Surgical treatment of functional glioma by neuronavigation with intraoperative ultrasound / 中国基层医药

Objective To investigate the operation process,extent of resection,protection function,the tumor recurrence and clicical value of neuronavigation with intraoperative ultrasound for treating functional glioma;signifi-cance of intraoperative ultrasound for correcting brain shift.Methods We analyzed the cliclical materical of 24 case of functional gliomas which were resected by neuronavigation with intraoperative ultrasound.Results The accuracy of localization of functional glioma was 100%.The distance of brain shift was 2 to 10mm,with an average 4.7mm.After 24 hours MRI confirmed that total removal of function glioma was achieved in 21 cases,subtotal in 3 cases.After oper-ation function improve was 20 cases,invalid of 2 cases,hemiplegia happened in 2 cases and no death in all the patients.Conclusion Neuronavigation with intraoperative ultrasound can correct brain shift and improve the accuracy of localization of functional glioma,to improve extent of function glioma and decrease dysfunction.Neuronavigation with intraoperative ultrasound is important to functional glioma.

Analysis of resection of neurospongioma under neuronavigator and brain shift / 中国综合临床

Objective To investigate the application of neuronavigator in the resection of neurospongioma and management of brain shift.Methods Operation protocol was made according to three dimensional structure of neumspongioma under neuronavigation.The focus was sought by using viewing wand for the resection.Results All focus were removed under neuronavigator.The size and operation time was associated with brain shift along the operation pathway.Operative approach and depth of lesion was related to brain shift.Loss of large volume of cerebrospinal fluid exerted influences on the shift of codex along the operative pathway and plane side.Conclusion Neuronavigator can effectively protect nerve function when used in the resection of neurospongioma.As for brain shift,strict navigation and operative procedure would be useful for reducing loss of cerebrospinal fluid,removed volume of brain tissue and avoiding early release of tumor hydatid flui.

Shift of the Brain during Functional Neurosurgery

OBJECTIVE: The study investigates the extent of brain shift and its effect on the accuracy of the stereotaxic procedure. METHODS: Thirty-five patients underwent 40stereotactic procedures between June 2002 and March 2004. There were 26 males, mean age 59years old. There were 34procedures for Parkinson's disease, 2 for essential tremor, 3 for cerebral palsy, 1 for dystonia. Patients were divided in four groups based on postoperative pneumocephalus: under 5cc (9 procedures), between 5~10cc (13procedures), between 10~15cc (11procedures) and more than 15cc (7procedures). The coordinates of the anterior commissure(AC), posterior commissure(PC), and target were defined in pre-and intraoperative magnetic resonance image scans and the amount of air volume was measured with @Target (BrainLab, Heimstetten, Germany). RESULTS: The mean AC-PC was 26.5mm for patients with less than 5cc, 26.9mm for 5~10cc, 25.8mm for 10~15cc and 26.2mm for more than 15cc. The length of AC-PC line and coordinates of AC, PC was also not statistically different, Euclidean distance as well as delta x, delta y, delta z of AC, PC, and target were also not statistically different among the groups (p<0.1). There was a variance in target of 0.7~7.6mm, Euclidean distance of 2.5mm, related to electrophysiology but not to brain-shift. CONCLUSION: The amount of air accumulated in the intracranial space and compressing the cortical surface has no effect on the localization of subcortical stereotactic target and landmarks.

Clinical use and limitation of neuronavigation system-a report of 58 cases / 重庆医科大学学报

Objective:To discuss the effects and limitation of neuronavigation system in neurosurgical operations.Methods:58 cases surgically treated with Stealth Station 4.1 Neuronavigation System were analysed,including 52 cases of intracranial tumor,4 cases of cerebral vascular malformations and 2 cases of intracerebral abscess. The locations of lesion included superficial part of hemisphere (24 cases),deep part of hemisphere (21 cases),skull base (8 cases),cerebellum (2 cases) and brain stem (3 cases).Results:Among 58 cases,total removal of the lesion was performed on 45 cases,comprising 77.6%,subtotal removal on 5,comprising 8.6%,most removal on 2%,comprising 3.4% and partial removal on 6%, comprising 10.3%.Postoperative neurological functions were improved or remained unchanged in 52 cases while they were worsened in 5 cases,and 1 patient died.Conclusion:Neuronavigation system is safe and helpful for improving accuracy of neurosurgical operations and increasing total removal of lesions,and it can be used widely in neurosurgery. However,it can't avoid intraoperative brain shift.The effects of navigation system in different neurosurgical operations are evaluated.