Skip to main content
SpringerLink
Log in

Intracranial Neuroablation

  • Chapter
  • First Online:
Essentials of Interventional Cancer Pain Management

  • 1524 Accesses

Abstract

Although ablative surgical techniques are more commonly applied to the spine pain pathways for the treatment of cancer pain, there are indications for intracranial targets. Cingulotomy is used for widespread metastasis when there is a significant affective component in addition to pain. Hypophysectomy produces pain relief for widespread bone metastasis but may lead to hormonal dysfunction. Trigeminal nucleotractotomy improves pain in 80% of head and neck cancer at 6 months, with risk of ataxia and dysesthesia. Thalamotomy improves pain in more than half of patients and rarely causes permanent deficits.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Tracey I, Mantyh PW. The cerebral signature for pain perception and its modulation. Neuron. 2007;55:377–91.

    Article  CAS  Google Scholar 

  2. Rolls ET, O’Doherty J, Kringelbach ML, Francis S, Bowtell R, McGlone F. Representations of pleasant and painful touch in the human orbitofrontal and cingulate cortices. Cereb Cortex. 2003;13:308–17.

    Article  CAS  Google Scholar 

  3. Rosenstein D. Depression and end-of-life care for patients with cancer. Dialogues Clin Neurosci. 2011;13:101–8.

    PubMed  PubMed Central  Google Scholar 

  4. Viswanathan A, Harsh V, EAC P, Aziz TZ. Cingulotomy for medically refractory cancer pain. Neurosurg Focus. 2013;35:E1.

    Article  Google Scholar 

  5. Faillace LA, Allen RP, JD MQ, Northrup B. Cognitive deficits from bilateral cingulotomy for intractable pain in man. Dis Nerv Syst. 1971;32:171–5.

    CAS  PubMed  Google Scholar 

  6. Foltz EL, White LE Jr. Pain “relief” by frontal cingulumotomy. J Neurosurg. 1962;19:89–100.

    Article  CAS  Google Scholar 

  7. Hurt RW, Thomas Ballantine H Jr. Stereotactic anterior cingulate lesions for persistent pain: a report on 68 cases. Clin Neurosurg. 1974;21:334–51.

    Article  CAS  Google Scholar 

  8. Voris HC, Whisler WW. Results of stereotaxic surgery for intractable pain. Confin Neurol. 1975;37:86–96.

    Article  CAS  Google Scholar 

  9. Yen CP, Kuan CY, Sheehan J, Kung SS, Wang CC, CK L, Kwan AL. Stereotactic bilateral anterior cingulotomy for intractable pain. J Clin Neurosci. 2005;12:886–90.

    Article  Google Scholar 

  10. Yen CP, Kuan CY, Sheehan J, Kung SS, Wang CC, Liu CK, Kwan AL. Impact of bilateral anterior cingulotomy on neurocognitive function in patients with intractable pain. J Clin Neurosci. 2009;16:214–9.

    Article  Google Scholar 

  11. Wong ET, Gunes S, Gaughan E, Patt RB, Ginsberg LE, Hassenbusch SJ, Payne R. Palliation of intractable cancer pain by MRI-guided cingulotomy. Clin J Pain. 1997;13:260–3.

    Article  CAS  Google Scholar 

  12. Cosgrove GR, Rauch SL. Stereotactic cingulotomy. Neurosurg Clin N Am. 2003;14:225–35.

    Article  Google Scholar 

  13. Kanpolant Y. Percutaneous Cordotomy and Trigeminal Tractotomy-Nucleotomy. In: Alterman RL, Youmans LA, editors. Neurological Surgery. Philadelphia: Elsiver; 2011. p. 1851–8.

    Chapter  Google Scholar 

  14. Teixeira MJ, Fonoff ET. Technique of trigeminal nucleotractotomy. In: Lozano AM, Gildenberg PL, Tasker RR, editors. Textbook of stereotactic and functional neurosurgery. Berlin: Springer; 2009. p. 2097–123.

    Chapter  Google Scholar 

  15. Thompson EM, Burchiel KJ, Raslan AM. Percutaneous trigeminal tractotomy-nucleotomy with use of intraoperative computed tomography and general anesthesia: report of 2 cases. Neurosurg Focus. 2013;35:E5.

    Article  Google Scholar 

  16. Raslan A. Percutaneous computed tomography-guided radiofrequency ablation of upper spinal cord pain pathways for cancer-related pain. Neurosurgery. 2008;62:ONS226–33.

    Google Scholar 

  17. Vernon H, Mark MD, Frank R, Ervin MD, Thomas P, Hackett MD. clinical aspects of stereotactic thalamotomy in the human part I. The treatment of chronic severe pain. Arch Neurol. 1960;3(4):351–67. https://doi.org/10.1001/archneur.1960.00450040001001.

    Article  CAS  Google Scholar 

  18. Jeanmonod D, Magnin M, Morel A. Thalamus and neurogenic pain: physiological, anatomical, and clinical data. Neuroreport. 1993;4:475–8.

    Article  CAS  Google Scholar 

  19. Sano K. Intralaminal thalamotomy (thalamolaminotomy) and posterior-medial hypothalamotomy in the treatment of intractable pain. Prog Neurol Surg. 1977;8:50–103.

    Article  Google Scholar 

  20. Jeanmonod D, Morel A. The central lateral thalamotomy for neuropathic pain. In: Lozano AMGPTR, editor. Textbook of stereotactic and functional neurosurgery. Berlin/Heidelberg: Springer; 2009. p. 2081–96.

    Chapter  Google Scholar 

  21. Young RF, Vermeulen SS, Grimm P, Posewitz AE, Jacques DB, Rand RW, Copcutt BG. Gamma knife thalamotomy for the treatment of persistent pain. Stereotact Funct Neurosurg. 1995;64:172–81.

    Article  Google Scholar 

  22. Richardson DE. Thalamotomy for control of chronic pain. Acta Neurochir. 1974;21:77–88.

    PubMed  Google Scholar 

  23. Takeda F. Neurosurgical treatment of chronic pain. Postgrad Med J. 1984;60:905–13.

    Article  CAS  Google Scholar 

  24. Perrault M, Le Beau J, Klotz B, Sicard J, Clavel B. L’hypohysectomie totale dans le traitment du cancer du sein: premier cas francais: avenir de la methode. Therapie. 1952;7:290–300.

    CAS  PubMed  Google Scholar 

  25. Pearson OH, West CD, Hollander VP, Treves NE. Evaluation of endocrine therapy for advanced breast cancer. JAMA. 1954;154:234–9.

    Article  CAS  Google Scholar 

  26. Kennedy BJ, French LA, Peyton WT. Hypophysectomy in advanced breast cancer. NEJM. 1956;255:1165–72.

    Article  CAS  Google Scholar 

  27. Ramirez LF, Levin AB. Pain Relief after Hypophysectomy. Neurosurgery. 1984;4:499–504.

    Google Scholar 

  28. Daniel PM, Prichard MM. The human hypothalamus and pituitary stalk after Hypophysectomy or pituitary stalk section. Brain. 1972;95:813–24.

    Article  CAS  Google Scholar 

  29. Hosobuchi Y, Adams JE, Linchitz R. Pain relief by electrical stimulation of the central Gray matter in humans and its reversal by naloxone. Science. 1977;197:183–6.

    Article  CAS  Google Scholar 

  30. Levin AB, Ramirez LF, Katz J. The use of stereotaxic chemical Hypophysectomy in the treatment of thalamic pain syndrome. J Neurosurg. 1983;59(6):1002–6.

    Article  CAS  Google Scholar 

  31. Hayashi M, Taira T, Ochiai T, Chernov M, Takasu Y, Izawa M, Kouyama N, Tomida M, Tokumaru O, Katayama Y, Kawakami Y, Hori T, Takakura K. Gamma knife surgery of the pituitary: new treatment for thalamic pain syndrome. J Neurosurg. 2005;102(Suppl):38–41.

    Article  Google Scholar 

  32. Miles J. Neurological advances in the relief of pain. Br J Hosp Med. 1983;30:348. 350, 353.

    CAS  PubMed  Google Scholar 

  33. Madrid JL. Chemical hypophysectomy. Adv Pain Res Ther. 1979;2:381–91.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. West Virginia University, Department of Neurosurgery, Morgantown, WV, USA

    Roy Hwang

  2. Baylor College of Medicine, Department of Neurosurgery, Houston, TX, USA

    Ashwin Viswanathan

  3. Oregon Health & Science University, Department of Neurosurgery, Portland, OR, USA

    Ahmed M. Raslan

  4. Portland VA Medical Center, Neurological Surgery, Portland, OR, USA

    Ahmed M. Raslan

  5. New Orleans Neurosurgical Associates, Marrero, LA, USA

    Erich Richter

Authors
  1. Roy Hwang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ashwin Viswanathan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ahmed M. Raslan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Erich Richter
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Erich Richter .

Editor information

Editors and Affiliations

  1. Department of Anesthesiology and Critical Care, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Amitabh Gulati

  2. Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Vinay Puttanniah

  3. Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA

    Brian M. Bruel

  4. Midwest Neuroscience Institute, Center for the Relief of Pain, Kansas City, MO, USA

    William S. Rosenberg

  5. Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Joseph C. Hung

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Hwang, R., Viswanathan, A., Raslan, A.M., Richter, E. (2019). Intracranial Neuroablation. In: Gulati, A., Puttanniah, V., Bruel, B., Rosenberg, W., Hung, J. (eds) Essentials of Interventional Cancer Pain Management. Springer, Cham. https://doi.org/10.1007/978-3-319-99684-4_22

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-99684-4_22

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-99682-0

  • Online ISBN: 978-3-319-99684-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation