Studies in Stereoencephalotomy

Spiegel, E.A.; Wycis, H.T.; Baird, H.W.

doi:10.1159/000105774

Cited by 33 publications

(13 citation statements)

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“…Anatomical variability in the pallidum, as in other basal ganglia and thalamic nuclear structures, is well known [20]. With this in mind, electrophysiological recording is required to coordinate precise localization for lesioning in the internal segment of the globus pallidus [21,22].…”

Section: Discussionmentioning

confidence: 99%

Quantitative On-Line Analysis of Physiological Data for Lesion Placement in Pallidotomy

Lehman

Micheli-Tzanakou

Medl

et al. 2000

Stereotact Funct Neurosurg

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A computerized method of determining the focal point of electrical activity in the pallidum of parkinsonian patients was developed using on-line quantitative physiological data analysis. Thirty patients in a series of 70 were studied in depth. Neuronal activity was recorded from the pallidum using a semi-microelectrode. The signal is inspected visually while its average power, characteristic frequency and complexity are computed. The target locus was indicated by the highest level of global activity in the vicinity of the electrode (signal power maximum), maximal signal complexity and minimal characteristic frequency. Most often, the vertical coordinate required correction. The postoperative clinical and imaging results have indicated the effectiveness of this method.

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Section: Discussionmentioning

confidence: 99%

Quantitative On-Line Analysis of Physiological Data for Lesion Placement in Pallidotomy

Lehman

Micheli-Tzanakou

Medl

et al. 2000

Stereotact Funct Neurosurg

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“…The limitations of proportional factors as used by Hassler and Riechert was also pointed out by Spiegel [footnote in [52]]. Spiegel and colleagues [55,56] had also performed thorough brain variation studies and found that the position of the pallidum could neither be inferred reliably from the width of the brain nor from the width of the third ventricle. This is why Spiegel suggested the use of safety lines instead [2].…”

Section: Stereotactic Planningmentioning

confidence: 99%

The Pioneering and Unknown Stereotactic Approach of Roeder and Orthner from Göttingen. Part I. Surgical Technique for Tailoring Individualized Stereotactic Lesions

Hamel¹,

Köppen²,

Hariz³

et al. 2016

Stereotact Funct Neurosurg

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During the 1950s through the 1970s, Hans Orthner and Fritz Roeder, two German neurologists from Göttingen, developed a sophisticated technique to perform functional stereotactic surgery with outstanding accuracy. They introduced direct air ventriculography performed in the same surgical session as the ablative stereotactic procedure. For individualized surgical targeting, Orthner prepared a stereotactic atlas (>60 brains) with an ingenious brain-slicing device, the Göttinger macrotome. Brains were grouped based on similarity of six different head and ventricle measurements. A brain cluster representing the best match for a patient was selected for stereotactic targeting. Stereotactic lesions were tailored in an individual manner and shaped by stringing together multiple small coagulations following intraoperative test stimulation. This was achieved from a single probe trajectory by using well-engineered string electrodes with calibrated curving and involved laborious calculations. Only high-frequency thermocoagulation was regarded as appropriate for lesioning. With this meticulous technique, the most advanced stereotactic procedures were performed, including bilateral pallidotomy that ultimately could be restricted to the ansa lenticularis and ventromedial hypothalamotomy, the most delicate stereotactic operation performed to date. Outside Göttingen, this technique has only been used by Prof. Dieter Müller in Hamburg, Germany. This elaborate stereotactic approach is widely unknown and deserves to be discussed in a historical context.

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“…M. E. (No. 3) had a thalamotomy performed by Doctor I. Cooper of New York in 1962. We learned from the patient that at that time an intial postoperative hemiparesis was followed by recovery and reduction of tremor but not rigidity.…”

Section: Case Historiesmentioning

confidence: 99%