case_images: PMC5990850_01
case_images: T2 MRI of electrode implantation site, axial (A) and sagittal (B) views. Target location on the Schaltenbrand and Wahren atlas in axial (C) and saggital (D) views. Schaltenbrand G, Wahren W Atlas for stereotaxy of the human brain. Stuttgart: Thieme. T2-SPACE MRI, merged with intraoperative CT imaging. (A-B). The electrode is marked with a red dot. AC/PC coordinates were (Lat: -11, A-P: -5, Vert: -1.5). (A) Axial view, contact 1. Note STN is visible anterior to electrode location, with analogous relative location noted in C. (B) Sagittal view, contact 1. Note the electrode location on the sagittal view relative to STN in B, and D. Note also the large cystic lesion superior to the electrode within the thalamus. Electrode location, Schaltenbrand and Wahren atlas, with electrode location marked based on AC/PC coordinates (white circle). (C) Electrode location in axial plane (Plate 54, H.v -1.5). (D) Electrode location in the sagittal plane Schaltenbrand and Wahren, (Plate 44, S.l. 13)
case_images: fsurg-05-00021-g001.jpg
case_images: PMC5990850_01_fsurg-05-00021-g001.jpg
case_images: F1
case_images: We determined the target electrode (contact 0) to be approximately 3.5 mm off target, with contacts 0 and 1 located within the Raprl, inferior to the caudal zona incerta (CZi), and contacts 2 and 3 in the thalamus (SeeFigure 1).
case_images: DBS electrode in anatomical location demonstrating volume of tissue activated (green volume). Fibers were generated via computational tractography (red fibers). These fibers were found to project downward to dentate nucleus of cerebellum (lower region), and upward to the premotor and M1-motor strip of the cortex (upper region). Stimulation utilized contact 1 with amplitude -1V and pulse-width 90 microseconds.
case_images: fsurg-05-00021-g002.jpg
case_images: PMC5990850_01_fsurg-05-00021-g002.jpg
case_images: F2
case_images: CT imaging. Masks for the superior cerebellar peduncle and dentate gyrus were created manually, and along with the VTA estimation, were used as waypoint masks to generate the fiber model. Computed fibers travelled downward to the dentate nucleus of the cerebellum, and upwards towards the M1-and premotor areas (SeeFigure 2).