Thalamotomy

Thalamotomy
Intervention
ICD-9-CM	01.41
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Thalamotomy (Greek: θάλαμος thalamus lit. "chamber"; Greek: τομή tomē "cut, slice") is a surgical procedure in which an opening is made into the thalamus in order to improve the overall brain function in patients. First introduced in the 1950s, it is primarily effective for tremors such as those associated with Parkinson's disease (PD), where a selected portion of the thalamus is surgically destroyed (ablated). Neurosurgeons use specialized equipment to precisely locate an area of the thalamus, usually choosing to work on only one side (the side opposite that of the worst tremors). Bilateral procedures are poorly tolerated because of increased complication and risk, including vision and speech problems. The positive effects on tremors are immediate. Other less destructive procedures are sometimes preferred, such as subthalamic deep brain stimulation (DBS), since this procedure can also improve tremors and other symptoms of PD.

Thalamotomy is a complex procedure performed by specialists of brain or neurosurgeons. It is mostly indicated in following conditions: Stroke, damage to third ventricle of brain, brain hemorrhage, accidents leading to head injury, oedema around thalamus, subdural hemorrhage and cerebrovascular accident.

Sub-thalamotomy is a type of brain surgery in which the subthalamic nucleus is destroyed in attempt to help alleviate movement disorders often associated with Parkinson’s disease. This surgery has been most widely researched at Cuba’s International Center for Neurological Restoration (CIREN) located in Havana. This center has assumed a leading role in developing a surgical procedure that provides significant relief for patients experiencing the slowness of movement, tremor and muscle rigidity in middle to late stages of PD. Similar to the thalamotomy, this procedure can be repeated on both sides of the brain bilaterally, but is not recommended due to a large increase in the risk of speech and cognitive problems post-surgery. The aim of subthalamotomies is to reduce symptoms of PD and the uncontrolled movements that can occur in patients taking the drug levodopa for a long period of time.

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