Frameless stereotactic subcaudate tractotomy for intractable obsessive-compulsive disorder.
Obsessive-compulsive disorder (OCD) is a chronic, disabling disorder. Psychosurgery may be indicated for a subset of patients for whom no conventional treatment is satisfactory. This paper focuses on the stereotactic subcaudate tractotomy (SST). Thus far, these procedures have been carried out using frame-based stereotactic techniques. However, modern - highly accurate - frameless stereotactic procedures have successfully been introduced in neurosurgical practice. We developed a novel frameless stereotactic subcaudate tractotomy procedure with promising initial results in a patient suffering from intractable OCD. This is the first report on frameless SST. Future studies should examine whether other ablative stereotactic psychosurgery procedures can be done using frameless stereotactic methods.
Department of Neurosurgery, Rudolf Magnus Institute of Neuroscience, University Medical Center-Utrecht, The Netherlands. p.a.woerdeman@neuro.azu.nl
P A
PA
Woerdeman
P W A
PW
Willems
H J
HJ
Noordmans
J W
JW
Berkelbach van der Sprenkel
P C
PC
van Rijen
D000344:Afferent Pathways / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods / Q000592:standards / Q000639:trends; D002421:Caudate Nucleus / Q000033:anatomy & histology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D038361:Neuronavigation / Q000379:methods* / Q000592:standards / Q000639:trends; D009714:Nucleus Accumbens / Q000503:physiopathology; D009771:Obsessive-Compulsive Disorder / Q000503:physiopathology / Q000601:surgery*; D017397:Prefrontal Cortex / Q000503:physiopathology / Q000601:surgery*; D011300:Preoperative Care; D011612:Psychosurgery / Q000379:methods* / Q000592:standards / Q000639:trends; D020127:Recovery of Function / Q000502:physiology; D013788:Thalamus / Q000503:physiopathology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome