Deep Brain Stimulation Surgery


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Glossary

Anesthesia, General:
Drugs administered intravenously or through inhaled gasses that prevent a patient from remembering or feeling anything during a medical procedure.  The ‘sleep’ the patient experiences under general anesthesia is not the same as regular sleep since memories are not typically formed nor pain signals felt. 

Anesthesia, Local:
Also known as topical anesthetics.  This group of medicines is used to temporarily deaden the nerves in the skin to prevent pain or itching.  Local anesthesia does not cause unconsciousness or ‘sleep’ in the patient.

Basal Ganglia:
Responsible for cognitive function, coordinating movements and controlling voluntary movements.  The basal ganglia is the located deep within the cerebral hemispheres and is comprised of the corpus stratium, subthalamic nucleus and the substantia nigra.

Bovie:
A device used to electrically cauterize, or burn and seal  the ends of blood vessels that are bleeding into the surgical field.

CT Scan:
Also known as computerized tomography.  This is an x-ray imaging technique that produces images of the brain or other parts of the body in cross section.   A typical x-ray is a flat picture of the body, similar to a photograph.  The CT scan is an x-ray unit that rotates around the body and uses a powerful computer to produce many cross-sectional views of the organ being scanned.

Deep Brain Stimulation Surgery:
A stimulation probe is surgically implanted in the brain and acts much like a pace maker, sending electrical signals to specific areas of the brain, thereby changing the symptoms of some diseases such as Parkinson’s, Distonia, and receives stimulation impulses from a neurostimulator or battery. This stimulator or battery is normally placed in the upper chest like a pacemaker.

Fiducials:
Screws or markers that are placed in the patient’s skull to aid in scanning, mapping and performing surgery.  The fiducials assist the surgeon in aligning MRI and CT scans saved on a computer with the actual locations on a patient’s head. These assist the surgeon in registering the patient's head to the scans in the navigational computer system, thus allowing the surgeon to navigate in a real time fashion on the computer screen. The fiducial is paramount in building the relationship between the computerized scans of the patient's head and the actual live patient in the operating room.

Frameless Stereotaxy:
This system matches the fiducials on the patient to the patient's MRI and CT scans that were downloaded into the computer system. The MRI and CT scans are very important to the surgeon because he or she plans the surgery by identifying and selecting a target within the brain. The system is made up of a computer planning system, camera, mini frame, a reference probe and reference arc which the camera can identify or "see". Think of this as a small GPS system. Together these technologies enable the surgeon to produce a three dimensional space within the computer system and allows him or her to navigate or "move" the probe around the patients head to "find" the intended or planned target.

Global Positioning System:
A system that uses satellites and portable receiving units to determine location very accurately.

IO Ban:
A sticky plastic that is infused with betadine (antibacterial substance) used to cover skin during surgery.  It lowers in the incidence of infection of the surgical incision by bacteria. 

Lap Sponge:
A square of sterile gauze used during many medical procedures to absorb liquid or clean an area.

MRI Scan:
Magnetic Resonance Imaging.  A diagnostic test that uses magnetic fields instead of x-rays to produce two- or three-dimensional images of organs inside the body.  This scan is especially useful for soft tissues such as the brain or spinal cord.

Neurologist:
A medical doctor that specializes in the study of the brain, spinal cord and nervous system. 

Neurosurgeon:
A surgeon specializing in the treatment of diseases of the nervous system that respond to surgical intervention.

Parkinson’s Disease:
A degenerative disease that causes shaking (tremor) and difficulty with walking, movement, and coordination.  It is caused by decreased levels of the neurotransmitter dopamine.

Recording Probe or Electrode:
A probe that is inserted into the brain during deep brain stimulation surgery that is used to record the sounds of the brain.  This probe is removed prior to the end of surgery and is replaced with the implanted lead or electrode catheter.

Scalp:
The skin covering the top of the head.

Scalpel:
A sharp, sterile knife used to during surgery to cut tissue.

Skull:
The main bone of the head which protects the brain, also known as the cranium.

Stimulation Probe or Electrode:
A probe that is inserted during deep brain stimulation surgery that stimulates or sends electrical impulses to a targeted area of the brain.  This probe is left in the brain after surgery and attached to a battery pack to provide the stimulation to the patient after surgery. 

Subthalamic Nucleus or STN:
A structure located deep in the brain in the basal ganglia that is involved in motor control.

Tower System or 'Microdrive':
The system used in deep brain stimulation that helps hold and guide the stimulation probe into the brain.  The tower is set to allow the probe to be inserted to a particular depth and therefore allows the surgeon to be extremely accurate when inserting the probe.

Trajectory:
The intended path of the electrode probe from the skull surface to the target deep in the brain.

Tunneler:
A long, thin instrument used to go under the skin from the top of the skull to the clavicle.  The instrument is then used to grab the lead of the battery and pull it under the skin back to the top of the skull so the lead can be connected to the stimulation probe.