| Abstrakt: |
The work is based on the results of operations on the cerebellar dentate nuclei in 92 patients. In 42 of them, combined manipulations were carried out on the cerebellar dentate nuclei and the diencephalic structures (relay nuclei, median centre, pulvinar and subthalamus). Analysis of the results showed that stereotaxic destruction of the ventrooral parts of the cerebellar dentate nucleus is a very effective surgical manipulation in various forms of spastic dyskinesia. A natural decrease in the spastic component of the muscular hypertonia is the principal clinical effect of dentatotomy. Its effect on the rigid component of muscular hypertension is negligible. Combined manipulations on the cerebellar dentate nuclei and diencephalic structures are indicated in cases with combined spastic conditions and hyperkinesia which cannot be corrected by dentatotomy. The analysis of the results of combined interventions on the nuclear structures of the thalamus shows that pulvinarotomy is most effective, it reduces or corrects hyperkinesia in infantile cerebral paralysis and, in addition, causes diminution of the general hypertonia, of the upper extremities before all else. Proper rehabilitation treatment is the decisive factor in the final outcomes of stereotaxic intervention on the cerebellar motor systems and on those of the diencephalon in spastic forms of hyperkinesia. |
