Tasker R R, Dostrovsky J O, Dolan E J
Toronto Hospital, Department of Surgery, University of Toronto, Canada.
Stereotact Funct Neurosurg. 1991;57(4):157-66. doi: 10.1159/000099568.
Eighty-three consecutive functional stereotactic procedures (56 thalamotomies, 1 medial thalamotomy, and 26 chronic brain stimulatory electrode introductions) were done using CT to identify the three-dimensional coordinates of anterior and posterior commissures. The three-dimensional locations of the tactile relay in ventrobasal complex for manual digits were then determined as the first step in physiological corroboration of target site using single-cell recordings and microstimulation. The measured location of this structure was then compared with that predicted by the Schaltenbrand and Bailey atlas. There was no discrepancy in the mediolateral plane in 62.7%, in the dorsoventral plane in 63.9%, and in the anteroposterior plane in 44.6% of the cases. Over 2 mm deviation occurred in 10.8, 12.0, and 19.2% of the cases in these three planes, respectively. This precision of localization is better than that reported with ventriculography. Many of the larger discrepancies occurred in patients who had suffered from stroke, multiple sclerosis, severe head injury, or after craniotomy.
连续进行了83例功能性立体定向手术（56例丘脑切开术、1例内侧丘脑切开术和26例慢性脑刺激电极植入术），使用CT确定前连合和后连合的三维坐标。然后，将手部手指腹侧基底复合体中触觉中继的三维位置确定为使用单细胞记录和微刺激对靶点进行生理学验证的第一步。随后将该结构的测量位置与Schaltenbrand和Bailey图谱预测的位置进行比较。在62.7%的病例中，内外侧平面无差异；在63.9%的病例中，背腹平面无差异；在44.6%的病例中，前后平面无差异。在这三个平面中，分别有10.8%、12.0%和19.2%的病例出现超过2 mm的偏差。这种定位精度优于脑室造影报告的精度。许多较大的差异出现在患有中风、多发性硬化症、严重头部损伤的患者或开颅术后的患者中。
