Neurosurgery or neurological surgery, known in common parlance as brain surgery, is the medical specialty concerned with the surgical treatment of disorders which affect any portion of the nervous system including the brain, spinal cord and peripheral nervous system.
Psychosurgery, also called neurosurgery for mental disorder (NMD), is the neurosurgical treatment of mental disorder. Psychosurgery has always been a controversial medical field. The modern history of psychosurgery begins in the 1880s under the Swiss psychiatrist Gottlieb Burckhardt. The first significant foray into psychosurgery in the 20th century was conducted by the Portuguese neurologist Egas Moniz who during the mid-1930s developed the operation known as leucotomy. The practice was enthusiastically taken up in the United States by the neuropsychiatrist Walter Freeman and the neurosurgeon James W. Watts who devised what became the standard prefrontal procedure and named their operative technique lobotomy, although the operation was called leucotomy in the United Kingdom. In spite of the award of the Nobel prize to Moniz in 1949, the use of psychosurgery declined during the 1950s. By the 1970s the standard Freeman-Watts type of operation was very rare, but other forms of psychosurgery, although used on a much smaller scale, survived. Some countries have abandoned psychosurgery altogether; in others, for example the US and the UK, it is only used in a few centres on small numbers of people with depression or obsessive-compulsive disorder (OCD). In some countries it is also used in the treatment of schizophrenia and other disorders.
Lars Leksell was a Swedish physician and Professor of Neurosurgery at the Karolinska Institute in Stockholm, Sweden. He was the inventor of radiosurgery.
Radiosurgery is surgery using radiation, that is, the destruction of precisely selected areas of tissue using ionizing radiation rather than excision with a blade. Like other forms of radiation therapy, it is usually used to treat cancer. Radiosurgery was originally defined by the Swedish neurosurgeon Lars Leksell as "a single high dose fraction of radiation, stereotactically directed to an intracranial region of interest".
Stereotactic surgery is a minimally invasive form of surgical intervention that makes use of a three-dimensional coordinate system to locate small targets inside the body and to perform on them some action such as ablation, biopsy, lesion, injection, stimulation, implantation, radiosurgery (SRS), etc.
Image-guided surgery (IGS) is any surgical procedure where the surgeon uses tracked surgical instruments in conjunction with preoperative or intraoperative images in order to directly or indirectly guide the procedure. Image guided surgery systems use cameras, ultrasonic, electromagnetic or a combination of fields to capture and relay the patient's anatomy and the surgeon's precise movements in relation to the patient, to computer monitors in the operating room or to augmented reality headsets. This is generally performed in real-time though there may be delays of seconds or minutes depending on the modality and application.
Jean Talairach was a psychiatrist and neurosurgeon who practiced at the Sainte-Anne Hospital Center in Paris, and who is noted for the Talairach coordinates, which are relevant in stereotactic neurosurgery.
Talairach coordinates, also known as Talairach space, is a 3-dimensional coordinate system of the human brain, which is used to map the location of brain structures independent from individual differences in the size and overall shape of the brain. It is still common to use Talairach coordinates in functional brain imaging studies and to target transcranial stimulation of brain regions. However, alternative methods such as the MNI Coordinate System have largely replaced Talairach for stereotaxy and other procedures.
Hirotaro Narabayashi was a prominent Japanese neurosurgeon.
Neuronavigation is the set of computer-assisted technologies used by neurosurgeons to guide or "navigate" within the confines of the skull or vertebral column during surgery, and used by psychiatrists to accurately target rTMS. The set of hardware for these purposes is referred to as a neuronavigator.
Stereotactic radiation therapy (SRT), also called stereotactic external-beam radiation therapy and stereotaxic radiation therapy, is a type of external radiation therapy that uses special equipment to position the patient and precisely deliver radiation to a tumor. The total dose of radiation is divided into several smaller doses given over several days. Stereotactic radiation therapy is used to treat brain tumors and other brain disorders. It is also being studied in the treatment of other types of cancer, such as lung cancer. What differentiates Stereotactic from conventional radiotherapy is the precision with which it is delivered. There are multiple systems available, some of which use specially designed frames which physically attach to the patient's skull while newer more advanced techniques use thermoplastic masks and highly accurate imaging systems to locate the patient. The end result is the delivery of high doses of radiation with sub-millimetre accuracy.
Mammotome is a Cincinnati, OH based company who pioneered a vacuum-assisted breast biopsy (VAC) device that uses image guidance such as x-ray, ultrasound and/or MRI to perform breast biopsies. A biopsy using a Mammotome® device can be done on an outpatient basis with a local anesthetic. The Mammotome brand is sold in over 45 different countries throughout the world.
Stereotactic injection is a procedure in which a computer and a 3-dimensional scanning device are used to inject anticancer drugs directly into a tumor.
Patient registration is used to correlate the reference position of a virtual 3D dataset gathered by computer medical imaging with the reference position of the patient. This procedure is crucial in computer assisted surgery, in order to insure the reproducitibility of the preoperative registration and the clinical situation during surgery. The use of the term "patient registration" out of this context can lead to a confusion with the procedure of registering a patient into the files of a medical institution.
Ablative brain surgery is the surgical ablation by various methods of brain tissue to treat neurological or psychological disorders. The word "Ablation" stems from the Latin word Ablatus meaning "carried away". In most cases, however, ablative brain surgery does not involve removing brain tissue, but rather destroying tissue and leaving it in place. The lesions it causes are irreversible. There are some target nuclei for ablative surgery and deep brain stimulation. Those nuclei are the motor thalamus, the globus pallidus, and the subthalamic nucleus.
T. S. Kanaka or Thanjavur Santhanakrishna Kanaka, also known as Tanjore Santhana Krishna Kanaka, was Asia's first female neurosurgeon and one of the world's first few female neurosurgeons. She was the first neurosurgeon in India to perform chronic electrode implants in the brain, having been also the first to perform deep brain stimulation as early as in 1975. She pioneered functional neurosurgery in the 1960s and 1970s along with Prof. Balasubramaniam, Prof. S. Kalyanaraman; and received recognition for her research and contributions to the field of stereotactic surgery. She is also a recipient of the Lifetime Achievement Award of Madras Neuro Trust.
The N-localizer is a device that enables guidance of stereotactic surgery or radiosurgery using tomographic images that are obtained via computed tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET). The N-localizer comprises a diagonal rod that spans two vertical rods to form an N-shape and permits calculation of the point where a tomographic image plane intersects the diagonal rod. Attaching three N-localizers to a stereotactic instrument allows calculation of three points where a tomographic image plane intersects three diagonal rods. These points determine the spatial orientation of the tomographic image plane relative to the stereotactic frame.
A brain atlas is composed of serial sections along different anatomical planes of the healthy or diseased developing or adult animal or human brain where each relevant brain structure is assigned a number of coordinates to define its outline or volume. Brain atlases are contiguous, comprehensive results of visual brain mapping and may include anatomical, genetic or functional features. A functional brain atlas is made up of regions of interest, where these regions are typically defined as spatially contiguous and functionally coherent patches of gray matter.
Subramanian Kalyanaraman is an Indian neurosurgeon and a former head of the Department of Neurosurgery at Apollo Hospitals, Chennai. He was known for his pioneering techniques in stereotactic surgery and is an elected fellow of a number of science and medical academies including the National Academy of Medical Sciences and the Indian Academy of Sciences. The Council of Scientific and Industrial Research, the apex agency of the Government of India for scientific research, awarded him the Shanti Swarup Bhatnagar Prize for Science and Technology, one of the highest Indian science awards for his contributions to Medical Sciences in 1969.
Amygdalotomy is a form of psychosurgery which involves the surgical removal or destruction of the amygdala, or parts of the amygdala. It is usually a last-resort treatment for severe aggressive behavioral disorders and similar behaviors including hyperexcitability, violent outbursts, and self-mutilation. The practice of medical amygdalotomy typically involves the administration of general anesthesia and is achieved through the application of cranial stereotactic surgery to target regions of the amygdala for surgical destruction. While some studies have found stereotactic amygdalotomy in humans to be an effective treatment for severe cases of intractable aggressive behavior that has not responded to standard treatment methods, other studies remain inconclusive. In most cases of amygdalectomy in humans, there is no substantial evidence of impairment in overall cognitive function, including intelligence and working memory, however, deficits in specific areas of memory have been noted pertaining to the recognition and emotional interpretation of facial stimuli. This is because there are specialized cells in the amygdala which attend to facial stimuli.
