Departments of1Neurosurgery and.
3Wayne State University School of Medicine, Detroit, Michigan; and.
Neurosurg Focus. 2018 Aug;45(2):E19. doi: 10.3171/2018.4.FOCUS18130.
Neuromodulation and deep brain stimulation (DBS) have been increasingly used in many neurological ailments, including essential tremor, Parkinson's disease, epilepsy, and more. Yet for many patients and practitioners the desire to utilize these therapies is met with caution, given the need for craniotomy, lead insertion through brain parenchyma, and, at many times, bilateral invasive procedures. Currently endovascular therapy is a standard of care for emergency thrombectomy, aneurysm treatment, and other vascular malformation/occlusive disease of the cerebrum. Endovascular techniques and delivery catheters have advanced greatly in both their ability to safely reach remote brain locations and deliver devices. In this review the authors discuss minimally invasive endovascular delivery of devices and neural stimulating and recording from cortical and DBS targets via the neurovascular network.
神经调节和深部脑刺激(DBS)已越来越多地应用于许多神经疾病,包括原发性震颤、帕金森病、癫痫等。然而,对于许多患者和医生来说,由于需要开颅手术、将导线插入脑实质,并且在许多情况下需要进行双侧侵入性手术,因此对使用这些疗法持谨慎态度。目前,血管内治疗是急性血栓切除术、动脉瘤治疗和大脑其他血管畸形/闭塞性疾病的标准治疗方法。血管内技术和输送导管在安全到达远程脑部位和输送设备的能力方面都有了很大的进步。在这篇综述中,作者讨论了通过神经血管网络经微创血管内途径输送装置和神经刺激及记录皮质和 DBS 靶点的技术。