Owen Robert L, Grewal Sanjeet S, Thompson Jessica M, Hassan Anhar, Lee Kendall H, Klassen Bryan T
Mayo Clinic Alix School of Medicine, Mayo Clinic, Rochester, MN.
Department of Neurosurgery, Mayo Clinic, Jacksonville, FL.
Mayo Clin Proc Innov Qual Outcomes. 2022 Feb 21;6(2):137-142. doi: 10.1016/j.mayocpiqo.2022.01.001. eCollection 2022 Apr.
Herein we report that the ventralis oralis anterior and posterior (Voa/Vop) nuclei of the thalamus may be effective alternative targets for deep brain stimulation (DBS) to improve posttraumatic dystonia when the globus pallidus interna is traumatically damaged. This patient presented at age 35 years with a clinical diagnosis of posttraumatic cervical and bilateral upper limb acquired dystonia resulting from intracerebral and intraventricular hemorrhage after a motorcycle accident at age 19 years. Due to a right globus pallidus interna traumatic lesion, conventional DBS targeting of the inferior basal ganglia was not possible; thus, the alternative Voa/Vop nuclei target was implanted. The patient realized significant benefit and at last follow-up 3 years postoperatively continued to endorse marked benefit and improvement of dystonia symptoms with minimal adverse effects from bilateral DBS implantation in the alternative targets of the Voa/Vop nuclei of the thalamus.
在此我们报告，当内侧苍白球受到创伤性损伤时，丘脑腹前核和腹后核（Voa/Vop）可能是改善创伤后肌张力障碍的深部脑刺激（DBS）的有效替代靶点。该患者35岁，临床诊断为创伤后颈部及双侧上肢获得性肌张力障碍，病因是19岁时摩托车事故导致的脑内和脑室内出血。由于右侧内侧苍白球创伤性病变，无法对基底节下部进行传统的DBS靶向治疗；因此，植入了替代的Voa/Vop核靶点。患者获得了显著益处，术后3年的最后一次随访中，患者仍认可双侧DBS植入丘脑Voa/Vop核替代靶点带来了明显益处，肌张力障碍症状得到改善，且不良反应最小。
