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Robotic-guided stereotactic RF bilateral lesioning of accumbens nuclei in depression: technical aspects
Author(s): ,
A. Pichierri
Affiliations:
University of Bristol, Neurosurgery, Bristol, United Kingdom
,
R. Ashida
Affiliations:
University of Bristol, Neurosurgery, Bristol, United Kingdom
,
A. Milizia
Affiliations:
University of Bristol, Neurosurgery, Bristol, United Kingdom
N. Patel
Affiliations:
University of Bristol, Neurosurgery, Bristol, United Kingdom
EANS Academy. Pichierri A. Oct 21, 2018; 226023; EP12016
Mr. Angelo Pichierri
Mr. Angelo Pichierri
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Abstract
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Background: Subcaudate tractotomies to disconnect the abnormal interactivity of accumbens nuclei and subcallosal cingulate cortex were first performed by Knight in 1964. The addition of stereotaxy enabled standardized lesion localization and radioactive rods have been soon replaced by thermocontrolled high-frequency electrocoagulation. Half of the treated patients live a normal or near normal life at 1-year after the procedure.
More recent advancement in MRI imaging, stereotactic robotic technologies and readiofrequency devices led to submillimetric localization of the targets, extremely accurate placement of the electrodes and more controlled delivery of the electrocoagulation, both in terms of shape and size of the lesion.
Case description: We present the case of a 64 year-old lady affected by intractable major depression, focusing on technical aspects and costs of our setting.
Conclusions: The precision offered by this cutting edge scenario allowed us to perform the lesions easily, precisely, quickly, and in a standardized way, reducing chances of post-operative complications and the hospital stay: only a short period of observation was necessary to rule out transient neurological issues related to the perilesional oedema.
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