Stereotactic rostral mesencephalotomy in cancer pain and deafferentation pain. A series of 40 cases with follow-up results.
Stereotactic rostral mesencephalotomy was performed in two groups of patients to investigate the long-term results in regard to pain relief. A standardized technique of target localization with ventriculography was used. Group A consisted of 33 patients with otherwise intractable pain due to cancer. Group B consisted of seven patients with deafferentation pain. Long-term pain relief was good (57%) for Group A and nonexistent for Group B patients. It is concluded that stereotactic rostral mesencepthalotomy is a valuable means for treating nociceptive cancer pain in lateral syndromes, but is of no value in neuropathic pain. Anatomical correlates for the results obtained are discussed and a hypothesis on the plasticity of the neo- and paleospinal afferent systems is formulated.
Division of Neurosurgery, University of Amsterdam Hospital, The Netherlands.
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Bosch
D000344:Afferent Pathways / Q000502:physiology; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008636:Mesencephalon / Q000601:surgery*; D009369:Neoplasms / Q000503:physiopathology*; D010146:Pain / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications / Q000401:mortality; D013238:Stereotaxic Techniques