基于導(dǎo)航的立體定向腦電圖在癲癇外科中的應(yīng)用
發(fā)布時間：2018-08-27 06:35
【摘要】：目的通過綜合應(yīng)用神經(jīng)導(dǎo)航結(jié)合腦立體定向技術(shù)獲取患者三維立體腦電圖以精確定位顱內(nèi)致癇灶指導(dǎo)外科手術(shù)治療,觀察在難治性癲癇患者治療中的安全性、有效性。方法我科收治的14例藥物難治性癲癇患者行顱腦三維磁共振及頭顱靜脈成像,利用Brain-LAB神經(jīng)導(dǎo)航系統(tǒng)融合影像數(shù)據(jù),建立立體大腦及皮層靜脈模型,設(shè)計路徑避開皮層血管,導(dǎo)航生成靶點坐標,然后在Leksell立體定向下植入立體定向電極,分析其安全性及有效性。結(jié)果 14例患者共植入94枚電極,所有電極均成功植入,主要并發(fā)癥是一例電極植入位置偏移及該電極導(dǎo)致的顱內(nèi)少量出血及一例間接顱內(nèi)感染,術(shù)后進行視頻腦電監(jiān)測,確定顱內(nèi)致癇灶并進行手術(shù)(一例患者腦深部電刺激治療),術(shù)后隨訪療效滿意。結(jié)論建立立體大腦及皮層靜脈模型有效避免電極植入出血;立體定向電極植入作為侵襲性評估致癇灶的方法是安全、有效的,并在行硬膜下皮層電極植入術(shù)后效果不佳的病例中體現(xiàn)優(yōu)越性。
[Abstract]:Objective to evaluate the safety and efficacy of neuronavigation combined with stereotactic technique in the treatment of intracerebral epilepsy. Methods Fourteen patients with drug-resistant epilepsy were treated with three-dimensional craniocerebral magnetic resonance imaging and cephalic vein imaging. The three-dimensional cerebral and cortical vein models were established by Brain-LAB neuronavigation system to avoid cortical vessels. The target coordinates were generated by navigation and the stereotactic electrode was implanted under Leksell stereotactic orientation to analyze its safety and effectiveness. Results 94 electrodes were implanted in 14 patients, all the electrodes were implanted successfully. The main complications were the displacement of the electrode implantation, the small amount of intracranial hemorrhage caused by the electrode and the indirect intracranial infection. The video EEG monitoring was performed after operation. Intracranial epileptogenic foci were determined and operated on (one patient with deep brain stimulation). Conclusion Stereotactic electrode implantation is a safe and effective method to evaluate the invasiveness of epileptic foci. And the superiority of subdural cortical electrode implantation was demonstrated in the cases with poor effect.
【作者單位】： 上海交通大學醫(yī)學院附屬仁濟醫(yī)院功能神經(jīng)科;
【分類號】：R651.1
[Abstract]:Objective to evaluate the safety and efficacy of neuronavigation combined with stereotactic technique in the treatment of intracerebral epilepsy. Methods Fourteen patients with drug-resistant epilepsy were treated with three-dimensional craniocerebral magnetic resonance imaging and cephalic vein imaging. The three-dimensional cerebral and cortical vein models were established by Brain-LAB neuronavigation system to avoid cortical vessels. The target coordinates were generated by navigation and the stereotactic electrode was implanted under Leksell stereotactic orientation to analyze its safety and effectiveness. Results 94 electrodes were implanted in 14 patients, all the electrodes were implanted successfully. The main complications were the displacement of the electrode implantation, the small amount of intracranial hemorrhage caused by the electrode and the indirect intracranial infection. The video EEG monitoring was performed after operation. Intracranial epileptogenic foci were determined and operated on (one patient with deep brain stimulation). Conclusion Stereotactic electrode implantation is a safe and effective method to evaluate the invasiveness of epileptic foci. And the superiority of subdural cortical electrode implantation was demonstrated in the cases with poor effect.
【作者單位】： 上海交通大學醫(yī)學院附屬仁濟醫(yī)院功能神經(jīng)科;
【分類號】：R651.1
【共引文獻】
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6 劉光耀;楊曉萍;張U，
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