Skip to main content
Log in

Gamma knife pallidotomy: Case report

  • Clinical Articles
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Summary

We report a case of gamma knife pallidotomy resulting in a permanent contralateral homonymous hemianopsia and transient contralateral hemiparesis with some improvement in contralateral parkinsonian symptoms. This case illustrates the risk of gamma knife pallidotomy which precludes physiologic target localization and can subject structures surrounding the target to a significant radiosurgical dose. Until noninvasive physiologic target localization is available gamma knife pallidotomy and thalamotomy should be limited to patients with an unacceptably high risk for stereotactic percutaneous thermocoagulation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Aminoff MJ (1994) Treatment of Parkinson's disease. West J Med 161: 303–308

    PubMed  Google Scholar 

  2. Burchiel KJ (1992) Image-based functional neurosurgery. Clin Neurosurg 39: 314–330

    PubMed  Google Scholar 

  3. Cooper IS, Bravo G (1958) Chemipallidectomy and chemothalamectomy. J Neurosurg 15: 244

    PubMed  Google Scholar 

  4. Fabbrini G, Mouradian MM, Juncos JL, Schlegel J, Mohr E, Chase TN (1988) Motor fluctuations in Parkinson's disease: central pathophysiological mechanisms, part I. Ann Neurol 24: 366–371

    PubMed  Google Scholar 

  5. Flickinger J, Lunsford LD, Kondzioloka D (1992) Dose prescription and dose-volume effects in radiosurgery. In: Lunsford LD (ed) Stereotactic radiosurgery. Neurosurg Clin North Am 3 (1): 51–59

  6. Grossman RG, Hamilton WJ (1993) Surgery for movement disorders. In: Jankovic T, Tolosa E (eds) Parkinson's disease and movement disorders. Williams and Wilkins, Baltimore, pp 531–548

    Google Scholar 

  7. Hariz M (1992) Correlation between clinical outcome and size and site of the lesion in computed tomography guided thalamotomy and pallidotomy. Stereotact Funct Neurosurg 54–55: 172–185

    Google Scholar 

  8. Hassler R, Riechert T (1954) Indikationen und Lokalisationsmethode der gezielten Hirnoperationen. Nervenarzt 25: 441

    PubMed  Google Scholar 

  9. Iacono RP, Shima F, Lonser RR,et al (1995) The results, indications, and physiology of posteroventral pallidotomy for patients with Parkinson's disease. Neurosurgery 36: 1118–1127

    PubMed  Google Scholar 

  10. Jones MW, Tasker RR (1990) The relationship of documented destruction of specific cell types to complications and effectiveness in thalamotomy for tremor in Parkinson's disease. Stereotact Funct Neurosurg 54–55: 207

    Google Scholar 

  11. Kawashima Y, Chen HJ, Takahashi A,et al (1992) Application of magnetic resonance imaging in functional stereotactic thalamotomy for the evaluation of individual variations of the thalamus. Stereotact Funct Neurosurg 58: 33–38

    PubMed  Google Scholar 

  12. Kelly PJ (1995) Pallidotomy in Parkinson's disease. Neurosurgery 36: 1154–1157

    PubMed  Google Scholar 

  13. Laitinen L (1972) Surgical treatment, past and present. In: Parkinson's disease. Acta Neurol Scand 51: 43

    Google Scholar 

  14. Laitinen LV, Bergenheim AT, Hariz MI (1992) Leksell's posterior ventral pallidotomy in the treatment of Parkinson's disease. J Neurosurg 76: 53

    PubMed  Google Scholar 

  15. Laitinen LV, Bergenheim AT, Hariz MI (1992) Ventroposterolateral pallidotomy can abolish all parkinsonian symptoms. Stereotact Funct Neurosurg 58: 14

    PubMed  Google Scholar 

  16. Laitinen LV (1995) Pallidotomy for Parkinson's disease. In: Lundsford LD (ed) Functional neurosurgery. Neurosurg Clin North Am 6(1): 105–110

  17. Lindquist C, Steiner L, Hindmarsh T (1992) Gamma knife thalamotomy for tremor: report of two cases. In: Steiner L,et al (ed) Radiosurgery: baseline and trends. Raven, New York, pp 237–243

    Google Scholar 

  18. Michels J, Bosman H, Pelgrims P,et al (1994) On the problem of geometric distortion in magnetic resonance images for stereotactic neurosurgery. Magn Reson Imaging 12: 749–765

    PubMed  Google Scholar 

  19. Narabayashi H (1989) Striatal symptoms. Stereotact Funct Neurosurg 52: 200

    PubMed  Google Scholar 

  20. Narabayashi H (1990) Surgical treatment in the levodopa era. In: Stern G (ed) Parkinson's disease. Chapman and Hall, London, pp 597–646

    Google Scholar 

  21. Ohye Ch (1988) Selective thalamotomy for movement disorders: microelectrode stimulation techniques and results. In: Lundsford LD (ed) Modern stereotactic neurosurgery. Martinus Nijhoff, Boston, pp 315–331

    Google Scholar 

  22. Peters T, Pike GB, Clark J (1992) A personal computer based workstation for the planning of stereotactic neurosurgical procedures. In: Kelly P, Kall B (ed) Computers in stereotactic neurosurgery. Blackwell, Boston

    Google Scholar 

  23. Struppler A (1989) Stereoencephalotomy and control of skeletal muscle tone. Stereotact Funct Neurosurg 52: 205

    PubMed  Google Scholar 

  24. Sumanaweera TS, Adler JR, Napel S, Glover GH (1994) Characterization of spatial distortion in magnetic resonance imaging and its implications for stereotactic surgery. Neurosurgery 35: 696–704

    PubMed  Google Scholar 

  25. Svennilson E, Torvik A, Lowe R,et al (1960) Treatment of parkinsonism by stereotactic thermolesions in the pallidal region. Acta Psychiatr Neurol Scand 35: 358

    Google Scholar 

  26. Tasker RR, Siqueira J, Hawrylyshyn P,et al (1983) What happened to Vim thalamotomy for Parkinson's disease? Appl Neurophysiol 46: 68

    PubMed  Google Scholar 

  27. Wester K, Hauglie-Hanssen E (1990) Stereotaxic thalamotomy-experiences from the levodopa era. J Neurol Neurosurg Psychiatry 53: 427–430

    PubMed  Google Scholar 

  28. Wu A (1992) Physics and dosimetry of the gamma knife. In: Lunsford LD (ed) Stereotactic radiosurgery. Neurosurg Clin N Am 3 (1): 35–50

  29. Yahr MD (1993) Parkinson's disease: new approaches to diagnosis and treatment. Acta Neurol Scand 87 [Suppl] 146: 22–25

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bonnen, J.G., Iacono, R.P., Lulu, B. et al. Gamma knife pallidotomy: Case report. Acta neurochir 139, 442–445 (1997). https://doi.org/10.1007/BF01808881

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01808881

Keywords

Navigation