Stereotaxis: Difference between revisions
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(Original text was in wikiskripta: Stereotaxe https://www.wikiskripta.eu/index.php?curid=2154) |
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''' | '''The stereotatic technique''' enables operations on deep [[brain]] structures with minimal tissue damage in the approach path. | ||
* | * They are puncture procedures performed with a targeted trepanation drill bit with high targeting accuracy. | ||
* | * They are used either in functional neurosuregery (affecting [[dyskinesia]]) or as a [[puncture biopsy]], evacuation of [[cysts]], [[abscessses]], etc. | ||
* | * For orientation, the patient has a stereotaxic device fixed on is head. | ||
== | == Functional operations == | ||
[[Soubor:Brain biopsy under stereotaxy.jpg|thumb|right|Biopsie mozku pod stereotaktickou kontrolou]] | [[Soubor:Brain biopsy under stereotaxy.jpg|thumb|right|Biopsie mozku pod stereotaktickou kontrolou]] | ||
* | * The target structures are deep structures in the brain (nuclei of the [[thalamus]] , [[Basal ganglia|BG]] , etc.). | ||
* | * Aiming is done using reference points in the vicinity III. ventricles (anterior commisure and psterior commissure) – shown by [[MRI]] or [[ventriculography]] . | ||
* | * The procedure itself is the targeted destruction of the tissue of a defined volume, most often we do it with a high-frequency current or gamma radiation ( [[Leskell gamma knife|LGK]] ). | ||
* | * Procedures are performed under [[Local anesthesia|LA]] (local anesthesia), due to contact with the patient - the possibility of clinical and [[EEG]] monitoring. | ||
* | * Two phases: | ||
# | *# after deploying the device, we aim at te points according to the MRI, determine the target point; | ||
# | *# we make a trepanation drill bit and introduce the probe using the guidance device. | ||
== | * the stereotatic frame is made of special materials so as not to interfere with imaging techniques | ||
* | |||
* | == Indication == | ||
* | * The most common are various forms of dysinesia. | ||
* | * Often in [[Parkinson's disease]] - in the case of pharmacologically uncontrolled [[tremor]] , which also affects rigidity, coagulation lesions are made in the nuclei of the thalamus, in the subthalamus and in the [[pallidum]] . | ||
* | * Other controllable dyskinesias – [[chorea]] , [[athetosis]] , [[hemiballismus]] . | ||
** | * In children with severe forms of [[Cerebral Palsy in Children|DMO]] ,dentate nucleus is destroyed of the [[cerebellum]] → we reduce muscle [[hypertonus]] . | ||
** [[ | * Less common indications: | ||
* | ** chronic [[pain]] (nonspecific thalamic nuclei); | ||
** [[psychoses]] – bilateral gyrus cinguli coagulation. | |||
* Sometimes we can implant electrodes and stimulate long-term. | |||
<noinclude> | <noinclude> | ||
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=== | == Links == | ||
* {{ | === Sources === | ||
| | * {{Cite|type=web|cited=2010|name1=Jiří|surname1=Beneš|source_name=Studijní materiály|year=2007|url=http://www.jirben.wz.cz/}} | ||
| | === Reference === | ||
| | * {{Cite|isbn=80-7262-260-9|name1=Miroslav|location=Prague|surname1=Zeman|year=2004|range=575|title=Speciální chirurgie|type=book|publisher=Galen|edition=2}} | ||
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|url = http://www.jirben.wz.cz/}} | |||
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</noinclude> | </noinclude> | ||
[[ | [[:Category:Neurosurgery|Category:Neurosurgery]] | ||
[[ | [[:Category:Neurology|Category:Neurology]] | ||
Revision as of 15:50, 22 December 2022
The stereotatic technique enables operations on deep brain structures with minimal tissue damage in the approach path.
- They are puncture procedures performed with a targeted trepanation drill bit with high targeting accuracy.
- They are used either in functional neurosuregery (affecting dyskinesia) or as a puncture biopsy, evacuation of cysts, abscessses, etc.
- For orientation, the patient has a stereotaxic device fixed on is head.
Functional operations
thumb|right|Biopsie mozku pod stereotaktickou kontrolou
- The target structures are deep structures in the brain (nuclei of the thalamus , BG , etc.).
- Aiming is done using reference points in the vicinity III. ventricles (anterior commisure and psterior commissure) – shown by MRI or ventriculography .
- The procedure itself is the targeted destruction of the tissue of a defined volume, most often we do it with a high-frequency current or gamma radiation ( LGK ).
- Procedures are performed under LA (local anesthesia), due to contact with the patient - the possibility of clinical and EEG monitoring.
- Two phases:
- after deploying the device, we aim at te points according to the MRI, determine the target point;
- we make a trepanation drill bit and introduce the probe using the guidance device.
- the stereotatic frame is made of special materials so as not to interfere with imaging techniques
Indication
- The most common are various forms of dysinesia.
- Often in Parkinson's disease - in the case of pharmacologically uncontrolled tremor , which also affects rigidity, coagulation lesions are made in the nuclei of the thalamus, in the subthalamus and in the pallidum .
- Other controllable dyskinesias – chorea , athetosis , hemiballismus .
- In children with severe forms of DMO ,dentate nucleus is destroyed of the cerebellum → we reduce muscle hypertonus .
- Less common indications:
- Sometimes we can implant electrodes and stimulate long-term.
Links
Sources
- BENEŠ, Jiří. Studijní materiály [online]. ©2007. [cit. 2010]. <http://www.jirben.wz.cz/>.
Reference
- ZEMAN, Miroslav. Speciální chirurgie. 2. edition. Prague : Galen, 2004. 575 pp. ISBN 80-7262-260-9.
