the neurosurgeon due to the close vicinity to functional important motor and speech areas. The purpose of the present study is to analyse on a homogenous patient group pre- and postoperative functional deficits...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章


    authors: Peraud A,Ilmberger J,Reulen HJ

    更新日期:2004-01-01 00:00:00

  • Aberrant trans-osseous venous drainage of the superficial middle cerebral vein: case report.

    abstract::The superficial middle cerebral veins (SMCVs) are large veins to drain the brain and therefore anatomical knowledge of them is important for neurosurgeons and neuroradiologists. In a patient with a ruptured blister aneurysm, we incidentally found during angiography an aberrant drainage of the SMCVs, which penetrated t...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章


    authors: Mizutani K,Consoli A,Di Maria F,Coskun O,Rodesch G

    更新日期:2019-04-01 00:00:00

  • Cervical cord compression and severe hydrocephalus in a child with Saudi variant of multiple sulfatase deficiency. Report of case.

    abstract::We report a 2.5-year-old boy with Saudi variant of multiple sulfatase deficiency (MSD or Austin's disease). He presented with the features of cervical cord compression and a severe form of hydrocephalus. The former was due to a thickened posterior arch of the atlas and the latter from a narrow foramen magnum and menin...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章


    authors: al-Moutaery KR,Choudhury AR,Hassanen MO

    更新日期:1994-01-01 00:00:00

  • Respiration and acid-base balance of blood after diffuse experimental brain injury.

    abstract::Diffuse brain injury in rabbits was caused by injecting olive oil and saline into one internal carotid artery. In this report, the fourth of a series, the effects of this experimental brain injury on respiration and acid-base balance of blood are analyzed. The animals that withstood the injury best were those that had...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章


    authors: Valtonen S

    更新日期:1975-01-01 00:00:00

  • Suboccipital endoscopic management of the entrapped fourth ventricle: technical note.

    abstract:BACKGROUND:Entrapped fourth ventricle is the result of both inlet aqueduct and outlet fourth ventricular midline and lateral foraminae obstruction. It occurs as a sequalae of intracranial hemorrhagic or inflammatory disease condition. Usually it presents after previous shunting for communicating hydrocephalus with a pe...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章


    authors: Raouf A,Zidan I

    更新日期:2013-10-01 00:00:00

  • Early radiologically proven rebleeding from intracranial cavernous angiomas: report of 6 cases and review of the literature.

    abstract::Although intracranial cavernomas are known to cause haemorrhage, data concerning the frequency, severity and delay of recurrent bleedings are controversial. We report a series of 6 patients with histologically proven cavernoma, presenting with early clinical signs and radiological proof of rebleeding, that is occurrin...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章,评审


    authors: Duffau H,Capelle L,Sichez JP,Faillot T,Bitar A,Arthuis F,Van Effenterre R,Fohanno D

    更新日期:1997-01-01 00:00:00

  • "Twiddler syndrome" in two patients with deep brain stimulation.

    abstract::Twiddler syndrome occurs when a patient intentionally or unintentionally manipulates an implantable generator (usually a pacemaker) and dislodges the pacing leads, causing malfunction of the device. Though the syndrome has been described in patients with pacemakers, to our knowledge only one spontaneous case has been ...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章


    authors: Gelabert-Gonzalez M,Relova-Quinteiro JL,Castro-García A

    更新日期:2010-03-01 00:00:00

  • Urinary incontinence following deep brain stimulation of the pedunculopontine nucleus.

    abstract::Low-frequency deep brain stimulation (DBS) of the pedunculopontine nucleus (PPN) has been reported to improve akinesia and gait difficulties in patients with Parkinson's disease (PD). We report on a patient with PD and L: -dopa refractory gait symptoms who developed detrusor over-activity immediately after right PPN D...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章


    authors: Aviles-Olmos I,Foltynie T,Panicker J,Cowie D,Limousin P,Hariz M,Fowler CJ,Zrinzo L

    更新日期:2011-12-01 00:00:00

  • Linear accelerator and Greitz-Bergstrom's head fixation system in radiosurgery of single cerebral metastases. A report of 86 cases.

    abstract::Between 1984 and 1991 86 patients with single cerebral metastases underwent linear accelerator radiosurgery using the atraumatic and reproducible Greitz-Bergström head-fixation device. Routine one-month follow-up documented disappearance of the tumour in 16 patients, with resolution of the oedema and ventricular shift...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章


    authors: Valentino V,Mirri MA,Schinaia G,Dalle Ore G

    更新日期:1993-01-01 00:00:00

  • Malignancy and viability of intraparenchymal brain tumours: correlation between Gd-DTPA contrast MR images and proliferative potentials.

    abstract::The feasibility of diagnosing the malignancy and viability of intraparenchymal brain tumours using Gd-DTPA, enhanced and unenhanced T1-weighted MRIs was investigated. The relationship between the Gd-DTPA enhancement pattern, the growth fraction (GF) determined by using the anti-bromide-oxyuridine (BrdU) monoclonal ant...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章


    authors: Yoshii Y,Komatsu Y,Yamada T,Hyodo A,Nose T,Kobayashi E

    更新日期:1992-01-01 00:00:00

  • Chemokines as markers of local inflammation and angiogenesis in patients with chronic subdural hematoma: a prospective study.

    abstract:OBJECTIVE:The goal of this study was to investigate the chemokines CCL2, CXCL8, CXCL9 and CXCL10 as markers of the inflammatory responses in chronic subdural hematoma (CSDH). METHODS:Samples of peripheral venous blood and CSDH fluid (obtained during surgery) in 76 adult patients were prospectively analyzed. Chemokine ...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章


    authors: Stanisic M,Lyngstadaas SP,Pripp AH,Aasen AO,Lindegaard KF,Ivanovic J,Ilstad E,Konglund A,Sandell T,Ellingsen O,Saehle T

    更新日期:2012-01-01 00:00:00

  • Computerized tomography (CT) in patients with head injuries. Assessment of outcome based upon initial clinical findings and initial CT scans.

    abstract::In this study, which comprises 144 consecutive head injuries, the initial clinical assessment and the findings of the initial CT scan are related to the outcome. The mortality is related to the patient's level of consciousness and pupillary light reflex on admission. The disability rate (= number of disabled/number of...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章


    authors: Espersen JO,Petersen OF

    更新日期:1982-01-01 00:00:00

  • Cerebral cavernous malformations and intractable epilepsy: the limited usefulness of current literature.

    abstract:BACKGROUND:Cerebral cavernous malformations (CCM) are known to be highly epileptogenic lesions. A number of studies on CCM surgery deal with CCM-associated seizures and/or epilepsy. In order to counsel patients with CCM-associated epilepsy, clear results from such studies would be highly useful. This study reviews the ...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章,评审


    authors: von der Brelie C,Schramm J

    更新日期:2011-02-01 00:00:00

  • Endarterectomy for asymptomatic carotid artery stenosis under local anaesthesia.

    abstract:BACKGROUND:In this article, we present our experience with such operations performed under local anaesthesia. METHODS:From January 1997 to November 2007, there were 387 patients operated on for asymptomatic carotid stenosis. Patient data were retrospectively evaluated. Thirty-day neurological morbidity and mortality f...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章


    authors: Sokol D,Fiedler J,Chlouba V,Bombic M,Priban V

    更新日期:2011-02-01 00:00:00

  • Rerupture of cerebral aneurysms during angiography--a retrospective study of 13 patients with subarachnoid hemorrhage.

    abstract:UNLABELLED:OBJECTIVE, BACKGROUND: Cerebral angiography, performed within 24 hr of aneurysmal rupture, carries an increased risk of rebleeding. We have investigated the rerupture rate during angiography procedures under deep general anesthesia and the factors that contribute to rebleeding. METHODS:We divided 69 patient...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章


    authors: Kusumi M,Yamada M,Kitahara T,Endo M,Kan S,Iida H,Sagiuchi T,Fujii K

    更新日期:2005-08-01 00:00:00

  • Radio- and chemotherapy of malignant gliomas. Pathological changes in the normal nervous tissue.

    abstract::The pathological effects of radio- and chemotherapy on the normal nervous tissue have been studied in 42 brains with malignant gliomas. The brains have been examined by means of the complete study technique. In seven cases the picture of delayed radionecrosis has been found. Apart from this, many histological features...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章


    authors: Schiffer D,Giordana MT,Soffietti R,Tarenzi L,Milani R,Vasario E,Paoletti P

    更新日期:1981-01-01 00:00:00

  • Oculomotor nerve palsy in pituitary apoplexy associated with pituitary adenoma: a radiological analysis with fast imaging employing with steady-state acquisition.

    abstract:PURPOSE:Oculomotor nerve palsy (ONP) occasionally occurs in cases of pituitary apoplexy (PA) associated with pituitary adenoma, but its mechanism remains unclear. Intracranial nerves are clearly visualized by fast-imaging employing with steady-state acquisition (FIESTA). Here, we assessed the oculomotor nerve compressi...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章


    authors: Sasagawa Y,Aburano H,Ooiso K,Oishi M,Hayashi Y,Nakada M

    更新日期:2021-02-01 00:00:00

  • Accumulation of PN1 and PN3 sodium channels in painful human neuroma-evidence from immunocytochemistry.

    abstract:BACKGROUND:The axolemmal distribution and density of voltage-gated sodium channels largely determines the electrical excitability of sprouting neurites. Recent evidence suggests that accumulation of sodium channels at injured axonal tips may be responsible for ectopic axonal hyperexcitability and the resulting abnormal...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章


    authors: Kretschmer T,Happel LT,England JD,Nguyen DH,Tiel RL,Beuerman RW,Kline DG

    更新日期:2002-08-01 00:00:00

  • The use of ciliary neurotrophic factor to promote recovery after peripheral nerve injury by delivering it at the site of the cell body.

    abstract::Despite a body of evidence showing that various neurotrophic factors support the survival of nerve cells and stimulate axonal outgrowth, doubt remains about their optimal site of application as well as the more compelling question of what clinical benefit, if any, they would confer. Ciliary neurotrophic factor (CNTF) ...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章


    authors: Kelleher MO,Myles LM,Al-Abri RK,Glasby MA

    更新日期:2006-01-01 00:00:00

  • Computed tomography and magnetic resonance imaging of mild head injury--is it appropriate to classify patients with Glasgow Coma Scale score of 13 to 15 as "mild injury"?

    abstract:OBJECTIVE:The purpose of this study is to examine the relation between Glasgow Coma Scale (GCS) score and findings on computed tomography (CT) and magnetic resonance (MR) imaging of patients with mild head injury presenting GCS scores between 13 and 15. METHODS:Data were collected from all consecutive patients with mi...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章


    authors: Uchino Y,Okimura Y,Tanaka M,Saeki N,Yamaura A

    更新日期:2001-10-01 00:00:00

  • Vascular endothelial growth-permeability factor in granulation tissue of chronic subdural haematomas.

    abstract:BACKGROUND:Vascular Endothelial Growth/Permeability Factor (VEG/PF) has been correlated with angiogenesis and vascular leakage in diverse pathological conditions of the brain. On the other hand, neoformation of capillaries and vascular hyperpermeability have been related to progressive enlargement of chronic subdural h...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章


    authors: Vaquero J,Zurita M,Cincu R

    更新日期:2002-04-01 00:00:00

  • Operative findings and surgical outcomes in patients undergoing Chiari 1 malformation decompression: relationship to the extent of tonsillar ectopia.

    abstract:BACKGROUND:The diagnosis of Chiari 1 malformation is based on the extent of tonsillar ectopia. OBJECTIVE:To examine the relationship between the extent of tonsillar ectopia and the intra-operative findings and clinical outcome following Chiari decompression surgery. METHODS:Patients were divided into four groups depe...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章


    authors: Heffez DS,Golchini R,Ghorai J,Cohen B

    更新日期:2020-07-01 00:00:00

  • An isotope agarose assay for rapid testing of the sensitivity of glioma biopsies to chemotherapeutic drugs and biological response modifiers. Effects of BCNU, vincristine, lymphokines and the recombinant agents interferon alpha 2c, interferon gamma and tu

    abstract::A method based on growth of cells from glioma biopsies in a triple layer agarose system has been used to test the sensitivity of the tumour cells to different chemotherapeutic and immunotherapeutic agents. A special agarose that could be melted at 65 degrees C, enabled registration of proliferation by an easy and prec...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章


    authors: Unsgaard G,Helseth E,Vik R,Dalen A

    更新日期:1988-01-01 00:00:00

  • Co-existence of abdominal aortic aneurysms and intracranial aneurysms.

    abstract::The occurrence of abdominal aortic aneurysms (AAAs) and intracranial aneurysms (IAs) in the same patient and in the same family was studied among 89 patients with AAAs and 485 patients with IAs. Among the AAA-patients two had IAs themselves and five had IAs in the family, whereas three IA-patients had AAAs themselves ...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章


    authors: Norrgård O,Angqvist KA,Fodstad H,Forssell A,Lindberg M

    更新日期:1987-01-01 00:00:00

  • The late morbidity and mortality in ruptured single anterior circulation aneurysms treated by non-surgical therapy.

    abstract::Three hundred and sixty-four patients who suffered a subarachnoid haemorrhage from an aneurysm at either the anterior (ACA) or posterior (PCA) communicating artery location and who were not surgically treated have been followed for up to 21 years in order to study the late morbidity and mortality. For the 213 patients...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章


    authors: Winn HR,Richardson AE,Jane JA

    更新日期:1982-01-01 00:00:00