case_images: PMC10564991_01
case_images: Characteristics of the patient's dentate nucleus on 7T MRI. There is a clear view of the dentate nucleus of the cerebellum. Mag (a), Mip (b), Pha (c), and SWI images (d) have different characteristics, with Mip images being the clearest (see arrow).
case_images: fneur-14-1246430-g0001.jpg
case_images: PMC10564991_01_fneur-14-1246430-g0001.jpg
case_images: F1
case_images: After processing, magnitude (Mag), phase (Pha), minimum-intensity projection (Mip), and susceptibility weighted images (SWI) were obtained (Figure 1). The DN is visible in T2WI-FLAIR MRI (Figure 1).
case_images: (a-c) Preoperative axial, coronal, and sagittal 18F-FDG images showed hypometabolism in the bilateral cerebellar hemisphere; (a'-c') Postoperative axial, coronal, and sagittal 18F-FDG images showed increased uptake in the cerebellum (see box). (d, e) Preoperative axial 18F-FDG images showed normal metabolism in the bilateral cerebral cortex, GPi area, and basal ganglia; (d', e') There was no change in 18F-FDG in the cerebral cortex, GPi area, or basal ganglia after stimulation (see box). (f) Preoperative axial DAT PET/CT showed normal DAT density in the bilateral caudate nucleus and putamen; (f') Compared with the findings in a pre-stimulation image, there were no significant differences in DAT binding in the bilateral caudate nucleus and putamen.
case_images: fneur-14-1246430-g0002.jpg
case_images: PMC10564991_01_fneur-14-1246430-g0002.jpg
case_images: F2
case_images: FDG-PET. Patients were injected with 370 MBq of 18F-FDG, in a dimly lit room with minimal background noise. Fifty minutes after 18F-FDG injection, a scan lasting 10 min was acquired (Figures 2a-e).
case_images: (a-c) A fused image of the intraoperative 3DT1-weighted sequence and the preoperative plan shows that the stimulation lead position and pathway (black dot and line) are consistent with the preoperative plan (green line), and the stimulation lead position is accurate. (d, e) Axial and sagittal diffusion tensor imaging shows the dentatorubrothalamic tract and the relationship between the dentatorubrothalamic tract and stimulation lead in the DN. (f) A coronal 3DT1 image showing the relationship between the pyramidal tract and the stimulation lead in the GPi.
case_images: fneur-14-1246430-g0003.jpg
case_images: PMC10564991_01_fneur-14-1246430-g0003.jpg
case_images: F3
case_images: For the DN pathway, according to the DN position and the electrode covering the anterior and upper third of the DN, the entry point should be as close to the transverse sinus as possible (Figures 3a, b). We reconstructed the dentatorubrothalamic tract by fiber tracking to observe its relationship with the lead (BrainLab, Feldkirchen, Germany) (Figure 3).