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Sunil Manjila, Aditya Karhade, Ji Hoon Phi, R Michael Scott, Edward R Smith
BACKGROUND/AIMS: Brain shift during the exposure of cranial lesions may reduce the accuracy of frameless stereotaxy. We describe a rapid, safe, and effective method to approach deep-seated brain lesions using real-time intraoperative ultrasound placement of a catheter to mark the dissection trajectory to the lesion. METHODS: With Institutional Review Board approval, we retrospectively reviewed the radiographic, pathologic, and intraoperative data of 11 pediatric patients who underwent excision of 12 lesions by means of this technique...
January 20, 2017: Pediatric Neurosurgery
C Ma, O Chibani, A Eldib, J Li, L Chen
PURPOSE: Because of their effectiveness and efficiency, rotational arc radiotherapy (MAT) techniques have been developed on both specialty machines such as Tomotherapy and conventional linear accelerators. This work investigates a new rotating Gamma therapy system for image guided MAT and SBRT of intra/extracranial tumors. METHODS: The CyberMAT system (Cyber Medical Corp., China) consists of a ring gantry with a gamma source (effective source size 1cm and 1.7cm respectively), a 120-leaf MLC, a kV CBCT and an EPID...
June 2016: Medical Physics
Justin Sharim, Nader Pouratian
BACKGROUND: Anterior cingulotomy for chronic pain aims to modulate patients' attention or emotional reaction to pain rather than to modulate pain intensity. OBJECTIVES: To evaluate the clinical efficacy, both short- and long-term, of anterior cingulotomy in the treatment of chronic pain. STUDY DESIGN: Systematic review. SETTING: This systematic review assessed studies reporting anterior cingulotomy for the treatment of chronic pain...
November 2016: Pain Physician
João Gabriel Ribeiro Gomes, Alessandra Augusta Gorgulho, Amanda de Oliveira López, Crystian Wilian Chagas Saraiva, Lucas Petri Damiani, Anderson Martins Pássaro, João Victor Salvajoli, Ludmila de Oliveira Siqueira, Bernardo Peres Salvajoli, Antônio Afonso Ferreira De Salles
OBJECTIVE The role of tractography in Gamma Knife thalamotomy (GK-T) planning is still unclear. Pyramidal tractography might reduce the risk of radiation injury to the pyramidal tract and reduce motor complications. METHODS In this study, the ventralis intermedius nucleus (VIM) targets of 20 patients were bilaterally defined using Iplannet Stereotaxy Software, according to the anterior commissure-posterior commissure (AC-PC) line and considering the localization of the pyramidal tract. The 40 targets and tractography were transferred as objects to the GammaPlan Treatment Planning System (GP-TPS)...
December 2016: Journal of Neurosurgery
P Fernández-García, S F Marco-Doménech, L Lizán-Tudela, M V Ibáñez-Gual, A Navarro-Ballester, E Casanovas-Feliu
OBJECTIVES: To determine the cost effectiveness of breast biopsy by 9G vacuum-assisted guided by vertical stereotaxy or ultrasonography in comparison with breast biopsy by 14G core-needle biopsy and surgical biopsy. MATERIAL AND METHODS: We analyzed a total of 997 biopsies (181 vacuum-assisted, 626 core, and 190 surgical biopsies). We calculated the total costs (indirect and direct) of the three types of biopsy. We did not calculate intangible costs. We measured the percentage of correct diagnoses obtained with each technique...
November 16, 2016: Radiología
Prateek Agarwal, Christina E Sarris, Yehuda Herschman, Nitin Agarwal, Antonios Mammis
Schizophrenia is a chronic and progressive psychiatric disease that remains difficult to manage in the 21st century. Current medical therapies have been able to give reprieve and decrease incidence of psychotic episodes. However, as the disease progresses, patients can become ever more refractory to current pharmaceutical agents and the polypharmacy that is attempted in treatment. Additionally, many of these drugs have significant adverse effects, leaving the practitioner in a difficult predicament for treating these patients...
December 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Thomas J Wilson, Kathleen E McCoy, Wajd N Al-Holou, Sergio L Molina, Matthew D Smyth, Stephen E Sullivan
OBJECTIVE The aim of this paper is to compare the accuracy of the freehand technique versus the use of intraoperative guidance (either ultrasound guidance or frameless stereotaxy) for placement of parietooccipital ventricular catheters and to determine factors associated with reduced proximal shunt failure. METHODS This retrospective cohort study included all patients from 2 institutions who underwent a ventricular cerebrospinal fluid (CSF) shunting procedure in which a new parietooccipital ventricular catheter was placed between January 2005 and December 2013...
September 2016: Neurosurgical Focus
Venugopal Lalitha, Gopal Krushna Pal, Pravati Pal, Subash Chandra Parija, Sathish Babu Murugaiyan
Lesion of posterodorsal amygdala (PDA) has been known to produce hyperphagia and obesity in animal models. However, the influence of gender on food intake (FI), body weight (BW) and immunological parameters following PDA lesion is not yet known. The present work was carried out to study the effect of gender on the regulation of FI, BW and immunological parameters following lesions of PDA in albino Wistar rats. Twenty-four albino Wistar rats were divided equally into 2 groups - PDA group and control group - with 6 male and 6 female rats in each...
March 2016: Annals of Neurosciences
D Rueß, M Kocher, H Treuer, M I Ruge
The irradiation of tumors in the brain is challenging due to the proximity of radiation sensitive critical structures and the tumors to be treated. In addition, irradiation above a certain level can cause irreversible damage to nerve tissue. The irradiation of benign and malignant brain tumors requires precise techniques to preserve critical structures while simultaneously administering a high radiation dose for maximum effectiveness. Therefore, stereotaxy, as a subspecialty of neurosurgery, has developed various irradiation techniques, e...
January 2017: HNO
Yislenz Narváez-Martínez, Sergio García, Pedro Roldán, Jorge Torales, Jordi Rumià
OBJECTIVE: To report a novel, accurate, and safe technique for deep brain electrode implantation to register brain electrical activity or SEEG, using frameless stereotaxy, neuronavigation assisted, and intraoperative CT-guided O-Arm(®) and the Vertek(®) articulated passive arm. MATERIAL AND METHODS: All patients implanted by this technique in Barcelona Hospital Clinic were included. A prospective evaluation was made of the accuracy of the technique, as well as complications, surgical time, length of stay, and short-term outcomes...
June 23, 2016: Neurocirugía
Jeffrey P Mullin, Saksith Smithason, Jorge Gonzalez-Martinez
SEEG is a method and technique which is used for accurate, invasive recording of seizure activity via three dimensional recordings. In epilepsy patients who are deemed appropriate candidates for invasive recordings, the decision to monitor is made between the subdural grids versus SEEG. Invasive neuromonitoring for epilepsy is pursued in patients with complex, medically refractory epilepsy. The goal of invasive monitoring is to offer resective surgery with the hope of allowing seizure freedom. SEEG's advantages include access to deep cortical structures, an ability to localize the epileptogenic zone (EZ) when subdural grids have failed to do so, and in patients with non-lesional extra-temporal epilepsies...
2016: Journal of Visualized Experiments: JoVE
Yaser Maddahi, Kourosh Zareinia, Liu Shi Gan, Christina Sutherland, Sanju Lama, Garnette R Sutherland
The use of robotic technology in the surgical treatment of brain tumour promises increased precision and accuracy in the performance of surgery. Robotic manipulators may allow superior access to narrow surgical corridors compared to freehand or conventional neurosurgery. This paper reports values and ranges of tool-tissue interaction forces during the performance of glioma surgery using an MR compatible, image-guided neurosurgical robot called neuroArm. The system, capable of microsurgery and stereotaxy, was used in the surgical resection of glioma in seven cases...
2016: BioMed Research International
Jeeyeon Lee, Ho Yong Park, Jin Hyang Jung, Wan Wook Kim, Seung Ook Hwang, Taek Ju Kwon, Jin Ho Chung, Youngtae Bae
BACKGROUND: Stereotactic breast biopsy is a standard intervention for evaluation of "microcalcification-only" lesions. However, an expensive stereotactic device and radiologic expertise are necessary for this procedure. We herein report a non-stereotactic technique involving the combination of wire localization and vacuum-assisted breast biopsy (VABB) under ultrasound (US) guidance. METHODS: Twenty-two consecutive patients with category 3 or 4a microcalcification only as shown by mammography underwent the above-mentioned non-stereotactic combination method involving US-guided wire localization and VABB...
June 2016: Gland Surgery
Peter F Morgenstern, Scott Connors, Anne S Reiner, Jeffrey P Greenfield
OBJECTIVE: Ommaya reservoirs are used for administration of intrathecal chemotherapy and cerebrospinal fluid sampling. Ventricular catheter placement for these purposes requires a high degree of accuracy. Various options exist to optimize catheter placement. We analyze a cohort of patients receiving catheters using 2 different technologies. METHODS: Retrospective chart review was performed on patients undergoing Ommaya reservoir placement between 2011 and 2014. Most procedures were assisted by either frameless stereotactic neuronavigation or fluoroscopic guidance with pneumoencephalogram...
September 2016: World Neurosurgery
Rachel Pruitt, Alexander Gamble, Karen Black, Michael Schulder, Ashesh D Mehta
OBJECTIVE Complications of laser interstitial thermal therapy (LITT) are underreported. The authors discuss how they have modified their technique in the context of technical and treatment-related adverse events. METHODS The Medtronic Visualase system was used in 49 procedures in 46 patients. Between 1 and 3 cooling catheters/laser fiber assemblies were placed, for a total of 62 implanted devices. Devices were placed using frameless stereotaxy (n = 3), frameless stereotaxy with intraoperative MRI (iMRI) (n = 9), iMRI under direct vision (n = 2), MRI alone (n = 1), or frame-based (n = 47) techniques...
June 3, 2016: Journal of Neurosurgery
Rimal Hanif Dossani, Steven Carr, Gene Bolles, Razvan Balata, Bharat Guthikonda
The medical infrastructure of Iraqi Kurdistan, a semiautonomous region in the northern part of Iraq, lags disproportionately behind relative to the otherwise booming industrial advances of the region. Although neurosurgical training is available, the local population lacks trust in its own neurosurgeons. Medical facilities suffer from a lack of basic resources, such as high-speed drills, intracranial pressure monitoring, and stereotaxy to care for neurosurgical patients. Since 2012, American volunteer neurosurgeons have delivered lectures and mentored local neurosurgeons in performing neurosurgical procedures...
August 2016: World Neurosurgery
B Sarkar, A Pradhan, A Munshi
INTRODUCTION: Linear accelerator (Linac) based stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT) using volumetric modulated arc therapy (VMAT) has been used for treating small intracranial lesions. Recent development in the Linacs such as inbuilt micro multileaf collimator (MLC) and flattening filter free (FFF) beam are intended to provide a better dose conformity and faster delivery when using VMAT technique. This study was aimed to compare the dosimetric outcomes and monitor units (MUs) of the stereotactic treatment plans for different commercially available MLC models and beam profiles...
January 2016: Indian Journal of Cancer
Fernando Alonso, Jennifer Sweet, Jonathan Miller
OBJECTIVES: The Wada test is the gold standard for identification of the side of speech dominance but is associated with risk of angiography and requires patient cooperation. We report a method to verify speech laterality using implanted electrodes in patients undergoing stereo-encephalography (SEEG). PATIENTS AND METHODS: Four pediatric patients with frontal lobe drug-resistant epilepsy underwent implantation of multiple SEEG electrodes using framed stereotaxy to identify the epileptogenic zone, including electrodes placed bilaterally into the pars opercularis of each inferior frontal gyrus from a superior parasagittal entry point...
May 2016: Clinical Neurology and Neurosurgery
Thierry Van den Bosch, Angelo Votino, Ann Cornelis, Lieselore Vandermeulen, Catherine Van Pachterbeke, Dominique Van Schoubroeck, Dirk Timmerman
The use of in vitro three-dimensional ultrasound examination with needle stereotaxis after hysterectomy is illustrated in a case of extensive adenomyosis. The quality of the images at in vitro ultrasonography was compared with the quality of the images obtained at the preoperative ultrasound examination. The ultrasound findings were compared with the macroscopical and the microscopical examination. This new approach helps in indicating the precise location of the preoperatively identified adenomyosis lesions to the pathologist...
2016: Gynecologic and Obstetric Investigation
Jody F Capitanio, Sara Camporesi, Alberto Franzin, Lina R Barzaghi, Piero Picozzi, Pietro Mortini
BACKGROUND: The specificity of imaging alone in diagnosing posterior fossa lesions is insufficient, hence the importance of biopsy for diagnostic, therapeutic and prognostic purposes. Concerning the operative technique, many studies have demonstrated the superior safety of stereotactic biopsy over craniotomy and superior accuracy of frame-based systems over frameless ones as far as the posterior fossa is concerned; however versatile, frame-based instruments bear some intrinsic limitations in the positioning of frame in lower lesions mainly in short neck and kyphotic patients...
March 15, 2016: Journal of Neurosurgical Sciences
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