From WikiLectures

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]

Biopsie mozku pod stereotaktickou kontrolou
  • 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:
    1. after deploying the device, we aim at the points according to the MRI, determine the target point;
    2. 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:
    • chronic pain (nonspecific thalamic nuclei);
    • psychoses – bilateral cingulate gyrus coagulation.
  • Sometimes we can implant electrodes and stimulate long-term.

Links[edit | edit source]

Sources[edit | edit source]

Reference[edit | edit source]

  • ZEMAN, Miroslav. Speciální chirurgie. 2. edition. Prague : Galen, 2004. 575 pp. ISBN 80-7262-260-9.