Critical approach to intrastriatal medullary adrenal implants via open surgery in parkinsonism. Case report

Encouraged by the recent reports on the beneficial effects obtained with open transplantation of autologous adrenal medullary grafts into striatal structures in case with resistent Parkinson's disease, our team used this procedure in a 63-year-old man presenting with severe bradykinesia and rigidity resistent to all pharmacological attempts. In this case through a laparotomy the right adrenal gland was removed and stored in oxygenated Collins and bicarbonated Ringer solution mixtures while a F2 transventricular approach to the head of the caudatum was done. With the surgical microscope the medullary part of the adrenal gland was dissected and four pieces of mm3 of tissue selected, implanting them in a bed previously carved in the caudatum. Endocrinologic and hydroelectrolytic problems appeared during the immediate postoperative period. In the following 5 months no clinical benefit nor electroneurophysiological changes were observed.