Stereotactic surgery


Heat - radiofrequency current delivered through a fine electrode 1 lesion size

Cooling - with a cryogenic probe J determined by

Radiation - implantation of radioactive seed, e.g. yttrium110 temperature

- focussed beam from cobalt*'0 rods (sited on a specially change and adapted Leksell frame) or from a linear accelerator. duration.


- tremor 1 lesions in

- dystonia f thalamic

- spasmodic torticollis J nuclei

- spasticity - lesion in dentate nucleus or pulvinar.

- dyskinesia - lesion in globus pallidus


Pain - especially intractable head or neck pain in malignancy.

- Lesion in centromedian nucleus of the thalamus and intralaminar nuclei, or descending tract of the trigeminal nucleus.


Obsessive and compulsive illness Intractable depression

Bilateral cingulotomy.

Subcaudate tractotomy stimulation

Movement disorders <

Pain - intractable pain, unresponsive to other measures spasticity - cerebellar stimulation tremor - thalamic stimulation

- stimulation of the thalamic relay nuclei, internal capsule, periaqueductal or periventricular grey matter aspiration biopsy -

irradiation cyst, abscess, or haematoma particularly for small and deeply situated tumours

, implantation of radioactive seeds, e.g. craniopharyngioma

■ external stereotactic irradiation appears useful in the treatment of small deep arteriovenous malformations

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