Articles: neuronavigation.
-
Frame-based stereotaxy represents the gold standard for biopsy of deep-seated lesions. Visual control of possible bleeding in these lesions is not possible. Neuroendoscopic biopsy represents an alternative procedure for tissue sampling in deep-seated intraventricular lesions. The authors present a technique for transventricular-navigated endoscopic biopsy of lesions that are located in the paraventricular region. ⋯ Endoscopically conducted biopsies with the aid of navigated tracking of the probe represent a possible additional technique in selected paraventricular intraparenchymal pathologies. The endoscopic approach enables the direct visualization of the intraventricular surface and its vessels. In contrast to standard stereotactic biopsy, direct visual control of hemostasis can be obtained even in paraventricular tumors.
-
Using a stereotactic technique, surgeons can accurately place a depth electrode (DE), but sometimes the DE deviates from the intended target due to movement of the electrode or leakage of cerebrospinal fluid when placing the electrode. If DEs can be anchored before removing the catheter insertion guide pipe, more accurate placement may be possible. ⋯ DEs can be anchored using the side slit guide pipe for more precise placement.
-
Review Meta Analysis
The reliability of fMRI in brain tumor patients: a critical review and meta-analysis.
Formal studies that validated functional magnetic resonance imaging (fMRI) against direct cortical stimulation (DCS) have shown inconsistencies. ⋯ The results from the present analysis of the available reported evidence suggest that fMRI itself (due to neurovascular uncoupling) or analysis of the findings have limitations regarding reliability when validated against DCS. From the existing studies, our results indicate that using fMRI alone for surgical planning could lead to undesirable outcomes.
-
Oper Neurosurg (Hagerstown) · May 2019
Review Case ReportsUse of Tubular Retractor for Resection of Colloid Cysts: Single Surgeon Experience and Review of the Literature.
Colloid cysts are challenging lesions to access. Various surgical approaches are utilized which all require brain retraction, creating focal pressure, local trauma, and potentially surgical morbidity. Recently, tubular retractors have been developed that reduce retraction pressure by distributing it radially. Such retractors may be beneficial in colloid cyst resection. ⋯ Tubular retractors offer an attractive surgical corridor for colloid cyst resections, avoiding much of the morbidity of interhemispheric approaches, while minimizing damage to normal cortex. There were no permanent complications in our series of ten cases, and a literature review found a similarly benign safety profile.
-
We investigated how augmented reality (AR) can be applied to support transsphenoidal surgery. ⋯ Microscope-based AR is a reliable tool to increase patient safety in complicated transsphenoidal procedures. Intraoperative imaging-based automatic patient registration is recommended.