METHODS OF LESION MAKING
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.
USES OF STEREOTACTIC SURGERY Movement disorders
- 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
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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