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José M. R. Delgado

summary of observations and inferences relative to stereotaxy as currently applied to problems in human neurology. The authors have dealt ably with matters of basic as well as clinical scientific interest and have succeeded in bringing us up to date in respect of a technical agent that has been usefully employed by neuro-anatomists and physiologists for over a quarter of a century and which, it seems safe to say, is destined to become within the foreseeable future an integral agent of neurosurgery. If any doubts as to the potential uses of stereotaxy in human problems

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Russell Meyers, William J. Fry, Frank J. Fry, Leroy L. Dreyer, Donald F. Schultz and Robert F. Noyes

lesions produced by dosages that result in selective action possess sharp borders and exhibit minimal evidence of diapedesis. Except when very heavy doses of ultrasound are used, blood vessels coursing through the lesion remain histologically intact and capable of transmitting blood. The principles of Horsley-Clarke stereotaxy, establishing certain cranial landmarks as “zero” planes and using craniocerebral coordinates fashioned therefrom, were employed by Fry and associates to place ultrasonic lesions of desired sizes, shapes and orientations at preselected sites

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Joel Brumlik, Nicholas Wetzel, George Potter and Mathew Petrovick

ventralis lateralis within), internal capsule and the globus pallidus, according to the atlas of stereotaxy of Schaltenbrand and Bailey. 16 For each position used, a fraction indicates the number of positive responses obtained at that point out of the total number of stimuli there delivered. Change of tremor and evoked responses are both listed. At each position the voltages used to elicit the responses are represented on a scale of 15 V. per interelectrode distance on the diagrams. Discussion As defined by the present study, four possible events may

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S. Kalyanaraman and F. John Gillingham

were after a previous operation and also the piece of subcortical tissue were excluded. This left 88 cases shown in Table 1 , which suggests that the degree of accuracy with radiological localisation with this method decreases in the following order for targets in our method of stereotaxy—thalamus, pallidum and capsule. TABLE 1 Correlation between intended site of biopsy as per stereotaxic atlas and histological report (88 biopsies) Intended Site Histological Report Grey Matter White Matter Both Thalamus (46 biopsies

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Peter G. Petty and George Edsall

T he destruction of discrete regions in the brain by electric current has been used as an investigative technique in neurophysiology for over 50 years. 2 More recently, stereotaxy has been successful as a means of locating deep structures; one of the methods used to produce lesions in conjunction with this technique is electrocoagulation. Mullan, et al. , 5 recently gave a clear account of the use of direct current for the production of lesions in nerve tissue, and Rowland, et al. , 6 considered the use of pulsed bidirectional direct current. Several

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Richard M. Bergland, Bronson S. Ray and Richard M. Torack

a shallow depression on the anterior surface of the dorsum sellae. Conclusions The common anatomical variations of the pituitary and its adjacent structures explain many of the hazards and complications attending the various hypophyseal ablative procedures 11 and some of the changes noted in the pathological conditions of the gland. Routine roentgenograms employed in stereotaxy can neither define the size, shape, or position of the pituitary, nor accurately predict variations in the position of the important adjacent structures. Although more refined x

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Kenichiro Sugita, Terushige Doi, Osamu Sato, Yoshiro Takaoka, Naomi Mutsuga and Ryuichi Tsugane

critical structures and were able to remove the bullet successfully with minimal damage to the brain tissue, namely, that caused by the track of the forceps carrying the bullet. Mundinger 13 reported a case in which a bullet lodged intracranially was removed by the combined techniques of craniotomy and stereotaxy. Since it is not under direct vision, a stereotaxic operation is disadvantageous in the event of hemorrhage from a vessel inadvertently clamped by the forceps when grasping the bullet. Carotid arteriography could be used to determine whether there was any

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Edward R. Hitchcock

stereotaxic coordinates were available for the precise localization of the spinothalamic pathway in the brain stem. Examination of anatomical atlases gave approximate values, and a number of brain stems were carefully prepared and measured. Then a system of coordinates established the spinothalamic tract in relation to the floor of the fourth ventricle, the closest structure that can be revealed by radiological techniques ( Fig. 1 ). A stereotaxic frame developed for spinal stereotaxy but also used for intracranial stereotaxy, including dentatotomy, was adapted for this

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Chihiro Ohye and Hirotaro Narabayashi

D etailed physiological observations by micro- or semi-microelectrodes have been an important and reliable device in human stereotaxy in order to achieve constant results with accuracy of targeting. Exploring the thalamic sensory nucleus, we discussed in a previous paper 20 a possibility that kinesthetic (deep) sensation projected separately to the ventralis intermedius (Vim) nucleus, which is located posteriorly to the ventralis lateralis (VL) nucleus, and rostrally to the ventralis caudalis (Vc), the latter receiving tactile sensation. The Vim nucleus has

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Patrick J. Kelly and F. John Gillingham

that occur with L-dopa, as noted in this study and by others. 13, 17 Even though the longevity of patients with Parkinson's disease cannot be improved at the present time, their eventual disability can be delayed with appropriate treatment. A carefully performed stereotaxic procedure can control tremor and rigidity for a number of years, and reduce the incidence of L-dopa-related involuntary movements once this drug is instituted to treat bradykinesia. Modern stereotaxy with the precision afforded by microelectrode recording allows precise subcortical localization