Novosti
Khirurgii
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Year 2010 Vol. 18 No 4

NEUROSURGERY

S.A. LIKHACHEV, R.R. SIDOROVICH, V.V. ALESEYEVETS, D.N. SHKOUT, L.N. YUDINA, A.N. KACHINSKY

APPROACHES TO THE SURGICAL TREATMENT OF THE MOVEMENT DISORDERS AT PARKINSON DISEASE

Objectives. Working out of indications and contraindications for the surgical treatment of Parkinson disease, the estimation of the obtained results.
Methods. 189 Parkinson disease patients were examined. While selecting the candidates for the operative treatment the test with levodopa was used. Preoperative scanning of the brain was carried out with magneto-resonant tomography with the intravenous contrasting of the vessels. To estimate the efficacy and objectification of the treatment results the method of analysis of the statokinetic function of the Parkinson patients was used.
Results. From all the examined patients 48 (25,4%) corresponded to the selection criteria for the operative treatment. Stereotaxic thalamo- and pallidotomies were carried out in 32 patients. The operative intervention was done with the stereotaxic apparatus Leksell G (Sweden) and the computer planning station. There were no complications. Significant improvement of the movement function was observed in all patients in the postoperative period, it permitted to decrease the dose of the medicinal preparations and taking into account possible side-effects of preparations against Parkinson disease one managed to reverse the complications of this medication.
Conclusions. Use of the described selection criteria and methods of computer planning of the operation permitted to increase significantly the efficacy of the operative treatment as well as to minimize the number of postoperative treatment.

Keywords: Parkinson disease, stereotaxic thalamotomy, stereotaxic pallidotomy, stabilometry
p. 72-81 of the original issue
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