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Stereotactic & Functional

Stereotactic and Functional Neurosurgery at Dartmouth-Hitchcock Medical Center (DHMC) offers a wide variety of treatment modalities.

Photo of Dr. David Roberts

Dr. David Roberts

These include the treatment of pain, epilepsy and movement disorders, stereotactic radiosurgery as well as surgical navigation via frame based and/or frameless stereotactic systems. DHMC has been on the cutting edge in the development of frameless surgical navigation. A coordinated program between the section of Neurosurgery and the Thayer School of Engineering has been led by Dr. David Roberts. The results of this research have culminated in the development of techniques allowing for intra-operative localization of structures. The primary surgical navigation tool used at DHMC is the Surgi-Scope.

This microscope is robotically controlled by the surgeon and is registered to the patient's own imaging data. This permits the surgeon to know the location of the microscope's view on the patients imaging studies or, alternatively, have the robot drive the focal point of the microscope to a desired target. These techniques are extremely helpful in guiding the complete resection of tumors or in epilepsy surgery. Frame based stereotactic technique is used for tumor biopsies. Research is currently under way to develop a frameless stereotactic biopsy technique.

The Epilepsy Center at DHMC is a multidisciplinary team involving Neurosurgery (Dr. David Roberts), Neurology (Dr. Peter Williamson and Dr. Vijay Thadani) and Neuropsychology. Surgical options for epilepsy include selective amygdalo-hippocampectomy, lesion resection, cortical resection, corpus callosotomy, and vagal nerve stimulator (VNS) placement. Intracranial electrode monitoring with depth electrodes, strip electrodes grid electrodes, or some combination of the above, is sometimes required prior to definitive treatment and is also done routinely at DHMC.

Movement Disorders are also treated by a multidisciplinary team involving Neurosurgery, Neurology and Neuropsychology. Stereotactic thalamotomies for tremor, stereotactic pallidotomies and deep brain stimulators for Parkinson's Disease and other stereotactic procedures for essential tremor and other movement disorders are all performed at DHMC. After these procedures many patients experience dramatic improvement in their symptoms.

The Stereotactic Radiosurgery Program at DHMC is under the direction of Dr. David Roberts. Stereotactic radiosurgical devices deliver high doses of focused radiation directly to the lesion sparing surrounding structures of the brain. Stereotactic radiosurgery provides patients and physicians with a powerful tool in the fight against cancer and other intracranial lesions such as arteriovenous malformations. For more information on any of these programs please contact (603) 650-5109.

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