Staged functional neurosurgery using image fusion

electronic atlas and microelectrode recording at Dundee

M. S. Eljamel, A. Forster, M. Tulley, K. Matthews

    Research output: Contribution to journalArticle

    9 Citations (Scopus)

    Abstract

    The unforgiving nature of the thalamus, the globus pallidus and the subthalamic nucleus necessitates precise localization of functional targets. This requires the total attention of both the patient and the surgeon. To maximize the concentration of the patient and provide the most accurate localization, we performed staged stereotactic functional procedures. The first stage was performed under general anesthesia to abolish any head movement. We fused CT and MRI images and correlated the fused images with a digitized Talairach brain atlas. We calculated the target coordinates and fixed a modified Bennett Sphere to the skull with the central hole defining the trajectory to the target. The surrounding 12 holes gave parallel trajectories to targets surrounding the anatomical target at 2-mm intervals. The second stage was performed at least a week later under local anesthesia. Microelectrode recording using three simultaneous channels was used to refine the target. Once the microelectrode recordings and macrostimulation confirmed the desired target, a lesion was created or an Activa neurostimulator was inserted. Our early results using this technique in 28 procedures (in 19 patients) indicate a good outcome in 86% and a technical failure in 1 patient.
    Original languageEnglish
    Pages (from-to)140-142
    Number of pages3
    JournalStereotactic and Functional Neurosurgery
    Volume73
    Issue number1-4
    DOIs
    Publication statusPublished - May 2000
    EventAmerican Society for Stereotactic and Functional Neurosurgery Meeting - Snowbird, Utah, United States
    Duration: 8 Jul 199910 Jul 1999

    Fingerprint

    Atlases
    Neurosurgery
    Microelectrodes
    Subthalamic Nucleus
    Head Movements
    Globus Pallidus
    Local Anesthesia
    Thalamus
    Skull
    General Anesthesia
    Brain

    Keywords

    • Diagnostic Imaging
    • Electric Stimulation
    • Electronics, Medical
    • Humans
    • Intraoperative Complications
    • Magnetic Resonance Imaging
    • Microelectrodes
    • Neurosurgery
    • Stereotaxic Techniques
    • Tomography, X-Ray Computed
    • Treatment Outcome

    Cite this

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    abstract = "The unforgiving nature of the thalamus, the globus pallidus and the subthalamic nucleus necessitates precise localization of functional targets. This requires the total attention of both the patient and the surgeon. To maximize the concentration of the patient and provide the most accurate localization, we performed staged stereotactic functional procedures. The first stage was performed under general anesthesia to abolish any head movement. We fused CT and MRI images and correlated the fused images with a digitized Talairach brain atlas. We calculated the target coordinates and fixed a modified Bennett Sphere to the skull with the central hole defining the trajectory to the target. The surrounding 12 holes gave parallel trajectories to targets surrounding the anatomical target at 2-mm intervals. The second stage was performed at least a week later under local anesthesia. Microelectrode recording using three simultaneous channels was used to refine the target. Once the microelectrode recordings and macrostimulation confirmed the desired target, a lesion was created or an Activa neurostimulator was inserted. Our early results using this technique in 28 procedures (in 19 patients) indicate a good outcome in 86{\%} and a technical failure in 1 patient.",
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    Staged functional neurosurgery using image fusion : electronic atlas and microelectrode recording at Dundee. / Eljamel, M. S.; Forster, A.; Tulley, M.; Matthews, K.

    In: Stereotactic and Functional Neurosurgery, Vol. 73, No. 1-4, 05.2000, p. 140-142.

    Research output: Contribution to journalArticle

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    AU - Tulley, M.

    AU - Matthews, K.

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    KW - Stereotaxic Techniques

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