Articles: neuronavigation.
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To evaluate, regardless of the clinical results, the contribution of combining functional magnetic resonance imaging (fMRI) with intraoperative cortical brain mapping (iCM) as functional targeting methods for epidural chronic motor cortex stimulation (MCS) in refractory neuropathic pain. ⋯ This study confirms the functional accuracy of fMRI guidance in neuropathic pain and illustrates the usefulness of combining fMRI guidance with iCM to improve the functional targeting in MCS. Because appropriate targeting is crucial to obtaining pain relief, this combination may increase the analgesic efficacy of MCS.
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Comput. Aided Surg. · Mar 2005
Comparative StudyImage-guided neurosurgery system integrating AR-based navigation and open-MRI monitoring.
As endoscopic surgery has become a popular form of minimally invasive surgery, it increasingly requires useful imaging tools to help the surgeons perform safe and secure operations. Our navigation system provides surgeons with visual information by overlaying 3D wire frame models of tumor onto live images, as well as by displaying relative the positions of surgical tools and the target tumor. ⋯ This function allows surgeons to carefully observe the vicinity of the tumor regions to be removed, by rendering the sectional views with respect to the surgical tool position, so that surgical performance can be easily monitored during the operation. We tested this navigation system in more than 10 clinical operations and verified the effectiveness of the navigation and surgical performance.
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Case Reports Comparative Study
Supratentorial cavernomas in eloquent brain areas: application of neuronavigation and functional MRI in operative planning.
Cavernomas located in eloquent areas of cerebral hemispheres represent a challenge for the neurosurgeon. An accurate surgical approach is essential to completely remove the lesion with function preservation. Aim of this study was to evaluate the usefulness of integration between standard magnetic resonance imaging (MRI) for neuronavigation and functional MRI (fMRI) in preoperative planning and intraoperative removal of cavernomas. ⋯ In all the cases the use of neuronavigation allowed minimally invasive approaches and radical excision of the lesions. Moreover, fMRI seemed to provide important additional information in patients with lesions in eloquent brain areas, allowing a more aggressive approach on the perilesional tissue to the aim of resolving seizures, in absence of an increase in the morbidity rate.
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IEEE Trans Biomed Eng · Feb 2005
Clinical TrialBrain shift estimation in image-guided neurosurgery using 3-D ultrasound.
Intraoperative brain deformation is one of the most important causes affecting the overall accuracy of image-guided neurosurgical procedures. One option for correcting for this deformation is to acquire three-dimensional (3-D) ultrasound data during the operation and use this data to update the information provided by the preoperatively acquired MR data. For 12 patients 3-D ultrasound images have been reconstructed from freehand sweeps acquired during neurosurgical procedures. ⋯ After opening the dura the shift increased on average 0.2 mm parallel to the direction of gravity and 1.4 mm perpendicular to the direction of gravity. Brain shift can be detected by acquiring 3-D ultrasound data during image-guided neurosurgery. Therefore, it can be used as a basis for correcting image data and preoperative planning for intraoperative deformations.
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Acta neurochirurgica · Feb 2005
Case ReportsSuccessful resection of a left insular cavernous angioma using neuronavigation and intraoperative language mapping.
Despite recent literature advocating the surgical removal of symptomatic Cavernous Angiomas (CA), even in critical brain areas, very few observations of insular CA surgery have been described, particularly in the left hemisphere. We report the case of a successful resection of a CA located in the dominant insula, using both neuronavigation and intra-operative functional mapping. This 33-year-old right-handed man harbored a left insular CA, revealed by generalized seizures following a bleed confirmed on MRI. ⋯ There was no postsurgical deficit, nor any seizure without treatment (follow-up: 4.5 years). The diagnosis of CA was confirmed by histological examination. Taking account of the risk of morbidity due to the natural history of CA, particularly in eloquent brain regions, we suggest to routinely consider the possibility of a surgical treatment in cases of symptomatic (left dominant) insular CA, using combined intra-operative anatomical and physiological localization methods.