Document Detail


Radiofrequency cingulotomy for intractable cancer pain using stereotaxis guided by magnetic resonance imaging.
MedLine Citation:
PMID:  2200976     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study presents a new and simplified method of creating cingulate gyrus lesions by using stereotaxis guided by magnetic resonance imaging (MRI). Previous methods have utilized ventriculogram-guided stereotaxis requiring indirect cingulate gyrus localization and general anesthesia. With the present technique a BRW stereotactic frame was applied with the patient under local anesthesia. An MRI scan was performed using a T1 signal (TR, 600 ms; TE, 30 ms) in the coronal plane with 5-mm thick sections spaced every 6 mm. The coronal slice 24 mm posterior to the anterior tip of lateral ventricle was identified. The center of each (right and left) cingulate gyrus was identified as a target area, and appropriate coordinates were determined. Approach parameters were calculated for the right and left gyri using an azimuth of 45 degrees and 315 degrees, respectively, and a declination of 45 degrees. A radiofrequency electrode was stereotactically placed so that the electrode tip was at a target point which was the center of the cingulate gyrus. A radiofrequency lesion (75 degrees, 60 seconds) was made in each hemisphere's cingulate gyrus. Four patients with intractable terminal cancer pain have been initially treated in this manner. The lesions were well-localized on postoperative MRI scans. There have been no complications except for perilesional edema for 10 days in 1 patient (treated with longer radiofrequency settings that have subsequently been modified).(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
S J Hassenbusch; P K Pillay; G H Barnett
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  27     ISSN:  0148-396X     ISO Abbreviation:  Neurosurgery     Publication Date:  1990 Aug 
Date Detail:
Created Date:  1990-09-18     Completed Date:  1990-09-18     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  220-3     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Cleveland Clinic Foundation, Ohio.
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MeSH Terms
Descriptor/Qualifier:
Aged
Breast Neoplasms / complications
Carcinoma / complications
Gyrus Cinguli*
Humans
Lung Neoplasms / complications
Magnetic Resonance Imaging*
Middle Aged
Multiple Myeloma / complications
Pain, Intractable / etiology,  therapy*
Radio Waves / therapeutic use*
Stereotaxic Techniques*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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