Transcranial sonography-assisted stereotaxy and follow-up of deep brain implants in patients with movement disorders.

Transcranial sonography (TCS) of the brain parenchyma meanwhile allows a high-resolution imaging of deep brain structures in the majority of adults. Two pilot studies have demonstrated that the intraoperative visualization with TCS and the TCS-assisted insertion of deep-brain stimulation (DBS) electrodes into the subthalamic nucleus and the globus pallidus interna are feasible and safe provided there is exact knowledge on the extent of electrode TCS imaging artifacts. Moreover, TCS can be recommended for the postoperative monitoring of DBS electrode position. Dislocation of a DBS electrode can be easily detected. It is likely that the obvious advantages of TCS will promote its increasing use for the intra- and postoperative monitoring of deep brain implants.

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