Tract Identification by Novel MRI Signal Changes following Stereotactic Anterior CapsulotomyHurwitz T.A. · Mandat T. · Forster B. · Honey C.
Departments of aPsychiatry and bRadiology and cDivision of Neurosurgery, University of British Columbia, Vancouver, Canada
Background: Five patients underwent magnetic resonance imaging (MRI) following MRI-guided stereotactic bilateral anterior capsulotomy to detect lesion-related anatomic changes. Methods: Five disabled and treatment-resistant patients with major depression (n = 4) and obsessive-compulsive disorder (n = 1) underwent stereotactic bilateral anterior capsulotomy. All patients had postoperative MRI at 2 months and at 1–4 years after surgery. An additional patient who had a pure motor deficit following a spontaneous basal ganglia hemorrhagic stroke was imaged as a comparator. Results: The 2-month postcapsulotomy MRI showed a previously undescribed increase in T1-weighted signal within similar neural pathways for each patient. These pathways showed no changes in T2-weighted or fluid-attenuated inversion recovery sequences. The signal changes are different from the expected changes associated with anterograde Wallerian degeneration and identify retrograde changes in the proximal segment of the interrupted axon. Conclusion: Previously undescribed T1-weighted signal alterations following stereotactic surgery identify retrograde non-Wallerian changes in interrupted axons and provide a new method in identifying and tracing lesioned pathways.
|Direct payment||This item at the regular price: USD 38.00|
|Payment from account||With a Karger Pay-per-View account (down payment USD 150)
you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50