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[edit | edit source]
- 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 posterior 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 the 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[edit | edit source]
- 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[edit | edit source]
Sources[edit | edit source]
- BENEŠ, Jiří. Studijní materiály [online]. ©2007. [cit. 2010]. <http://www.jirben.wz.cz/>.
Reference[edit | edit source]
- ZEMAN, Miroslav. Speciální chirurgie. 2. edition. Prague : Galen, 2004. 575 pp. ISBN 80-7262-260-9.