Document Detail


Stereotactic radiosurgery for functional disorders.
MedLine Citation:
PMID:  18081480     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Stereotactic radiosurgery (SRS) with the Gamma Knife and linear accelerator has revolutionized neurosurgery over the past 20 years. The most common indications for radiosurgery today are tumors and arteriovenous malformations of the brain. Functional indications such as treatment of movement disorders or intractable pain only contribute a small percentage of treated patients. Although SRS is the only noninvasive form of treatment for functional disorders, it also has some limitations: neurophysiological confirmation of the target structure is not possible, and one therefore must rely exclusively on anatomical targeting. Furthermore, lesion sizes may vary, and shielding adjacent radiosensitive neural structures may be difficult or impossible. The most common indication for functional SRS is the treatment of trigeminal neuralgia. Radiosurgical treatment for epilepsy and certain psychiatric illnesses is performed in several centers as part of strict research protocols, and radiosurgical pallidotomy or medial thalamotomy is no longer recommended due to the high risk of complications. Radiosurgical ventrolateral thalamotomy for the treatment of tremor in patients with Parkinson disease or multiple sclerosis, as well as in the treatment of essential tremor, may be indicated for a select group of patients with advanced age, significant medical conditions that preclude treatment with open surgery, or patients who must receive anticoagulation therapy. A promising new application of SRS is high-dose radiosurgery delivered to the pituitary stalk. This treatment has already been successfully performed in several centers around the world to treat severe pain in patients with end-stage cancer.
Authors:
Gerhard M Friehs; Michael C Park; Marc A Goldman; Vasilios A Zerris; Georg Norén; Prakash Sampath
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Neurosurgical focus     Volume:  23     ISSN:  1092-0684     ISO Abbreviation:  Neurosurg Focus     Publication Date:  2007  
Date Detail:
Created Date:  2007-12-17     Completed Date:  2008-02-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100896471     Medline TA:  Neurosurg Focus     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E3     Citation Subset:  IM    
Affiliation:
Department of Clinical Neurosciences Program in Neurosurgery and New England Gamma Knife Center, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, Rhode Island, USA. gfriehs@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Epilepsy / surgery*
Humans
Magnetic Resonance Imaging / methods
Movement Disorders / pathology,  surgery*
Obsessive-Compulsive Disorder / surgery*
Pain / surgery*
Radiosurgery / methods*
Stereotaxic Techniques

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


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