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“Sukeroku sign” and “dent internal-capsule sign”—identification guide for targeting the subthalamic nucleus for placement of deep brain stimulation electrodes

  • Diagnostic Neuroradiology
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Abstract

Introduction

The purpose of this study was to assess the usefulness of signs (“Sukeroku sign” and “dent internal-capsule sign”) for the recognition of subthalamic nucleus (STN).

Materials and methods

Five Parkinson’s disease cases in which there was a successful placement of deep brain stimulation (DBS) electrodes at the STN were retrospectively reviewed. Five radiologists who were not engaged in localization of STNs in clinical practice were asked to locate the STNs before and after instructions on the signs. We evaluated the deviation between the reader-located points and the location of the DBS electrode for which there had been a successful installation.

Results

After instruction, there was a significant reduction in the deviation between the reader-located points and the DBS electrode. The time required for localization was also reduced after the instructions.

Conclusion

Sukeroku sign and dent internal-capsule sign are feasible indicators of STN and seem to be useful in helping to identify the STN.

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Acknowledgment

We deeply appreciate the Research and Training Department, Japan Art Council for the permission granted for us to use the “Ukiyo-e” print of “Sukeroku” in this article and for providing us a copy of the fine art.

Conflict of interest statement

We declare that we have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan

    Toshiaki Taoka, Hiroyuki Nakagawa, Masahiko Sakamoto, Satoru Kitano, Junko Takahama, Nagaaki Marugami, Katsutoshi Takayama, Toshiaki Akashi, Toshiteru Miyasaka & Kimihiko Kichikawa

  2. Department of Neurosurgery, Nara Medical University, Nara, Japan

    Hidehiro Hirabayashi & Toshisuke Sakaki

  3. Department of Radiology, Higashiosaka City General Hospital, Osaka, Japan

    Satoru Iwasaki

  4. Department of Anesthesiology, Nara Medical University, Nara, Japan

    Naoko Kurita

Authors
  1. Toshiaki Taoka
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  2. Hidehiro Hirabayashi
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  3. Hiroyuki Nakagawa
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  4. Masahiko Sakamoto
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  5. Satoru Kitano
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  6. Junko Takahama
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  7. Nagaaki Marugami
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  8. Katsutoshi Takayama
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  9. Toshiaki Akashi
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  10. Toshiteru Miyasaka
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  11. Satoru Iwasaki
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  12. Naoko Kurita
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  13. Toshisuke Sakaki
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  14. Kimihiko Kichikawa
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Corresponding author

Correspondence to Toshiaki Taoka.

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Taoka, T., Hirabayashi, H., Nakagawa, H. et al. “Sukeroku sign” and “dent internal-capsule sign”—identification guide for targeting the subthalamic nucleus for placement of deep brain stimulation electrodes. Neuroradiology 51, 11–16 (2009). https://doi.org/10.1007/s00234-008-0451-1

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  • DOI: https://doi.org/10.1007/s00234-008-0451-1

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