The Experts below are selected from a list of 2670 Experts worldwide ranked by ideXlab platform
S Blond - One of the best experts on this subject based on the ideXlab platform.
-
endoscopic versus Stereotactic Procedure for pineal tumor biopsies focus on overall efficacy rate
World Neurosurgery, 2016Co-Authors: Anne Balossier, S Blond, Nicolas ReynsAbstract:Objective The management of pineal region tumors depends on the histologic subtypes. Two minimally invasive techniques are available: endoscopic intraventricular biopsies and Stereotactic biopsies. The recent Southampton and Lille series are the largest endoscopic and Stereotactic series of pineal region tumors reporting both diagnosis rate and accuracy rate, respectively; we elaborated on these results in the light of other recent studies. Methods We compared the Southampton endoscopic series with the Lille series, reflecting our 25-year experience of Stereotactic biopsies, and the metadata of the literature for both approaches, as reported in the 2013 Report of the French-Speaking Society of Neurosurgery on tumors of the pineal region. Results The results of the Southampton series match the endoscopic literature, in particular regarding the diagnosis rate (81.2%) and the perioperative morbidity (25.0%), and provide a rarely reported accuracy rate (78.6%), giving access to the overall efficacy rate (63.8%). The results of the Lille series match the Stereotactic literature and show better results than endoscopic biopsies concerning the diagnosis rate (98.9%), accuracy rate (100%), resulting overall efficacy rate (98.9%), and perioperative morbidity (6.4%). Conclusions The Southampton and Lille series provide a unique opportunity to compare the overall efficacy rates of endoscopic and Stereotactic biopsies, respectively. The Stereotactic approach is safer and more effective for biopsies of pineal region tumors. To improve the safety and reliability of endoscopic biopsies, various methods have to be evaluated: alternative burr-hole strategies, use of neuronavigation, and a combination of flexible and rigid endoscopes.
-
endoscopic versus Stereotactic Procedure for pineal tumour biopsies comparative review of the literature and learning from a 25 year experience
Neurochirurgie, 2015Co-Authors: Anne Balossier, S Blond, Gustavo Touzet, M Lefranc, T De Saintdenis, C A Maurage, N. ReynsAbstract:Abstract Background and purpose Pineal tumours account for 1% to 4% of brain tumours in adults and for around 10% in children. Except in a few cases where germ cell markers are elevated, accurate histological samples are mandatory to initiate the treatment. Open surgery still has a high morbidity and is often needless. Biopsies can either be obtained by endoscopic or Stereotactic Procedures. Methods Following an extensive review of the literature (PubMed 1970–2013; keywords pineal tumour, biopsy; English and French), 33 studies were analysed and relevant data compared regarding the type of Procedure, diagnosis rate, cerebrospinal fluid diversion type and rate, perioperative mortality, morbidity. Results Endoscopic and Stereotactic biopsies showed a diagnosis rate of 81.1% (20%–100%) and 93.7% (82%–100%), respectively. Endoscopic biopsies involved 21.0% of minor and 2.0% of major complications whereas Stereotactic biopsies involved 6.4% of minor and 1.6% of major complications. The most frequently reported complication was haemorrhage for both endoscopic and Stereotactic Procedures, accounting for 4.8% and 4.3%, respectively. Mortality rate was low for both endoscopic and Stereotactic Procedures, equal to 0.4% and 1.3%, respectively. Local experience of Stereotactic biopsies was also reported and corroborated the previous data. Conclusions The difference between both Procedures is not statistically significant (p > 0.05) across large series (≥ 20 patients). Nevertheless, tissue diagnosis appears less accurate with endoscopic Procedures than with Stereotactic Procedures (81.1% versus 93.7%, weighted mean across all series). In our opinion, the neuroendoscopic approach is the best tool for managing hydrocephalus, whereas Stereotactic biopsies remain the best way to obtain a tissue diagnosis with accuracy and low morbidity.
-
Place of Stereotactic techniques in the modern management of lateral ventricle tumors. Stereotactic biopsies and radiosurgery
Neurochirurgie, 2011Co-Authors: Michel Lefranc, N. Reyns, S BlondAbstract:The authors make an overview about the use of Stereotactic techniques in the management of lateral ventricle tumors. If Stereotactic techniques are not in the foreground for the management of lateral ventricle tumors, Stereotactic biopsies can be very useful in case of atypical, clinical or radiological presentation of the tumors and radiosurgery can help in case of evolution or re-evolution of tumors after resection. In these cases, Stereotactic Procedures are very safe. Modern technical evolutions allow the optimization of the Stereotactic Procedure but also to mix robotic with endoscopic techniques in order to offer new surgical perspectives.
-
control of tremor and involuntary movement disorders by chronic Stereotactic stimulation of the ventral intermediate thalamic nucleus
Journal of Neurosurgery, 1992Co-Authors: S Blond, D Caparroslefebvre, F Parker, Richard Assaker, Henri Petit, J D Guieu, Jeanlouis ChristiaensAbstract:✓ The authors report on the long-term results of chronic Stereotactic stimulation of the ventralis intermedius thalamic nucleus performed in 14 cases of disabling and intractable tremor. There were 10 patients with parkinsonian tremor and four with essential tremor. Three of the 10 parkinsonian patients had previously undergone contralateral thalamotomy. Tremor was assessed by clinical evaluation, surface electromyography, accelerometer, and videotape recordings before and after stimulation. The deep-brain electrode was implanted in the ventralis intermedius nucleus according to Stereotactic Procedure and connected to a subcutaneous pulse generator after a stimulation test period. Tremor suppression or reduction was obtained in all cases with high-frequency (130 Hz) stimulation. Marked functional improvement was maintained in 11 patients with a mean follow-up interval of 17 months. Levodopa-induced dyskinesias observed in five parkinsonian patients prior to surgery were improved or suppressed in four case...
Jin Woo Chang - One of the best experts on this subject based on the ideXlab platform.
-
Treatment of secondary dystonia with a combined Stereotactic Procedure: long-term surgical outcomes
Acta Neurochirurgica, 2011Co-Authors: Won Seok Chang, Jin Woo ChangAbstract:Objective There is some debate about the effects of pallidal deep brain stimulation (DBS) or lesioning on secondary dystonia. We applied a multimodal method to maximize the treatment effects of deep brain stimulation in patients with secondary dystonia. Methods Between March 2003 and January 2009, four patients underwent bilateral globus pallidus internus (GPi) DBS and six patients underwent bilateral GPi DBS plus unilateral thalamotomy for treatment of cerebral palsy (CP). Among the patients with secondary dystonia without CP, five were also treated by DBS. We classified patients with generalized secondary dystonia with cerebral palsy into group I and patients with focal dystonia without CP into group II. Clinical outcome assessments were based on Burke-Fahn-Marsden Dystonia Rating Scale movement and disability scores. Heath-related quality of life was assessed with a 36-item short-form general health survey questionnaire preoperatively and at the last follow-up. Results The movement and disability scores of group I-A had improved by 32.0% ( P = 0.285) and 14.3% ( P = 0.593), respectively, at the last follow-up compared with baseline. The movement and disability scores of group I-B had improved by 31.5% and 0.18% at the last follow-up compared with baseline, respectively. In comparison with patients in group I-A, patients in group I-B showed a significant improvement in movement scores for the contralateral arm ( P = 0.042). Group II patients showed a marked improvement in movement and disability scores of 77.7% ( P = 0.039) and 80.0% ( P = 0.041), respectively. Conclusions We demonstrated that DBS plus unilateral ventralis oralis thalamotomy for CP patients with fixed states in the upper extremities is useful not only to treat secondary dystonic movement but also to improve quality of life. In group II patients with post-traumatic dystonia and tardive dyskinesia, we achieved excellent clinical outcomes using a Stereotactic Procedure.
-
Treatment of secondary dystonia with a combined Stereotactic Procedure: Long-term surgical outcomes
Acta Neurochirurgica, 2011Co-Authors: Joo Pyung Kim, Won Seok Chang, Jin Woo ChangAbstract:Objective There is some debate about the effects of pallidal deep brain stimulation (DBS) or lesioning on secondary dystonia. We applied a multimodal method to maximize the treatment effects of deep brain stimulation in patients with secondary dystonia.
Pierre Fréger - One of the best experts on this subject based on the ideXlab platform.
-
Deep Brain Stimulation of the Subthalamic Nucleus in Parkinson’s Disease: Usefulness of Intraoperative Radiological Guidance
Stereotactic and Functional Neurosurgery, 2008Co-Authors: Stéphane Derrey, David Maltête, Nathalie Chastan, B. Debono, François Proust, Emmanuel Gerardin, Jacques Weber, Bruno Mihout, Pierre FrégerAbstract:Background: In our Stereotactic Procedure, intraoperative radiological documentation of electrode localization is performed using the Stereoplan. The aim of the study was to evaluat
-
Deep brain stimulation of the subthalamic nucleus in Parkinson's disease: usefulness of intraoperative radiological guidance. The Stereoplan.
Stereotactic and Functional Neurosurgery, 2008Co-Authors: Stéphane Derrey, David Maltête, Nathalie Chastan, B. Debono, François Proust, Emmanuel Gerardin, Jacques Weber, Bruno Mihout, Pierre FrégerAbstract:BACKGROUND: In our Stereotactic Procedure, intraoperative radiological documentation of electrode localization is performed using the Stereoplan. The aim of the study was to evaluate its accuracy. PATIENTS AND METHODS: Data of 20 consecutive patients, treated for Parkinson's disease by implantation of deep brain stimulators into the subthalamic nucleus, were collected prospectively. During surgery, Stereoplan coordinates of the tip of the central macroelectrodes were compared with intended coordinates along the central trajectory at 4 levels: (1) 10 mm above the anatomical target, (2) in the target, (3) in the substantia nigra pars reticulata, and (4) at the depth of contact 1. Before the frame's removal, Stereoplan coordinates of the contacts of the definitive electrode were compared with postoperative MRI coordinates. The mean of the differences was calculated in the x-, y-, and z-axis. Clinical results at 6 months were recorded. RESULTS: The mean of the differences between Stereoplan coordinates and intended coordinates for the macroelectrodes was lower than 1 mm. A submillimeter difference was also found for the definitive contacts. At 6 months, the Unified Parkinson's Disease Rating Scale III score improved by 70.6% compared with the baseline score. Dyskinesia and motor fluctuations decreased by 85.7 and 87%, respectively (p < 0.0001). CONCLUSION: Stereoplan could be considered an accurate intraoperative radiological system which assures the correct position of the electrode in the anatomical target.
Won Seok Chang - One of the best experts on this subject based on the ideXlab platform.
-
Treatment of secondary dystonia with a combined Stereotactic Procedure: long-term surgical outcomes
Acta Neurochirurgica, 2011Co-Authors: Won Seok Chang, Jin Woo ChangAbstract:Objective There is some debate about the effects of pallidal deep brain stimulation (DBS) or lesioning on secondary dystonia. We applied a multimodal method to maximize the treatment effects of deep brain stimulation in patients with secondary dystonia. Methods Between March 2003 and January 2009, four patients underwent bilateral globus pallidus internus (GPi) DBS and six patients underwent bilateral GPi DBS plus unilateral thalamotomy for treatment of cerebral palsy (CP). Among the patients with secondary dystonia without CP, five were also treated by DBS. We classified patients with generalized secondary dystonia with cerebral palsy into group I and patients with focal dystonia without CP into group II. Clinical outcome assessments were based on Burke-Fahn-Marsden Dystonia Rating Scale movement and disability scores. Heath-related quality of life was assessed with a 36-item short-form general health survey questionnaire preoperatively and at the last follow-up. Results The movement and disability scores of group I-A had improved by 32.0% ( P = 0.285) and 14.3% ( P = 0.593), respectively, at the last follow-up compared with baseline. The movement and disability scores of group I-B had improved by 31.5% and 0.18% at the last follow-up compared with baseline, respectively. In comparison with patients in group I-A, patients in group I-B showed a significant improvement in movement scores for the contralateral arm ( P = 0.042). Group II patients showed a marked improvement in movement and disability scores of 77.7% ( P = 0.039) and 80.0% ( P = 0.041), respectively. Conclusions We demonstrated that DBS plus unilateral ventralis oralis thalamotomy for CP patients with fixed states in the upper extremities is useful not only to treat secondary dystonic movement but also to improve quality of life. In group II patients with post-traumatic dystonia and tardive dyskinesia, we achieved excellent clinical outcomes using a Stereotactic Procedure.
-
Treatment of secondary dystonia with a combined Stereotactic Procedure: Long-term surgical outcomes
Acta Neurochirurgica, 2011Co-Authors: Joo Pyung Kim, Won Seok Chang, Jin Woo ChangAbstract:Objective There is some debate about the effects of pallidal deep brain stimulation (DBS) or lesioning on secondary dystonia. We applied a multimodal method to maximize the treatment effects of deep brain stimulation in patients with secondary dystonia.
Stéphane Derrey - One of the best experts on this subject based on the ideXlab platform.
-
Deep Brain Stimulation of the Subthalamic Nucleus in Parkinson’s Disease: Usefulness of Intraoperative Radiological Guidance
Stereotactic and Functional Neurosurgery, 2008Co-Authors: Stéphane Derrey, David Maltête, Nathalie Chastan, B. Debono, François Proust, Emmanuel Gerardin, Jacques Weber, Bruno Mihout, Pierre FrégerAbstract:Background: In our Stereotactic Procedure, intraoperative radiological documentation of electrode localization is performed using the Stereoplan. The aim of the study was to evaluat
-
Deep brain stimulation of the subthalamic nucleus in Parkinson's disease: usefulness of intraoperative radiological guidance. The Stereoplan.
Stereotactic and Functional Neurosurgery, 2008Co-Authors: Stéphane Derrey, David Maltête, Nathalie Chastan, B. Debono, François Proust, Emmanuel Gerardin, Jacques Weber, Bruno Mihout, Pierre FrégerAbstract:BACKGROUND: In our Stereotactic Procedure, intraoperative radiological documentation of electrode localization is performed using the Stereoplan. The aim of the study was to evaluate its accuracy. PATIENTS AND METHODS: Data of 20 consecutive patients, treated for Parkinson's disease by implantation of deep brain stimulators into the subthalamic nucleus, were collected prospectively. During surgery, Stereoplan coordinates of the tip of the central macroelectrodes were compared with intended coordinates along the central trajectory at 4 levels: (1) 10 mm above the anatomical target, (2) in the target, (3) in the substantia nigra pars reticulata, and (4) at the depth of contact 1. Before the frame's removal, Stereoplan coordinates of the contacts of the definitive electrode were compared with postoperative MRI coordinates. The mean of the differences was calculated in the x-, y-, and z-axis. Clinical results at 6 months were recorded. RESULTS: The mean of the differences between Stereoplan coordinates and intended coordinates for the macroelectrodes was lower than 1 mm. A submillimeter difference was also found for the definitive contacts. At 6 months, the Unified Parkinson's Disease Rating Scale III score improved by 70.6% compared with the baseline score. Dyskinesia and motor fluctuations decreased by 85.7 and 87%, respectively (p < 0.0001). CONCLUSION: Stereoplan could be considered an accurate intraoperative radiological system which assures the correct position of the electrode in the anatomical target.
