| The Functional
and Stereotactic Neurosurgery Center provides comprehensive
evaluation and care for patients with movement disorders,
epilepsy, obsessive-compulsive disorder, and certain
chronic pain syndromes. The center works closely
with the Partners
Parkinson and Movement Disorders Treatment Center,
and the MGH
Epilepsy Unit.
Currently available treatments for movement disorders
include microelectrode-guided deep brain stimulation
of the subthalamic nucleus, the globus pallidus
or the thalamus as appropriate. The Epilepsy
Surgery Unit at MGH offers a full range of treatments
for medically refractory seizure disorders in children
and adults. Procedures to treat chronic pain disorders
such as trigeminal neuralgia include microvascular
decompression, radio-frequency lesions, and deep-brain
or motor-cortex stimulation.
OnLine Article - The
Journal of the American Medical Association
December 26, 2001, Vol286, No24 Surgical
Treatment of Parkinson Disease Emad N. Eskandar,
MD; G. Rees Cosgrove, MD, FRCSC; Leslie A. Shinobu,
MD, PhD Full
Text | PDF
version
Surgery for Parkinson's
Disease Parkinson's Disease (PD) is a progressive
neurological disorder caused by a loss of nerve
cells in the substantia nigra, a small area deep
within the brainstem. In most cases, the cause of
PD is unknown although Parkinson's-like conditions
can be seen after stroke, encephalitis, carbon monoxide
or manganese poisoning and head trauma. The onset
is usually insidious and occurs in most patients
in their 50's and 60's. The major manifestations
of the disease consist of resting tremor, rigidity,
bradykinesia [slowness of movements] and involuntary
movements. Gait disturbance is also a prominent
symptom of Parkinson's Disease. Attending
neurosurgeons in functional and stereotactic neurosurgery
(including electrophysiologically monitored pallidotomy
for Parkinson's disease and thalamotomy for disabling
tremor):
Neurosurgical Treatment
Chronic Pain Syndromes - Surgery can dramatically
benefit people suffering from certain pain syndromes,
particularly those characterized by paroxysmal pain
such as trigeminal and glossopharyngeal neuralgia.
Operations available for certain specific syndromes
include radiofrequency lesioning, glycerol or phenol
injection, the insertion of epidural catheters for
continuous medication infusion, cordotomy, and stereotactic
cingulotomy:
Neurosurgical Treatment
of Movement Disorders - Spasmodic Torticollis
(ST) is a neurological disorder that affects the
muscles of the neck causing the head to pull, turn
or jerk toward the shoulder. It is generally a chronic
condition which may last indefinitely. It can begin
at any time in life, although the symptoms appear
in middle age. About 3 out of every 10,000 people
are affected. This means that approximately 83,000
people have ST. Although caused by a dysfunction
in the brain, its symptoms are limited to sustained
or intermittent involuntary contractions of the
muscles around the neck which control the position
of the head. This causes the head to lean or turn
to one side; it may also be pulled forward or backward.
Some patients also experience shaking movements
of the head and arms. Neurosurgical
treatments can provide dramatic relief in selected
cases of spasmodic torticollis and other focal dystonias.
Neurosurgical treatment is also available for spasticity
(muscle spasms, usually caused by stroke or other
neurologic diseases) of the arms and legs that is
refractory to medical treatments. A variety of procedures
are available through the MGH neurosurgical service.
For more information contact:
Neurosurgical Treatment for
Refractory Psychiatric Diseases - Neurosurgical
treatment of medically refractory psychiatric diseases
such as depression and obsessive-compulsive disorder
(OCD):
Information
resources (Links):
Selected Publications:
- Treatment
of Intractable Psychiatric Illness and Chronic
Pain by Stereotactic Cingulotomy, Ballantine
HT and Cosgrove GR in Operative Neurosurgical
Techniques. Schmidek HH and Sweet WH
(eds), WB Saunders and Co:Philadelphia,
1995.
- Motor
Sequelae and Involuntary Movement Disorders,
Frim DM and Cosgrove GR in Outcome After
Head, Neck and Spinal Trauma: A Medico-legal
Guide. MacFarlane R and Hardy D (eds),
Butterworth-Heinemann, London, 1995.
- An
Approach to Neurosurgical Interventions
for Persistent Pain, Frim DM and Cosgrove
GR in The MGH Manual for Pain. Boorsok
D (ed), 1995.
- Pyschosurgery,
Cosgrove GR and Rauch SL in Neurosurgical
Clinics of North America. Gildenberg
PH (ed), WB Saunders and Co:Philadelphia,
1995.
- Interstitial
Radiosurgery, Zervas NT and Cosgrove GR
in A Textbook of Stereotactic andFunctional
Neurosurgery. Gildenberg PH and Tasker
R (eds), McGraw-Hill, Philadelphia, 1996.
- Cingulotomy
for Psychiatric Illness, Cosgrove GR and
Ballantine HT in A Textbook of Stereotactic
and Functional Neurosurgery. Gildenberg
PH and Tasker R (eds), McGraw-Hill, Philadelphia,
1996.
- Functional
Magnetic Resonance Imaging for Intracranial
Navigation, Cosgrove GR, Buchbinder BR and
Jiang H in Neurosurgical Clinics of North
America. Maciunas R (ed), WB Saunders
and Co:Philadelphia, 1996.
- The
Surgical Treatment of Epilepsy, Cosgrove
GR and Cole AJ in University Reports
on Epilepsy. Dreifuss FE (ed),
AAMC, Newtown, 1996.
- Interstitial
Brachytherapy for Intracranial Metastases,
McDermott MW, Cosgrove GR, Larson DA, Sneed
PK, Gutin PH in Neurosurgical Clinics
of North America. Harsh GR (ed), WB
Saunders and Co:Philadelphia, 1996.
- Psychosurgery,
Cosgrove GR and Rauch SL in Encyclopedia
of Neuroscience. Adelman G and Smith
B (eds), Elsevier, Amsterdam, 1997.
- Neurosurgical
Treatments, Rauch SL and Cosgrove GR in
Comprehensive Textbook of Psychiatry.
Kaplan HI and Sadock BJ (eds), Williams
and Wilkins Co: Baltimore, MD, 1997.
- Outcomes
Assessment of Pallidotomy, Cosgrove GR,
Shinobu L and Penney J in Clinical
Neurosurgery. Grady S (eds) Williams
and Wilkins Co: Baltimore, MD, 1997.
- Thalamotomy
and Pallidotomy, Cosgrove GR and Eskandar
E in Operative Neurosurgery. Kaye
AH and Black P (eds), Churchill Livingstone:
London, UK, 1997.
- Interstitial
Radiosurgery: The Photoelectron Device,
Cosgrove GR, Abdelaziz O and Zervas NT in
Advanced Neurosurgical Navigation.
Alexander E and Maciunas R (eds), Thieme:
New York, NY, 1997.
- Functional
MRI for Planning Cortical Resections Cosgrove
GR and Buchbinder BR in Advanced Neurosurgical
Navigation. Alexander E and Maciunas
R (eds), Thieme: New York, NY, 1997.
- MR
Guided Stereotactic Cingulotomy for Intractable
Psychiatric Disease, Abdelaziz O and Cosgrove
GR in Neurosurgical Operative Atlas.
Rengachary SS and Wilkins RH (eds), Williams
and Wilkins Co: Baltimore, MD, 1997.
- Functional
MRI and PET Scanning as an Adjunct to Surgery,
Cosgrove GR in Cerebral Cortical Surgery
with Functional Mapping. Black P (ed),
1997.
- Psychosurgery:
Current Status, Johnston KR and Cosgrove
GR in Contemporary Neurosurgery.
Tindall GT (ed), Williams and Wilkins Co:
Baltimore, MD, 1997.
- Neurosurgical
Treatment of Neuropsychiatric Disorders,
Marino R, Cosgrove GR, in Psychiatric
Clinics of North America. Miguel EC,
Leckman JF, Rauch S (eds), WB Saunders andCo:Philadelphia,
1997.
![[Functional and Stereotactic Neurosurgery]](/images/FUNChome8.JPG) |
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Local
Emergency
Neurosurgical Hotline
617-277-2381
National
and
International Referrals
Neurosurgery @ MGH
617-726-8581
Neurosurgical
Spine
Referral Line
617-726-8668 |
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