Three-Dimensional Volumetric Imaging for Stereotactic Lesional and Deep Brain Stimulation Surgery by Paul C. Francel, M.D., PH.D.

FRANCEL AND COFFMAN
3-D VOLUMETRIC IMAGING FOR STEREOTACTIC LESIONAL AND DEEP BRAIN STIMULATION SURGERY

P-I-E-N-O Current Topics Home	Introduction	Patient Selection	Preoperative Requirements	Operative Procedure
Stereotactic Frame Placement	3-D Volumetric MRI	Stereotactic Planning Software	Pallidotomy/Thalamotomy DBS Surgical Procedure	Conclusion
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Paul C. Francel, M.D., Ph.D., Assistant Professor
Dept. of Neurosurgery
The University of Oklahoma, Health Sciences Center
Oklahoma City, OK

Education:
1979-82: Undergraduate B.A., Harvard University, Magna cum Laude, Biology. Thesis: Neurophysiological Investigation of the Temperature Control Centers in the Hypothalamus of Hibernating Mammals.

1982-89: Medical Scientist Training Program (M.D.-Ph.D.)

1987: Ph.D. University of Chicago, Division of Biological Sciences, Department of Pharmaco-logical/Physiological Sciences. Thesis: Modulation of Bradykinin-induced Inositol Triphosphate Production in Neuronal Clonal Cell Lines. Preceptors: Glyn Dawson, Ph.D., Richard Miller, Ph.D.

1989: M.D. University of Chicago, Pritzker School of Medicine Accepted for Neurological Clerkship: Queen Square, London, England

1989-1993: Residency, Neurological Surgery, Department of Neurological Surgery, University of Virginia Health Sciences Center, Charlottesville, Virginia - Dr. John A. Jane, Chairman

1993-1994: Pediatric Neurological Surgery - One Year Fellowship - Department of Neurosurgery, St. Louis Children's Hospital/Barnes Hospital University of Washington, St. Louis, Missouri

1994-1995: Senior Registrar, Neurological Surgery, Derriford Hospital, Plymouth, Devon, England, Dev. Mohan, Chairman

1995-1996: Chief Resident, Department of Neurological Surgery, University of Virginia Health Sciences Center, Charlottesville, Virginia, Dr. John A. Jane, Chairman

Bibliography:

Abstracts:
1. Francel PC, Dohrmann G. Characterization of a novel neuroblastoma dorsal root ganglion hybrid cell line, F-11. AANS, 1989.

2. Francel PC, Keefer JF, Dawson G. Competitive antagonists block bradykinin-induced second messenger production in a sensory neuron cell. AANS, 1989.

3. Francel PC. Bradykinin and activation of nociceptive neurons. Society of the Virginias, 1989.

4. Francel PC. Coronal Craniosynostosis. AANS, Pediatric Section, 1990.

5. Francel PC. Bradykinin and neuronal injury. Society of Neurotrauma, 1990.

6. Francel PC, et al. Surgical management of syndromic vs non-syndromic bilateral coronal craniosynostosis. 19th Winter Meeting, Section of Pediatric Neurologic Surgeons of the AANS, 1990. (And presented at the Neurosurgical Society of the Virginias, 1991)

7. Francel PC, et al. Experimental craniofacial suture stenosis: A model of craniofacial anomalies. 59th Annual Meeting, AANS, April, 1991.

8. Francel PC, et al. Repeat radiosurgical treatment in arteriovenous malformations following unsatisfactory results of initial high-dose radiation. 59th Annual Meeting, AANS, April, 1991. (Lecture)

9. Malik J., Long B, Francel PC, and VandenBerg S. Protective effects of a free radical scavenger and CSF drainage in experimental spinal cord ischemia. Congress of Neurologic Surgeons, 1991.

10. Persing J, Francel PC, Lettieri J, Cronin A, Wolcott P, Singh V, Morgan E. Craniofacial suture stenosis: morphologic effects. AANS, 1991.

11. Francel PC, Long BA, Malik JM, Flanagan TC, Tribble C, Kron IL. Limiting ischemic spinal cord injury using a 21-aminosteroid free radical scavenger: possible role of altering cerebrospinal fluid pressure. AANS, 60th Annual Meeting, 1992.

12. Francel PC, Jane JA. Cranial vault reconstruction for sagittal craniosynostosis. AANS, 1993.

13. Francel PC, Caver J, Phillips D, Jane JA. Supraselective intra-arterial chemotherapy for high grade gliomas. AANS, 1993.

14. Francel PC, Jane JA. Single-stage major cranial vault reconstruction for craniosynostosis: new operative methods obviating the need for two stage operations or the modified prone technique. AANS, 1993.

15. Francel PC, Jane JA. Poor operative results in craniosynostosis repair. Pediatric section meeting of AANS, 1993.

16. Francel PC, Long VA, Malik JM, Tribble C, Jane JA, Kron IL. Pharmacologic protection against ischemic spinal cord injury. National Neurotrauma Society Meeting, 1993.

17. Koby M, Francel PC, Francel TJ, Kaufman BA, MacKinnon SE, Noetzel MJ, Park TS, Lee BCP. Fast spin echo MRI in evaluation and treatment planning of birth-related brachial plexus injuries. American Society of Neuroradiology.

18. Koby M, Francel PC, Hatfield GA, Kaufman BA, Kido DK, Park TS, Lee BCP, Marsh JL. Preoperative three dimension MRI in craniosynostosis. American Society of Neuroradiology.

19. Marsh JL, Koby M., Francel PC, Lee BCP. Brain dysmorphology in craniosynostosis. American Association of Plastic Surgery Annual Meeting 1994.

20. Francel PC, Koby M., Kenagar M., Kaufman BA, MacKinnon SE, Noetzel MJ, Lee BCP, Park TS. Evaluation of neonatal brachial plexus injuries with fast-spin echo magnetic resonance imaging. International Society for Pediatric Neurosurgery, Birmingham, UK, 1994.

21. Francel PC, DiPierro CG, Laws, ER. Discrepancies between preoperative presumptive diagnosis and histopathology in 249 sellar lesions treated by transphenoidal microsurgery. 11th International Congress of Neurological Surgery, Amsterdam , 1997.

22. Francel PC, Oomen KJ. Relationship between cerebral perfusion and EEG in the rat brain. National Student Research Forum, 1998.

23. Oommen KJ, Jones H, King JA, Francel P, Reynolds E, Couch JR. Functional reorganization in the homunculus: electrocorticographic evidence. American Clinical Neurophysiology Society Annual Meeting, New Orleans, LA, 1998.

Publications:

1. Francel PC, Dawson G. Bradykinin induces a rapid release of inositol triphosphate from a neuroblastoma hybrid cell line NCB-20 is not antagonized by enkephalin. Biochem Biophys Res Commun 135:507514, 1986.

2. Francel PC, Dawson G. Bradykinin-induced release of IP3 is not antagonized by enkephalin. Trans Amer Soc Neurochemistry 17:167, 1986.

3. Francel PC, Harris K, Smith M, Fishman MC, Dawson G, Miller RJ. Neurochemical characteristics of a novel dorsal root ganglion X neuroblastoma hybrid cell line, F-11. J. Neurochem 48:1624-1631, 1987.

4. Francel PC, Dawson G. Mechanism of action of bradykinin and related peptides on cells of neural origin. J. Neurochem 48:170, 1987.

5. Francel PC, Miller RJ, Dawson G. Modulation of bradykinin-induced inositol triphosphate release in a novel neuroblastoma X dorsal root ganglion sensory neuron cell line (F-11). J. Neurochem 48:1632-1639, 1987.

6. Francel PC, Modulation of bradykinin-induced inositol triphosphate production in neuronal clonal cell lines. University of Chicago, Division of Biological Sciences. Department of Pharmacology/Physiological Sciences, Ph.D. thesis, 1988.

7. Francel PC, Dawson G. Bradykinin induces the biphasic production of lysophosphatidylinositol and diacylglycerol in a dorsal root ganglion X neurotumor hybrid cell line, F-11. Biochem Biophys Res Commun 152:724-731, 1988.

8. Francel PC, Keefer JF, Dawson G. Bradykinin analogs antagonize bradykinin-induced second messenger production in a sensory neuron cell line. Mol Pharmacol 35:34-38, 1989.

9. Francel PC, Persing, JA. Evolving concepts in the pre-operative management and surgical treatment of craniosynostosis. Indian J Pediatrics 58(2): 183-190, 1990.

10. Francel PC, Bradykinin and neuronal injury. J Neurotrauma 9(1):S27-S45, 1992.

11. Francel PC, Persing JA, Cantrell RW, Levine PA, Newman SA. Neurological deterioration after lumbar cerebrospinal fluid drainage. J Craniofacial Surgery 3(3):145-148, 1992.

12. Francel PC, Persing JA, Dodson EE. Embryology of craniofacial development. In: Neurosurgery, The Scientific Basis of Clinical Practice. (Crockard, Hayward, Hoff, eds.) Vol 1, p 48-62. Blackwell Scientific Publishers, Oxford, 1992.

13. Francel PC. Development malformation: embryologic and developmental aspects and clinical correlates. In: The Human Brain and Spinal Cord (L. Heiner, eds.) 2nd Edition, Springer-Verlag, NY, 1993.

14. Francel PC, Persing JA. Microplating and Screw Systems for Cranial Bone Fixation. Neurosurgery 32(4):683-686, 1993.

15. Francel PC, Persing JA. Neurosurgical Aspects of Cranial Base Surgery in: Procedures in Cranial Base Surgery. Problems in Plastic Reconstructive Surgery, 3:156-171, 1993.

16. Jane JA, Francel PC. Evolution of the treatment for sagittal synostosis. A personal record, in Craniofacial Anomalies: Growth and Development from a Surgical Perspective (Goodrich JT, Hall CD eds.), Thieme Medical Publishers, NY, NY 1995.

17. Francel PC, Long BA, Malik JM, Tribble C, Jane JA, Krin IL. Limiting ischemic spinal cord injury using a free radical scavenger 21-aminosteroid (Tirilazad, U74006F): Possible preventive role of decreased cerebrospinal fluid pressure. J Neurosurgery 79, 742-751, 1993.

18. Francel PC, Bell A, Jane JA. Operative positioning for patients undergoing repair of craniosynostosis. Neurosurgery 35:304-306, 1994.

19. Francel PC, Jane JA. "Age and outcome from head injury" in Neurotrauma (Narayan RK, Wilbergh JE, Poveistock JT Ed). McGraw-Hill Inc., 1995.

20. Francel PC, Park TS, Shaffrey ME, Jane JA. Diagnosis and treatment of moderate and severe head injuries in infants and children. (Youman, JR editor). Neurological Surgery, 4, 1995.

21. Francel PC, Alves W, Jane JA. Mild head injuries in adults. (Youman JR editor), 4, 1995.

22. Francel PC, Koby M, Henagar MM, Kaufman BA, Noetzel MJ, MacKinnon SE, Lee BCP, Park TS. Fast-spin echo magnetic resonance imaging for radiological assessment of neonatal brachial plexus injury. J Neurosurgery 83:461-466, 1995.

23. Francel PC, Marsh J, Park TS. "Frontal plagiocephaly secondary to early synostosis of the frontosphenoidal suture. Case report. J Neurosurgery 83:733-736, October 1995.

24. Francel PC, Jane JA. Image reconstruction and craniofacial repair, Current Techs in Neurosurgery, 1995 (in press).

25. Francel PC, Jane JA, Kron IL. A model of spinal cord ischemia. In: Central Nervous System Trauma: Laboratory Techniques and Recent Advancements. (Ohnishi ST editor), 1995 (in press).

26. Francel PC, Cummings D, Park TS. "Malignant degeneration of a glioneurofibroma to an anaplastic astrocytoma". J Neurosurgery, 1995 (submitted).

27. Francel PC, Kaufman BA, Roberts R, Park TS. Lateral chondroid chordoma of the skull base, case report. J Neurosurgery (submitted).

28. Francel PC, Roberts R, Flaris N, Kaufman BA, Park TS. Oligodendroglioma of the optic nerve and chiasm. Case report. J Neurosurgery (submitted).

29. Kolby M., Francel PC, Lee BCP, Marsh J. "3-dimensional MRI analysis of craniosynostosis; no longer just a cosmetic operation." (submitted).

30. Francel PC, Jane JA. Current neurosurgical techniques for repair of sagittal synostosis (in preparation).

31. Muldowney S, Francel PC, Lee BCP, Park TS. Klippel-Feil anomaly and cervicomedullary diastematomyelia in a newborn, case report (in preparation).

32. Francel PC, Roberts R, Flaris NA, Park TS. Giant cell arteritis producing a basilar tip aneurysm in a four year old child, case report (in preparation).

33. Francel PC, Francel TJ, Park TS. Brachial plexus injuries in infants and children (in preparation).

34. Francel PC, Francel TJ, MacKinnon SE. Peripheral nerve grafting using "stepping stone" silicone tubes: A functional, electrophysiological, and morphohistologic analysis. J Neurosurgery (in press).

35. Francel PC, Laws ER. Cerebral atrophy, Cushing's disease, and hypercortisolism, (in preparation).

36. Francel PC, Laws ER. Transphenoidal surgery and definitive diagnosis in sellar and suprasellar masses, (in preparation).

37. Francel PC, Kassell NF. AVMs and subarachnoid hemorrhage: neurosurgical aspects, (in preparation).

38. Francel PC, Jensen ME, Dion JE, Kassell NF. Cerebral aneurysms and GDC coiling, (in preparation).

39. Francel PC, Lanzino G, Kassell NF: PICA aneurysms: natural history and operative results (in preparation).

40. Jensen ME, Francel PC, Kassell NF, Steiner L, Dion JE. Combined glue embolization and gamma knife radiosurgery of large AVMs: preliminary results, (in preparation).

41. Replogle RE, Francel PC, Lanzino G, Henson S, Lin K, Jane JA. Reinforced acrylic cranioplasty using mini-plate struts. J Neurosurgery, (submitted).

42. Kallmes DF, Lanzino G, Dix JE, Dion JE, Francel PC, Woodcock RJ, Kassell NF. Patterns of hemorrhage with ruptured PICA aneurysms: CT findings in 44 cases. Amer J Neurorad (submitted).

43. Francel PC, Alves W. Pathophysiology in clinical trials/data management for neuroemergencies. In: Neuroemergencies, part of the Neurosurgical Topic series, 1996, American Association of Neurologic Surgeons.

44. Francel PC, Jane JA. Current neurosurgical techniques for repair of sagittal synostosis. In: Neurosurgical Operative Atlas. Rengachary SS and Wilkins RH (eds). Williams & Wilkins, Baltimore, MD, Volume 5, 1996.

45. Kaufman BA, Francel PC, Roberts RI, Argemand E, Park TS, Dehner LP. Chondroid chordoma of the lateral skull base: Case report. J Pediatric Neurosurgery.

46. Alston SR, Francel PC, Jane JA.. Solitary Fibrous Tumor of the Spinal Cord. Amer J Surg Pathol 21:477-483, 1997.

47. DiPierro CG, Francel PC. Jackson TR, Kamiryo T, Laws ER. Optimized magnetic resonance image-guided stereotaxis: a technique with validation based on the anterior commissure-posterior commissure line. Neurosurg Focus 2(3): Article 1, 1997.

48. Bhattacharjee S, Francel PC. Pediatric Spinal Tumors. Principles of Neurosurgery, Second Edition