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Zach Folzenlogen and D. Ryan Ormond
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
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
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
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
Alexandre Boutet, Aaron Loh, Clement T. Chow, Alaa Taha, Gavin J. B. Elias, Clemens Neudorfer, Jurgen Germann, Michelle Paff, Ludvic Zrinzo, Alfonso Fasano, Suneil K. Kalia, Christopher J. Steele, David Mikulis, Walter Kucharczyk, and Andres M. Lozano
sequences, IR sequences have been found to be superior to routine T1W imaging ( Table 2 ). 62 , 69 Limitations As recently as 15 years ago, indirect targeting based on anatomical landmarks was the mainstay of preoperative surgical planning for most functional neurosurgery services. However, advances in MRI hardware and techniques have allowed direct targeting to become more accessible and clinically feasible. 25 Despite these improvements, there is limited consensus on the optimal MRI sequences for direct visualization of common DBS targets. While addressing
Marian T. Park, Giancarlo Mignucci-Jiménez, Lena Mary Houlihan, and Mark C. Preul
surgery of the nervous system and the neurologically associated restoration of functionality, focusing on the social context and battlefield environment, which were conducive to his revolutionary ideas. 2 – 4 Surgical Institutions The age of the Hundred Years’ War (1337–1453) and Italian Wars (1494–1559) contributed to the expansion of surgery and introduction of surgical training communities. 5 A formal surgical curriculum did not exist until the early 16th century. In France, there were 3 hierarchical classes of medical professionals. The physicians, usually
P. Richard Schuurman, Rob M. A. de Bie, Charles B. L. Majoie, Johannes D. Speelman, and D. Andries Bosch
T here is a resurgence of interest in stereotactic functional neurosurgery, especially in the treatment of Parkinson's disease, with many reports describing positive effects of pallidotomy, thalamotomy, and continuous deep brain stimulation of the thalamus, globus pallidus, or subthalamic nucleus. 4, 11–13, 15, 16 The mainstay of these procedures is accurate target determination, for which various techniques are available. Ventriculography is still used widely in target calculation but is increasingly being supplemented or even replaced by computerized
Michael G. Hart, Stephen J. Price, and John Suckling
N eurosurgical management of focal brain lesions is based on the tenet that a more accurate and extensive resection is often closely correlated with successful outcomes, but only if resection can be achieved while preserving (or even improving) brain function. 33 , 49 , 50 Function therefore constrains resection and ultimately the success of much of what is attempted in neurosurgery. Accordingly, understanding functional neuroanatomy is fundamental to the advancement of neurosurgery. Functional brain mapping has a rich history involving many modalities 9 , 14
Constantin Tuleasca, Jean Régis, Elena Najdenovska, Tatiana Witjas, Nadine Girard, Jean-Philippe Thiran, Meritxell Bach Cuadra, Marc Levivier, and Dimitri Van De Ville
functional neurosurgery intervention. Whereas prior to LITT, brain activity showed robust interhemispheric functional connectivity, it was greatly reduced following callosotomy, with intrahemispheric functional connectivity being largely maintained. Understanding how brain rewiring after functional neurosurgery procedures impacts brain activity is essential for our understanding and for future developments in this extraordinary and continuously expanding field. In that context, rs-fMRI is particularly useful given its ability to map various functional networks
