Summary
The accuracy with which the ventrolateral thalamic nucleus could be targetted using the BRW stereotactic system and unreformatted axial CT imaging was evaluated in cadaver brains mounted in a skull. Ball bearings (1.82 mm diameter) were placed in the nuclei ventro intermedius (Vim), ventro oralis anterior (Voa) and posterior (Vop) and the brains then sectioned, the locations of the ball bearings relative to the anterior (AC) and posterior commissures (PC) measured and evaluated with reference to a Schaltenbrandt and Bailey stereotactic atlas. Targetting of the ventrolateral thalamic region was frequently accurate (77%) but because of errors in estimation of the AC-PC plane (mean forward angulation of 9°) some ball bearings were placed too deeply in the Fields of and Forel, zona incerta and rostral subthalamic nucleus. Ventrolateral thalamotomy using the BRW stereotactic system and unreformatted axial CT imaging was undertaken in six patients with tremor due to a range of pathologies. The tremor was abolished or altered in four patients whilst no lesion was made in the other two patients since no site that reduced the tremor, could be located. The surgical and clinical implications of this study are discussed.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Bullard DE, Nashold BS (1988) Postraumatic movement disorders. In: Lunsford LD (ed) Modern stereotactic neurosurgery. Martinus Nijhoff, Boston, pp 341–352
Hadley MN, Shetter AG, Amos MR (1985) Use of the BrownRoberts-Wells stereotactic frame for functional neurosurgery. Appl Neurophysiol 48: 61–68
Hariz MI, Bergenheim AT (1990) A comparative study on ventriculographic and computerized tomography-guided determinations of brain targets in functional stereotaxis. J Neurosurg 73: 565–571
Hassler R, Mundinger F, Riechert T (1979) Stereotaxis in Parkinson syndrome. Springer, Berlin Heidelberg New York, p 568
Laitinen LV (1985) Brain targets in surgery for Parkinson’s disease. J Neurosurg 62: 349–351
Laitinen LV (1985) CT-guided ablative stereotaxis without ventriculography. Appl Neurophysiol 48: 18–21
Latchaw RE, Lunsford LD, Kennedy WH (1985) Reformatted imaging to define the intercommissurral line for CT guided stereotaxic functional neurosurgery. AJNR 6: 429–433
Nageseki Y, Shinazaki T, Hirai Bhauh, et al (1986) Long term follow up results of selective VIM thalamotomy. J Neurosurg 65: 296–302
Taskar RR, Yamashiro K, Lrnz F, et al (1988) Thalamotomy for Parkinson’s disease: Microelectrode technique. In: Lunsford LD (ed) Modern stereotactic neurosurgery. Martinus Nijhoff, Boston, pp 297–314
Whittle IR, O’Sullivan MG, Ironside JW, et al (1993) An experimental study to evaluate the accuracy of diencephalic and pallidal target localization using the Brown-Roberts-Wells stereotactic system and unreformatted axial GE8800 CT scanning. Br J Neurosurg (in press)
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1993 Springer-Verlag Wien
About this paper
Cite this paper
Whittle, I.R., O’Sullivan, M.G., Ironside, J.W., Sellar, R. (1993). Accuracy of Ventrolateral Thalamic Nucleus Localization Using Unreformatted CT Scans and the B-R-W System. In: Meyerson, B.A., Broggi, G., Martin-Rodriguez, J., Ostertag, C., Sindou, M. (eds) Advances in Stereotactic and Functional Neurosurgery 10. Acta Neurochirurgica, vol 58. Springer, Vienna. https://doi.org/10.1007/978-3-7091-9297-9_13
Download citation
DOI: https://doi.org/10.1007/978-3-7091-9297-9_13
Publisher Name: Springer, Vienna
Print ISBN: 978-3-7091-9299-3
Online ISBN: 978-3-7091-9297-9
eBook Packages: Springer Book Archive