Biomedical subjects
Publications and source records attributed to Y Kanpolat.
C.T.-guided stereotactic destructive pain procedures; percutaneous cordotomy, trigeminal tractotomy-nucleotomy and extralemniscal myelotomy are presented. All procedures were applied in 32 cases without any mispuncture or complication. Advantages of C.T. guidance are direct visualization of target electrode relations, measurements of spinal cord diameters at the lesion site, and demonstration of spinal cord displacement during the procedure.
Percutaneous cordotomy is a commonly applied and effective procedure among the ablative pain surgeries. As plain X-ray does not permit visualization of the target relative to the electrode the chances of obtaining good results are decreased and the risk of complications are increased. The use of CT has been found to be useful in cordotomy. The procedure is performed under CT control on the patients who have previously been given 5 ml iohexol into the subarachnoid space. The needle electrode is manipulated by free hand technique. It is possible to measure the diameter of the spinal cord and to detect cord dislocation in the spinal canal. When the electrode system is introduced it is possible to visualize the tip of the electrode which is pushing or puncturing the spinal cord. As the procedure directly visualizes the relation of the electrode to the target it is possible to place the electrode in the lateral spinothalamic tract. Another advantage of the procedure is to enable us to visualize haematomas or other changes that may result from the cordotomy. The application of the technique and clinical results will be presented.
Trigeminal tractotomy is an effective procedure in denervating pain areas of 5th, 7th, 9th and 10th nerves. The classical imaging technique is the x-ray method which visualizes the target electrode relation indirectly. The method of CT-guided trigeminal tractotomy demonstrates the target electrode relation directly.
CT guided Extralemniscal Myelotomy (E.M.) is described. Direct visualization of the target is the main advantage of the method. The method was applied successfully in two patients.
A case of hydatid cyst in the cavernous sinus is reported. The cyst was treated by cyst aspiration and formalin injection.
Percutaneous selective radiofrequency (RF) neurotomy is described in the treatment of spasticity dominant in femoral adductor and gastrocnemius muscles. The effectiveness of neurotomy has been tested by means of infiltration of nerves with local anesthetic agents before neurotomy in one case. A temperature monitoring needle electrode system with 5 mm noninsulated tip has been used for localization of the nerves by stimulation. Percutaneous obturator neurotomy was performed in the most proximal portion accessible. Posterior tibial neurotomy was performed in two branches of the nerve which innervates the medial and lateral heads of gastrocnemius. Four lesions lasting 60 seconds were made in four different directions between 65 degrees and 70 degrees.
Haematoma of cavum septi pellucidi is a rare condition. Mass effect of the haematoma of cavum may block the foramen of Monro, leading to hydrocephalus and increased intracranial pressure. We are reporting a case of spontaneous haematoma of the cavum septi pellucidi caused by hypertension.
Between 1974 and 1984, 428 trigeminal neuralgia cases were treated by controlled radiofrequency thermocoagulation (RFTC). 29 had recurrent trigeminal neuralgia after intracranial surgery. 26 of the 29 patients were treated by retrogasserian rhizotomy and 3 by posterior fossa exploration. Among the 26 recurrent trigeminal neuralgia following retrogasserian rhizotomy, RFTC was effective in 23 cases (88.5%), and in 3 cases (11.5%) RFTC was effective for a short period. Repeated RFTC was unable to control the pain attacks which were later relieved by posterior fossa exploration and root section. Of the 3 recurrent trigeminal neuralgia following posterior fossa exploration, RFTC was effective in 2 cases (66.6%).
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The microtechnical approach to third ventriculostomy is presented. Opening of the lamina terminalis and basal membrane of the floor of the third ventricle is combined with opening of the membrane of Liliequist. The technique was used in five cases of aqueductal stenosis. We stress the importance of the microscope, and opening of the membrane of Liliequist to gain additional access.
Non-tumoral aqueductal stenosis with hydrocephalus causes dilatation of the third ventricle. This in turn may compress the hypothalamus and optic nerves and erode the clinoids and enlarge the sella turcica. In female patients, amenorrhea or oligomenorrhea is the predominant endocrinologic symptom. Symptoms usually disappear after the drainage of cerebrospinal fluid. Third ventriculostomy by microtechnique was used for operative treatment of our three cases. In all of these, the hydrocephalus was arrested.