Articles: neuronavigation.
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Comparative Study
Intraoperative Magnetic Resonance Imaging in Intracranial Glioma Resection: A Single-Center, Retrospective Blinded Volumetric Study.
Intraoperative magnetic resonance imaging (IoMRI) was devised to overcome brain shifts during craniotomies. Yet, the acceptance of IoMRI is limited. ⋯ This study shows that the use of IoMRI was associated with greater rates of EOR and GTR, and better overall 5-year survival in both eloquent brain areas located and non-eloquent brain areas located gliomas, with no increased risk of neurologic complication.
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Navigated intracranial endoscopy with conventional technique usually requires sharp head fixation. In children, especially in those younger than 1 year of age and in older children with thin skulls due to chronic hydrocephalus, sharp head fixation is not possible. Here, we studied the feasibility, safety, and accuracy of electromagnetic (EM)-navigated endoscopy in a series of children, obviating the need of sharp head fixation. ⋯ EM-navigated endoscopy in children is a safe and useful technique enhancing endoscopic intracranial surgery and obviating the need of sharp head fixation. It is a good alternative to the common opto-electric navigation system in this age group.
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To examine the microsurgical anatomy of the nucleus accumbens and related structures using fiber dissection technique. ⋯ The nucleus accumbens and its related cortical and subcortical gray matter and fiber pathways play a major role in the etiopathogenesis of psychiatric disorders. Therefore, a better understanding of the neuroanatomical features of the nucleus accumbens and its related structures will enable more accurate surgical treatment of neuropsychiatric disorders.
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Comparative Study
Minimally Invasive Endoscopic Supracerebellar-Infratentorial Surgery of the Pineal Region: Anatomical Comparison of Four Variant Approaches.
The endoscopic supracerebellar-infratentorial (SCIT) approach is a viable method to access pathology of the posterior incisura, but a narrow working space and frequent instrument conflict can potentially limit its surgical efficacy. Until now, no rigorous studies were available comparing surgical freedom and angle of attack for four previously well-described approaches to pineal region targets. ⋯ Presurgical planning and a detailed understanding of the important neurovascular structures in the pineal region are paramount to safe and successful surgical execution. Our current cadaveric study indicates that the medial-to-lateral location of craniotomy can maximize access to pineal region targets. Furthermore, the endoscope is a viable alternative to the microscope for identifying pathology of the posterior incisura. These differences in surgical freedom and angle of attack to the pineal region may be useful to consider when planning minimal-access approaches.
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Neuronavigation is an essential tool in cranial neurosurgery. Despite continuing improvements in the technologies used for neuronavigation, certain events can lead to unacceptable mismatches. To provide the best possible outcome for the patients, surgeons need to do everything possible to reduce mismatches. ⋯ Both techniques are easy to use, do not require expensive additional instruments, and are helpful in procedures involving neuronavigation.