Stereotactic Neurosurgery |
Winter 2008 |
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CONTENTS OF THIS ISSUE:
A Letter from the Editor
Edward B. Arenson, MD
In the current issue of the CNI Review entitled Stereotactic Radiosurgery, Drs. John McVicker, Marcus Keep, Rajeev Kumar and Karen Theriot present scholarly and timely reviews of one of the most exciting and evolving areas of medicine and neurology... [read more]
Making the Brain Better: A Brief Overview of Stereotactic, Functional and Restorative Neurosurgery
John H. McVicker, MD
Most people know the term "Neurosurgery." Neurosurgery refers not just to brain surgery, but to
multiple subspecialty areas of brain, spine and peripheral nerve surgery such as pediatric neurosurgery,
neuro-oncology, or neurotrauma. Mention stereotactic, functional and restorative neurosurgery during
your next informal conversation, however, and expect a blank stare in return. To what does each of
these cryptic descriptors refer, and how have they come to relate to the practice of neurosurgery in
the 21st century? [read more]
The Gamma Knife as a Tool in Restorative Neurosurgery
Marcus F. Keep, MD, FRCSC, FACS
Restorative neurosurgery of a small portion of a diseased brain can return a person to neurological
health. The Gamma Knife radioneurosurgical device non-invasively makes small lesions in the brain,
restoring normal function. Gamma Knife treats functional diseases including severe facial pain
syndromes such as trigeminal neuralgia, anesthesia dolorosa and thalamic pain syndrome, essential
and Parkinson’s tremor, epilepsy and obsessive compulsive disorder. [read more]
Deep Brain Stimulation for Movement Disorders
Drew S. Kern, MS and Rajeev Kumar, MD
Neurosurgery for the treatment of movement disorders has markedly expanded and become
increasingly common in the past decade with deep brain stimulation (DBS) largely supplanting ablative
procedures. DBS results in fewer adverse effects and has long-term efficacy in the management of
medication-refractory Parkinson’s disease, tremor, and dystonia. DBS holds promise as a treatment for
a great number of other neurologic and neuropsychiatric disorders. [read more]
Surgery and Rehabilitation
Karen Theriot, MD
Neurosurgical intervention for movement disorders such as Parkinson’s disease can improve symptoms
when medications are not effective. A team approach is recommended for appropriate patient
selection, surgery and post-operative management. There may however be symptoms, secondary
complications due to progressive symptoms and co-morbidities that are not benefited by either
medication or surgical intervention. Non-pharmacologic therapies or rehabilitation interventions
do have demonstrated benefit. Incorporating rehabilitation as part of the team for pre-surgical
assessment, patient selection, post-operative programming and management can enhance functional
and quality of life outcomes. [read more]
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