Shieff C, Nashold B S
Department of Surgery, Duke University Medical Center, Durham, North Carolina.
Acta Neurochir Suppl (Wien). 1988;42:239-42. doi: 10.1007/978-3-7091-8975-7_46.
The severe pain that can be experienced by stroke patients is refractory both to drugs and to non-medical therapies. Various surgical procedures are widely advocated for its relief, stereotactic mesencephalic tractotomy in particular providing good results. Twenty seven patients with pain of central origin following stroke underwent stereotactic mesencephalic tractotomy by thermocoagulation at one of two alternative sites. Fourteen had lesions created at the original target adjacent to the superior colliculus, 75% reporting long term relief of their pain. Of this group, 83% had residual postoperative ocular dysfunction (50% symptomatic) and two died soon after surgery. Thirteen patients had surgery at the revised target at the level of the inferior colliculus: 58% had long term pain relief, 23% had ocular problems (none symptomatic) and mortality was nil.
中风患者可能经历的剧痛对药物和非医学疗法均难以奏效。为缓解这种疼痛，人们广泛倡导各种外科手术，尤其是立体定向中脑束切断术，效果良好。27例中风后中枢性疼痛患者在两个备选部位之一接受了热凝立体定向中脑束切断术。14例在与上丘相邻的原始靶点形成损伤，75%报告疼痛长期缓解。该组中，83%术后有残余眼功能障碍（50%有症状），2例术后不久死亡。13例患者在位于下丘水平的修订靶点接受手术：58%疼痛长期缓解，23%有眼部问题（均无症状），无死亡病例。
