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Gene H. Barnett, Donald W. Kormos, Charles P. Steiner and Joe Weisenberger

humidity. Localizer hardware employs components of a modified commercially available sonic 3-D digitizer. * Near point-source pulse-gap emitters are contained within a pointing device (wand) of known geometry ( Fig. 2 ). A custom array of four microphone/emitter assemblies is rigidly affixed to the operating room near the surgical field ( Fig. 3 ). This improves the signal-to-noise ratio characteristics of the digitizer and permits movement of the operating table after initial registration of the patient's head. Assessment of local ambient conditions (to adjust range

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Narendra Nathoo, Marc R. Mayberg and Gene H. Barnett

perform an LP during surgery, if required. By adding a table top to the backward-tilted chair and a three-point head fixation device, the supine patient could be readied for craniotomies. The chair was also accompanied by a lifter that could lower the patient into an adjacent bed. Tantalum Cranioplasty (1944) Although Fulcher was the first to report the use of tantalum in repairing a cranial defect, it was Gardner who popularized this material (pure metal: 73rd element in the Periodic Table). Using a thinner sheet (to reduce the degree of radiopacity) cut

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Gene H. Barnett, Allan H. Ropper and June Romeo

11 15 ↑ ↓ vegetative * Glasgow Coma Scale (GCS) score at time of insertion of intracranial pressure (ICP) measuring device. † Time between onset of neurological symptoms and insertion of the ICP device. ‡ ↑ = initial increase in ICP; ↓ = ICP controlled (< 20 torr); ↔ = no change in initial ICP. Eight patients had biopsy-proven herpes simplex encephalitis (HSE) and one had acute hemorrhagic leukoencephalitis. The cause of one case of encephalitis was not determined. At the time the ICP monitoring device was inserted

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Gene H. Barnett, David W. Miller and Joseph Weisenberger

digitizer technology have been reliable, and user friendly and have demonstrated reproducible results. 3–5 Reports on the use of these systems for biopsy and related procedures, however, are few and limited to small series of patients. 20, 28, 39, 56 Encouraged by our experience with this technology, in mid-1994 we began developing a technique to adapt SNSs with scalp-applied fiducial markers for use in image-guided percutaneous brain biopsy and similar point-stereotactic procedures. Special hardware was devised to guide and hold biopsy probes and similar devices, and

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Gene H. Barnett, Allan H. Ropper and Keith A. Johnson

electrical, electronic, or mechanical life-support and monitoring equipment. Conversely, the RF energy generated by these devices may interfere with MR signal detection and produce artifacts that degrade image quality. 5 During image acquisition, the patient lies inside the bore of the magnet. Although staff can see and hear the patient, a period of approximately 10 seconds is required to move the imaging table so as to gain necessary access such as to examine cranial nerve functions or catheterization sites. Reliable monitoring procedures are therefore of particular

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Symeon Missios, Kimon Bekelis and Gene H. Barnett

optical fiber in a diffusion sheath, which allowed for the power density to be reduced across the tip and for a higher laser power to be used; it also offered a nonstick surface lining the exposed optical fiber. 7 , 37 One of the most important advances in LITT probe design was the introduction of a cooling mechanism that takes the form of a sheath-like device that cools the optical fiber with a constant stream of fluid (water or saline) or cooled gas (liquid CO 2 ). The cooling mechanism removes heat from the probe-tissue interface and minimizes carbonization or

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Narendra Nathoo, Frederick K. Lautzenheiser and Gene H. Barnett

and bloodless surgery combined with safe anesthesia. 42 In 1903, Crile developed his “pneumatic rubber suit,” a device created from rubber to prevent postural hypotension during surgery ( Fig. 4 ); 1 year later he reported its successful use. 6, 23, 34 Following the success of blood transfusions, the pneumatic suit fell out of favor. Interestingly, early in World War II, the pneumatic suit became the forerunner of the aviator's antigravity suit. Crile, together with the US Army and the Goodyear Tire and Rubber Company, modified the suit for flying in the

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Andrew A. Kanner, Michael A. Vogelbaum, Marc R. Mayberg, Joseph P. Weisenberger and Gene H. Barnett

, a registration error of the spatial accuracy will be provided. Registration inaccuracy was observed in the first cases because of the relative movement of the patient and magnet base. This problem has since been resolved by installation of a brake, which locks the position of the magnet base. Intraoperative Imaging Procedure The magnets are draped in a sterile fashion and then retracted under the bed. The patient's head is prepared and draped in the usual fashion, and is sterilely draped as well. Reverse orientation of the device has been used for trans

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Michael A. Vogelbaum, Cathy Brewer, Gene H. Barnett, Alireza M. Mohammadi, David M. Peereboom, Manmeet S. Ahluwalia and Shenqiang Gao

, several post hoc analyses indicated that unreliable catheter placement and backflow were likely sources of poor delivery and hence lack of effect of the “delivered” therapeutic. 18 , 20 It had been previously demonstrated that a small, sub-millimeter delivery port would be less prone to backflow. 13 It was a technical challenge, however, to create a device that would be small enough to resist backflow yet could be made rigid enough to be reliably implanted transcranially to specific locations of the brain. One approach has been to create so-called “step-down” cannulas

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Michael A. Vogelbaum, Cathy Brewer, Gene H. Barnett, Alireza M. Mohammadi, David M. Peereboom, Manmeet S. Ahluwalia and Shenqiang Gao

, several post hoc analyses indicated that unreliable catheter placement and backflow were likely sources of poor delivery and hence lack of effect of the “delivered” therapeutic. 18 , 20 It had been previously demonstrated that a small, sub-millimeter delivery port would be less prone to backflow. 13 It was a technical challenge, however, to create a device that would be small enough to resist backflow yet could be made rigid enough to be reliably implanted transcranially to specific locations of the brain. One approach has been to create so-called “step-down” cannulas