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Easy anchoring and smaller skin incision procedure for neuronavigation-based frameless stereoelectroencephalography.

基于神经导航的无框架立体脑电图容易锚定和较小的皮肤切口程序。

  • 影响因子:1.63
  • DOI:10.1016/j.jocn.2019.12.008
  • 作者列表:"Fujimoto A","Sakakura K","Ichikawa N","Okanishi T
  • 发表时间:2020-04-01
Abstract

:Epilepsy surgery uses both depth electrodes (DEs) and subdural electrodes (SE). DEs have mainly been developed and used in Europe. As we are able to use the DEs safely due to the current advanced level of technology, use of DEs has been increasing rapidly over the last decade. Unlike placement of SEs, which simply requires craniotomy, DE placement generally requires stereotactic techniques such as frame-based stereotactic or robotic arm-based methods. However, such methods are not always available at every epilepsy center. We therefore invented guide pipes for accurate DE placement. With this guide pipe and neuronavigation-based (NB) DE placement system, we are able to place DEs accurately. However, the disadvantages of our original procedure were a relatively large skin incision and the difficulty in anchoring DEs. The purpose of this technical note is to introduce a method to perform NB DE placement with a smaller skin incision and simple anchoring procedure. As we could make the skin incision smaller and achieved easier anchoring of DEs using a titanium plate, we hope this procedure will help facilities to perform DE placement with neuronavigation systems.

摘要

: 癫痫手术同时使用深度电极 (DEs) 和硬膜下电极 (SE)。DEs主要在欧洲开发和使用。由于目前先进的技术水平,我们能够安全地使用DEs,在过去十年中,DEs的使用迅速增加。与仅需要开颅手术的SEs放置不同,去放置通常需要立体定向技术,例如基于框架的立体定向或基于机器人臂的方法。然而,这些方法并不总是在每个癫痫中心可用。因此,我们发明了用于精确放置的导向管。有了这个导管和基于神经导航 (NB) 的DE放置系统,我们能够准确地放置DEs。然而,我们最初手术的缺点是相对较大的皮肤切口和固定DEs的困难。本技术说明的目的是介绍一种用较小的皮肤切口和简单的锚固程序进行NB DE放置的方法。由于我们可以使用钛板使皮肤切口更小并实现DEs的更容易锚固,我们希望该程序将有助于使用神经导航系统进行DE放置的设施。

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作者列表:["Delattre BMA","Boudabbous S","Hansen C","Neroladaki A","Hachulla AL","Vargas MI"]

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影响因子:2.98
发表时间:2020-01-01
DOI:10.1136/neurintsurg-2019-014962
作者列表:["Guo W","Liu H","Tan Z","Zhang X","Gao J","Zhang L","Guo H","Bai H","Cui W","Liu X","Wu X","Luo J","Qu Y"]

METHODS:BACKGROUND:The main surgical techniques for spontaneous basal ganglia hemorrhage include stereotactic aspiration, endoscopic aspiration, and craniotomy. However, credible evidence is still needed to validate the effect of these techniques. OBJECTIVE:To explore the long-term outcomes of the three surgical techniques in the treatment of spontaneous basal ganglia hemorrhage. METHODS:Five hundred and sixteen patients with spontaneous basal ganglia hemorrhage who received stereotactic aspiration, endoscopic aspiration, or craniotomy were reviewed retrospectively. Six-month mortality and the modified Rankin Scale score were the primary and secondary outcomes, respectively. A multivariate logistic regression model was used to assess the effects of different surgical techniques on patient outcomes. RESULTS:For the entire cohort, the 6-month mortality in the endoscopic aspiration group was significantly lower than that in the stereotactic aspiration group (odds ratio (OR) 4.280, 95% CI 2.186 to 8.380); the 6-month mortality in the endoscopic aspiration group was lower than that in the craniotomy group, but the difference was not significant (OR=1.930, 95% CI 0.835 to 4.465). A further subgroup analysis was stratified by hematoma volume. The mortality in the endoscopic aspiration group was significantly lower than in the stereotactic aspiration group in the medium (≥40-<80 mL) (OR=2.438, 95% CI 1.101 to 5.402) and large hematoma subgroup (≥80 mL) (OR=66.532, 95% CI 6.345 to 697.675). Compared with the endoscopic aspiration group, a trend towards increased mortality was observed in the large hematoma subgroup of the craniotomy group (OR=8.721, 95% CI 0.933 to 81.551). CONCLUSION:Endoscopic aspiration can decrease the 6-month mortality of spontaneous basal ganglia hemorrhage, especially in patients with a hematoma volume ≥40 mL.

影响因子:0.96
发表时间:2020-02-01
DOI:10.1002/jcu.22762
作者列表:["Meng L","Zhao D","Yang Z","Wang B"]

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