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Related Concept Videos

Psychosurgery01:30

Psychosurgery

Psychosurgery, the surgical alteration or permanent removal of brain tissue to alleviate severe psychological conditions, stands as one of the most radical and controversial treatments in the history of mental health care. Its development and application have evolved significantly, marked by dramatic shifts in scientific understanding and ethical perspectives.
Historical Development of Psychosurgery
In the 1930s, Portuguese neurologist Antonio Egas Moniz introduced a surgical procedure designed...

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Subcutaneous Trigeminal Nerve Field Stimulation for Refractory Facial Pain
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Published on: May 10, 2017

Cingulotomy for medically refractory cancer pain.

Ashwin Viswanathan1, Viraat Harsh, Erlick A C Pereira

  • 1Department of Neurosurgery, Baylor College of Medicine, Houston, Texas 77030, USA. ashwinv@bcm.edu

Neurosurgical Focus
|September 3, 2013
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Summary

Stereotactic cingulotomy offers meaningful pain relief for many cancer patients, particularly those with diffuse pain or emotional distress. While generally safe, potential side effects include temporary attention deficits and apathy.

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Area of Science:

  • Neurosurgery
  • Oncology
  • Pain Management

Background:

  • Refractory cancer pain poses a significant challenge.
  • Cingulotomy is a potential neurosurgical intervention for intractable pain.
  • Optimal patient selection and outcomes for cingulotomy in cancer pain require further clarification.

Purpose of the Study:

  • To review the existing literature on cingulotomy for cancer-related pain.
  • To characterize optimal candidates and outcomes for this intervention.

Main Methods:

  • Systematic literature search of PubMed, PubMed Central, Cochrane Library, and MEDLINE.
  • Included studies utilized stereotactic techniques for cingulotomy in cancer pain patients.
  • Excluded open techniques and avoided double-counting patient data.

Main Results:

  • Eight unique studies reported outcomes of stereotactic cingulotomy for cancer pain.
  • Meaningful pain relief was observed in 32% to 83% of patients.
  • Adverse events were rare, though early postoperative decline in focused attention, apathy, and decreased activity were noted.

Conclusions:

  • Stereotactic cingulotomy may be a safe option for cancer pain patients with diffuse pain syndromes, head and neck malignancies, and significant emotional distress.
  • The procedure is associated with minimal cognitive changes.