A Methodology Designed to Increase Accuracy and Safety in Stereotactic Brain Surgery

T. Kamiryo; T. Jackson; E. Laws Jr

doi:10.1055/s-2000-8811

min - Minimally Invasive Neurosurgery, Table of Contents

Minim Invasive Neurosurg 2000; 43(1): 1-3
DOI: 10.1055/s-2000-8811

ORIGINAL PAPER

Georg Thieme Verlag Stuttgart · New York

A Methodology Designed to Increase Accuracy and Safety in Stereotactic Brain Surgery

T. Kamiryo, T. Jackson, E. Laws Jr.

Department of Neurological Surgery, Virginia Neurological Institute, University of Virginia, USA

Abstract

A series of technical tips and devices designed to increase accuracy and safety in stereotactic surgery are presented. We use stereotactic magnetic resonance imaging with three-dimensional magnetization-prepared rapid gradient-echo (MP-RAGE) imaging to minimize image distortion, and a three-dimensional stereotactic planning system for accurately registering three-dimensional space. We also developed several technical devices useful for stereotactic intracranial procedures; an applicator system attached to the frame which simulates the fiducial markers in order to keep the target at a suitable position in stereotactic space; a torque wrench to set the torque on the fixing pins to the frame reproducibly at 5 inch pounds in order to keep distortion of the frame to a minimum while maintaining secure fixation; an entry point marker to maintain the calculated trajectory angle; a straightening cannula to prevent the thermo-coagulation needle from bending; a microvascular Doppler and its holder to detect significant vessels and to know their precise depth in order to avoid vascular injury from thermocoagulation; a burr hole button device to secure depth electrode cables at the patient's skull.

Key words:

Stereotactic magnetic resonance imaging - Stereotactic frame - Technical adjuncts

Full Text

References

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Corresponding Author

F.A.C.S M.D. Edward R. Laws
Jr.

Department of Neurological Surgery University of Virginia, Health Sciences Center, Box 212

Charlottesville

VA 22908

USA

Phone: +1804-924-2650

Fax: +1804-924-5894

Email: e15g@virginia.edu