TAILIEUCHUNG - Báo cáo khoa học: "Gamma knife radiosurgery for movement disorders: a concise review of the literature"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Gamma knife radiosurgery for movement disorders: a concise review of the literature | Elaimy et al. World Journal of Surgical Oncology 2010 8 61 http content 8 1 61 WORLD JOURNAL OF SURGICAL ONCOLOGY REVIEW Open Access Gamma knife radiosurgery for movement disorders a concise review of the literature Ameer L Elaimy 1 4 Benjamin J Arthurs1 2 Wayne T Lamoreaux1 4 John J Demakas1 3 Alexander R Mackay1 5 Robert K Fairbanks1 4 David R Greeley6 Barton S Cooke1 and Christopher M Lee 1 4 Abstract Medication is the predominant method for the management of patients with movement disorders. However there is a fraction of patients who experience limited relief from pharmaceuticals or experience bothersome side-effects of the drugs. Deep brain stimulation DBS and surgical lesioning of the thalamus and basal ganglia are respected neurosurgical procedures with valued success rates and a very low incidence of complications. Despite these positive outcomes DBS and surgical lesioning procedures are contraindicated for some patients. Stereotactic radiosurgery with the Gamma Knife GK has been used as a lesioning technique for patients seeking a non-invasive treatment alternative and for medication-intolerable patients who are unable to undergo DBS or lesioning due to comorbid medical conditions. Tremors of various etiologies are treated using GK thalamotomy which targets the ventralis intermedius nucleus. GK thalamotomy produces favorable outcomes when treating tremors with success rates ranging from 80100 . In contrast GK pallidotomy targets the internal globus pallidus and is used in treating bradykinesia rigidity and dyskinesia. Although radiosurgery has proven beneficial for tremors radiosurgical pallidotomy for bradykinesia rigidity and dyskinesia remains questionable with mixed success rates in the literature that ranges from 0-87 . We suggest that GK thalamotomy be offered along with other neurosurgical approaches as a feasible treatment option to patients who prefer the non-invasive nature of radiosurgery and to those who are unqualified candidates

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