Pallidotomy Lesion Locations: Significance of Microelectrode Refinement

Pallidotomy Lesion Locations: Significance of Microelectrode Refinement AbstractOBJECTIVE:To determine whether stereotactic pallidotomy requires refinement using microelectrode recording to ensure proper lesion placement.METHODS:The experiment approach was based on retrospective comparisons of microelectrode-refined radiofrequency lesion locations with hypothetical unrefined lesion positions. Actual and hypothetical pallidotomy lesions were classified based on their lesion center (thermocoagulative zone) locations and their total lesion areas (surrounding edematous zone) relative to the pallidal target. Assessments were made using postoperative T2-weighted magnetic resonance axial images, which showed both the lesion and globus pallidus (CP). The magnitude of microelectrode refinement from an initial preoperative starting point determined by computed tomography was calculated using stereotactic coordinates and included corrections for the lesioning tract trajectory angle.RESULTS:In all 25 patients, the center of the actual pallidotomy lesion was within the GP. Without microelectrode refinement, 13 of 25 hypothetical lesion positions would have been localized such that the lesion center would not have remained in the GP. In eight cases, microelectrode refinement resulted in no significant change in lesion location, but in one case, microelectrode refinement resulted in lesion center placement away from the GP.CONCLUSION:Kinesthetically driven microelectrode refinement in pallidotomy lesioning seems to be required to ensure proper lesion location within the GP. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

Pallidotomy Lesion Locations: Significance of Microelectrode Refinement

Pallidotomy Lesion Locations: Significance of Microelectrode Refinement

T E C H N IQ U E A P P L IC A T IO N S Pallidotomy Lesion Locations: Significance of Microelectrode Refinement Kuojen Tsao, M.D., Steve W ilkinson, M.D., John Overman, B.S., W illiam C. Koller, M.D., Ph.D., Solomon Batnitzky, M.D., Michael A. Gordon, Ph.D. Imaging Resource Center (KJT, SW, JO, M A C), Department of Surgery, Division of Neurosurgery (SW, JO), and Departments of Neurology (W CK), Radiology (SB), and Pharmacology, Toxicology and Therapeutics (MAG), University of Kansas Medical Center, Kansas City, Kansas O B JE C T IV E : To determine whether stereotactic pallidotomy requires refinement using m icroelectrode recording to ensure proper lesion placement. M E T H O D S : The experiment approach was based on retrospective comparisons of microelectrode-refined radiofre­ quency lesion locations with hypothetical unrefined lesion positions. Actual and hypothetical pallidotomy lesions were classified based on their lesion center (thermocoagulative zone) locations and their total lesion areas (surrounding edematous zone) relative to the pallidal target. Assessments were made using postoperative T2-weighted magnetic resonance axial images, which showed both the lesion and globus pallidus (CP). The magnitude of microelectrode refinement from an initial preoperative starting point determined by computed tomography was calculated using stereotactic coordinates and included corrections for the lesioning tract trajectory angle. RESULTS: In all 25 patients, the center of the actual pallidotomy lesion was within the GP. Without microelectrode refinement, 13 of 25 hypothetical lesion positions would have been localized such that the lesion center would not have remained in the GP. In eight cases, microelectrode refinement resulted in no significant change in lesion location, but in one case, microelectrode refinement resulted in lesion center placement away from the GP. C O N C L U S IO N : Kinesthetically driven microelectrode refinement in pallidotomy lesioning...
Loading next page...
 
/lp/ou_press/pallidotomy-lesion-locations-significance-of-microelectrode-refinement-pOHNnehnyd
Publisher
Congress of Neurological Surgeons
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199809000-00061
Publisher site
See Article on Publisher Site

Abstract

AbstractOBJECTIVE:To determine whether stereotactic pallidotomy requires refinement using microelectrode recording to ensure proper lesion placement.METHODS:The experiment approach was based on retrospective comparisons of microelectrode-refined radiofrequency lesion locations with hypothetical unrefined lesion positions. Actual and hypothetical pallidotomy lesions were classified based on their lesion center (thermocoagulative zone) locations and their total lesion areas (surrounding edematous zone) relative to the pallidal target. Assessments were made using postoperative T2-weighted magnetic resonance axial images, which showed both the lesion and globus pallidus (CP). The magnitude of microelectrode refinement from an initial preoperative starting point determined by computed tomography was calculated using stereotactic coordinates and included corrections for the lesioning tract trajectory angle.RESULTS:In all 25 patients, the center of the actual pallidotomy lesion was within the GP. Without microelectrode refinement, 13 of 25 hypothetical lesion positions would have been localized such that the lesion center would not have remained in the GP. In eight cases, microelectrode refinement resulted in no significant change in lesion location, but in one case, microelectrode refinement resulted in lesion center placement away from the GP.CONCLUSION:Kinesthetically driven microelectrode refinement in pallidotomy lesioning seems to be required to ensure proper lesion location within the GP.

Journal

NeurosurgeryOxford University Press

Published: Sep 1, 1998

There are no references for this article.

You’re reading a free preview. Subscribe to read the entire article.


DeepDyve is your
personal research library

It’s your single place to instantly
discover and read the research
that matters to you.

Enjoy affordable access to
over 12 million articles from more than
10,000 peer-reviewed journals.

All for just $49/month

Explore the DeepDyve Library

Unlimited reading

Read as many articles as you need. Full articles with original layout, charts and figures. Read online, from anywhere.

Stay up to date

Keep up with your field with Personalized Recommendations and Follow Journals to get automatic updates.

Organize your research

It’s easy to organize your research with our built-in tools.

Your journals are on DeepDyve

Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.

All the latest content is available, no embargo periods.

See the journals in your area

Monthly Plan

  • Read unlimited articles
  • Personalized recommendations
  • No expiration
  • Print 20 pages per month
  • 20% off on PDF purchases
  • Organize your research
  • Get updates on your journals and topic searches

$49/month

Start Free Trial

14-day Free Trial

Best Deal — 39% off

Annual Plan

  • All the features of the Professional Plan, but for 39% off!
  • Billed annually
  • No expiration
  • For the normal price of 10 articles elsewhere, you get one full year of unlimited access to articles.

$588

$360/year

billed annually
Start Free Trial

14-day Free Trial