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錐體外路系障碍에 對한 安定的腦深部 手術經驗

Streoencephalotomy for Extrapyramidal System Disorders

대한의학협회지 1963년 6권 9호 p.934 ~ 944
우정현,
소속 상세정보
우정현 (  ) - 수도의과대학 신경외과학교실

Abstract


Since 1960, 14 chemothalamectomies and 1 chemopallidectomy have been performed on 11 Patients with extrapyramidal system disorders : Parkilson´s diseases7, dystonia musculorum deformans 2, hemiballism Iand writer´s clamp.
ln all cases presented in this paper, Cooper´s canula-ballooning-alcohol-pantopaque method was used modifying some of the of orginal technic In . order tofacilitate fixation of the canula.
All cases but one writer´s clamp showed immediate relief of symptoms such as tremor, rigidity, ballismic movement, and torsion spasm, following the surgery. The follow up observation, ore to three years, revealed satisfactory results except, orle dystonia casewho died of general malasia and pneumonia at 3months post-operatively.
The chemothalamectomy. appealed to be superior to the chemopallidectomy in regard to relief of tremor and riditiy. Spasticity has also improved some what following the chemothalamectomy, and accurately placedbilateral chemothalanlectomy was believed the choiceof treatment of well selected bilateral Parkinsonism. Transitory facial weakness, hemiparesis and mildaphasia in the dominant hemisphere were commonly observed following the chemothalamectomy and these complications have been cleared up in one or two weeks without sequelae.
A mild pseudobullbar palsy was experienced in bilateral chemothalamectomy which had also improvedgradualIy. It is believed that lesions accurately confined to ventrolateral nucleus of the thalamus could avoid these complications.

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