Department of Anatomy, University of Athens School of Medicine, Athens, Greece
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Our purpose was to study the surgical anatomy of the deep brain stimulation technique, focusing on the extracerebral part of this minimally invasive procedure.
Materials and methods
Our study was based on four formalin-embalmed adult human cadavers from cadaver donors. We created a set of deep brain stimulation-like materials for the extracerebral technique and formed a step by step diagram of the extracerebral surgical procedure. We also studied the course of the supraorbital nerve.
A small intermediate incision at the midpoint of each tunnel significantly helps in decreasing the procedureâ€™s duration and risks. The lateral limit of the subclavicular pocketâ€™s incision must be vertical to the cervical tunnel axis in order to avoid accidental traumatism during tunneling. Information regarding the supraorbital nerve and skin landmarks of the head, for safer pins or fiducialsâ€™ placement, is also provided.
The extracerebral surgical technique hides uncommon anatomical details and difficult technical points. Their knowledge can help neurosurgeons in decreasing the observed complication rates.