Preface.
Authors: Slavin KV
PMID: 32698186 [PubMed - as supplied by publisher] (Source: Progress in Neurological Surgery)
Source: Progress in Neurological Surgery - July 24, 2020 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Percutaneous Electrical Nerve Stimulation for Facial Pain.
Authors: Vajramani G
Abstract
Percutaneous electrical nerve stimulation (PENS) is a novel, minimally invasive and useful treatment modality. Its use in complex facial pain has been on the rise, and its utility will further increase with the advances in the technology and renewed interest in the field of peripheral neuromodulation. PENS therapy can be used both as diagnostic and therapeutic option. The precise mechanism of action is not known, although a combination of electrical neuromodulation and release of endogenous morphine-like substance in the central nervous system appears as plausible explanation....
Source: Progress in Neurological Surgery - July 24, 2020 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Peripheral Nerve Stimulation for Facial Pain Using Conventional Devices: Indications and Results.
Authors: Winfree CJ
Abstract
Trigeminal branch stimulation is a type of peripheral nerve stimulation (PNS) used to treat a variety of craniofacial pain disorders. Common indications include trigeminal neuralgia, trigeminal neuropathic pain, trigeminal deafferentation pain, trigeminal postherpetic neuralgia, supraorbital neuralgia, and migraine headaches. Supraorbital and infraorbital arrays are the most common electrode configurations, although preauricular, mandibular branch, and subcutaneous peripheral nerve field stimulation arrays have also been described. Trigeminal branch stimulation may be used as a...
Source: Progress in Neurological Surgery - July 21, 2020 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Leksell Radiosurgery for Vestibular Schwannomas.
Authors: Bowden GN, Niranjan A, Lunsford LD
Abstract
Vestibular schwannomas (VS) are benign tumors predominantly originating from the balance portion of cranial nerve VIII. These tumors have an incidence of 1-2 per 100,000 people. The growth of these tumors is approximately 1-2 mm per year. A VS can result in significant neurologic dysfunction from continued growth or the management paradigms designed to control this predominantly benign tumor. The impacts on the critical space within the auditory canal and cerebellopontine angle can lead to hearing deficits, tinnitus, vestibular dysfunction, facial nerve ...
Source: Progress in Neurological Surgery - May 18, 2019 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Targeted Therapies for Brain Metastases.
Authors: Niranjan A, Lunsford LD, Ahluwalia MS
Abstract
The most common primary cancers that metastasize to the brain are lung cancer, breast cancer, and melanoma. The established management approaches for brain metastasis include stereotactic radiosurgery, fractionated radiation therapy, and surgical resection. In the past the role of medical therapies in brain metastases was limited. In the last decade, our understanding of molecular drivers of brain metastases and CNS penetration of drugs across the blood-brain barrier has improved. The molecular targeted tyrosine kinase inhibitors have shown effectiven...
Source: Progress in Neurological Surgery - May 18, 2019 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Frame versus Frameless Leksell Stereotactic Radiosurgery.
Authors: Lunsford LD, Niranjan A, Fallon K, Kim JO
Abstract
For more than 65 years localization of brain targets suitable for stereotactic radiosurgery has been performed after application of an intracranial guiding device to the cranial vault. After imaging and dose planning the same frame is used to secure the target at the focus of the intersection of the ionizing radiation beams that create the radiobiological effect. Non-invasive immobilization systems first proposed for linear accelerator or proton radiation technologies have now been developed for the Leksell Gamma Knife ICON radiosurgical system. T...
Source: Progress in Neurological Surgery - May 18, 2019 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
The Role of Leksell Radiosurgery in the Management of Craniopharyngiomas.
Authors: Niranjan A, Lunsford LD
Abstract
Management of craniopharyngiomas remains challenging due to the tumor's often intimate relationship with the optic apparatus, the hypothalamus, and the pituitary gland. Often multimodal management is needed to achieve the best treatment outcome: tumor control coupled with endocrine, visual, and neurocognitive preservation. Many surgeons favor initial subtotal resection followed by adjunctive therapy to improve quality of life in a tumor with potentially long-term survival even if coupled with a need for periodic new interventions. During the patient's subsequent fo...
Source: Progress in Neurological Surgery - May 18, 2019 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Radiosurgery for Behavioral Disorders.
Authors: Martínez-Álvarez R
Abstract
Psychiatric illnesses create great suffering for patients and the medical solution is sometimes limited. The experience observed after treating patients with obsessive-compulsive disorder (OCD), depression, and anorexia nervosa by Gamma Knife radiosurgery (GKRS) is presented. Ten patients with medically refractory OCD, 3 patients with depression resistant to medical treatment and electroconvulsive therapy, and 5 patients with refractory anorexia nervosa have been treated. Bilateral anterior capsulotomy has been performed to treat OCD and bilateral cingulotomy has been...
Source: Progress in Neurological Surgery - May 18, 2019 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Leksell Radiosurgery for Ependymomas and Oligodendrogliomas.
This report examines the role of SRS in these less common glial tumors.
PMID: 31096227 [PubMed - as supplied by publisher] (Source: Progress in Neurological Surgery)
Source: Progress in Neurological Surgery - May 18, 2019 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Leksell Radiosurgery for Orbital, Uveal, and Choroidal Tumors.
Authors: Ares WJ, Flickinger JC, Lunsford LD
Abstract
Stereotactic radiosurgery using the Leksell Gamma Knife has proven to be a valuable alternative to orbital enucleation or fractionated radiation therapy for primary tumors of the orbit, metastatic tumors to the choroid, and primary uveal melanomas. With this approach in a single outpatient setting, the eye is immobilized by a local block after which high-definition MRI or CT is performed to define the target. After rapid dose planning, radiation delivery is completed before the local block dissipates. The tumor response is often dramatic. The risk of ac...
Source: Progress in Neurological Surgery - May 18, 2019 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Pituitary Tumor Radiosurgery.
Authors: Trifiletti DM, Dutta SW, Lee CC, Sheehan JP
Abstract
Pituitary adenomas represent a common intracranial pathology, usually resulting in the systemic secretion of hormones and compression of local endocrine and optic structures, causing a wide variety of clinical sequelae. While they are typically treated with upfront endocrine and/or surgical decompressive therapy, in patients with residual, recurrent, or refractory disease, decades of data support management with stereotactic radiosurgery. This modality offers favorable local tumor control, endocrine remission rates, and infrequent toxicity. In t...
Source: Progress in Neurological Surgery - May 18, 2019 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
The First North American Clinical Gamma Knife Center.
This report summarizes the rationale for acquisition, the challenges and the early years, and then the evolution of our center which installed the first US 201 source Gamma Knife.
PMID: 31096232 [PubMed - as supplied by publisher] (Source: Progress in Neurological Surgery)
Source: Progress in Neurological Surgery - May 18, 2019 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Leksell Radiosurgery for Movement Disorders.
Authors: Niranjan A, Raju SS, Lunsford LD
Abstract
Tremor is the most prevalent movement disorder in adults. Patients who are refractory to medical management can explore surgical intervention. Deep-brain stimulation (DBS) and radiofrequency thalamotomy (RFT) are surgical procedures for intractable tremor that target the ventralis intermedius (VIM) nucleus to relieve contralateral tremor. For patients who are not candidates for surgical procedures, stereotactic radiosurgery (SRS) is a minimally invasive management option for tremor relief. SRS has been used for the elderly, those considered high surgical r...
Source: Progress in Neurological Surgery - May 18, 2019 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Re-Evaluating Clinical Outcomes for AVM Stereotactic Radiosurgery.
Authors: Tonetti DA, Gross BA
Abstract
Traditional outcome measures after stereotactic radiosurgery (SRS) for cerebral arteriovenous malformations (AVMs) have focused predominantly on angiographic obliteration and general neurologic complications. Several grading scales attempting to predict the outcome for specific patients have previously been proposed and validated, and are outlined here. These have largely been based on both AVM and patient characteristics and attempt to predict obliteration. However, the most practical and clinically oriented goal in the management of AVMs is the prospective avoidance...
Source: Progress in Neurological Surgery - May 18, 2019 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Radiosurgery for Chordoma and Chondrosarcoma.
This report examines the role of SRS in these skull base tumors.
PMID: 31096236 [PubMed - as supplied by publisher] (Source: Progress in Neurological Surgery)
Source: Progress in Neurological Surgery - May 18, 2019 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
