- Pallidothalamic Tractotomy (Forel's Field H1-tomy) for Dystonia: Preliminary Results. [Journal Article]
- WNWorld Neurosurg 2019 Jun 14
- CONCLUSIONS: This study suggests that pallidothalamic tractotomy can be an alternative treatment target for dystonia. A larger and longer prospective study is needed to elucidate the safety and efficacy of pallidothalamic tractotomy for dystonia.
- Radiological and Thermal Dose Correlations in Pallidothalamic Tractotomy With MRgFUS. [Journal Article]
- FSFront Surg 2019; 6:28
- CONCLUSIONS: Our current approach using a thermal dose steering for multiple target lesion sub-units could be reproduced in 31 interventions with a good lesion size predictability.
- Anatomical and Technical Reappraisal of the Pallidothalamic Tractotomy With the Incisionless Transcranial MR-Guided Focused Ultrasound. A Technical Note. [Journal Article]
- FSFront Surg 2019; 6:2
- Background: MR-guided focused ultrasound (MRgFUS) offers new perspectives for safe and efficient lesioning inside the brain. The issue of target coverage remains primordial and sub-optimally address…
Background: MR-guided focused ultrasound (MRgFUS) offers new perspectives for safe and efficient lesioning inside the brain. The issue of target coverage remains primordial and sub-optimally addressed or solved in the field of functional neurosurgery. Objective: To provide an optimized planning and operative strategy to perform a pallidothalamic tractotomy (PTT) in chronic therapy-resistant Parkinson's disease (PD) with the technology of MRgFUS. Methods and results: Histological sections and maps from 6 human brain hemispheres were analyzed and outlines of the pallidothalamic tract on Myelin-stained sections were drawn and superimposed. We determined a standardized PTT target coverage characterized by 5 to 7 preplanned target lesion sub-units of 1.5 × 1.5 × 3.0 mm, which were placed using focal point displacements and shortest possible times, under thermal dose control. Conclusion: We hereby present our current approach to the MRgFUS PTT on the basis of a histological reappraisal and optimized heat application to the pallidothalamic tract in the H1 field of Forel.
- Pallidothalamic Tractotomy for Parkinson Disease with 1-Year Follow-Up: A Case Report. [Case Reports]
- WNWorld Neurosurg 2019; 121:193-195
- CONCLUSIONS: We present a rare case of PTT performed in a patient with Parkinson disease. PTT might be useful in patients who do not desire device implantation.
- Safety and accuracy of incisionless transcranial MR-guided focused ultrasound functional neurosurgery: single-center experience with 253 targets in 180 treatments. [Journal Article]
- JNJ Neurosurg 2018 May 01; :1-10
- CONCLUSIONS: The incisionless transcranial MRgFUS technology demonstrates a higher targeting accuracy and a lower side-effect profile than techniques requiring cerebral penetration. In the absence of penetration brain shift, this technique avoids the placement of a thermolesion away from the chosen target, thus suppressing the need for reversible therapeutic energy application. With the use of proper physiopathology-based targets, definitive therapeutic effects can be coupled with sparing of sensory, motor, and paralimbic/multimodal thalamocortical functions. Clinical efficacy, not analyzed in this investigation, will ultimately rest in proper target selection and optimized thermolesional coverage of the target.
- Subcaudate Tractotomy White Matter Anatomy and Variability: A Diffusion Tensor Imaging Study. [Journal Article]
- SFStereotact Funct Neurosurg 2018; 96(2):71-82
- CONCLUSIONS: We have demonstrated a detailed analysis of the white matter tracts and their anatomical variability underlying subcaudate tractotomy. This has significant implications for neurosurgical targeting.
- Successful Tractotomy Technique for a Penetrating Lung Injury in a Patient with One Lung. [Case Reports]
- KJKorean J Thorac Cardiovasc Surg 2017; 50(5):399-402
- We report the case of a patient with penetrating chest trauma (right chest) who had undergone a left pneumonectomy due to pulmonary tuberculosis 24 years ago. We performed an emergent thoracotomy, fi…
We report the case of a patient with penetrating chest trauma (right chest) who had undergone a left pneumonectomy due to pulmonary tuberculosis 24 years ago. We performed an emergent thoracotomy, finding an opening of the penetrating wound in a lower-lobe basal segment of the right lung. A stapled tractotomy was performed along the tract. Bleeding control and air-leakage control was done easily and rapidly. The patient was discharged without any complications on the seventh day of admission. Tractotomy can be a good option for treating penetrating lung injuries in patients with limited lung function who need emergent surgery.
- The History and Future of Ablative Neurosurgery for Major Depressive Disorder. [Review]
- SFStereotact Funct Neurosurg 2017; 95(4):216-228
- CONCLUSIONS: The longitudinal experience with ablative procedures shows that there remains an important role for accurate, discrete lesions in disrupting affective circuitry in the treatment of TRD. New modalities, such as MRgFUS, have the potential to further improve the accuracy of ablative procedures, while enhancing safety by obviating the need for open brain surgery.
- Predictors of outcome in 101 patients requiring emergent thoracotomy for penetrating pulmonary injuries. [Journal Article]
- EJEur J Trauma Emerg Surg 2018; 44(1):55-61
- CONCLUSIONS: Predictors of outcome for penetrating pulmonary injuries requiring thoracotomy are identified and must be taken into account in their operative management. Tissue sparing techniques-stapled pulmonary tractotomy is once again validated, and it remains effective as the mainstay for their management; however, only pneumonectomy predicts outcome. AAST-OIS injury grades IV-VI predict outcome with higher injury grades requiring resective procedures.
New Search Next
- Gamma-knife subcaudate tractotomy for treatment-resistant depression and target characteristics: a case report and review. [Case Reports]
- ANActa Neurochir (Wien) 2017; 159(1):113-120
- Stereotactic subcaudate tractotomy has previously been suggested to be an effective treatment for depression. This is the first study to report the use of gamma-knife subcaudate tractotomy for treatm…
Stereotactic subcaudate tractotomy has previously been suggested to be an effective treatment for depression. This is the first study to report the use of gamma-knife subcaudate tractotomy for treatment-resistant depression. A 49-year-old woman with major depressive disorder had been treated for 30 years, with nine suicide attempts during that time. The right and left target maximum diameter was 11 mm within 50 % isodose lines. The target was located more posteriorly and inferiorly than the subgenual cingulate target typically used for deep-brain stimulation. The maximum radiation dose was 130 Gy. During the 4 months after surgery, the patient improved gradually from 23 to 4 according to the Hamilton Rating Scale for Depression and antidepressant medication was discontinued. Target-sized focal lesions were identified and no edema was seen postoperatively. No aggravation or neurologic deficit occurred during the 2.5 years of follow-up. Gamma-knife subcaudate tractotomy for depression is a minimally invasive technique. Investigations of the effectiveness and safety profile in a larger group are warranted.