Comparison of actual pallidotomy lesion location with expected stereotactic location

KuoJen Tsao, Steve Wilkinson, John Overman, Jennifer Kieltyka, Travis Tate Tollefson, William C. Koller, Rajesh Pahwa, Alexander I. Troster, Kelly E. Lyons, Solomon Batznitzky, Louis Wetzel, Michael A. Gordon

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Accuracy of pallidotomy lesion placement was assessed by comparing actual lesion locations with expected pallidotomy lesion locations based on stereotaxy. Actual and expected lesions were compared in anteroposterior, dorsoventral and lateral axes. In 22 pallidotomies, actual lesion locations were determined using axial MR images. Expected lesion locations were calculated using a starting point derived from preoperative computerized tomography, displacements from the starting point based on microelectrode- driven electrophysiological refinement, and the trajectory angle of the lesioning tract relative to the anterior-posterior commissural plane. On average, actual lesion locations were found 2.91 ± 2.23 mm posterior, 3.22 ± 2.49 mm ventral, and 0.05 ± 1.80 mm lateral compared to the expected lesion location. Discrepancies between the actual lesion and expected lesion locations may be mostly accounted for by posterior and ventral lesion spread from the exposed electrode tip, in-plane and volume averaging effects associated with MR images, and possible brain shifting during surgery. However, despite the remaining small differences between actual and expected lesion location, good clinical outcome of reduced dyskinesias and 'off' time along with UPDRS-based improvement in mentation, motor and activity of daily living measures was observed.

Original languageEnglish (US)
Pages (from-to)1-19
Number of pages19
JournalStereotactic and Functional Neurosurgery
Volume71
Issue number1
DOIs
StatePublished - 1998
Externally publishedYes

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Pallidotomy
Dyskinesias
Microelectrodes
Activities of Daily Living
Electrodes
Motor Activity
Tomography
Brain

Keywords

  • Magnetic resonance imaging
  • Pallidotomy accuracy
  • Parkinson's disease
  • Radiofrequency lesions
  • Stereotaxy

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Comparison of actual pallidotomy lesion location with expected stereotactic location. / Tsao, KuoJen; Wilkinson, Steve; Overman, John; Kieltyka, Jennifer; Tollefson, Travis Tate; Koller, William C.; Pahwa, Rajesh; Troster, Alexander I.; Lyons, Kelly E.; Batznitzky, Solomon; Wetzel, Louis; Gordon, Michael A.

In: Stereotactic and Functional Neurosurgery, Vol. 71, No. 1, 1998, p. 1-19.

Research output: Contribution to journalArticle

Tsao, K, Wilkinson, S, Overman, J, Kieltyka, J, Tollefson, TT, Koller, WC, Pahwa, R, Troster, AI, Lyons, KE, Batznitzky, S, Wetzel, L & Gordon, MA 1998, 'Comparison of actual pallidotomy lesion location with expected stereotactic location', Stereotactic and Functional Neurosurgery, vol. 71, no. 1, pp. 1-19. https://doi.org/10.1159/000029642
Tsao, KuoJen ; Wilkinson, Steve ; Overman, John ; Kieltyka, Jennifer ; Tollefson, Travis Tate ; Koller, William C. ; Pahwa, Rajesh ; Troster, Alexander I. ; Lyons, Kelly E. ; Batznitzky, Solomon ; Wetzel, Louis ; Gordon, Michael A. / Comparison of actual pallidotomy lesion location with expected stereotactic location. In: Stereotactic and Functional Neurosurgery. 1998 ; Vol. 71, No. 1. pp. 1-19.
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