100%
CASE 3 — TREMOR: VIM OR PSA?
- Target choice is evolving from nucleus to pathway
- ET CASE
- Medication-refractory severe tremor
- + head tremor
- + speech concern
- VIM vs PSA / DRTT
- VIM — Established target; strong evidence and clinical familiarity.
- PSA — Can produce tremor control at lower stimulation intensity in some studies; may improve selected head tremor/QoL outcomes.
- TRADE-OFF — Target and trajectory must be matched to anatomy and side-effect profile.
- QUESTION — Where is the therapeutic contact relative to the DRTT?
- Evidence note: a small randomized crossover trial found comparable total tremor reduction, with PSA showing lower stimulation intensity.
- Dr Vikas Kathuria | MCh Neurosurgery
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49A VIM VERSUS PSA / DRTT ANATOMICAL SCHEMATIC — INSERT AUTHENTIC IMAGE
Real clinical image required
Image typePSA / DRTT anatomy
DescriptionAuthentic anatomical figure or an original educational schematic. Never fabricate tractography output.
Clinical purposeSupport fellowship-level case and evidence discussion without fabricating patient imaging, published trial figures or lead-localization results.
Suggested sourceINSERT AUTHENTIC PUBLISHED / INSTITUTIONAL IMAGE HERE (licensing and consent confirmed)
Copyright statusSource, consent and reproduction rights must be confirmed before use.
CaptionTo be written with the final image
AssociationModule 10 · Slide 49
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49B TRACTOGRAPHY AND LEAD RELATIONSHIP — INSERT AUTHENTIC IMAGE
Real clinical image required
Image typeTractography
DescriptionAuthentic tractography reproduced with permission; tractography is a model, not direct axon visualization.
Clinical purposeSupport fellowship-level case and evidence discussion without fabricating patient imaging, published trial figures or lead-localization results.
Suggested sourceINSERT AUTHENTIC PUBLISHED / INSTITUTIONAL IMAGE HERE (licensing and consent confirmed)
Copyright statusSource, consent and reproduction rights must be confirmed before use.
CaptionTo be written with the final image
AssociationModule 10 · Slide 49