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Publication:

Surgical Technology International XV - Neurosurgery

Article title:

Local Infusion Therapy in the Monkey Brainstem: Technical Considerations

Author(s)

George I. Jallo, M.D.
Associate Professor

 

Marc Becker, B.S.
Research Scientist

 

Ya J. Liu, M.D.
Research Scientist

 

Benjamin S. Carson Sr., M.D.
Professor

Michael Guarnieri, Ph.D.
Research Associate

Division of Pediatric Neurological Surgery
Johns Hopkins University
Baltimore, Maryland

Abstract

This chapter assesses the safety of freehand placement of an infusion catheter (outer diameter, 0.3 mm) in brainstems of cynomolgus monkeys (Macaca fascicularis) for local infusion therapy. A posterior midline approach through the cerebellum and roof of the fourth ventricle was used to implant catheters into a pontine target area. Computer tomography (CT), magnetic resonance imaging (MRI), and histology were used to examine the position of the implants. The freehand placement of a catheter resulted in approximately 5-mm variations in anterior-posterior and dorsal-ventral locations of the targeted implantation site. No evidence of morbidity from the surgery, or from the infusion process was present. In conclusion, small-diameter catheters for chronic drug infusions can be implanted safely into the brainstem, an eloquent region that has been considered surgically inoperable. Infusion systems may offer a minimally invasive, generally applicable tool to provide chronic therapy for central nervous system (CNS) lesions.