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Ludvic Zrinzo, Thomas Foltynie, Patricia Limousin and Marwan I. Hariz

reduce the risk of those that cause permanent neurological disability or death. Given the low frequency of hemorrhage in functional neurosurgery, estimating its true incidence and identifying risk factors are challenging. We reviewed the hemorrhage rate in a consecutive series of patients undergoing functional neurosurgery via an image-guided approach at our institution. Evidence from the literature was also examined to determine the incidence and risk factors for hemorrhage as a complication of functional neurosurgery. Methods Our Consecutive Series of Image

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David Moser, Eyal Zadicario, Gilat Schiff and Daniel Jeanmonod

T he therapeutic application of focused ultrasound in functional neurosurgery requires refined target reconstructions and precise targeting accuracy measurements within the millimeter domain. Because targets are in normal tissue, coordinates have to be established for each target on the basis of a stereotactic atlas of the human brain. Such an atlas uses internal landmarks to position a coordinate system onto the brain, allowing the placement of any desired target inside the brain. We use the Stereotactic Atlas of the Human Thalamus and Basal Ganglia , 1

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Kaushik Das, Deborah L. Benzil, Richard L. Rovit, Raj Murali and William T. Couldwell

in 1985. Fig. 1. Photograph of Irving S. Cooper, circa 1947. Courtesy of John Hogle, photographer. Foundations of Functional Neurosurgery At the time Cooper completed his neurosurgical training, surgical management of movement disorders focused on the treatment of Parkinson's disease. In the 1930s and 1940s there were a large number of patients with postencephalitic Parkinson's disease. 84 Medical therapy was limited, leaving surgery as the sole method available to alleviate the patients' distressing tremor. During this period, operations had

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Alessandra Gorgulho, Antonio A. F. De Salles, Leonardo Frighetto and Eric Behnke

age of this cohort was 59.6 years (range 3–87 years). Detailed demographic data obtained in these patients are presented in Table 1 . Fifty-seven patients underwent multiple surgical procedures as detailed in Table 2 . TABLE 1 Characteristics of 178 patients who underwent functional neurosurgery in which electrophysiological monitoring was performed * Characteristic Value patient age (yrs)  mean 59.6  range 3–87 sex  male 106  female 72 indication for surgery in 178 patients

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Giuseppe R. Giammalva, Cesare Gagliardo, Rosario Maugeri, Massimo Midiri and Domenico G. Iacopino

both ET and PD were successfully treated by VIM (ventral intermediate nucleus) thalamotomy in order to control medically refractory tremor. The excellent results obtained by the authors further support the effectiveness and safety of MRgFUS thalamotomy in the armamentarium of functional neurosurgery. In particular, only a small rate of mild and temporary adverse events was reported, and most of the patients experienced a sustained and significant improvement in their tremor. The effectiveness of transcranial (tc) MRgFUS in the treatment of movement disorders has been

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Marc N. Gallay, David Moser and Daniel Jeanmonod

T he first clinical study with incisionless transcranial MR-guided high-intensity focused ultrasound in the field of functional neurosurgery was published by Martin et al. in 2009. Since publication of this first trial, around 200 treatments have been reported. As each reported series has small numbers, 8 , 11 , 12 , 14 , 19 , 20 , 24 , 26 , 28 , 40 , 41 , 44 no procedure-related risk profile can be reliably inferred yet. To assess risks, one also needs an analysis of targeting accuracy, which is directly related to the risk of damage to neighboring structures

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Jean Régis and Constantin Tuleasca

modern serious peer-reviewed series published in the last 16 years. In conclusion, this series of the Top 25 papers in JNS on GKS for trigeminal neuralgia bears witness to the fact that radiosurgery is an example of a true disruptive innovation in the field of functional neurosurgery and, specifically, in the neurosurgical management of trigeminal neuralgia. These articles demonstrate how greatly this innovation has changed neurosurgical practice in just a few years. Disclosure Professor Régis states that, although he receives no money personally, his

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Taylor J. Abel, Timothy Walch and Matthew A. Howard III

advances are now and will continue to be key procedures in the future of functional neurosurgery. What is little remembered, however, is that both procedures (i.e., extrapyramidal intervention for movement disorders and focused ultrasonic lesions of subcortical brain structures) have their origins in the pioneering work of one American neurosurgeon: Russell Meyers ( Fig. 1 ). FIG. 1. Portrait of Russell Meyers during his time as chairman of the Division of Neurosurgery at the SUI. Used with permission of the Department of Neurosurgery Archives, University of Iowa

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Michael G. Hart, Rolf J. F. Ypma, Rafael Romero-Garcia, Stephen J. Price and John Suckling

established we then describe how new avenues have been created in understanding functional brain anatomy, resilience, recovery, cognitive function, and disease biomarkers. Finally, we discuss how complex network analyses and graph theory have already been applied to “real-world” scenarios, including traumatic brain injury, neurooncology, and functional neurosurgery for psychiatric disease. Development of the Network Based Approach: a Historical Perspective Noninvasive, tomographic, in vivo functional neuroimaging began with the discovery of blood oxygenation level

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Antonio Di Ieva, Timothy Lam, Paula Alcaide-Leon, Aditya Bharatha, Walter Montanera and Michael D. Cusimano

as deoxygenated hemoglobin, with high contrast 42 and to help investigate neurological diseases, 82 grade tumors, 25 , 63 and assist in determining treatment or prognosis. 18 , 26 , 37 , 70 , 71 , 115 Over the past years, the SWI technique has found applications in the different fields of neurosurgery, namely neurooncology, vascular neurosurgery, neurotraumatology, and functional neurosurgery. We here address SWI’s current and future applications to make it more accessible to a broader audience of neurosurgeons. Technical Aspects of SWI T2* Gradient