Invasive Neurosurgical Procedures Research Articles

Intraoperative fusion of field images with CT/MRI data by means of a stereotactic mechanical arm.

In this paper we describe a neurosurgical articulated arm used as a pointer and as a support for intraoperative image acquisition, integrated with a graphic 3-D rendering system. The patient's anatomy is volumetrically displayed, from stereotactically acquired CT, MRI, and DSA images; the head holder is the common reference system for image reconstruction and for the calibration of the surgical arm. Arm orientation in stereotatic space is displayed, together with the surgical arm. Arm orientation in stereotatic space is displayed, together with the volumetric reconstruction of cerebral lesions and surrounding healthy tissue. The arm, equipped with fail-safe electromagnetic brakes, can be employed to support imaging sources such as an endoscope, an echographic probe, or a CCD camera, whose images can be stereotactically integrated with preoperative data in performing minimally invasive neurosurgical procedures.

Blood-brain barrier penetration and in vivo activity of an NGF conjugate.

Nerve growth factor (NGF) is essential for the survival of both peripheral ganglion cells and central cholinergic neurons of the basal forebrain. The accelerated loss of central cholinergic neurons during Alzheimer's disease may be a determinant of dementia in these patients and may therefore suggest a therapeutic role for NGF. However, NGF does not significantly penetrate the blood-brain barrier, which makes its clinical utility dependent on invasive neurosurgical procedures. When conjugated to an antibody to the transferrin receptor, however, NGF crossed the blood-brain barrier after peripheral injection. This conjugated NGF increased the survival of both cholinergic and noncholinergic neurons of the medial septal nucleus that had been transplanted into the anterior chamber of the rat eye. This approach may prove useful for the treatment of Alzheimer's disease and other neurological disorders that are amenable to treatment by proteins that do not readily cross the blood-brain barrier.