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Biomedical subjects

C Berk

Publications and source records attributed to C Berk.

15 recordsLinked to original sources
PubMed2001

Percutaneous controlled radiofrequency trigeminal rhizotomy for the treatment of idiopathic trigeminal neuralgia: 25-year experience with 1,600 patients.

OBJECTIVE: The objective of this study was to evaluate the effectiveness of percutaneous, controlled radiofrequency trigeminal rhizotomy (RF-TR). The outcome of 1,600 patients with idiopathic trigeminal neuralgia after RF-TR was analyzed after a follow-up period of 1 to 25 years. METHODS: A total of 1,600 patients with idiopathic trigeminal neuralgia underwent 2,138 percutaneous radiofrequency rhizotomy procedures between 1974 and 1999. Sixty-seven patients had bilateral idiopathic trigeminal neuralgia, and 36 of them were treated with bilateral RF-TR; 1,216 patients (76%) were successfully managed with a single procedure, and the remainder were treated with multiple procedures. Benzodiazepines and narcotic analgesics were used for anesthesia because patient cooperation during the procedures was essential so that the physician could create selective, controlled lesions. RESULTS: The average follow-up time was 68.1 +/- 66.4 months (range, 12-300 mo). Acute pain relief was accomplished in 97.6% of patients. Complete pain relief was achieved at 5 years in 57.7% of the patients who underwent a single procedure. Pain relief was reported in 92% of patients with a single procedure or with multiple procedures 5 years after the first rhizotomy was performed. At 10-year follow-up, 52.3% of the patients who underwent a single procedure and 94.2% of the patients who underwent multiple procedures had experienced pain relief; at 20-year follow-up, 41 and 100% of these patients, respectively, had experienced pain relief. No mortalities occurred. After the first procedure was performed, early pain recurrence (<6 mo) was observed in 123 patients (7.7%) and late pain recurrence was observed in 278 patients (17.4%). Complications included diminished corneal reflex in 91 patients (5.7%), masseter weakness and paralysis in 66 (4.1%), dysesthesia in 16 (1 %), anesthesia dolorosa in 12 (0.8%), keratitis in 10 (0.6%), and transient paralysis of Cranial Nerves III and VI in 12 (0.8%). Permanent Cranial Nerve VI palsy was observed in two patients, cerebrospinal fluid leakage in two, carotid-cavernous fistula in one, and aseptic meningitis in one. CONCLUSION: Percutaneous, controlled RF-TR represents a minimally invasive, low-risk technique with a high rate of efficacy. The procedure may safely be repeated if pain recurs.

Adolescent↗
PubMed2001

Microelectrode recording for pallidotomy: mandatory, beneficial or dangerous?

There is an active debate regarding whether pallidotomy should be performed with microelectrode recording or macroelectrode stimulation. A meta-analysis was performed on the published reports (1992-2000) of unilateral pallidotomy for Parkinson's disease to determine if the outcome or complications of this procedure significantly differed between these two techniques. Papers were excluded if they followed a cohort of less than ten patients, had follow-up less than three months, or included previously reported patients. There were no significant differences between the two techniques in improvement of dyskinesia (p = 0.66) or UPDRS motor score (p = 0.62). Microelectrode recording had a significantly higher (p = 0.012) intracerebral hemorrhage rate (1.3 +/- 0.4%) compared to macroelectrode stimulation (0.2 +/- 0.2%).

Brain Damage, Chronic↗
PubMed2000

Percutaneous controlled radiofrequency rhizotomy in the management of patients with trigeminal neuralgia due to multiple sclerosis.

Between the years 1974 and 1999, 1,672 patients with medically intractable trigeminal neuralgia (TN) were treated by percutaneous controlled radiofrequency (RF) rhizotomy by the senior author and co-workers at the Department of Neurosurgery, Ankara University School of Medicine. Sixteen hundred cases (95.7%) were found to have idiopathic TN, while 72 cases (4.3%) were classified as symptomatic. In the latter group, TN was found to be caused by multiple sclerosis (MS) in 17 cases (23.6%), one of whom had bilateral TN. All patients having TN with MS (17 cases) underwent percutaneous controlled radiofrequency rhizotomy (25 procedures) as the procedure of choice. The MS patients were followed for an average of 60 months (range: 6-141 months). Complete pain relief was achieved with a single procedure in 12 of the 17 MS cases (70.6%). Early (less than 2 weeks) pain recurrence was seen in two patients (11.8%), while the overall recurrence rate was 29.4%. A second procedure was required to control TN in three cases (17.6%), a third in one (5.9%), and twice for each side for the case with bilateral TN (5.9%). Pain was completely relieved in 14 cases (82.4%) with single or multiple RF rhizotomies. In three cases (17.6%), partial pain control was achieved with RF rhizotomy, and the patients continued to receive adjunctive medical therapy. No complications were observed. All 17 patients (100%) were classified to have done well with RF rhizotomy. Satisfactory results and good long-term pain control were obtained in patients having TN due to MS with percutaneous controlled RF rhizotomy. The authors propose that RF rhizotomy may be a safe and effective procedure in the neurosurgical armamentarium for the treatment of patients having TN due to MS.

Adult↗
PubMed2000

Hydatid disease.

Explore the source record for details and available documents.

Echinococcosis↗
PubMed1998

MRI in primary intraspinal extradural hydatid disease: case report.

A rare case of pathologically proven primary intraspinal extradural hydatid disease of the thoracic region with spinal cord compression is reported. The diagnosis was established preoperatively on the basis of the MRI findings. The patient underwent surgery and recovered completely.

Adolescent↗