Abstract: Apparatus for delivering therapeutic agents to the central nervous system of a subject is described. The apparatus includes at least one intracranial catheter and a percutaneous access device. The percutaneous access device includes a body having at least one extracorporeal surface and at least one subcutaneous surface, the body defining at least one port for connection to an implanted intracranial catheter. The port is accessible from the extracorporeal surface of the device, but is provided with a seal such as a rubber bung between the lumen of the port and the extracorporeal surface. The percutaneous access device may have more than two ports and/or a flange. A method of implanting the percutaneous access device is also described.

Abstract: Apparatus for delivering therapeutic agents to the central nervous system of a subject is described. The apparatus comprises at least one intracranial catheter and a percutaneous access device. The percutaneous access device comprises a body having at least one extracorporeal surface and at least one subcutaneous surface, the body defining at least one port for connection to an implanted intracranial catheter. The port is accessible from the extracorporeal surface of the device, but is provided with a seal such as a rubber bung between the lumen of the port and the extracorporeal surface. The percutaneous access device may have more than two ports and/or a flange. A method of implanting the percutaneous access device is also described.

Abstract: A medical fluid connector is described that includes a first fluid connector portion that can be connected to a second fluid connector portion. The first fluid connector portion includes a first locking member, a lumen and a septum for sealing the lumen. The second fluid connector portion includes a second locking member, a lumen and a hollow needle that is retained in and protrudes from the aperture at the end of the lumen. The variation in cross-sectional area of the fluid path through the fluid connector portion is less than 1 mm2 to reduce mixing effects. The use of such a connector for neurosurgical purposes is described.

Abstract: Percutaneous access apparatus is described that includes a percutaneous fluid access device having an extracorporeal portion, one or more ports accessible from the extracorporeal portion and a septum for sealing each port. A connector device having one or more hollow needles is attachable to the percutaneous fluid access device. The apparatus also includes an attachment mechanism for attaching the connector device to the extracorporeal portion and an actuation mechanism that, after the connector device has been attached to the extracorporeal portion, can be used to drive the one or more hollow needles through the septum to establish fluid communication between the one or more hollow needles and the one or more ports. The apparatus may be used for neurosurgery applications.

Abstract: The invention relates to a composition comprising albumin and a therapeutic agent, particularly a gene therapy vector. The composition is useful in the treatment of glioma.

Abstract: An implantable percutaneous fluid delivery device is described that includes a subcutaneous base portion having one or more ports for supplying fluid to one or more implanted catheter devices and a percutaneous portion including an extracorporeal surface. The one or more ports of the subcutaneous base portion are accessible from the extracorporeal surface of the percutaneous portion. The subcutaneous base portion is at least partially insertable into a complementary recess formed in a bone, the subcutaneous base portion including one or more features for gripping the internal surface of such a complementary recess thereby directly anchoring the subcutaneous base portion to the bone. The device may be used to route fluid to neurosurgical catheters optionally via a router unit.

Abstract: A method for delivering fluid to a brain of a subject using a modular fluid delivery apparatus is described. The method comprises taking a subject having a first part of the modular fluid delivery apparatus subcutaneously implanted therein, the first part of the modular fluid delivery apparatus comprising a first end having a first fluid connector portion attached thereto and a second end being connected to one or more catheters implanted within the brain of the subject. The method also comprises taking a second part of the modular fluid delivery apparatus, the second part comprising a third end comprising a second fluid connector portion. The method further comprises making an incision in the subject to gain access to the first fluid connector portion of the first part of the modular fluid delivery apparatus, and connecting the first fluid connector portion to the second fluid connector portion.

Abstract: The invention relates to a composition comprising albumin and a therapeutic agent, particularly a gene therapy vector. The composition is useful in the treatment of glioma.

Abstract: A method is described for determining brain shift, such as the brain shift that occurs following a neurosurgical intervention. The method includes taking a first image of the brain of a subject, the first image showing the position of blood vessels in the brain relative to a reference position. A second image of the brain that has been acquired following an intervention on the subject is also taken. This second image has been acquired using computed tomography imaging apparatus. The second image shows the position of blood vessels in the brain relative to the reference position. Brain shift is then determined from the shift in position of the blood vessels in at least one region of interest of the brain, with respect to the reference position, between the first and second images. Corresponding apparatus is also described.

Abstract: The invention relates to a cap for use in neurosurgery. The cap may be applied to a bore hole in a patient's skull, allowing the entry and removal of neurosurgical instruments, while providing an openable seal over the bore hole.

Abstract: An implantable fluid router is described that includes one or more inlets, one or more outlets and at least one gas vent for removing gas from liquid routed from the one or more inlets to the one or more outlets, The implantable router may be used with implantable drug delivery apparatus. A catheter device including such a fluid router is also described.

Abstract: An implantable percutaneous fluid delivery device is described that includes a subcutaneous base portion having one or more ports for supplying fluid to one or more implanted catheter devices and a percutaneous portion including an extracorporeal surface. The one or more ports of the subcutaneous base portion are accessible from the extracorporeal surface of the percutaneous portion. The subcutaneous base portion is at least partially insertable into a complementary recess formed in a bone, the subcutaneous base portion including one or more features for gripping the internal surface of such a complementary recess thereby directly anchoring the subcutaneous base portion to the bone. The device may be used to route fluid to neurosurgical catheters optionally via a router unit.

Abstract: A guide element for insertion into the brain to guide implantable instruments, wherein the guide element comprises an elongate part, the elongate part having a composition of at least 80% tungsten carbide. The guide element may have a coating, such as a biocompatible plastics material which is more resilient than the elongate part.

Abstract: A head clamp for neurosurgery is described that includes a member for at least partially encircling the head of a subject. The first end and second end of the head clamp include first and second skull attachment portions for attaching the member to the head of a subject. A position setter, such as an indexing mechanism, is also provided that allows the member to be moved or indexed between at least two repeatable relative positions.

Abstract: Apparatus for imaging a body part of a subject, for example using MRI, is described. The apparatus includes a housing for at least partially surrounding a body part (e.g. a head) and a first fiducial marker assembly retained at least partially within the housing that includes one or more fiducial markers and a datum feature. The position of the datum feature is fixed relative to the one or more fiducial markers. The first fiducial marker assembly is moveable with respect to the housing and the datum feature is accessible from outside of the housing.

Abstract: A catheter for use in neurosurgery, and a method of positioning neurosurgical apparatus. The catheter has a fine tube arranged for insertion into the brain parenchyma of a patient with an external diameter of not more than 1.0 mm. The catheter and method may be used in stereotactically targeting treatment of abnormalities of brain function, and for the infusion of therapeutic agents directly into the brain parenchyma. This is advantageous when a therapeutic agent would have widespread unwanted effects which could be avoided by confining the delivery to the malfunctioning or damaged brain tissue.

Abstract: A catheter for use in neurosurgery, and a method of positioning neurosurgical apparatus. The catheter has a fine tube arranged for insertion into the brain parenchyma of a patient with an external diameter of not more than 1.0 mm. The catheter and method may be used in stereotactically targeting treatment of abnormalities of brain function, and for the infusion of therapeutic agents directly into the brain parenchyma. This is advantageous when a therapeutic agent would have widespread unwanted effects which could be avoided by confining the delivery to the malfunctioning or damaged brain tissue.

Abstract: A tomogram taken on an imaging path of a tomograph is corrected by using sets of tomogram correction data for neighbouring positions on that path, in an interpolative process. An error map of a tomograph is built up by comparing tomograms of a phantom with the expected appearance of the phantom at the tomogram positions. Also provided is a phantom having a body with one or more imaging fluid receptacles formed therein.

Abstract: A connector is described that comprises a male connector portion that is releasably connectable to a complimentary female connector portion. The male fluid connector portion comprises a plurality of hollow needles that are each in fluid communication with a lumen of the associated tubing. The female connector portion comprises plurality of chambers or apertures that comprise a septum seal through which a hollow needle can be passed. Tubing having a plurality of lumens is coupled to the female connector portion and each lumen is in fluid communication with one of said chambers. The male and/or female connector portions also include an alignment guide that allows the hollow needles of the male part to be uniquely aligned with the corresponding septum seals of the female part. The use of the connector for medical purposes is described.

Abstract: A skull mount (50;150;170;200;300) is described that is attachable to a hole (60) formed in the skull. The skull mount (50;150;170;200;300) comprises an alignment guide (62;152;172;216;306) defining an alignment axis (22;210;312) along which neurosurgical instruments can be passed. The skull mount, when attached to a hole in a skull, is arranged such that it does not substantially protrude from the outermost surface of the skull and does not extend into the brain parenchyma. Also described is a neurosurgical alignment instrument (30,206) for aligning such a skull mount (50;150;170;200;300) that comprises an elongate shaft (32) and an element (34,36) protruding from the distal end of the elongate shaft (32) for engaging and aligning the alignment guide (62;152;172;216;306) of an associated skull mount (50;150;170;200;300).