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Cryogenic Surgery of the Basal Ganglia FREE

Irving S. Cooper, M.D.
[+] Author Affiliations

Read before the Section of Nervous and Mental Diseases at the 111th Annual Meeting of the American Medical Association, Chicago, June 26, 1962.


JAMA. 1962;181(7):600-604. doi:10.1001/jama.1962.03050330030006
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Apparatus for the highly localized application of cold at various degrees from room temperature down to —190° C. (—310° F.) makes it possible to cause either temporary paralysis or permanent destruction of selected portions of the nervous system. The technique of cryogenic surgery consists of first applying moderate cold to identify the locus of abnormal neural activity and then intense cold to make a circumscribed lesion there. This paper reports the results of 2,060 applications of cryogenic surgery for the relief of the tremor and rigidity of parkinsonism and 150 applications for relief of other dystonic or hyperkinetic disorders. Since the lesion produced in the brain is sharply delimited and essentially nonhemorrhagic, the incidence of complications has been low, and in a series of 100 consecutive cases there was relief of symptoms in 90 cases with no deaths.

REFERENCES

Cooper, I. S.:  Results of 1000 Consecutive Basal Ganglia Operations for Parkinsonism , Ann Intern Med 3:483-499 ( (March) ) 1960;.
Cooper, I. S.: Parkinsonism: Its Medical and Surgical Therapy , Springfield, Ill.: Charles C Thomas, Publisher, 1961;.
Cooper, I. S., and Lee, A. S. J.:  Cryothalamectomy— Hypothermic Congelation: Technical Advance in Basal Ganglia Surgery: Preliminary Report , J Amer Geriat Soc 9:8 ( (Aug.) ) 1961;.
Cooper, I. S.; Grissman, F.; and Johnston, P.:  Complete System for Cryogenic Surgery , St Barnabas Hosp Med Bull 1:11-16, 1962;.
Hinojosa, U., et al.: Cryogenic Lesions in Cats' Brains, to be published.
Guiot, G., and Brion, S.:  Traitement des Mouvements Anormaux par la Coagulation Pallidale: Technique et Resultats , Rev Neurol (Par) 89:578-580, 1953;.
Gillingham, F. J., et al.:  Surgical Treatment of Parkinsonism , Brit Med J 2:1395-1402, 1960;.
Narabayashi, H.; Okuma, T.; and Shikiba, S.:  Procaine-Oil Blocking of Globus Pallidus , Arch Neurol Psychiat 75:36-48, 1956;.
Spiegel, E. A.; Wycis, H. T.; and Baird, H. W.:  Long Range Effects of Electro-Palliodansotomy in Extrapyramidal and Convulsive Disorders , Neurology 8:734, 740, 1958;.
Meyers, R., et al.:  Early Experience With Ultrasonic Irradiation of Pallidofugal and Nigral Complexes in Hyperkinetic and Hypertonic Disorders , J Neurosurg 16:32-53, 1959;.
Cooper, I. S., and Bravo, G.:  Chemopallidectomy and Chemothalamectomy , J Neurosurg 15:244-250, 1958;.
Stern, J., and Ward, A. A.:  Inhibition of Muscle Spindle Discharge by Ventrolateral Thalamic Stimulation: Its Relation to Parkinsonism , Arch Neurol 3:193-204, 1960;.
Stern, J., and Ward, A. A., Jr.:  Supraspinal and Drug Modulation of Alpha Motor System , Arch Neurol 5:404-413 ( (May) ) 1962;.
Reichert, T., and Hassler, R.:  Special Method of Stereotaxic Brain Operation , Proc Roy Soc Med 48:469-470 ( (June) ) 1955;.
Talairach, J., et al.: Atlas D'Anatomie Stereotaxique , Paris: Masson & Cie, 1957;.
Spiegel, E. A., and Wycis, H. T.:  Ansotomy in Paralysis Agitans , Arch Neurol Psychiat 71:598-614, 1954;.
Hassler, R., and Riechert, T.:  Indikationen und Lokalisationsmethode der Gezielten Hirnoperationen , Nervenzart 25:441-447, 1954;.
Bertrand, C., and Martinez, N.:  Apparatus and Technique for Surgery of Dyskinesias , Neurochirurgia 2:36-46, 1959;.
Cooper, I. S.:  Neurosurgical Alleviation of Intention Tremor of Multiple Sclerosis and Cerebellar Disease , New Engl J Med 263:441-444 ( (Sept. 1) ) 1960;.
Cooper, I. S.:  Surgical Studies of Reversibility of Dystonia , Trans Amer Neurol Ass , 1961;.
Haas, G. H., and Taylor, C. B.:  Quantitative Hypothermal Method for Production of Local Injury to Tissue , Arch Path 45:563-580 ( (Nov.) ) 1948;.
Balthasar, K. L.:  Direct Cold Injuries in Cerebral Cortex of Cat , Deutsch Z Nervenheilk 176:173-199, 1957;.
Ries, L., and Tytus, J. S.:  Rapid Freezing: Surgical Technique (Preliminary Report) , Bull Mason Clin 14:20-26 ( (March) ) 1960;.
Rowbotham, G. F.; Haigh, A. L.; and Leslie, W. G.:  Cooling Cannula for Use in Treatment of Cerebral Neoplasm , Lancet 1:12-15 ( (Jan. 3) ) 1959;.
Dondey, M.; Rey, L.; and LeBeau, J.:  Présentation d'un Instrument Permettant le Refroidissement Controle' de Structures Cérébrales Superficielles , Rev Neurol (Par) 103:3:220 ( (Sept.) ) 1960;.
Weil, L.; Chanteur, J.; and Dondey, M.:  Dispositif Pour le Refroidissement Controlé de Certaines Structures Cérébrales Profondes , C R Acad Sci (Par) pp. 2947-2948 ( (May 8) ) 1961;.
Mark, V. H., et al.:  Localized Cooling in Brain , Science 134:1520-1521 ( (Nov. 10) ) 1961;.

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Cooper, I. S.:  Results of 1000 Consecutive Basal Ganglia Operations for Parkinsonism , Ann Intern Med 3:483-499 ( (March) ) 1960;.
Cooper, I. S.: Parkinsonism: Its Medical and Surgical Therapy , Springfield, Ill.: Charles C Thomas, Publisher, 1961;.
Cooper, I. S., and Lee, A. S. J.:  Cryothalamectomy— Hypothermic Congelation: Technical Advance in Basal Ganglia Surgery: Preliminary Report , J Amer Geriat Soc 9:8 ( (Aug.) ) 1961;.
Cooper, I. S.; Grissman, F.; and Johnston, P.:  Complete System for Cryogenic Surgery , St Barnabas Hosp Med Bull 1:11-16, 1962;.
Hinojosa, U., et al.: Cryogenic Lesions in Cats' Brains, to be published.
Guiot, G., and Brion, S.:  Traitement des Mouvements Anormaux par la Coagulation Pallidale: Technique et Resultats , Rev Neurol (Par) 89:578-580, 1953;.
Gillingham, F. J., et al.:  Surgical Treatment of Parkinsonism , Brit Med J 2:1395-1402, 1960;.
Narabayashi, H.; Okuma, T.; and Shikiba, S.:  Procaine-Oil Blocking of Globus Pallidus , Arch Neurol Psychiat 75:36-48, 1956;.
Spiegel, E. A.; Wycis, H. T.; and Baird, H. W.:  Long Range Effects of Electro-Palliodansotomy in Extrapyramidal and Convulsive Disorders , Neurology 8:734, 740, 1958;.
Meyers, R., et al.:  Early Experience With Ultrasonic Irradiation of Pallidofugal and Nigral Complexes in Hyperkinetic and Hypertonic Disorders , J Neurosurg 16:32-53, 1959;.
Cooper, I. S., and Bravo, G.:  Chemopallidectomy and Chemothalamectomy , J Neurosurg 15:244-250, 1958;.
Stern, J., and Ward, A. A.:  Inhibition of Muscle Spindle Discharge by Ventrolateral Thalamic Stimulation: Its Relation to Parkinsonism , Arch Neurol 3:193-204, 1960;.
Stern, J., and Ward, A. A., Jr.:  Supraspinal and Drug Modulation of Alpha Motor System , Arch Neurol 5:404-413 ( (May) ) 1962;.
Reichert, T., and Hassler, R.:  Special Method of Stereotaxic Brain Operation , Proc Roy Soc Med 48:469-470 ( (June) ) 1955;.
Talairach, J., et al.: Atlas D'Anatomie Stereotaxique , Paris: Masson & Cie, 1957;.
Spiegel, E. A., and Wycis, H. T.:  Ansotomy in Paralysis Agitans , Arch Neurol Psychiat 71:598-614, 1954;.
Hassler, R., and Riechert, T.:  Indikationen und Lokalisationsmethode der Gezielten Hirnoperationen , Nervenzart 25:441-447, 1954;.
Bertrand, C., and Martinez, N.:  Apparatus and Technique for Surgery of Dyskinesias , Neurochirurgia 2:36-46, 1959;.
Cooper, I. S.:  Neurosurgical Alleviation of Intention Tremor of Multiple Sclerosis and Cerebellar Disease , New Engl J Med 263:441-444 ( (Sept. 1) ) 1960;.
Cooper, I. S.:  Surgical Studies of Reversibility of Dystonia , Trans Amer Neurol Ass , 1961;.
Haas, G. H., and Taylor, C. B.:  Quantitative Hypothermal Method for Production of Local Injury to Tissue , Arch Path 45:563-580 ( (Nov.) ) 1948;.
Balthasar, K. L.:  Direct Cold Injuries in Cerebral Cortex of Cat , Deutsch Z Nervenheilk 176:173-199, 1957;.
Ries, L., and Tytus, J. S.:  Rapid Freezing: Surgical Technique (Preliminary Report) , Bull Mason Clin 14:20-26 ( (March) ) 1960;.
Rowbotham, G. F.; Haigh, A. L.; and Leslie, W. G.:  Cooling Cannula for Use in Treatment of Cerebral Neoplasm , Lancet 1:12-15 ( (Jan. 3) ) 1959;.
Dondey, M.; Rey, L.; and LeBeau, J.:  Présentation d'un Instrument Permettant le Refroidissement Controle' de Structures Cérébrales Superficielles , Rev Neurol (Par) 103:3:220 ( (Sept.) ) 1960;.
Weil, L.; Chanteur, J.; and Dondey, M.:  Dispositif Pour le Refroidissement Controlé de Certaines Structures Cérébrales Profondes , C R Acad Sci (Par) pp. 2947-2948 ( (May 8) ) 1961;.
Mark, V. H., et al.:  Localized Cooling in Brain , Science 134:1520-1521 ( (Nov. 10) ) 1961;.
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