Biomedical subjects

Zvi Israel

Publications and source records attributed to Zvi Israel.

7 recordsLinked to original sources

PubMed2006

Real-time refinement of subthalamic nucleus targeting using Bayesian decision-making on the root mean square measure.

The subthalamic nucleus (STN) is a major target for treatment of advanced Parkinson's disease patients undergoing deep brain stimulation surgery. Microelectrode recording (MER) is used in many cases to identify the target nucleus. A real-time procedure for identifying the entry and exit points of the STN would improve the outcome of this targeting procedure. We used the normalized root mean square (NRMS) of a short (5 seconds) MER sampled signal and the estimated anatomical distance to target (EDT) as the basis for this procedure. Electrode tip location was defined intraoperatively by an expert neurophysiologist to be before, within, or after the STN. Data from 46 trajectories of 27 patients were used to calculate the Bayesian posterior probability of being in each of these locations, given RMS-EDT pair values. We tested our predictions on each trajectory using a bootstrapping technique, with the rest of the trajectories serving as a training set and found the error in predicting the STN entry to be (mean +/- SD) 0.18 +/- 0.84, and 0.50 +/- 0.59 mm for STN exit point, which yields a 0.30 +/- 0.28 mm deviation from the expert's target center. The simplicity and computational ease of RMS calculation, its spike sorting-independent nature and tolerance to electrode parameters of this Bayesian predictor, can lead directly to the development of a fully automated intraoperative physiological procedure for the refinement of imaging estimates of STN borders.

Bayes Theorem↗

PubMed2006

Effect of deep brain subthalamic stimulation on camptocormia and postural abnormalities in idiopathic Parkinson's disease.

Camptocormia has been described in patients with idiopathic Parkinson's disease (PD). We present a patient with young-onset PD in whom the disease progressed over 25 years to a crippling state with severe camptocormia and bent knees. The camptocormia along with other parkinsonian symptoms improved dramatically after bilateral subthalamic deep brain stimulation.

Adult↗

PubMed2005

One for two? Exchanging implanted pulse generators for deep brain stimulation.

The use of a dual channel implantable pulse generator (IPG) for deep brain stimulation during de novo implantation is now routine in many centers. When the generator batteries of bilateral single channel generators expire, the issue of whether to exchange two single channel generators for one dual channel generator arises. This presents many debatable clinical, practical and fiscal issues. We discuss these issues and describe the "one for two" technique we have adopted for exchanging IPGs.

Brain↗

PubMed2005

Neurosurgery at the Hadassah-Hebrew University Medical Center in Jerusalem.

Henrietta Szold founded the Hadassah Women's Organization in the United States in 1912 to alleviate widespread disease and poverty in Jerusalem. In 1918, the Rothschild-Hadassah Hospital and the Hadassah School of Nursing opened in central Jerusalem. Chaim Weizmann and Albert Einstein, together with a small group of visionaries, founded the Hebrew University in 1923. After 1933, many physicians and scientists fled from Europe to Jerusalem, where they carried on their tradition of academic research at the university and Hadassah, and British military doctors joined medical rounds and lectures at Hadassah beginning in the 1930s. Young physicians who had graduated from European medical schools were trained in the subspecialties at Hadassah beginning in the 1940s, and the Hebrew University-Hadassah Medical School enrolled its first class in 1949. These were the first academic institutions of their kind in Israel. The Department of Neurosurgery at Hadassah was established in 1941 under the leadership of Dr. Henry Wigderson, who was recruited from the United States. Dr. Aaron Beller became chairman in 1951, Dr. Mordechai Shalit became chairman in 1977, and Dr. Felix Umansky, the current chairman, was appointed in 1993. Today, more than 900 neurosurgical procedures spanning the spectrum of subspecialties and using state-of-the-art techniques and equipment are performed annually.

History, 20th Century↗

PubMed2005

Subthalamic stimulation for Parkinson's disease.

Subthalamic nucleus stimulation by means of permanently implanted brain electrodes is a very effective therapy for all the cardinal features of Parkinson's disease. In appropriate patients, motor improvement is accompanied by a significantly improved quality of life and a reduced necessity for medication. This article briefly reviews the indications, technique and postoperative management of patients undergoing subthalamic nucleus stimulation.

Contraindications↗

PubMed2003

Spontaneous spinal epidural hematoma in a 14-year-old girl. Case report and review of the literature.

Spontaneous spinal epidural hematoma is a rare cause of spinal cord compression in adults and even rarer in children. It is characterized by a sudden onset of acute back pain followed by acute neurological deterioration within a few hours. We report the case of a 14-year-old girl who presented with acute onset of back pain and progressive weakness of her lower limbs, to the point of being unable to stand or walk. CT imaging disclosed an acute thoracic spinal epidural hematoma. The hematoma was emergently evacuated. Postoperative examination disclosed no neurological deficit.

Adolescent↗

PubMed2003

Surgery for tremor.

Tremor is extremely common and often functionally disabling. When tremor becomes medically intractable, surgery is a good and safe option for appropriate candidates. Both stereotactic thalamotomy and thalamic deep brain stimulation by means of an implanted electrode offer very high rates of success with an acceptably low complication rate.

Dopamine↗