Articles: neuronavigation.
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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.
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Acta neurochirurgica · Feb 2005
Image guided interstitial laser thermotherapy: a canine model evaluated by magnetic resonance imaging and quantitative autoradiography.
To determine the applicability and safety of a new canine model suitable for correlative magnetic resonance imaging (MRI) studies and morphological/pathophysiological examination over time after interstitial laser thermotherapy (ILTT) in brain tissue. ⋯ ILTT causes transient, highly localised areas of increased capillary permeability surrounding the laser lesion. Phase contrast imaging for MRI thermomonitoring can currently not be used for reliable temperature readings in vivo. The suggested new canine model proved to be safe, accurate, easy to use, and provides clinical, radiographic, pathological and physiological correlations.
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Case Reports
Endoscopic aqueductal stenting via the fourth ventricle under navigating system guidance: technical note.
We report three patients with symptomatic isolated fourth ventricle after ventriculoperitoneal shunt placement for hydrocephalus associated with ventricular hemorrhage. All three patients were treated successfully with our new method of endoscopic aqueductal stenting under navigating system guidance. ⋯ Our method of aqueductal stenting is a reasonable choice for initial treatment of patients with isolated fourth ventricle, and it entails less invasive neurosurgery.
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We present a technique that allows intraoperative display of brain shift and its effects on fiber tracts. ⋯ By definition and sequential intraoperative registration of ultrasound landmarks near the fiber tract, brain shift-associated deformation of a tract that is not visible sonographically can be assessed correctly. This approach seems to help identify and avoid eloquent brain areas during intracranial surgery.