By Marwan I. Hariz M.D., Ph.D. (auth.), C. B. Ostertag, D. G. T. Thomas, A. Bosch, B. Linderoth, G. Broggi (eds.)
Neurosurgery o/the destiny: pcs and Robots in scientific Neurosurgical perform and in education - a Philosophical trip into the longer term Many modern-day neurosurgeons think that they already receive stable leads to operative surgical procedure with the advantage of the working microscope and different aids that have develop into on hand within the final 3 a long time and that the creation of pcs and robots to the working theatre is superfluous. in spite of the fact that, it really is transparent from analogy with the functionality of the airline pilot, one other occupation the place there are nice calls for on guide ability and on spatial wisdom, that those units do have a lot to provide neurosurgery. Classical neurosurgery, throughout Cushing, Dandy and Scarff, was once in response to a 3 dimensional photo of the patient's mind shaped within the surgeon's brain and infrequently illustrated in based drawings. Such photographs have been in accordance with neuroradiological experiences by means of pneumoencephalography, ventriculography or by means of angiography. in most cases those stud ies confirmed the presence and place of a lesion via displacement of standard mind buildings and the image was once equipped up by way of interference. This was once then switched over by means of the skilled neurosurgeon right into a plan for the craniotomy website and the trajectory of the surgical strategy. as soon as the mind was once uncovered extra pre-operative details was once bought via visible inspection and by way of palpation with the mind needle. those classical types ofneuroradiology have mostly been outdated by means of computerised tomography and via magnetic resonance imaging.
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Additional info for Advances in Stereotactic and Functional Neurosurgery 12: Proceedings of the 12th Meeting of the European Society for Stereotactic and Functional Neurosurgery, Milan 1996
Proceedings of the International Society for Magnetic Resonance in Medicine, New York, NY Correspondence: Richard M. , Division of Neurosurgery, UMDNJ-RWJMS, 125 Paterson Street, Suite 2100, New Brunswick, NJ 08901-1977, USA. Acta Neurochir (1997) [Suppl] 68: 37-41 © Springer-Verlag 1997 Unilateral Pallidotomy for Parkinson's Disease Promptly Improves a Wide Range of Voluntary Activities - Especially Gait and Trunk Movements c. H. A. K. Summary 26 patients with Parkinson's disease were assessed in the OFF state 2-3 days before and one week after pallidotomy for the time to complete each of 25 standardized motor tasks testing a wide range of voluntary activities important for daily living.
9] for time course). Separate assessments were performed, at each time point, in the practicallydefined worst "off" state, and one hour after their morning medications during their typical best "on" state. Videotapes were randomized and scored by a neurologist experienced in the use of the above scales, who was not involved in the patients' pre- or postoperative care. The non-blinded data were obtained form live assessments: UPDRS total score (including the blinded measures, above); ADL (activities of daily living); Schwab and England; rigidity, arm and leg rigidity components of UPDRS (score no.
Important issues that need to be addressed in future studies include: (I) the optimal location and size of the pallidal lesion, (2) the duration of clinical improvements, (3) when to operate during the course of the illness, and, (4) because the effects are predominantly contralateral, the safety and efficacy of bilateral surgery. Given the variability of the disease course, surgical variations and day-to-day fluctuations in patient performances, as well as the effects of patient and physician expectations on clinical evaluations, the authors recommend the adoption of blinded and randomized assessments of videotaped UPDRS examinations in the evaluation of the outcome of surgical interventions for PD.