Articles: neuronavigation.
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To describe a surgical technique for a minimally invasive transcortical transventricular amygdalohippocampectomy via the inferior temporal sulcus (ITS) using a stereotactic navigator. ⋯ Combined with the stereotactic navigation system, the ITS approach provides the least invasive amygdalohippocampectomy that preserves optic radiation. This approach seems beneficial especially in patients in whom the epileptic lesions are limited to the anterior mesial temporal lobe.
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Recent neurosurgical literature reflects rapidly evolving, technically enhanced methods that promise to improve neurosurgical outcomes. We review our experience with computer image guidance, linear or sigmoid incisions after minimal shaving, and liquid wound dressing with 2-octyl cyanoacrylate (Dermabond; Ethicon, Inc., Somerville, NJ) for tumor craniotomy or craniectomy in our attempt to optimize craniotomy or craniectomy for tumor. ⋯ Modern neurosurgical techniques are beneficial for patients undergoing craniotomy or craniectomy for tumor and seem to be superior to standard techniques. Although the study is multifactorial and retrospective, this conclusion is further supported by the enhanced self-image patients have during the postoperative period.
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Zh Vopr Neirokhir Im N N Burdenko · Apr 2003
Case Reports[The results of applying the system of neuronavigation in the intracranial surgery].
Frameless stereotactic techniques combined with a high-resolution neuro-imaging made its possible for us to perform, with high reliability, interactive image-guided procedures. We used the Carl Zeiss Surgical Microscope Navigator System with Carl Zeiss OPMI NC-4 microscope. We reported our results on the first 82 patients during the 20-month period. 36 were males (44%), 46--females (56%) with the age range of 15 to 79 (mean 43.43). ⋯ There were no significant technical problems. The clinical and surgical results were satisfying in all cases. 14 patients with secondary epilepsy, as the only symptom, were postoperatively seizure-free. Neuronavigation cuts the time of surgery and ensures a more radical resection of pathological tissue with lower mortality and morbidity thus improving the life quality of patients.
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To develop a method to place a lesion precisely in the subthalamic nucleus (STN) and evaluate its effectiveness. ⋯ The combination of computed tomographic imaging, semimicroelectrode recording, and microstimulation provides an effective method to identify the STN lesion in parkinsonian patients. The method used for anatomic localization and electrophysiological mapping of the subthalamus was found to be effective in reaching the sensorimotor region of the nucleus. We carried out an accurate determination of the subthalamus location and its volume in the lesioning.
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Minim Invas Neurosur · Apr 2003
Comparative StudyImage-guided removal of supratentorial cavernomas in critical brain areas: application of neuronavigation and intraoperative magnetic resonance imaging.
In a retrospective study the postoperative results of 26 patients operated on for supratentorial cavernous hemangiomas either deep-seated or near eloquent brain areas are summarized. An exact surgical approach to these lesions is essential to prevent neurological deterioration. Three different navigation systems were used and compared according to their clinical applicability. ⋯ The study indicates that the application of neuronavigation allows surgery on supratentorial cavernous hemangiomas in critical brain areas with low morbidity. The intraoperative visualization of eloquent cortex areas by integration of functional data allows a fast identification and exemption of eloquent brain areas, preventing neurological deterioration. Furthermore, the intraoperative MR resection control ensures a complete resection and illustrates the minimal invasive approach.