0000000000061909
AUTHOR
Eike Schwandt
showing 11 related works from this author
Minimally invasive cerebral cavernoma surgery using keyhole approaches - solutions for technique-related limitations.
2009
Cavernomas are often small in size and located in difficultly accessible regions. Preoperative identification of the ideal surgical approach as well as the precise intraoperative implementation of the surgical plan are of critical importance for successful surgery. While aiming for minimally invasive surgical techniques and maximally effective cavernoma resection, we envisaged that employing a combination of precise and technically sophisticated virtual reality surgery planning, modern navigation systems with augmented reality features and endoscope-assisted surgical techniques should contribute to achieve this goal. Between December 2002 and November 2005, 66 patients were operated on for …
Comprehensive Anatomic Assessment of Ipsilateral Pterional Versus Contralateral Subfrontal Approaches to the Internal Carotid Ophthalmic Segment: A C…
2019
Objective Medially pointing aneurysms of the ophthalmic segment of the internal carotid artery (oICA) represent a neurosurgical challenge. Conventional ipsilateral approaches require internal carotid artery and optic nerve (ON) mobilization as well as anterior clinoidectomy (AC), all associated with increased surgical risk. Contralateral approaches could provide a better exposure of the superomedial aspect of the oICA, ophthalmic artery, and superior hypophyseal artery, sparing AC and internal carotid artery or ON mobilization. However, the microsurgical anatomy of this approach has not been systematically studied. In the present work, we exhaustibly analyzed the anatomic and morphometric c…
A COLLABORATIVE VIRTUAL REALITY ENVIRONMENT FOR NEUROSURGICAL PLANNING AND TRAINING
2007
OBJECTIVE We have developed a highly interactive virtual environment that enables collaborative examination of stereoscopic three-dimensional (3-D) medical imaging data for planning, discussing, or teaching neurosurgical approaches and strategies. MATERIALS AND METHODS The system consists of an interactive console with which the user manipulates 3-D data using hand-held and tracked devices within a 3-D virtual workspace and a stereoscopic projection system. The projection system displays the 3-D data on a large screen while the user is working with it. This setup allows users to interact intuitively with complex 3-D data while sharing this information with a larger audience. RESULTS We have…
The minimally invasive supraorbital subfrontal key-hole approach for surgical treatment of temporomesial lesions of the dominant hemisphere
2009
INTRODUCTION: Surgery in the temporomesial region is generally performed using a subtemporal, transtemporal, or pterional-transsylvian approach. However, these approaches may lead to approach-related trauma of the temporal lobe and frontotemporal operculum with subsequent postoperative neurological deficits. Iatrogenic traumatisation is especially significant if surgery is performed in the dominant hemisphere. METHODS: During a five-year period between January 2003 and December 2007, we have approached the temporomesial region in 21 cases via the supraorbital approach. In 15 cases, the lesion was located within the dominant hemisphere, all lesions had space-occupying effects. In all cases, …
A novel minimally invasive, dorsolateral, tubular partial odontoidectomy and autologous bone augmentation to treat dens pseudarthrosis: cadaveric, 3D…
2017
OBJECTIVE The goal of this study was to demonstrate the clinical and technical nuances of a minimally invasive, dorsolateral, tubular approach for partial odontoidectomy, autologous bone augmentation, and temporary C1–2 fixation to treat dens pseudarthrosis. METHODS A cadaveric feasibility study, a 3D virtual reality reconstruction study, and the subsequent application of this approach in 2 clinical cases are reported. Eight procedures were completed in 4 human cadavers. A minimally invasive, dorsolateral, tubular approach for odontoidectomy was performed with the aid of a tubular retraction system, using a posterolateral incision and an oblique approach angle. Fluoroscopy and postprocedur…
The neuroprotective effect of lactate is not due to improved glutamate uptake after controlled cortical impact in rats.
2012
For many years lactate was considered to be a waste product of glycolysis. Data are accumulating that suggest that lactate is an important energy substrate for neurons during activation. In severe traumatic brain injury (TBI) glutamate release and ischemic cerebral blood flow (CBF) are major factors for a mismatch between energy demand and supply and for neuronal cell death. Although ATP and behavior could be improved by lactate treatment after TBI, no histological correlate nor any linkage to better astrocytic glutamate uptake or CBF as possible mechanisms have been described. We subjected male rats to a controlled cortical impact (CCI; 5 m/sec, 2.5 mm). To study the effects of lactate tre…
Operative Anatomy of the Skull Base: 3D Exploration with a Highly Detailed Interactive Atlas.
2020
Abstract Objective We evaluated the usefulness of a three-dimensional (3D) interactive atlas to illustrate and teach surgical skull base anatomy in a clinical setting. Study Design A highly detailed atlas of the adult human skull base was created from multiple high-resolution magnetic resonance imaging (MRI) and computed tomography (CT) scans of a healthy Caucasian male. It includes the parcellated and labeled bony skull base, intra- and extracranial vasculature, cranial nerves, cerebrum, cerebellum, and brainstem. We are reporting retrospectively on our experiences with employing the atlas for the simulation and teaching of neurosurgical approaches and concepts in a clinical setting. Setti…
Minimally invasive superficial temporal artery to middle cerebral artery bypass through a minicraniotomy: benefit of three-dimensional virtual realit…
2009
Object The aim of the authors in this study was to introduce a minimally invasive superficial temporal artery to middle cerebral artery (STA-MCA) bypass surgery by the preselection of appropriate donor and recipient branches in a 3D virtual reality setting based on 3-T MR angiography data. Methods An STA-MCA anastomosis was performed in each of 5 patients. Before surgery, 3-T MR imaging was performed with 3D magnetization-prepared rapid acquisition gradient echo sequences, and a high-resolution CT 3D dataset was obtained. Image fusion and the construction of a 3D virtual reality model of each patient were completed. Results In the 3D virtual reality setting, the skin surface, skull surface…
Neurocysticercosis with a single brain lesion in Germany: a case report
2009
Neurocysticercosis is rare in Western Europe and a high degree of physician awareness is necessary for diagnosis. We describe a case of Neurocysticercosis with a single brain lesion acquired in Germany in which only surgical removal and subsequent histological examination allowed diagnosis whereas diagnostic investigation yielded no pathological findings.
Safety and Efficacy of Microporous Polysaccharide Hemospheres in Neurosurgery
2011
BACKGROUND: Effective hemostasis is mandatory for brain tumor surgery. Microporous polysaccharide hemosphere (MPH) powder, a white powder compounded from potato starch, was recently introduced for surgical and emergency application. OBJECTIVE: To evaluate the safety and efficacy of MPHs in brain tumor surgery. METHODS: Thirty-three patients (mean age, 58 years; range, 22-84 years) underwent microsurgical brain tumor resection. Final hemostasis was performed by topical application of MPHs, video recorded, and subsequently analyzed. Blood samples were taken before surgery, before application of hemospheres, and postoperatively. Volume measurements of the tumor, resection cavity, and postopera…