Functional Neurosurgery Research Papers - Academia.edu (original) (raw)

Background: Gallbladder cancer is a highly aggressive malignancy of the biliary system having the shortest median survival rate. Being aggressive biological nature and lack of sensitive screening test for early detection it has a poor prognosis. Aim: The purpose is to study the relative frequency of gallbladder cancer in reference to age, sex, etiological factors, clinical signs and symptoms in relation to the stages and the outcomes of different treatment modalities. Methods: This study is observational and conducted in the

- by Dr Tushar Suroshe and +1
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- Functional Neurosurgery

The amygdaloid body is a limbic nuclear complex characterized by connections with the thalamus, the brainstem and the neocortex. The recent advances in functional neurosurgery regarding the treatment of refractory epilepsy and several neuropsychiatric disorders renewed the interest in the study of its functional Neuroanatomy. In this scenario, we felt that a morphological study focused on the amygdaloid body and its connections could improve the understanding of the possible implications in functional neurosurgery. With this purpose we performed a morfological study using nine formalin-fixed human hemispheres dissected under microscopic magnification by using the fiber dissection technique originally described by Klingler. In our results the amygdaloid body presents two divergent projection systems named dorsal and ventral amyg-dalofugal pathways connecting the nuclear complex with the septum and the hypothalamus. Furthermore, the amygdaloid body is connected with the hippocampus through the amygdalo-hippocampal bundle, with the anterolateral temporal cortex through the amygdalo-temporalis fascicle, the anterior commissure and the temporo-pulvinar bundle of Arnold, with the insular cortex through the lateral olfactory stria, with the ambiens gyrus, the para-hippocampal gyrus and the basal forebrain through the cingulum, and with the frontal cortex through the uncinate fascicle. Finally, the amygdaloid body is connected with the brainstem through the medial forebrain bundle. Our description of the topographic anatomy of the amygdaloid body and its connections, hopefully represents a useful tool for clinicians and scientists, both in the scope of application and speculation.

- by Alessandro Weiss and +2
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- Neurosurgery, Neuroanatomy, White Matter Architecture, Functional Neurosurgery

Background: Subthalamic Deep Brain Stimulation is a valid surgical procedure for the treatment of idiopathic PD, although its precise mechanism of action is still unclear; moreover, there are no conclusive data about the functional anatomy of the human subthalamic region. Identifying the location of active contacts for StnDBS can yield interesting insights on the mechanisms of action of DBS and the different role played by the anatomical structures of the subthalamic region. Methods: Twenty-five patients operated on for bilateral StnDBS were considered. During the surgical procedure, a complete intraoperative neurophysiological study was obtained by means of semimicrorecordings and stimulations. After surgery, an MRI study confirmed the position of the electrodes; MR images were subsequently superimposed onto a stereotactic atlas by using a dedicated workstation. The coordinates relative to the tip of the electrodes and active contacts were then calculated. Results: Most of the electrode tips are located inside the subthalamus or immediately ventrally to it. Of the active contacts used for chronic stimulation, 96.5% are located in a well-defined anatomical region, which includes subthalamus, zona incerta, and FF. Conclusions: Our findings seem to suggest that other structures beyond the subthalamus itself play a clinical role in symptoms control after DBS for PD.

- by Michele Parolin
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- Deep Brain Stimulation, Magnetic Resonance Imaging, Medicine, Subthalamic Nucleus

The objective of this study was to review the literature on glossopharyngeal neuralgia and to discuss its differential diagnosis and treatment options. Despite the significant improvement of trigeminal neuralgia with pharmacological treatment, glossopharyngeal neuralgia has a higher incidence of treatment failure and neurosurgery is necessary for the majority of patients. Functional neurosurgery has a great rate of success for glossopharyngeal neuralgia, especially techniques such as percutaneous thermal rhizotomy, trigeminal tractotomy and=or nucleotomy. The main problem with glossopharyngeal neuralgia remains the diagnosis as it is a rare disease with similarities to trigeminal neuralgia, including the same pharmacological treatment. Facial pain specialists should be trained to achieve a better accuracy of diagnosis.

- by Manoel Teixeira
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- Neurosurgery, Review, Trigeminal Neuralgia, Functional Neurosurgery

Idiopathic trigeminal neuralgia (ITN) is a chronic neuropathic pain that affects the masticatory system. The objective of this study was to identify orofacial pain and temporomandibular characteristics, including temporomandibular disorder (TMD), in a sample of 105 ITN patients treated with compression of the trigeminal ganglion. The evaluations occurred before, 7, 30 (1 month), 120 (3 months) and 210 days (7 months) after surgery. The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), the Clinical Questionnaire (EDOF-HC) and Helkimo Indexes were used. Findings before neurosurgery were used as control for parameters. McNemar test and variance analysis for repetitive measurements were used for statistical analysis; 45AE3% of the edentulous patients presented severe dental occlusion index; numbness was an important masticatory complaint in 42AE6%; mastication became bilateral, but its discomfort continued during all period; headache and body pain reduced after surgery; TMD, present in 43AE8% before surgery, increased but normalized after 7 months; jaw mobility compromise was still present, but daily activities improved after 7 months. We concluded that: (i) ITN relief reduced headache, body pain, depression and unspecific symptoms; and (ii) TMD before surgery and at 7 months suggests that this may be a contributory factor to patients' pain complaints.

- by Manoel Teixeira
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- Dentistry, Neurosurgery, Biomedical Engineering, Pain

Vestibular paroxysmia is defined as paroxysms of vertigo that could be presented with paroxysmal pulsatile tinnitus.
It is usually caused by neurovascular compression of the vestibulocochlear nerve. The condition is responsive to
carbamazepine. Refractory cases are treated with microvascular decompression. We present a case of vestibular
paroxysmia of 27 years old patient that was her main presentation is tinnitus in addition to vertigo. She was treated with
microvascular decompression (MVD).

- by Armando Alaminos Bouza
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- Neurosurgery, Medical Physics, Functional Neurosurgery, DBS

The N-localizer and the Sturm-Pastyr localizer are two technologies that facilitate image-guided stereotactic surgery. Both localizers enable the geometric transformation of tomographic image data from the two-dimensional coordinate system of a medical image into the three-dimensional coordinate system of the stereotactic frame. Monte Carlo simulations reveal that the Sturm-Pastyr localizer is less accurate than the N-localizer in the presence of image noise.

- by Armando Alaminos Bouza
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- Neurosurgery, Medical Physics, Functional Neurosurgery, DBS

Este estudo avaliou a hemodinâmica cerebral através da análise da velocidade de fluxo sangüíneo cerebral a partir da utilização do US-color Doppler (ultra-som Doppler com fluxo a cores) em crianças e adolescentes com diagnóstico de hidrocefalia e portadores de derivação liquórica ventrículo peritoneal (DVP). Testes de avaliação funcional foram realizados: teste de compressão da fontanela anterior e teste de vasoreatividade ao CO 2 .

Idiopathic trigeminal neuralgia (ITN) is a well-known disease often treated with neurosurgical procedures, which may produce sensorial abnormalities, such as numbness, dysesthesia and taste complaints. We studied 12 patients that underwent this technique, in order to verify pain, gustative and olfactory thresholds abnormalities, with a follow-up of 120 days. We compared the patients with a matched control group of 12 patients. Our results found a significant difference in the olfactory threshold at the immediate post-operative period (p=0.048). We concluded that injured trigeminal fibers are probably associated with the increase in the olfactory threshold after the surgery, supporting the sensorial interaction theory.

- by Manoel Teixeira
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- Neuroscience, Neurosurgery, Psychometrics, Olfactory Neuroscience

- by Manoel Teixeira and +1
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- Neurosurgery, Review, Trigeminal Neuralgia, Functional Neurosurgery