Search results for "Neuronavigation"
showing 10 items of 30 documents
Neuronavigation-guided biopsy for differential diagnosis of pseudotumoral demyelinating brain lesions
2014
Abstract Marburg's disease (MD) is an extremely rare and aggressive form of multiple sclerosis (MS). In some cases, MD presents with tumefactive demyelinating lesions with a “tumor-like” appearance in MRI images, for which it may be difficult to achieve a form of differential diagnosis between definitive tumors or abscesses. Here we report a case of MD histopathologically confirmed after neuronavigationguided biopsy. Postoperative course was uneventful and following discharge, the patient attended outpatient follow-up appointments and received i.v. cyclophopsphamide, achieving progressive clinical remission. A nine-month follow-up brain MRI scan with gadolinium showed no signs of progressin…
Caliper navigation for craniotomy planning of convexity targets.
2021
Introduction A technique to localize a radiological target on the head convexity fast and with acceptable precision is sufficient for surgeries of superficial intracranial lesions, and of help in the setting of emergency surgery, computer navigation breakdown, limited resources and education. We present a caliper technique based on fundamental geometry, with inexpensive and globally available tools (conventional CT or MRI image viewer, calculator, caliper). Methods The distances of the radiological target from two landmarks (nasion and porus acusticus externus) are assessed with an image viewer and Pythagoras’ theorem. The two distances are then marked around the landmarks onto the head of…
German neuroendoscopy above the skull base
2009
Endoscopy plays an important part in current minimally invasive neurosurgery. The concepts, indications, and standards of current neuroendoscopy were developed in the beginning of the 1990s by several groups of neurosurgeons. Several factors contributed to its success and acceptance, including technical development, influence of other disciplines, and adaptation to neurosurgical requirements. This historical survey focuses on the period when this technique initially emerged, including the scientific discussions of each group as well as the arguments and reasons that led to present intraventricular neuroendoscopy. Interestingly, despite the almost independent development of neuroendoscopic s…
Intraoperative Ultrasound: Emerging Technology and Novel Applications in Brain Tumor Surgery
2022
Intraoperative ultrasound (IOUS) is becoming progressively more common during brain tumor surgery. We present data from our case series of brain tumor surgery performed with the aid of IOUS in order to identify IOUS advantages and crucial aspects that may improve the management of neurosurgical procedures for brain tumors. From January 2021 to September 2021, 17 patients with different brain tumors underwent brain tumor surgery aided by the use of IOUS. During surgery, the procedure was supported by the use of multiples ultrasonographic modalities in addition to standard B-mode: Doppler, color Doppler, elastosonography, and contrast-enhanced intraoperative ultrasound (CEUS). In selected cas…
Coplanar Indirect-Navigated Intraoperative Ultrasound: Matching Un-navigated Probes With Neuronavigation During Neurosurgical Procedures. How We Do I…
2021
BACKGROUND Intraoperative ultrasound (IOUS) is becoming more and more adopted in neurosurgery, since it has been associated to greater extent of resection (EOR) and to gross total resection (GTR) during brain tumor surgery. IOUS main limitations are spatial resolution, width and orientation of the field of view and scan quality, which are operator-dependent. Furthermore, most neurosurgeons are not confident with this technique, which needs a long learning curve in order to identify and interpret anatomic structures. OBJECTIVE To describe an effective procedure to take advantages of both IOUS and neuronavigation in case of lack of a navigated ultrasound system. METHODS We propose a reliable …
Computer-aided navigation in neurosurgery
2003
The article comprises three main parts: a historical review on navigation, the mathematical basics for calculation and the clinical applications of navigation devices. Main historical steps are described from the first idea till the realisation of the frame-based and frameless navigation devices including robots. In particular the idea of robots can be traced back to the Iliad of Homer, the first testimony of European literature over 2500 years ago. In the second part the mathematical calculation of the mapping between the navigation and the image space is demonstrated, including different registration modalities and error estimations. The error of the navigation has to be divided into the …
Neuronavigation and epilepsy surgery
2010
Resective epilepsy surgery is an elective therapy indicated in focal epilepsy patients who are resistant to pharmacotherapy. Every effort should be undertaken to perform the procedures as safe and less traumatic as possible. Neuronavigation could represent a suitable tool to reduce surgical morbidity and increase surgical radicality. Here, we present a series of 41 patients who were operated on for medically intractable epilepsy using neuronavigation. Overall, complication rate was 17% with a favourable seizure outcome of 88% (Engel’s class I/II). Our data suggest that neuronavigation is a valuable surgical technique to accomplish a favourable outcome in epilepsy surgery.
Neuronavigation in der Zentralregion: Bedeutung für einzelne Operationsphasen bei verschiedenen Prozesslokalisationen
2000
The neurosurgical treatment of space occupying processes in the central area bears a relatively high risk of either postoperative neurological deficits ("radical approach") or of residual tumor ("conservative approach"). Therefore, special techniques of intraoperative topographic orientation (image-guided surgery) play an important role here. The possible impact of neuronavigation on different neurosurgical steps (craniotomy, corticotomy, localization of the process, definition of borders of resection) was studied in relation to the site of pathology (extraaxial, intraaxial/superficial, intraaxial/deep) in 46 patients harbouring space occupying lesions of the central area. In intraaxial pat…
Vertebrobasilar junction giant aneurysm: Lessons learned from a neurosurgical audit and anatomical investigation.
2015
The treatment of vascular lesions of the vertebrobasilar junction (VBJ) remains a challenging task in the neurosurgical practice and the gold standard therapy is still under debate. In this article, the authors report a detailed postmortem study of a VBJ giant aneurysm (GA) previously endovascularly treated. Although the decision-making process for the vast majority of neurosurgical treatment can nowadays be accurately carried out during the preoperative planning (i.e., with the aid of neuroimaging fusion protocols, neuronavigation platforms, etc.) meant to maximize the anatomical understanding of the lesions and minimize possible intraprocedural challenges, this postmortem study represents…
A new tool to improve pedicle screw placement accuracy in navigated spine surgery: A monocentric study
2021
Objective Navigated instrumented spine surgery is burden by a low but significant screw mispositioning risks, respectively, for the 2D imaging system from 15 to 40% and, for the 3D imaging system, ranging from 4.1 to 11.5%. The primary objective of this study was to demonstrate the efficacy of a new "screw-like" tool in order to further decrease pedicle screws mispositioning rate during vertebral navigated spine surgery. Materials and methods Between January and June 2019 an initial case series of 18 patients were enrolled. All patients underwent a pedicle screw fixation, both in thoracic (Th10-Th12) and lumbosacral (L1-S1) spine, using O-arm (Medtronic Navigation, Louisville, Colorado) and…