Placement of deep brain stimulators into the subthalamic nucleus.
We present our technique for deep brain stimulation (DBS) of the subthalamic nucleus (STN) and include information which may be helpful in general DBS. With the patient in a stereotactic head frame, the anterior and posterior commissures are identified on SPGR-sequence magnetic resonance imaging (MRI). STN coordinates are based on a stereotactic brain atlas at 12 mm lateral, 2 mm posterior and 5 mm caudal to the midcommissural point. Surgical navigation software allows for planning of the trajectory. Electromyography is used to quantitatively measure tremor responses to macrostimulation. Permanent lead placement is confirmed with intraoperative fluoroscopy and postoperative MRI.
Yoon
M S
MS
Department of Neurosurgery, Temple University School of Medicine, Philadelphia, PA 19140, USA. myoon000@nimbus.temple.edu
Munz
M
M
D001931:Brain Mapping; D004599:Electric Stimulation Therapy / Q000295:instrumentation*; D004567:Electrodes, Implanted; D004576:Electromyography; D005471:Fluoroscopy; D006801:Humans; D008279:Magnetic Resonance Imaging; D016343:Monitoring, Intraoperative / Q000295:instrumentation* / Q000379:methods; D010300:Parkinson Disease / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D011182:Postoperative Care; D011300:Preoperative Care; D012984:Software; D013238:Stereotaxic Techniques; D020531:Subthalamic Nucleus / Q000473:pathology*