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        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Debido a que no existe un m&#233;todo radiol&#243;gico que nos permita determinar con total seguridad el punto diana &#243;ptimo para la cirug&#237;a de la enfermedad de Parkinson y que por otro lado se sabe&#44; que los mejores resultados en dicha cirug&#237;a se obtienen lesionando el conjunto celular del n&#250;cleo ventral intermedio del t&#225;lamo o del p&#225;lido medial&#44; el objetivo de este trabajo&#44; es valorar la exactitud de las coordenadas calculadas mediante la imagen radiol&#243;gica de la tomograf&#237;a axial computarizada craneal &#40;TAC craneal&#41; con respecto a las obtenidas mediante el registro intracerebral con semielectrodo&#46; A 14 pacientes se les practic&#243; 6 palidotom&#237;as&#44; 4 talamotom&#237;as y 4 implantes de electrodo para estimulaci&#243;n cerebral profunda &#40;DBS&#41; mediante cirug&#237;a estereot&#225;xica y monitorizaci&#243;n con registros intracerebrales&#46; Las diferencisa entre la&#8764; coordenadas estereot&#225;xicas obtenidas mediante la imagen de la TAC craneal y las del registro neurofisiol&#243;gico fueron para la palidotom&#237;a de X&#58; 2<span class="elsevierStyleHsp" style=""></span>mm&#44; Y&#58; 1&#46;3<span class="elsevierStyleHsp" style=""></span>mm y Z&#58; 1&#46;1<span class="elsevierStyleHsp" style=""></span>mm y para la talamotom&#237;a&#47;implante de DBS de X&#58; 1&#46;5<span class="elsevierStyleHsp" style=""></span>mm&#44; Y&#58; 1&#46;3<span class="elsevierStyleHsp" style=""></span>mm y Z&#58; Omm&#46; Las mayores diferencias se obtuvieron en la palidotom&#237;a&#44; en especial&#44; para la coordenada X&#44; y las menores para la talamotom&#237;a&#44; especialmente en la coordenada Z&#46; La mayor diferencia individual se obtuvo en un paciente sometido a palidotom&#237;a en el que se evidenci&#243; una diferencia en las coordenadas de X&#58; 3<span class="elsevierStyleHsp" style=""></span>mm&#44; Y&#58; 2&#46;5<span class="elsevierStyleHsp" style=""></span>mm y Z&#58; 5<span class="elsevierStyleHsp" style=""></span>mm&#46; En otro paciente al que se le realiz&#243; una talamotom&#237;a no existi&#243; diferencia ninguna en las tres coordenadas&#46;</p>"
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        "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The aim of this work is to analyse the accuracy of the coordinates calculated by means of computed tomography &#40;CT&#41; as compared with those obtained by electrophysiological intracerebral recording with a semi- electrode&#46; Fourteen stereotactic operations have been performed&#58; six pallidotomies&#44; four thalamotomies and four electrode implants for deep brain intracerebral stimulation &#40;DBS&#41; by using intraoperative neurophysiological monitorization&#46; The differences between the stereotactic coordinates obtained by means of CT and by means of the neurophysiological search were&#44; X&#58; 2<span class="elsevierStyleHsp" style=""></span>mm&#44; Y&#58; 1&#46;3<span class="elsevierStyleHsp" style=""></span>mm&#44; Z&#58; 1&#46;1<span class="elsevierStyleHsp" style=""></span>mm for pallidotomy&#44; and X&#58; 1&#46;5<span class="elsevierStyleHsp" style=""></span>mm&#44; Y&#58; 1&#46;3<span class="elsevierStyleHsp" style=""></span>mm and Z&#58; Omm for thalamotomy&#47;DBS implanto The major differences were obtained in the X coordinate for pallidotomy&#44; and the minor in the Z coordinate for thalamotomy&#47;DBS implanto</p>"
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Vol. 10. Núm. 3.
Páginas 226-232 (enero 1998)
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Vol. 10. Núm. 3.
Páginas 226-232 (enero 1998)
Valor del registro neurofisiológico en la cirugía de la enfermedad de Parkinson. Estudio preliminar
The significance of microelectrode recording in Parkinson's disease surgery
Visitas
1709
F. Seijo, J.M. Moreno
Servicio de Neurocirugía. Hospital Central de Asturias. Oviedo
F. Fernández González*, C. Salvador**, L. Menéndez-Guisasola**
* Servicio de Neurofisiología Clínica. Hospital Central de Asturias. Oviedo
** Servicios de Neurología I y II. Hospital Central de Asturias. Oviedo
Este artículo ha recibido
Información del artículo
Resumen

Debido a que no existe un método radiológico que nos permita determinar con total seguridad el punto diana óptimo para la cirugía de la enfermedad de Parkinson y que por otro lado se sabe, que los mejores resultados en dicha cirugía se obtienen lesionando el conjunto celular del núcleo ventral intermedio del tálamo o del pálido medial, el objetivo de este trabajo, es valorar la exactitud de las coordenadas calculadas mediante la imagen radiológica de la tomografía axial computarizada craneal (TAC craneal) con respecto a las obtenidas mediante el registro intracerebral con semielectrodo. A 14 pacientes se les practicó 6 palidotomías, 4 talamotomías y 4 implantes de electrodo para estimulación cerebral profunda (DBS) mediante cirugía estereotáxica y monitorización con registros intracerebrales. Las diferencisa entre la∼ coordenadas estereotáxicas obtenidas mediante la imagen de la TAC craneal y las del registro neurofisiológico fueron para la palidotomía de X: 2mm, Y: 1.3mm y Z: 1.1mm y para la talamotomía/implante de DBS de X: 1.5mm, Y: 1.3mm y Z: Omm. Las mayores diferencias se obtuvieron en la palidotomía, en especial, para la coordenada X, y las menores para la talamotomía, especialmente en la coordenada Z. La mayor diferencia individual se obtuvo en un paciente sometido a palidotomía en el que se evidenció una diferencia en las coordenadas de X: 3mm, Y: 2.5mm y Z: 5mm. En otro paciente al que se le realizó una talamotomía no existió diferencia ninguna en las tres coordenadas.

Palabras clave:
Palidotomía
Talamotomía
Semiregistro cerebral
Estereotaxia
Enfermedad de Parkinson
Summary

The aim of this work is to analyse the accuracy of the coordinates calculated by means of computed tomography (CT) as compared with those obtained by electrophysiological intracerebral recording with a semi- electrode. Fourteen stereotactic operations have been performed: six pallidotomies, four thalamotomies and four electrode implants for deep brain intracerebral stimulation (DBS) by using intraoperative neurophysiological monitorization. The differences between the stereotactic coordinates obtained by means of CT and by means of the neurophysiological search were, X: 2mm, Y: 1.3mm, Z: 1.1mm for pallidotomy, and X: 1.5mm, Y: 1.3mm and Z: Omm for thalamotomy/DBS implanto The major differences were obtained in the X coordinate for pallidotomy, and the minor in the Z coordinate for thalamotomy/DBS implanto

Key words:
Pallidotomy
Thalamotomy
Microelectrode recording
Stereotactic surgery
Parkinson's disease

Artículo

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