| 1. |
- Elmi Terander, Adrian, et al.
(författare)
-
Spinal neurokirurgi på grund av radikulopati och myelopat : [Spinal neurosurgery radiculopathy and myelopathy]
- 2023
-
Ingår i: Läkartidningen. - : Läkartidningen Förlag. - 0023-7205 .- 1652-7518. ; 120
-
Tidskriftsartikel (refereegranskat)abstract
- The field of spinal neurosurgery covers degenerative conditions and trauma as well as tumors, malformations and vascular disorders of spine and spinal cord. This article focuses on the Swedish spinal neurosurgical care regarding radiculopathy and myelopathy. Disc herniation, foraminal stenosis, spinal stenosis and spinal cord compression due to degenerative disorders or tumors are discussed. Treatment options such as anterior cervical decompression and fusion, posterior forami-notomy, laminectomy and approaches to spinal intradural tumors are briefly presented. The aim is to present symptoms, diagnostics and treatment options of common conditions to facilitate early detection and referral to neurosurgical centers to avoid delayed dia-gnosis and neurological impairment.
|
|
| 2. |
- Haj-Hosseini, Neda, 1980-, et al.
(författare)
-
5-ALA fluorescence and laser Doppler flowmetry for guidance in a stereotactic brain tumor biopsy
- 2018
-
Ingår i: Biomedical Optics Express. - : Optical Society of America. - 2156-7085. ; 9:5, s. 2284-2296
-
Tidskriftsartikel (refereegranskat)abstract
- A fiber optic probe was developed for guidance during stereotactic brain biopsy procedures to target tumor tissue and reduce the risk of hemorrhage. The probe was connected to a setup for the measurement of 5-aminolevulinic acid (5-ALA) induced fluorescence and microvascular blood flow. Along three stereotactic trajectories, fluorescence (n = 109) and laser Doppler flowmetry (LDF) (n = 144) measurements were done in millimeter increments. The recorded signals were compared to histopathology and radiology images. The median ratio of protoporphyrin IX (PpIX) fluorescence and autofluorescence (AF) in the tumor was considerably higher than the marginal zone (17.3 vs 0.9). The blood flow showed two high spots (3%) in total. The proposed setup allows simultaneous and real-time detection of tumor tissue and microvascular blood flow for tracking the vessels.
|
|
| 3. |
|
|
| 4. |
|
|
| 5. |
- Haj-Hosseini, Neda, 1980-, et al.
(författare)
-
Photobleaching behavior of protoporphyrin IX during 5-aminolevulinic acid marked glioblastoma detection
- 2009
-
Ingår i: PHOTONIC THERAPEUTICS AND DIAGNOSTICS V. - : SPIE. - 0277-786X .- 1996-756X. - 9780819474070 ; 7161
-
Konferensbidrag (refereegranskat)abstract
- The highly malignant brain tumor, glioblastoma multiforme (GBM), is difficult to fully delineate during surgical resection due to its infiltrative ingrowth and morphological similarities to surrounding functioning brain tissue. Selectiveness of GBM to 5-aminolevulinic acid (5-ALA) induced protoporphyrin IX (PpIX) is reported by other researchers to visualize tumor margins under blue light microscopy. To allow objective detection of GBM, a compact and portable fiber optic based fluorescence spectroscopy system is developed. This system is able to deliver excitation laser light (405 nm) in both the continuous and pulsed mode. PpIX fluorescence peaks are detected at 635 and 704 nm, using a fiber-coupled spectrometer. It is necessary to optimize the detection efficiency of the system as the PpIX quickly photobleaches during the laser illumination. A light dose of 2.5 mJ (fluence rate = 9 mJ/mm(2)) is experimentally approved to excite an acceptable level of fluourescence signal arising from glioblastoma. In pulsed illumination mode, an excitation dose of 2.5 mJ, with a dark interval of 0.5 s (duty cycle 50\%) shows a significantly shorter photobleaching time in comparison to the continuous illumination mode with the same laser power (p < 0.05). To avoid photobleaching (the remaining signal is more than 90\% of its initial value) when measuring with 2.5 mJ delivered energy, the time for continuous and pulsed illumination should be restricted to 2.5 and 1.1 s, respectively.
|
|
| 6. |
|
|
| 7. |
- Ilias, Michail, 1971-, et al.
(författare)
-
Evaluation of a Fiber-Optic Fluorescence Spectroscopy System to Assist Neurosurgical Tumor Resections
- 2007
-
Ingår i: Novel Optical Instrumentation for Biomedical Applications III (Proceedings Volume). - Bellingham, Washington, USA : SPIE - International Society for Optical Engineering. - 0277-786X .- 1996-756X. - 9780819467751 ; , s. 66310W-1-66310W-8
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The highly malignant brain tumor, glioblastoma multiforme, is difficult to totally resect without aid due to its infiltrative way of growing and its morphological similarities to surrounding functioning brain under direct vision in the operating field. The need for an inexpensive and robust real-time visualizing system for resection guiding in neurosurgery has been formulated by research groups all over the world. The main goal is to develop a system that helps the neurosurgeon to make decisions during the surgical procedure. A compact fiber optic system using fluorescence spectroscopy has been developed for guiding neurosurgical resections. The system is based on a high power light emitting diode at 395 nm and a spectrometer. A fiber bundle arrangement is used to guide the excitation light and fluorescence light between the instrument and the tissue target. The system is controlled through a computer interface and software package especially developed for the application. This robust and simple instrument has been evaluated in vivo both on healthy skin but also during a neurosurgical resection procedure. Before surgery the patient received orally a low dose of 5-aminolevulinic acid, converted to the fluorescence tumor marker protoporphyrin IX in the malignant cells. Preliminary results indicate that PpIX fluorescence and brain tissue autofluorescence can be recorded with the help of the developed system intraoperatively during resection of glioblastoma multiforme.
|
|
| 8. |
|
|
| 9. |
- Wårdell, Karin, 1959-, et al.
(författare)
-
One-Insertion Stereotactic Brain Biopsy Using In Vivo Optical Guidance-A Case Study
- 2023
-
Ingår i: Operative Neurosurgery. - : LIPPINCOTT WILLIAMS & WILKINS. - 2332-4252 .- 2332-4260. ; 25:2, s. 176-182
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Stereotactic neurosurgical brain biopsies are afflicted with risks of inconclusive results and hemorrhage. Such complications can necessitate repeated trajectories and prolong surgical time.OBJECTIVE: To develop and introduce a 1-insertion stereotactic biopsy kit with direct intraoperative optical feedback and to evaluate its applicability in 3 clinical cases.METHODS: An in-house forward-looking probe with optical fibers was designed to fit the outer cannula of a side-cutting biopsy kit. A small aperture was made at the tip of the outer cannula and the edges aligned with the optical probe inside. Stereotactic biopsies were performed using the Leksell Stereotactic System. Optical signals were measured in millimeter steps along the preplanned trajectory during the insertion. At the region with the highest 5-aminolevulinic acid (5-ALA)-induced fluorescence, the probe was replaced by the inner cannula, and tissue samples were taken. The waiting time for pathology diagnosis was noted.RESULTS: Measurements took 5 to 10 minutes, and the surgeon received direct visual feedback of intraoperative 5-ALA fluorescence, microcirculation, and tissue gray-whiteness. The 5-ALA fluorescence corroborated with the pathological findings which had waiting times of 45, 50, and 75 minutes. Because only 1 trajectory was required and the patient could be prepared for the end of surgery immediately after sampling, this shortened the total surgical time.CONCLUSION: A 1-insertion stereotactic biopsy procedure with real-time optical guidance has been presented and successfully evaluated in 3 clinical cases. The method can be modified for frameless navigation and thus has great potential to improve safety and diagnostic yield for both frameless and frame-based neurosurgical biopsy procedures.
|
|
| 10. |
|
|
