Publications by authors named "Nova B Thani"
Objective: The magnetic resonance imaging (MRI)-directed implantable guide tube technique allows for direct targeting of deep brain structures without microelectrode recording or intraoperative clinical assessment. This study describes a 10-year institutional experience of this technique including nuances that enable performance of surgery using readily available equipment.
Methods: Eighty-seven patients underwent deep brain stimulation surgery using the guide tube technique for Parkinson disease (n = 59), essential tremor (n = 16), and dystonia (n = 12).
Background: Endodermal cysts of the oculomotor nerve are rare presentations. Only case reports are available to help guide clinicians with managing this rare entity.
Case Description: A 3-year-old boy presented with an acute on chronic left oculomotor nerve palsy due to a left interpeduncular cistern cyst found on magnetic resonance imaging.
Background: Optic pathway gliomas and glioblastomas remain a rare entity within the infant population.
Case Description: We outline the case of a 6-month-old female who presented with failure to thrive, nystagmus and features of raised intracranial pressure. Subsequent magnetic resonance imaging demonstrated an infiltrating tumor radiating from the optic nerves bilaterally.
Background: Intracranial hypotension secondary to spontaneous spinal cerebrospinal fluid (CSF) fistula is a rare condition that can have serious sequelae. Early diagnosis and treatment can be challenging.
Case Description: We present the case of a 17-year-old male who presented with a history of sudden-onset, postural headaches associated with upper thoracic back pain.
Object: Symptomatic thoracic disc herniations (TDHs) are relatively uncommon, and the technical challenges of resecting the offending disc are formidable due to the location of spinal cord that has relatively poor perfusion characteristics within a narrow canal. The majority of disc herniations are long-standing calcified discs that can be adherent to the ventral dura. Real-time intraoperative ultrasound (RIOUS) visualization of the spinal cord during the retraction and resection of the disc greatly enhances the safety and efficacy of disc resection.
View Article and Find Full Text PDFBackground: Accurate placement of a probe to the deep regions of the brain is an important part of neurosurgery. In the modern era, magnetic resonance image (MRI)-based target planning with frame-based stereotaxis is the most common technique.
Objective: To quantify the inaccuracy in MRI-guided frame-based stereotaxis and to assess the relative contributions of frame movements and MRI distortion.
Background: Knowledge of the anatomic location of the deep brain stimulation (DBS) electrode in the brain is essential in quality control and judicious selection of stimulation parameters. Postoperative computed tomography (CT) imaging coregistered with preoperative magnetic resonance imaging (MRI) is commonly used to document the electrode location safely. The accuracy of this method, however, depends on many factors, including the quality of the source images, the area of signal artifact created by the DBS lead, and the fusion algorithm.
View Article and Find Full Text PDFBackground And Importance: Camptocormia is characterized by abnormal flexion of the thoracolumbar spine that increases during upright posture and abates in the recumbent position and has been reported to occur in patients with Parkinson disease. Camptocormia causes significant spinal and abdominal pain, impairment of balance, and social stigma.
Clinical Presentation: A 57-year-old woman with Parkinson disease developed severe camptocormia, which did not improve with trials of antiparkinsonian and muscle relaxant medications.