RESUMO
Advances in transcranial MRI-guided focused ultrasound have renewed interest in lesioning procedures in functional neurosurgery with a potential role in the treatment of neurological conditions such as chronic pain, brain tumours, movement disorders and psychiatric diseases. While the use of transcranial MRI-guided focused ultrasound represents a new innovation in neurosurgery, ultrasound has been used in neurosurgery for almost 60 years. This paper reviews the major historical milestones that have led to modern transcranial focused ultrasound and discusses current and evolving applications of ultrasound in the brain.
Assuntos
Neoplasias Encefálicas/diagnóstico por imagem , Encéfalo/cirurgia , Ablação por Ultrassom Focalizado de Alta Intensidade/métodos , Procedimentos Neurocirúrgicos/métodos , Humanos , UltrassonografiaRESUMO
Surgical neuromodulation has emerged as the primary method to treat the medically refractory symptoms of essential tremor and Parkinson disease. With reversible manipulation of CNS neurons, neuromodulation can be used to intraoperatively localize and verify a stereotactic target, and to chronically treat movement disorders. This article discusses the historical advances in stereotactic surgery using various modalities of neuromodulation leading to contemporary treatment. Electrical neuromodulation, or deep brain stimulation, is emphasized as the major surgical intervention with a discussion of the technique, surgical targets, and clinical outcomes. A comparison of neuromodulation techniques is presented.